期刊
MULTIPLE SCLEROSIS JOURNAL
卷 24, 期 8, 页码 1014-1022出版社
SAGE PUBLICATIONS LTD
DOI: 10.1177/1352458518775550
关键词
PML; immunosenescence; disease-modifying therapies; multiple sclerosis; risk assessment
资金
- NIH NIAID Autoimmune Center of Excellence [UM1-AI110557]
- NIH NINDS [R01-NS080821]
- Kirschstein-NRSA grant [2T32HD007505-21]
New potent immunomodulatory therapies for multiple sclerosis (MS) are associated with increased risk for progressive multifocal leukoencephalopathy (PML). It is unclear why a subset of treated patients develops PML, but patient age has emerged as an important risk factor. PML is caused by the JC virus and aging is associated with immune senescence, which increases susceptibility to infection. With the goal of improving PML risk stratification, we here describe the lymphocyte changes that occur with disease-modifying therapies (DMTs) associated with high or moderate risk toward PML in MS patients, how these changes compare to immune aging, and which measures best correlate with risk. We reviewed studies examining how these therapies alter patient immune profiles, which revealed the induction of changes to lymphocyte number and/or function that resemble immunosenescence. Therefore, the immunosuppressive activity of these MS DMTs may be enhanced in the context of an immune system that is already exhibiting features of senescence.
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