TY - JOUR
T1 - Novel syndromes associated with JC virus infection of neurons and meningeal cells
T2 - No longer a gray area
AU - Miskin, Dhanashri P.
AU - Koralnik, Igor J.
N1 - Publisher Copyright:
© 2015 Wolters Kluwer Health, Inc.
PY - 2015/6/6
Y1 - 2015/6/6
N2 - The availability of a growing number of immunomodulatory medications over the past few years has been associated with various JC virus (JCV)-associated brain syndromes in patients with autoimmune diseases, including multiple sclerosis, Crohn's disease, and psoriasis that had not been previously recognized as predisposing factors for progressive multifocal leukoencephalopathy. This review covers the three novel syndromes discovered in the last decade that are caused by JCV infection of neurons and meningeal cells. Recent findings For more than 30 years, JCV was thought to exclusively infect oligodendrocytes and astrocytes in the white matter of the brain of immunosuppressed individuals. We now recognize that JCV-infected glial cells are frequently located at the gray-white matter junction or exclusively within the gray matter causing demyelination in the cortex. Mutations in JCV can trigger a change in tropism leading to involvement of other cell types, such as neurons and meningeal cells, causing clinically distinct entities. These new features of JCV infection provide challenges for clinicians taking care of affected patients and investigators studying the biology of this polyomavirus, its pathogenesis, and tropism. Summary We hope that increasing awareness of these syndromes will lead to early diagnosis, and pave the way for new avenues of research to better understand all aspects of JCV pathogenesis and develop efficient therapies for our patients. However, we need to remain vigilant and open to the possibility that additional JC variants or yet unknown polyomaviruses may also be associated with neurological diseases.
AB - The availability of a growing number of immunomodulatory medications over the past few years has been associated with various JC virus (JCV)-associated brain syndromes in patients with autoimmune diseases, including multiple sclerosis, Crohn's disease, and psoriasis that had not been previously recognized as predisposing factors for progressive multifocal leukoencephalopathy. This review covers the three novel syndromes discovered in the last decade that are caused by JCV infection of neurons and meningeal cells. Recent findings For more than 30 years, JCV was thought to exclusively infect oligodendrocytes and astrocytes in the white matter of the brain of immunosuppressed individuals. We now recognize that JCV-infected glial cells are frequently located at the gray-white matter junction or exclusively within the gray matter causing demyelination in the cortex. Mutations in JCV can trigger a change in tropism leading to involvement of other cell types, such as neurons and meningeal cells, causing clinically distinct entities. These new features of JCV infection provide challenges for clinicians taking care of affected patients and investigators studying the biology of this polyomavirus, its pathogenesis, and tropism. Summary We hope that increasing awareness of these syndromes will lead to early diagnosis, and pave the way for new avenues of research to better understand all aspects of JCV pathogenesis and develop efficient therapies for our patients. However, we need to remain vigilant and open to the possibility that additional JC variants or yet unknown polyomaviruses may also be associated with neurological diseases.
KW - JC virus encephalopathy
KW - JC virus granule cell neuronopathy
KW - JC virus meningitis
KW - progressive multifocal leukoencephalopathy
UR - http://www.scopus.com/inward/record.url?scp=84929464076&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84929464076&partnerID=8YFLogxK
U2 - 10.1097/WCO.0000000000000201
DO - 10.1097/WCO.0000000000000201
M3 - Review article
C2 - 25887767
AN - SCOPUS:84929464076
SN - 1350-7540
VL - 28
SP - 288
EP - 294
JO - Current Opinion in Neurology
JF - Current Opinion in Neurology
IS - 3
ER -