Abstract
Progressive multifocal leukoencephalopathy (PML) is a rare but often fatal brain disease caused by reactivation of the polyomavirus JC. Knowledge of the characteristics of PML has substantially expanded since the introduction of combination antiretroviral therapy during the HIV epidemic and the development of immune reconstitution inflammatory syndrome (IRIS) in patients with PML. Recently, the monoclonal antibodies natalizumab, efalizumab, and rituximab-used for the treatment of multiple sclerosis, psoriasis, haematological malignancies, Crohn's disease, and rheumatic diseases-have been associated with PML. Additionally, the JC virus can also lead to novel neurological disorders such as JC virus granule cell neuronopathy and JC virus encephalopathy, and might also cause meningitis. The increasingly diverse populations at risk and the recent discovery of the presence of the JC virus in the grey matter invite us to reappraise the pathogenesis of this virus in the CNS.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 425-437 |
| Number of pages | 13 |
| Journal | The Lancet Neurology |
| Volume | 9 |
| Issue number | 4 |
| DOIs | |
| State | Published - Apr 2010 |
Funding
We are grateful to Christian Wüthrich and Sarah Gheuens (Beth Israel Deaconess Medical Center, Boston, MA, USA) for their help with figures 2, 3, 4, and 5 . We have received grants from the NIH ( R01 NS 041198, NS 047029, K24 NS 060950 [IJK], and K08 NS 064215-01A1 [CST]) and the Harvard Medical School Center for AIDS Research (CFAR; funded from a NIH-funded programme P30 AI60354 [CST]). IJK has received honoraria from Bristol-Myers Squibb, Ono Pharmaceuticals, Merck Serono, Antisense, and Alnylam, and has received research grants from the National Institutes of Health (NIH), the Neuro-AIDS research consortium, and Biogen-Idec. CST has received research grants from the NIH.
ASJC Scopus subject areas
- Clinical Neurology
