THE PREVALENCE OF ANTIBODIES AGAINST JOHN CUNNINGHAM VIRUS IN PATIENTS WITH MULTIPLE SCLEROSIS – AS A STRATIFICATION OF THE PROGRESSIVE MULTIFOCAL LEUKOENCEPHALOPATHY RISK DEGREE AT THIS DISEASE
Introduction. Progressive multifocal leukoencephalopathy (PML) is a rare and severe demyelinating disease of the white matter of the central nervous system (CNS) and caused by the John Cunningham virus (JCV). JCV infection has become important for neurologists after reporting two cases of PML in patients with multiple sclerosis (MS) treated with natalizumab.
Aim: To study the prevalence of antibodies against John Cunningham virus (JCV) in patients with multiple sclerosis and identify the relationship between clinical, demographic characteristics and seropositivity and seronegativity for anti-JCV.
Materials and methods. We conducted a retrospective assessment of a database of MS patients registered at the Multiple Sclerosis Center of Almaty, who are candidates for natalizumab, from April 2018 to June 2019. The diagnosis was diagnosed in accordance with 2017 MacDonald's revised criteria. Several factors were studied, such as age, gender, nationality, duration of illness, average score on the advanced EDSS disability rating scale, to determine cognitive function on the MOCA scale during testing for anti-JCV antibodies and previous immunotherapy. The relationship between the seropositivity of the anti-JCV antibody and the demographic characteristics and disease characteristics was evaluated.
Research results: Of the 71 examined patients with MS for the presence of antibodies against the JC virus, 76.1% were women (54) and 23.9% were men (17). The average age was 41.2 ± 11.4 years, and the duration of the disease was 11.9 ± 8.7 years. Most patients 77.5% (55) had relapsing - remitting MS, and the average EDSS score in the study group was 3.75 ± 1.45 points. The overall prevalence of seropositivity for anti-JC virus antibody was 85.9% (61), of which 73.8% were women.
Conclusions: Thus, the study confirmed the high prevalence of anti-JCV antibodies in patients with MS by 85.9%. The results of studies conducted to date confirm the prognostic value of measuring anti-JCV antibodies in assessing the risk of PML, however, changes in JCV status must be considered.
Aksholpan M. Sharapkhanova 1, https://orcid.org/0000-0001-5971-1358
Saltanat U. Kamenova 2, https://orcid.org/0000-0002-5285-8469
Karlygash K. Kuzhybaeva 2, https://orcid.org/0000-0002-7325-5624
Aida M. Kondybayeva 1, https://orcid.org/0000-0003-2213-0263
1 S.D. Asfendiyarov Kazakh National Medical University,
Department of Nervous Diseases with a course of neurosurgery,
Almaty, Republic of Kazakhstan;
2 Al-Farabi Kazakh National University, Department of Clinical Disciplines,
Almaty, Republic of Kazakhstan
1. Aström K.E., Mancall E.L., Richardson E.P. Jr. Progressive multifocal leuko-encephalopathy; a hitherto unrecognized complication of chronic lymphatic leukaemia and Hodgkin’s disease // Brain. 1958; 81:1.
2. Berger J.R., Aksamit A.J., Clifford D.B. et al. PML diagnostic criteria: consensus statement from the AAN Neuroinfectious Disease Section // Neurology. 2013; 80: 1430–8.
3. Berger J.R., Pall L., Lanska D., Whiteman M. Progressive multifocal leukoencephalopathy in patients with HIV infection // J Neurovirol 1998; 4(1):59-68.
4. Bloomgren G., Richman S., Hotermans C. et al. Risk of natalizumab – associated progressive multifocal leukoencephalopathy // N Engl J Med. 2012; 366:1870-1880.
5. Brew B.J., Davies N.W., Cinque P., Clifford D.B., Nath A. Progressive multifocal leukoencephalopathy and other forms of JC virus disease // Nat Rev Neurol (2010) 6(12):667–79.10.1038/nrneurol.2010.164
6. Frisque R.J., Bream G.L., Cannella M.T. Human polyomavirus JC virus genome // J Virol. 1984; 51:458-469.
7. Heesen C., Kleiter I., Nguyen F. et al. Risk perception in natalizumab –treated multiple sclerosis patients and their neurologists // Mult Scler. 2010; 16:1507-1512.
8. Katsuichi M. Prion Disease and Late Infection Research Group: 2017 Treatment Guide for Progressive Multifocal Leucoencephalopathy (PML). http://prion.umin.jp/guideline/guideline_PML_2017.pdf). Japan.№4879 (28.10.2017)
9. Kleinschmidt-DeMasters B.K., Tyler K.L. Progressive multi-focal leukoencephalopathy complicating treatment with natalizumab and interferon beta-1a for multiple sclerosis // N Engl J Med. 2005; 353: 369–74.
10. Koralnik I.J., Wuthrich C., Dang X. et.al. JC virus granule cell neuronopathy: a novel clinical syndrome distinct from progressive multifocal leukoencephalopathy // Ann. Neurol. 2005; 57:576-580.
11. Lee P., Plavina T., Castro A. et al. A second –generation ELISA (STRATIFI JCV DxSelect) for detection of JC virus antibodies in human serum and plasma to support progressive multifocal leukoencephalopathy risk stratification // J. Clin Virol. 2013; 57:141-146.
12. Padgett B.L., Walker D.L., Zu Rhein G.M. et al. Cultivation of papova-like virus from human brain with progressive multifocal leucoencephalopathy // Lancet. 1971; 1:1257-60.
13. Perez–Liz G., Del Valle L., Gentilella A., Croul S., Khalili K. Detection of JC virus DNA fragments but not proteins in normal brain tissue // Ann Neurol. 2008; 64:379-387.
14. Plavina T., Subramanyam M., Bloomgren G. et al. Anti-JC virus antibody levels in serum or plasma further define risk of natalizumab – associated progressive multifocal leukoencephalopathy // Ann Neurol.2014; 76:802-812.
15. Polman C.H., O’Connor P.W., Havrdova E. et al. A randomized, placebo-controlled trial of natalizumab for relapsing multiple sclerosis // N Engl J Med. 2006; 354:899–910.
16. Pucci E., Giuliani G., Solari A. et al. Natalizumab for relapsing remitting multiple sclerosis // Cochrane Database Syst Rev. 2011; 5: CD007621.
17. Rollison D.E., Utaipat U., Ryschkewitsch C. et al. Investigation of human brain tumors for the presence of polyomavirus genome sequences by two independent laboratories // Int J Cancer. 2005; 113:769-774.
18. Ruth A., Ariel V. Translation neuroimmunology in Multiple sclerosis. Elsevier; 2016. 223-224. ISBN: 978-0-12-801914-6.
19. Sandborn W.J., Colombel J.F., Enns R., et al. Natalizumabinduction and maintenance therapy for Crohn’s disease // N Engl J Med. 2005; 353:1912–25.
20. Sorensen P.S. New management algorithms in multiple sclerosis. Curr Opin Neurol. 2014; 27:246-259.
21. Tan C.S., Koralnik I.J. Progressive multifocal leukoencephalopathy and other disorders caused by JC virus: clinical features and pathogenesis // Lancet Neurol. 2010;9: 425–37.
22. Vargas D.L., Tyor W.R. Update on disease-modifying therapies for multiple sclerosis // J Investig Med (2017) 65(5):883–91.10.1136/jim-2016-000339
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Sharapkhanova A.M., Kamenova S.U., Kuzhybaeva K.K., Kondybayeva A.M. The prevalence of antibodies against John Cunningham virus in patients with multiple sclerosis – as a stratification of the progressive multifocal leukoencephalopathy risk degree at this disease // Nauka i Zdravookhranenie [Science & Healthcare]. 2020, (Vol.22) 1, pp. 64-71. doi:10.34689/SH.2020.22.1.007Related publications:
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