scholarly journals PROGRESSIVE MULTIFOCAL LEUKOENCEPHALOPATHY ASSOCIATED TO MULTIPLE SCLEROSIS THERAPIES: REVIEW OF THE LITERATURE

2015 ◽  
Vol 14 (4) ◽  
pp. 205-213
Author(s):  
Ana-Maria Vladila ◽  
◽  
Dan-Andrei Mitrea ◽  
Sanda Maria Nica ◽  
Ioan Buraga ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Central Nervous System ◽  
Nervous System ◽  
High Risk ◽  
Progressive Multifocal Leukoencephalopathy ◽  
Opportunistic Infection ◽  
Jc Virus ◽  
Review Of The Literature ◽  
Natalizumab Treatment ◽  
The Central Nervous System

Progressive multifocal leukoencephalopathy (PML) is an opportunistic infection associated with the reactivation of the JC virus, causing a severe demyelination within the central nervous system in patients with immunosuppression caused by disease or secondary to use of drugs. Several therapies used in the treatment of MS have reported cases of associated PML, most cases being related to Natalizumab treatment. In this article we review specific MS medication with a reported risk for PML, and also revise PML epidemiology, pathogenesis, treatment and available approaches on therapy in patients at high risk for developing this infection.

Disappearance of cerebrospinal fluid oligoclonal bands after natalizumab treatment of multiple sclerosis patients

2011 ◽  
Vol 18 (7) ◽  
pp. 1038-1041 ◽  
Author(s):  
Felipe von Glehn ◽  
Alessandro S Farias ◽  
Augusto C Penalva de Oliveira ◽  
Alfredo Damasceno ◽  
Ana Leda F Longhini ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Central Nervous System ◽  
Cerebrospinal Fluid ◽  
Nervous System ◽  
Oligoclonal Bands ◽  
Natalizumab Treatment ◽  
The Central Nervous System ◽  
Immunologic Abnormality ◽  
Csf Oligoclonal Bands ◽  
Multiple Sclerosis Patients

Intrathecal immunoglobulin synthesis in an oligoclonal pattern is the most common immunologic abnormality detected in MS patients. Various treatments, such as immunomodulators and immunosuppressors, have not been found to modify it. Natalizumab hinders migration of encephalitogenic T-cells into the central nervous system (CNS), reducing inflammatory response. Its impact on CSF oligoclonal bands (OCBs) has not been demonstrated. This report describes its effect in four out of six patients with multiple sclerosis after a mean of 10 infusions: the CSF was negative for OCBs at the second lumbar puncture. In conclusion, natalizumab treatment can reduce CSF OCBs to undetectable levels, although the clinical significance of this observation is not yet known.

scholarly journals Does Mefloquine (Lariam®) Therapy Improve the Prognosis of Human JC Polyomavirus-Induced Progressive Multifocal Leukoencephalopathy?

2014 ◽  
Vol 7 (1) ◽  
pp. 3-7
Author(s):  
Zlatko N. Kalvatchev ◽  
Iliya T. Tsekov
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Progressive Multifocal Leukoencephalopathy ◽  
Jc Virus ◽  
Published Data ◽  
Jc Polyomavirus ◽  
The Central Nervous System ◽  
Good Penetration

Abstract Progressive multifocal leukoencephalopathy (PML) is ademyelinating disease caused by infection with Polyomavirus hominis 2, popularly known as JC virus (JCV). The disease is usually fatal as it develops due to the progressive destruction of oligodendrocytes in multiple brain foci. Several substances that show effect against JCV have been investigated. However, only the antimalarial drug mefloquine has been reported to significantly influence the viral replication both in vitro and following in vivo therapy with good penetration and distribution of the drug at efficacious concentrations into the central nervous system (CNS). The current material presents some of the available published data, suggesting that the activity of mefloquine against JCV be considered for treatment of patients with PML.

scholarly journals Role of Natalizumab in Relapsing-Remitting Multiple Sclerosis: A review

2021 ◽  
Vol 2 (1) ◽  
pp. 2-12
Author(s):  
Anuj Krishna Paudel ◽  
Sanjiv Bastakoti ◽  
Nitesh Raj Dulal ◽  
Gunja Piya ◽  
Sashi Bhusan Singh
Keyword(s):  
Multiple Sclerosis ◽  
Central Nervous System ◽  
Nervous System ◽  
Side Effects ◽  
Literature Review ◽  
Progressive Multifocal Leukoencephalopathy ◽  
Relapsing Remitting ◽  
The Central Nervous System ◽  
Remitting Multiple Sclerosis ◽  
Relapsing Remitting Multiple Sclerosis

Introduction: Multiple sclerosis is a non-traumatic neurological disease caused by an immune-mediated reaction leading to a chronic inflammatory demyelinating disorder of the central nervous system. The treatments for multiple sclerosis are mainly divided into three categories: treatment of exacerbation, slowing disease progression with disease-modifying therapies, and symptomatic therapies. Natalizumab is a monoclonal antibody that works by preventing the adhesion of lymphocytes into the endothelium of the blood-brain barrier, reducing lymphocyte infiltration into the central nervous system. This review aims to study the efficacy and safety of natalizumab in relapsing-remitting multiple sclerosis. Methods: The review was performed using databases like PubMed, Cochrane library, Google scholar from which 48 relevant articles were selected based on the various inclusion criteria. The following keywords were used: “Natalizumab”, “Multiple sclerosis”, “side effects”, “Relapsing-remitting multiple sclerosis”, “progressive multifocal leukoencephalopathy” in different combinations. Results: The literature review suggests that natalizumab reduces the rate of sustained progression of the disease and disability, and was associated with a lower relapse rate in patients with relapsing-remitting multiple sclerosis. However, Progressive multifocal leukoencephalopathy is one of the serious side effects of natalizumab. Conclusion: The literature review suggests that Natalizumab has favorable outcomes in patients with relapsing-remitting multiple sclerosis. Since progressive multifocal leukoencephalopathy is one of the serious side effects of natalizumab, risk stratification should be done.

scholarly journals JC Polyomavirus (JCV) and Monoclonal Antibodies: Friends or Potential Foes?

2013 ◽  
Vol 2013 ◽  
pp. 1-11 ◽  
Author(s):  
Roberta Antonia Diotti ◽  
Akira Nakanishi ◽  
Nicola Clementi ◽  
Nicasio Mancini ◽  
Elena Criscuolo ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Central Nervous System ◽  
Nervous System ◽  
Monoclonal Antibodies ◽  
Demyelinating Disease ◽  
Jc Virus ◽  
Jc Polyomavirus ◽  
High Incidence ◽  
Two Factors ◽  
The Central Nervous System

Progressive multifocal leukoencephalopathy (PML) is a demyelinating disease of the central nervous system (CNS), observed in immunodeficient patients and caused by JC virus ((JCV), also called JC polyomavirus (JCPyV)). After the HIV pandemic and the introduction of immunomodulatory therapy, the PML incidence significantly increased. The correlation between the use of natalizumab, a drug used in multiple sclerosis (MS), and the PML development of particular relevance. The high incidence of PML in natalizumab-treated patients has highlighted the importance of two factors: the need of PML risk stratification among natalizumab-treated patients and the need of effective therapeutic options. In this review, we discuss these two needs under the light of the major viral models of PML etiopathogenesis.

First Presentation of an Acquired Demyelinating Syndrome

2017 ◽  
Vol 16 (03) ◽  
pp. 164-170
Author(s):  
Rachel Gottlieb-Smith ◽  
Amy Waldman
Keyword(s):  
Multiple Sclerosis ◽  
Central Nervous System ◽  
Nervous System ◽  
Differential Diagnosis ◽  
Optic Neuritis ◽  
Clinical Features ◽  
Neuromyelitis Optica ◽  
Transverse Myelitis ◽  
Acute Disseminated Encephalomyelitis ◽  
The Central Nervous System

AbstractAcquired demyelinating syndromes (ADS) present with acute or subacute monofocal or polyfocal neurologic deficits localizing to the central nervous system. The clinical features of distinct ADS have been carefully characterized including optic neuritis, transverse myelitis, and acute disseminated encephalomyelitis. These disorders may all be monophasic disorders. Alternatively, optic neuritis, partial transverse myelitis, and acute disseminated encephalomyelitis may be first presentations of a relapsing or polyphasic neuroinflammatory disorder, such as multiple sclerosis or neuromyelitis optica. The clinical features of these disorders and the differential diagnosis are discussed in this article.

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