Etiopathogenesis and diagnostics of progressive multifocal leukoencephalopathy in patients treated with natalizumab
Abstract
Etiological agent of progressive multifocal leukoencephalopathy (PML) is polyomavirus JCV (John Cunnigham virus). PML occurs in immunosuppressed patients including MS patients treated with disease-modifying drugs.
Activation of JCV in the nervous system and PML development is the result of dysregulation of genetic and immune cell mechanisms. The implementation of the safety treatment algorithm based on the length of treatment previous immunosuppressive drug treatment and positivity of the JCV antibody index is benefi cial in natalizumab treated patients from the clinical point of view.
Simultaneously with the use of MRI, the diagnosis of PML can be made in the preclinical phase of the disease and the prognosis of the disease can be improved.