Progresivní multifokální leukoencefalopatie – epidemiologie, imunitní odpověď, klinické rozdíly, léčba


Autoři: S. Snopková 1;  P. Štourač 2;  L. Fašaneková 1;  M. Mihalčin 1;  K. Havlíčková 1;  R. Svačinka 1;  P. Volfová 3;  P. Snopek 4;  P. Husa 1
Působiště autorů: Klinika infekčních chorob FN Brno a LF MU, Brno 1;  Neurologická klinika FN Brno a LF MU, Brno 2;  Interní hematoonkologická klinika FN Brno a LF MU, Brno 3;  Fakulta humanitních studií UTB, Zlín 4
Vyšlo v časopise: Epidemiol. Mikrobiol. Imunol. 68, 2019, č. 1, s. 24-31
Kategorie: Souhrnné sdělení

Souhrn

Progresivní multifokální leukoencefalopatie (PML) je závažné onemocnění centrální nervové soustavy s velmi vysokou mortalitou. Příčinou onemocnění je JC virus s vysokou séroprevalencí dosahující až 80 %. PML je typické oportunní onemocnění vyskytující se zejména u syndromu získané imunodeficience u pacientů s hlubokým imunodeficitem. Počet případů PML se však v posledních letech zvyšuje také u všeobecné populace jako důsledek vysoce účinných imunosupresivních a imunomodulačních léčebných postupů. V tomto článku autoři uvádějí virologické a epidemiologické souvislosti a charakteristické projevy PML. Jsou diskutovány možné vztahy humorální a buněčné imunity a jsou zmíněny omezené možnosti léčby včetně profylaxe.

Klíčová slova:

buněčná imunita – poměr CD4/CD8 – HIV – sclerosis multiplex – progresivní multifokální leukoencefalopatie


Zdroje

1. Hoffmann C. Opportunistic infections. In: Hoffmann C, Rockstroh JK. HIV 2015/2016. Hamburg: Medizin Fokus Verlag; 2015. pp. 377–380.

2. Smolle E, Trojan A, Schuster SJ, et al. Progressive multifocal leukoencephalopathy – a case report and review of the literature. In Vivo, 2014;28(5):941–948.

3. Sudhakar P, Bachman DM, Mark AS, et al. Progressive multifocal leukoencephalopathy: recent advances and a neuro-ophthalmological review. J Neuroophthalmol, 2015;35(3):296–305.

4. Bauer J, Gold R, Adams O, et al. Progressive multifocal leukoencephalopathy and immune reconstitution inflammatory syndrome (IRIS). Acta Neuropathol, 2015;130(6):751–764.

5. Koralnik IJ, Wuthrich C, Dang X, et al. JC virus granule cell neuronopathy: a novel clinical syndrome distinct from progressive multifocal leukoencephalopathy. Ann Neurol, 2005;57(4):576–580.

6. Wuthrich C, Dang X, Westmoreland S, et al. Fulminant JC virus encephalopathy with productive infection of cortical pyramidal neurons. Ann Neurol, 2009;65(6):742–748.

7. Shin J, Phelan PJ, Chhum P, et al. Analysis of JC virus DNA replication using a quantitative and high-throughput assay. Virology, 2014;468-470:113–125.

8. Rozsypal H, Jilich D, Hubacek P, et al. Úskalí diagnostiky progresivní multifokální leukoencefalopatie u pacientů infikovaných lidským virem imunodeficience – kazuistiky. Cesk Slov Neurol N, 2013;76/109(4):501–507.

9. Bellizzi A, Anzivino E, Rodio DM, et al. New insight on human polyomavirus JC and pathogenesis of progressive multifocal leukoencephalopathy. Clin Dev Immunol, 2013;2013:839719 [cit. 2017-12-12]. Dostupné na www: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3652120/

10. Delbue S, Elia F, Carloni C, et al. JC virus load in cerebrospinal fluid and transcriptional control region rearrangements may predict the clinical course of progressive multifocal leukoencephalopathy. J Cell Physiol, 2012;227(10):3511–3517.

11. Mateen FJ, Muralidharan R, Carone M, et al. Progressive multifocal leukoencephalopathy in transplant recipients. Ann Neurol, 2011;70:305–322.

12. Augusto L, Neves N, Reis C, et al. Clinical and radiological characterization of progressive multifocal leukoencephalopathy in HIV-infected patients: A retrospective analysis and review of the literature. Acta Med Port, 2015;28(3):286–296.

13. US Food and Drug Administration (2014): Drug safety and availability – FDA Drug Safety Communication: FDA warns about rare case of brain infection PML with MS drug Tecfidera (dimethyl fumarate) [cit. 2017-04-10]. Dostupné na www: http://www.fda.gov./Drugs/DrugSafety/ucm.424625.htm

14. Ermis U, Weis J, Schulz JB. PML in a patient treated with fumaric acid. N Engl J Med, 2013;368(17):1657–1658.

15. Linda H, von Heijne A Major EO, et al. Progressive multifocal leukoencephalopathy after natalizumab monotherapy. N Engl J Med, 2009;361(11):1081–1087.

16. Nieuwkamp DJ, Murk JL, Van Oosten BW, et al. PML in a patient without severe lymphocytopenia receiving dimethyl fumarate. N Engl J Med, 2015;372(15):1474–1476.

17. Perkins MR, Ryschkewitsch C, Liebner JC, et al. Changes in JC virus-specific T cell responses during natalizumab treatment and in natalizumab-associated progressive multifocal leukoencephalopathy. Plos Pathog, 2012;8(11):e1003014 [cit. 2017-11-12]. Dostupné na www: https://doi.org/10.1371/journal.ppat.1003014.

18. Vermersch P, Kappos L, Gold R, et al. Clinical outcomes of natalizumab-associated progressive multifocal leukoencephalopathy. Neurol, 2011;76(20):1697–1704.

19. Yousry TA, Pelletier D, Cadavid D, et al. Magnetic resonance imaging pattern in natalizumab-associated progressive multifocal leukoencephalopathy. Ann Neurol, 2012;72(5):779–787.

20. Amend KL, Turnbull B, Foskett N, et al. Incidence of progressive multifocal leukoencephalopathy in patients without HIV. Neurol, 2010;75(15):1326–1332.

21. Power C, Brown Gladen JG, Halliday W, et al. AIDS and non AIDS – related PML association with distinct p53 polymorphism. Neurol, 2000;54(3):743–746.

22. Aotsuka Y, Uzawa A, Nishimura K, et al. Progressive multifocal leukoencephalopathy localized in the cerebellum and brainstem associated with idiopathic CD4+ T lymphocytopenia. Intern Med, 2016;55(12):1645–1647.

23. Pavlovic D, Patera AC, Nyberg F, et al. Progressive multifocal leukoencephalopathy: current treatment options and future perspectives. Ther Adv Neurol Disord, 2015;8(6):255–273.

24. Durali D, de Goer de Herve M-G, Gasnault J, et al. B cells and progressive multifocal leukoencephalopathy: search for the missing link. Front Immunol, 2015;6:241 [cit.2017-07-10]. Dostupné www: https://doi.org/10.3389/fimmu.2015.00241.

25. Epperla N, Medina-Flores R, Mazza JJ, et al. Mirtazapine and mefloquine therapy for non-AIDS-related progressive multifocal leukoencephalopathy. WMJ, 2014;113(6):242–245.

26. Tan CS, Dezube BJ, Bhargava P, et al. Detection of JC virus DNA and proteins in the bone marrow of HIV-positive and HIV-negative patients: implications for viral latency and neurotropic transformation. J Infect Dis, 2009;199(6):881–888.

27. Marshall LJ, Ferenczy MW, Daley EL, et al. Lymphocyte gene expression and JC virus noncoding control region sequences are linked with the risk of progressive multifocal leukoencephalopathy. J Virol, 2014;88(9):5177–5183.

28. Bellizzi A, Nardis C, Anzivino E, et al. Human polyomavirus JC reactivation and pathogenetic mechanisms of progressive multifocal leukoencephalopathy and cancer in the era of monoclonal antibody therapies. J Neurovirol, 2012;18(1):1–11.

29. White MK, Khalili K. Pathogenesis of progressive multifocal leukoencephalopathy-revisited. J Infect Dis, 2011; 203(5):578–586.

30. Jelcic I, Faigle W, et al. Immunology of progressive multifocal leukoencephalopathy. J Neurovirol, 2015;21(6):614–622.

31. Kurmann R, Weisstanner C, Kardas P, et al. Progressive multifocal leukoencephalopathy in common variable immunodeficiency: mitigated course under mirtazapine and mefloquine. J Neurovirol, 2015;21(6):694–701.

32. Marshall LJ, Dunham L, Major EO. Transcription factor Spi-B binds unique sequences present in the tandem repeat promote/enhancer of JC virus and supports viral activity. J Gen Virol, 2010;91(12):3042–3052.

33. Bonafoux D, Nanthakumar S, Bandarage UK, et al. Fragment-based discovery of dual JC virus and BK virus helicase inhibitors. J Med Chem, 2016; 59(15):7138–7151.

34. Randhawa P, Zeng G, Bueno M, et al. Inhibition of large T antigen ATPase activity as potential strategy to develop anti-polyomavirus JC drugs. Antiviral Res, 2014;0:113–119.

35. Seguin SP, Ireland AW, Gupta T, et al. A screen for modulators of large T antigen´s ATPase activity uncovers novel inhibitors of Simian Virus 40 and BK virus replication. Antiviral Res, 2012;96(1):70–81.

36. Beltrami S, Gordon J. Immune surveillance and response to JC virus infection and PML. J Neurovirol, 2014;20(2):137–149.

37. Sariyer IK, Merabova N, Patel PK, et al. Bag3-induced autophagy is associated with degradation of JCV oncoprotein, T-Ag. PLoS One, 2023;7:e45000 [cit. 2017-09-12]. Dostupné na www: https://doi.org/10.1371/journal.pone.0045000.

38. Hatchwell E. Is there a (host) genetic predisposition to progressive multifocal leukoencephalopathy? Front Immunol, 2015;6:216 [cit. 2017-10-12]. Dostupné na www: https://www.frontiersin.org/articles/10.3389/fimmu.2015.00216/full.

39. Mori I. Transolfactory neuroinvasion by viruses threatens the human brain. Acta virol, 2015;59(4):338–349.

40. Warnke C, Ramanujam R, Plavina T, et al. Changes to anti-JCV antibody levels in a Swedish national MS cohort. J Neurol Neurosurg Psychiatry, 2013;84(11):1199–1205.

41. Trbojevic M. Detection of oligoclonal Ig bands: clinical significance and trends in methodological improvement. eJIFCC, 2004;15 [cit. 2017-08-11]. Dostupné na www: http://www.ifcc.org/ejifcc/vol15no3/150309200413.htm.

42. Khanna N, Wolbers M, Mueller NJ, et al. JC virus-specific immune responses in human immunodeficiency virus type 1 patients with progressive multifocal leukoencephalopathy. J Virol, 2009;83(9):4404–4411.

43. Monaco MCG, Major EO. Immune system involvement in the pathogenesis of JC virus induced PML: what is learned from studies of patients with underlying diseases and therapies as risk factor. Front Immunol, 2015;6:159 [cit. 2017-08-11]. Dostupné na www: http://doi.org/10.3389/fimmu.2015.00159.

44. Du Pasquier RA, Clark KW, Smith PS, et al. JCV-specific cellular immune response correlates with a favorable clinical outcome in HIV-infected individuals with progressive multifocal leukoencephalopathy. J Neurovirol, 2001;7(4):318–322.

45. Seng R, Goujard C, Krastinova E, et al. Influence of lifelong cumulative HIV viremia on long-term recovery of CD4+ count and CD4+/CD8+ ratio among patients on combination antiretroviral therapy. AIDS, 2015;29(5):595–607.

46. Sokol J, Lisá L, Zeleňáková J, et al. Rituximab – associated progressive multifocal leukoencephalopathy. Vnitř Lék, 2017;63(1):60–64.

47. Lima MA, Berna-Cano F, Clifford DB, et al. Clinical outcome of long/term survivors of progressive multifocal leukoencephalopathy. J Neurol Neurosurg Psychiatry, 2010;81(11):1288–1291.

48. Černý R, Machala L. Neurologické komplikace HIV/AIDS. Praha: Karolinum; 2007.

49. Jelcic I, Combaluzier B, Jelcic I, et al. Prevention and therapy of JC polyomavirus-mediated progressive multifocal leukoencephalopathy – a realistic possibility? Swiss Med Wkly, 2017;147:w14520 [cit. 2017-05-09]. Dostupné na www: http://www.zora.uzh.ch/id/eprint/142365/1/Jelcic_et_al.pdf.

50. Aly L, Yousef S, Schippling S, et al. Central role of JC virus-specific CD4+ lymphocytes in progressive multi-focal leukoencephalopathy-immune reconstitution inflammatory syndrome. Brain, 2011;134:2687–2702.

51. Berger JR, Aksamit AJ, Clifford DB, et al. PML diagnostic criteria – consensus statement from the AAN Neuroinfectious Disease Section. Neurol, 2013;80(15):1430–1438.

52. Polsky B, Suh JS. Viral Infections. In Kuritzke DR, Eron JJ, Squires KE. InPractice HIV [on line]. Jointly Provided by USF Health and Clinical Care Opinions, LLC. 2014 [cit. 2017-11-09]. Dostupné na www: http://www.inpractice.com/Textbooks/HIV/Management_of_Specific_Disease_States/ch29_pt1_Viral/Chapter-Pages/Page-5.aspx.

53. Berger JR. The clinical features of PML. Cleve Clin J Med, 2011;78(S2):8–12.

54. Boster A, Hreha S, Berger JR, et al. Progressive multifocal leukoencephalopathy and relapsing – remitting multiple sclerosis; a comparative study. Arch Neurol, 2009;66(5):593–599.

55. Coyle P, Foley J, Fox E, et al. Best practice recommendations for the selection and management of patients with multiple sclerosis receiving natalizumab therapy. Mult Scler, 2009;15:26–36 [cit. 2017-10-10].

56. Lima MA, Drislane FW, Koralnik IJ. Seizures and their outcome in progressive multifocal leukoencephalopathy. Neurol, 2006;66(2):262–264.

57. O´Connor PW. Natalizumab risk stratification: role of two – step anti JCV antibody assay. Can J Neurol Sci, 2012;39(5):670–675.

58. Anzai Y. Infectious and demyelinating disease. Progressive multifocal leukoencephalopathy. In: Osborn AG, Salzman KL, Barkovich AJ. Diagnostic imaging brain. 2nd ed. Amirsys: Altona. 2010. p. 92–93.

59. Metz I, Radue EW, Oterino A, et al. Pathology of immune reconstitution inflammatory syndrome in multiple sclerosis with natalizumab-associated progressive multifocal leukoencephalopathy. Acta Neuropathol, 2012;123(2):235–245.

60. Reuwer AQ, Heron M, van der Dussen D, et al. The clinical utility of JC virus antibody index measurements in the context of progressive multifocal leukoencephalopathy. Acta Neurol Scand, 2017; 136(S 201):37–44.

61. Salmen A, von Ahsen N, Trampe AK, et al. Longitudinal analyses of anti-JCV antibody index for risk assessment of progressive multifocal leukoencephalopathy. Mult Scler J Exp Transl Clin,2016;2:2055217316630008 [cit. 2017-10-10]. Dostupné na www: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5433507/.

62. Guidelines for Prevention and Treatment of Opportunistic Infections in HIV-Infected Adults and Adolescents. October 28, 2014 [on line]. Recommendations from the Centers for Disease Control and Prevention, the National Institutes of Health, and the HIV medicine Association of the Infectious Diseases Society of America [cit.2017-06-02]. Dostupné na www: https://aidsinfo.nih.gov/guidelines/html/4/adult-and-adolescent-oi-prevention-and-treatment-guidelines/.

63. Polák P. Editoria on Sokol J, Lisá L, Zeleňáková J, et al. Rituximab – associated progressive multifocal leukoencephalopathy. Vnitř Lék, 2017;63(1):22–23.

64. Tan IL, McArthur JC, Clifford DB, et al. Immune reconstitution inflammatory syndrome in natalizumab-associated PML. Neurol, 2011;77(11):1061–1067.

65. Antoniol C, Jílek S, Schluep M, et al. Impairment of JCV-specific T-cell response by corticotherapy: effect on PML-IRIS management? Neurology, 2012;79(23):2258–2264.

66. Scarpazza C, Prosperini L, Mancinelli CR, et al. Is maraviroc useful in multiple sclerosis patients with natalizumab-related progressive multifocal leukoencephalopathy? J Neurol Sci, 2017; 378:233–237.

67. Himedan M, Camelo-Piragua S, Mills EA, et al. Pathologic findings of chronic PML-IRIS in a patient with prolonged PML survival following natalizumab treatment. J Investig Med High Impact Case Rep, 2017;5:2324709617734248 [cit. 2017-09-08]. Dostupné na www: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5624358/.

68. Elphick GF, Querbes W, Jordan JA, et al. The human polyomavirus, JCV, uses serotonin receptors to infect cells. Science, 2004;306(5700):1380–1383.

69. Trentalange A, Calcagno A, Ghisetti V, et al. Clearance of cerebrospinal fluid JCV DNA with mirtazapine in a patient with progressive multifocal leukoencephalopathy and sarcoidosis. Antivir Ther, 2016;21(7):633–635.

70. Cettomai D, McArthur JC. Mirtazapine use in human immunodeficiency virus-infected patients with progressive multifocal leukoencephalopathy. Arch Neurol, 2009;66(2):255–258.

71. Brickelmaier M, Lugovskoy A, Kartikeyan R, et al. Identification and characterization of mefloquine efficacy against JC virus in vitro. Antimicrob Agents Chemother, 2009;53(5):1840–1849.

72. Nukuzuma S, Kameoka M, Sugiura S, et al. Suppressive effect of PARP-1 inhibitor on JC virus replication in vitro. J Med Virol, 2013;85(1):132–137.

73. Kock K, Grube M, Jedlitschky G, et al. Expression of adenosine triphosphate-binding cassette (ABC) drug transporters in peripheral blood cells. Clin Pharmacokinet, 2007;46(6):449–470.

74. Barraud de Lagerie S, Comets E, Gautrand C, et al. Cerebral uptake of mefloquine enantiomers with and without the P-gp inhibitor elacridar (GF1210918) in mice. Br J Pharmacol, 2004;141(7):1214–1222.

75. Senarathna SM, Page-Sharp M, Crowe A. The interactions of P-glycoproteine with antimalarial drugs, including substrate affinity, inhibition and regulation. PloS One, 2016;11(4): e0152677 [cit. 2017-10-10]. Dostupné na www: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4821601/.

76. Oga EF, Sekine S, Shitara Y, et al. Potential P-glycoprotein-mediated drug-drug interactions of antimalarial agents in caco-2 cells. Am J Trop Med Hyg, 2012;87(1):64–69.

77. Gofton TE, Al-Khotani A, O´Farrell B, et al. Mefloquine in the treatment of progressive multifocal leukoencephalopathy. J Neurol Neurosurg Psychiatry, 2011;82(4):452–455.

78. Moenster RP, Jett RA. Mirtazapine and mefloquine therapy for progressive multifocal leukoencephalopathy in a patient infected with human immunodeficiency virus. Am J Health Syst Pharm, 2012;69(6):496–498.

79. Clifford DB, Nath A, Cinque P, et al. A sudy of mefloquine treatment for progressive multifocal leukoencephalopathy: results and exploration of predictors of PML outcomes. J Neurovirol, 2013;19(4):351–358.

80. Khatri BO, Man S, Giovannoni G, et al. Effect of plasma exchange in accelerating natalizumab clearance and restoring leukocyte function. Neurol, 2009;72(5):402–409.

Štítky
Hygiena a epidemiologie Infekční lékařství Mikrobiologie

Článek vyšel v časopise

Epidemiologie, mikrobiologie, imunologie

Číslo 1

2019 Číslo 1

Nejčtenější v tomto čísle

Tomuto tématu se dále věnují…


Kurzy

Zvyšte si kvalifikaci online z pohodlí domova

Příběh jedlé sody
nový kurz
Autoři: MUDr. Ladislav Korábek, CSc., MBA

Krvácení v důsledku portální hypertenze při jaterní cirhóze – od pohledu záchranné služby až po závěrečný hepato-gastroenterologický pohled
Autoři: PhDr. Petr Jaššo, MBA, MUDr. Hynek Fiala, Ph.D., prof. MUDr. Radan Brůha, CSc., MUDr. Tomáš Fejfar, Ph.D., MUDr. David Astapenko, Ph.D., prof. MUDr. Vladimír Černý, Ph.D.

Rozšíření možností lokální terapie atopické dermatitidy v ordinaci praktického lékaře či alergologa
Autoři: MUDr. Nina Benáková, Ph.D.

Léčba bolesti v ordinaci praktického lékaře
Autoři: MUDr. PhDr. Zdeňka Nováková, Ph.D.

Revmatoidní artritida: včas a k cíli
Autoři: MUDr. Heřman Mann

Všechny kurzy
Kurzy Soutěž Doporučená témata Časopisy
Přihlášení
Zapomenuté heslo

Nemáte účet?  Registrujte se

Zapomenuté heslo

Zadejte e-mailovou adresu se kterou jste vytvářel(a) účet, budou Vám na ni zaslány informace k nastavení nového hesla.

Přihlášení

Nemáte účet?  Registrujte se