PML risk stratification using anti-JCV antibody index and L-selectin.

Détails

ID Serval
serval:BIB_47C09F0E3895
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
PML risk stratification using anti-JCV antibody index and L-selectin.
Périodique
Multiple sclerosis
Auteur(s)
Schwab N., Schneider-Hohendorf T., Pignolet B., Spadaro M., Görlich D., Meinl I., Windhagen S., Tackenberg B., Breuer J., Cantó E., Kümpfel T., Hohlfeld R., Siffrin V., Luessi F., Posevitz-Fejfár A., Montalban X., Meuth S.G., Zipp F., Gold R., Du Pasquier R.A., Kleinschnitz C., Jacobi A., Comabella M., Bertolotto A., Brassat D., Wiendl H.
ISSN
1477-0970 (Electronic)
ISSN-L
1352-4585
Statut éditorial
Publié
Date de publication
07/2016
Peer-reviewed
Oui
Volume
22
Numéro
8
Pages
1048-1060
Langue
anglais
Notes
Publication types: Journal Article ; Multicenter Study
Publication Status: ppublish
Résumé
Natalizumab treatment is associated with progressive multifocal leukoencephalopathy (PML) development. Treatment duration, prior immunosuppressant use, and JCV serostatus are currently used for risk stratification, but PML incidence stays high. Anti-JCV antibody index and L-selectin (CD62L) have been proposed as additional risk stratification parameters.
This study aimed at verifying and integrating both parameters into one algorithm for risk stratification.
Multicentric, international cohorts of natalizumab-treated MS patients were assessed for JCV index (1921 control patients and nine pre-PML patients) and CD62L (1410 control patients and 17 pre-PML patients).
CD62L values correlate with JCV serostatus, as well as JCV index values. Low CD62L in natalizumab-treated patients was confirmed and validated as a biomarker for PML risk with the risk factor "CD62L low" increasing a patient's relative risk 55-fold (p < 0.0001). Validation efforts established 86% sensitivity/91% specificity for CD62L and 100% sensitivity/59% specificity for JCV index as predictors of PML. Using both parameters identified 1.9% of natalizumab-treated patients in the reference center as the risk group.
Both JCV index and CD62L have merit for risk stratification and share a potential biological relationship with implications for general PML etiology. A risk algorithm incorporating both biomarkers could strongly reduce PML incidence.

Mots-clé
Algorithms, Antibodies, Viral/blood, Biomarkers/blood, Europe, Humans, Immunocompromised Host, JC Virus/immunology, L-Selectin/blood, Leukoencephalopathy, Progressive Multifocal/chemically induced, Leukoencephalopathy, Progressive Multifocal/immunology, Leukoencephalopathy, Progressive Multifocal/prevention & control, Leukoencephalopathy, Progressive Multifocal/virology, Multiple Sclerosis/blood, Multiple Sclerosis/diagnosis, Multiple Sclerosis/drug therapy, Multiple Sclerosis/immunology, Natalizumab/adverse effects, Opportunistic Infections/chemically induced, Opportunistic Infections/immunology, Opportunistic Infections/virology, Retrospective Studies, Risk Assessment, Risk Factors, Serologic Tests, Treatment Outcome, CD62L, JCV index, L-selectin, Natalizumab, PML, risk stratification
Pubmed
Web of science
Création de la notice
02/09/2016 10:36
Dernière modification de la notice
03/03/2018 16:50
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