JC viral loads in patients with Crohn's disease treated with immunosuppression: can we screen for elevated risk of progressive multifocal leukoencephalopathy?

J Verbeeck; G Van Assche; J Ryding; Wollants, E.; Rans, K.; Vermeire, S.; R.^Pourkarim, M.; Noman, M.; Dillner, J.; Van Ranst, M.; Rutgeerts, P.
October 2008
Gut;Oct2008, Vol. 57 Issue 10, p1393
Academic Journal
Background and aims: Anti-α4 integrin therapy with natalizumab is efficacious in refractory Crohn's disease and in multiple sclerosis, but carries an estimated 1/1 000 risk of progressive multifocal leukoencephalopathy (PML) caused by reactivation of latent JC virus infection. Athough anti-α4 integrin therapies are likely to be introduced in the clinic, screening for the risk of PML has not been developed. Methods: We prospectively collected urine, serum, plasma and bully coats from 125 patients with Crohn's disease, 100 control subjects with gastrointestinal (GI) disease, and 106 healthy volunteers. Four to eight weeks after this first sample collection, we additionally collected a set of urine, serum, plasma and bully coat samples from the 125 patients with Crohn's disease, and a next set of samples was collected 12-16 weeks after the first collection. JC viral loads were determined with quantitative real-time polymerase chain reaction (PCR), and JC virus seroprevalence with a specific enzyme-linked immunosorbant assay (ELISA). Results: The overall JC virus seroprevalence was 65%. JC virus DNA copies were detected in the urine from 29-44% of subjects, both those with Crohn's disease and controls. Median viral loads were significantly higher in patients with Crohn's disease who were immunosuppressed (7.36 × 106 copies/ml) compared to healthy volunteers (2.77 × 106 copies/ml) and compared to 01 controls (1.8 × 106 copies/ml). Clearance at any time point occurred in 4/107 (3.7%) subjects only. JC was found in two patients with Crohn's disease. Conclusions: The natural history of JC virus in patients with Crohn's disease is still unknown. Our study results show that JC virus latency and urine viral shedding is frequent in immunosuppressed patients with Crohn's disease. More prospective studies are needed in order to agree on possible recommendations concerning the exclusion of patients with JCV viraemia from anti-α4 integrin treatment.


Related Articles

  • Comparative study of four different assays for the detection of binding antibodies against interferon-�. Gneiss, C.; Brugger, M.; Millonig, A.; Fogdell-Hahn, A.; Rudzki, D.; Hillert, J.; Berger, T.; Reindl, M.; Deisenhammer, F. // Multiple Sclerosis (13524585);Jul2008, Vol. 14 Issue 6, p830 

    Background Binding antibodies (BAB) against interferon-�(IFN�) are often determined as screening assays before performing an expensive and elaborate neutralizing antibody (NAB) test. Methods In this study, we compared four BAB tests, a western blot (WB), a direct binding enzymelinked...

  • sICAM-1 is not a marker for disease activity in the relapse-free interval of multiple sclerosis - a cross-sectional pilot study. Flachenecker, Peter; Jung, Stefan; Rieckmann, Peter; Toyka, Klaus V. // Journal of Neurology;Aug2002, Vol. 249 Issue 8, p1001 

    In multiple sclerosis (MS), serum levels of ICAM-1 were elevated during acute exacerbations and were therefore proposed as a marker of disease activity, but the potential of this molecule as an indicator of long-term activity, i. e. the progression of the disease outside acute exacerbations, is...

  • Assay What? Tysabri's PML Woes Could Find Partial Fix. Osborne, Randy // BioWorld Insight;4/12/2010, Vol. 18 Issue 15, p1 

    The article discusses the issues about the use of Tysabri from Biogen Idec Inc. that could remove PML cases from multiple sclerosis patients in the U.S. According to Biogen Idec Inc., 55% of patients with multiple sclerosis carry JCV antibodies. However, questions are being asked on how will...

  • Predicting autoimmunity after alemtuzumab treatment of multiple sclerosis. Azzopardi, Laura; Thompson, Sara A. J.; Harding, Katherine E.; Cossburn, Mark; Robertson, Neil; Compston, Alastair; Coles, Alasdair J.; Jones, Joanne L. // Journal of Neurology, Neurosurgery & Psychiatry;Jul2014, Vol. 85 Issue 7, p795 

    Objective We have previously shown that autoimmunity following alemtuzumab treatment of multiple sclerosis can be predicted by high baseline serum interleukin IL-21 (IL-21), as measured using a now 'redundant' enzyme linked immunosorbent assay (ELISA). Here we ask whether currently available...

  • Peripheral T-lymphocyte subpopulations in different clinical stages of chronic HBV infection correlate with HBV load. Jing You; Lin Zhuang; Yi-Feng Zhang; Hong-Ying Chen; Hutcha Sriplung; Geater, Alan; Chongsuvivatwong, Virasakdi; Piratvisuth, Teerha; McNeil, Edward; Lan Yu; Bao-Zhang Tang; Jun-Hua Huang; Larrubia, Juan-Ramón // World Journal of Gastroenterology;7/21/2009, Vol. 15 Issue 27, p3382 

    AIM: To characterize the peripheral T-cell subpopulation profiles and their correlation with hepatitis B virus (HBV) replication in different clinical stages of chronic HBV infection. METHODS: A total of 422 patients with chronic HBV infection were enrolled in this study. The patients were...

  • Correlation of C-reactive protein to severity of symptoms in acute influenza A infection. Haran, John P.; Suner, Selim; Gardiner, Fenwick // Journal of Emergencies, Trauma & Shock;Apr2012, Vol. 5 Issue 2, p149 

    Background: Currently there is no objective measure to determine disease severity in patients with acute influenza infection. During acute viral infections, C-reactive protein (CRP) has been shown to be elevated. Aim: To study the relationship between the symptoms of acute influenza A infection...

  • Decreased T cell reactivity to Epstein–Barr virus infected lymphoblastoid cell lines in multiple sclerosis. M P Pender // Journal of Neurology, Neurosurgery & Psychiatry;May2009, Vol. 80 Issue 5, p498 

    OBJECTIVE: To investigate T cell and antibody immunity to Epstein–Barr virus (EBV) in multiple sclerosis (MS). METHODS: Immunoglobulin G (IgG) immunity to EBV nuclear antigen 1 (EBNA1) and viral capsid antigen was measured by enzyme linked immunosorbent assays, and T cell immunity was...

  • Resident Case Series.  // Review of Ophthalmology;Oct2012, Vol. 19 Issue 10, p92 

    The article offers information on diagnosis and treatment of the disease Herpes Simplex Virus (HSV) keratoconjunctivitis. It informs that several diagnostic tests should be perform in order to determine the HSV which include varicella zoster virus antibodies (IgG and IgM) test, human...

  • Immunodiagnostics finds new uses in the lab. Hogrefe, Wayne R. // MLO: Medical Laboratory Observer;Jul2012, Vol. 44 Issue 7, p72 

    The article evaluates immunodiagnostic tests that are being used in laboratories currently such as the ELISA testing service used for multiple sclerosis (MS).


Read the Article


Sign out of this library

Other Topics