Immunological Markers for PML Prediction in MS Patients Treated with Natalizumab

摘要: Natalizumab, a monoclonal antibody recognizing the alpha4 integrin chain, has been approved for treatment of active multiple sclerosis, but expose to onset rare side effect, progressive multifocal leurokoencephalitis (PML). Estimating individual risk PML in natalizumab-treated patients is major challenge, and therapeutic strategies are mainly guided by overall assessed identified factors: JCV seropositivity, duration (with peak incidence after 24 months) previous use immunosuppressive therapies. Given that this stratification does not yet allow precise prediction PML, other predictive markers needed, several immunological biomarkers have described. Quantification anti-JCV levels may improve value, with higher baseline titers indicating increased risk. Other such as leukocyte cell membrane (CD49d, CD11a, CD62L), detection circulating JCV-specific activated T effector memory cells (TEM) or genetic screening proposed. In review, we discuss how recent progress immunology paved way «new combined monitoring», which will include screening,