Immunological and clinical consequences of treating a patient with natalizumab
作者： Nicholas Schwab , Karin G Höhn , Tilman Schneider-Hohendorf , Imke Metz , Max-Philipp Stenner
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摘要: Background: Long-term therapy with natalizumab increases the risk of progressive multifocal leukoencephalopathy (PML).Objectives: We present a patient study through therapy, diagnosis PML (after 29 infusions), plasma exchange (PE) and development immune reconstitution inflammatory syndrome (IRIS).Methods: Routine diagnostics, magnetic resonance imaging (MRI), immunological status (flow cytometry, T-cell migration assays repertoire analysis), brain biopsy immunohistological analysis.Results: CD49d decreased after 12 months treatment. At diagnosis, expression migratory capacity T cells was low peripheral receptor (TCR) complexity showed severe perturbations. The distribution monocytes changed from CCR5+ to CCR7+. After PE some changes reverted: increased overshot earliest levels, capacities recovered TCR increased. With no clinical, routine laboratory or cerebrospinal fluid (CS...
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