JCV-specific cellular immune response correlates with a favorable clinical outcome in HIV-infected individuals with progressive multifocal leukoencephalopathy

被引：71

作者：

Du Pasquier R.A. ^{[1
]}

Clark K.W. ^{[1
]}

Smith P.S. ^{[1
]}

Joseph J.T. ^{[1
]}

Mazullo J.M. ^{[1
]}

De Girolami U. ^{[1
]}

Letvin N.L. ^{[1
]}

Koralnik I.J. ^{[1
]}

机构：

[1] Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA 02215

来源：

Journal of NeuroVirology | 2001年 / 7卷 / 4期

关键词：

Acquired immune deficiency syndrome (AIDS); Cytotoxic T lymphocytes; Human immunodeficiency virus (HIV); Progressive multifocal leukoencephalopathy (PML);

D O I：

10.1080/13550280152537175

中图分类号：

学科分类号：

摘要：

Most immunosuppressed individuals who develop progressive multifocal leukoencephalopathy (PML) have a rapid fatal outcome, whereas some become long-term survivors. We explored the impact of the cellular immune response against JC virus (JCV) on the clinical outcome of 7 HIV + and 3 HIV - individuals with PML. Of the 4 HIV +/PML survivors, all had detectable cytotoxic T lymphocytes (CTL) specific for JCV T or VP 1 proteins compared to none of the 3 HIV +/PML progressors tested. Of the 3 HIV -/PML patients, 1 was recently diagnosed with PML and showed evidence of neurologic improvement without any treatment. This patient had CTL specific for the VP1 protein of JCV. The other 2 HIV -/PML survivors were stable 3-8 years after the diagnosis of PML. They did not have any detectable CTL against JCV. These findings suggest that JCV-specific immune response is associated with favorable outcome in HIV + individuals with PML. The lack of detectable JCV-specific CTL in 2 HIV -/PML survivors might indicate a burnt-out disease without sufficient antigenic stimulation to maintain the cellular immune response. The detection of JCV-specific CTL in an HIV - patient recently diagnosed with PML, who was showing evidence of neurological improvement without any treatment, indicates that this finding may be used as a favorable prognostic marker of disease evolution in the clinical management of patients with PML. As the quest for an effective treatment of PML continues, JCV-specific cellular immune response deserves further attention because it appears to play a crucial role in the prevention of disease progression.

引用

页码：318 / 322

页数：4

共 24 条

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