Progressive multifocal leukoencephalopathy and its association with JC virus (John Cunningham): A bibliographical review from diagnosis to therapeutic strategies

Authors

DOI:

https://doi.org/10.52076/eacad-v5i1.529

Keywords:

Leukoencephalopathy, progressive multifocal; JC Virus; Human immunodeficiency virus; Antiretroviral therapy, highly active; Polyomaviridae.

Abstract

Progressive Multifocal Leukoencephalopathy (PML) is a neurological condition caused by the JC virus, predominantly impacting the central nervous system. Its aggressiveness is evident in patients with immunological compromise, such as those with HIV/AIDS, transplants or those undergoing specific therapies. The objective of this work is to analyze what the most recent literature presents on this topic, considering its relevance today. In this way, we intend to bring to light topics that can improve the life expectancy of these patients." A systematic and quantitative review of the literature was conducted, using platforms such as PubMed, SciELO and Google Scholar until 2023. Exclusion criteria were applied to select retrospective or prospective non-randomized studies for inclusion in the meta-analysis. When the JC virus is reanimated in immunosuppressed hosts, it plays a very important role in the development of PML. Its spectrum of manifestations ranges from demyelination to focal neurological deficits, detectable through examinations imaging techniques such as CT and MRI. Despite efforts, an effective treatment for PML has not yet been identified. Current strategies aim to strengthen the adaptive immune response, such as immediate initiation of antiretroviral therapy in patients with HIV. Research is exploring therapies involving HIV vaccines. dendritic cells and other approaches, but more research is needed. PML remains deadly in most cases. Early detection and a multidisciplinary approach are key to management. Healthcare professionals must be vigilant regarding neurological symptoms in immunosuppressed patients, while awareness and regular monitoring are crucial for patients.

References

Beudel, M., Rövekamp, F., van de Beek, D., & Brouwer, M. (2021). Single-Dose Pembrolizumab Treatment for Progressive Multifocal Leukoencephalopathy. Neurology - Neuroimmunology Neuroinflammation, 8(4), e1021. 10.1212/nxi.0000000000001021

Berzero, G., Basso, S., Stoppini, L., et al. (2021). Adoptive Transfer of JC Virus‐Specific T Lymphocytes for the Treatment of Progressive Multifocal Leukoencephalopathy. Annals of Neurology, 89(4), 769–779. 10.1002/ana.26020

Cortese, I., Beck, E.S., Al-Louzi, O., et al. (2021). BK virus-specific T cells for immunotherapy of progressive multifocal leukoencephalopathy: an open-label, single-cohort pilot study. The Lancet Neurology, 20(8), 639–652. 10.1016/s1474-4422(21)00174-5

Fischbach, L., Bauer, T., Rüber, T. R., et al. (2021). Treatment of progressive multifocal Leukoencephalopathy associated with idiopathic lymphocytopenia with Nivolumab. Journal of the Neurological Sciences, 427, 117503. 10.1016/j.jns.2021.117503

Garcia, J., Hendel-Chavez, H., De-Goer, M-G., et al. (2021). Progressive multifocal leukoencephalopathy on dimethyl fumarate with preserved lymphocyte count but deep T-cells exhaustion. Multiple Sclerosis (Houndmills, Basingstoke, England), 27(4), 640–644. 10.1177/1352458520942201

Hopfner, F., Möhn, N., Eiz-Vesper, B., et al. (2021). Allogeneic BK Virus-Specific T-Cell Treatment in 2 Patients With Progressive Multifocal Leukoencephalopathy. Neurology - Neuroimmunology Neuroinflammation, 8(4). 10.1212/NXI.0000000000001020

Moens, U., Van Gheule, M., & Johannessen, M. (2009). Human Polyomaviruses. Nova Science Pub Incorporated.

Morris-Love, J., & Atwood, W.J. (2022). Complexities of JC Polyomavirus Receptor-Dependent and -Independent Mechanisms of Infection, 14(6), 1130–1130. 10.3390/v14061130

Morris-Love, J., O’Hara, B.A., Gee, G.V., et al. (2022). Biogenesis of JC polyomavirus associated extracellular vesicles. Journal of Extracellular Biology, 1(5), e43. 10.1002/jex2.43

National Collaborating Centre for Chronic Conditions (Great Britain), College R., & Chartered Society of Physiotherapy (Great Britain). (2004). Multiple Sclerosis: National Clinical Guideline for Diagnosis and Management in Primary and Secondary Care. Royal College of Physicians.

Roos-Weil, D., Weiss, N., Guihot, A., et al. (2021). Immune checkpoint inhibitors for progressive multifocal leukoencephalopathy: a new gold standard? Journal of Neurology, 268(7), 2458–2465. 10.1007/s00415-021-10414-y

Schengrund, C-L., & Yu, R.K. (2022). Glycobiology of the Nervous System. Springer Nature.

Singh, S.K. (2013). Neuroviral Infections: General Principles and DNA Viruses. CRC Press.

Stögbauer, J., Schulz–Schaeffer, W., Mühl-Benninghaus, R., & Lochner, P. (2020). Clinical and magnetic resonance imaging monitoring in progressive multifocal leukoencephalopathy treated with pembrolizumab: a case report. Neurological Sciences, 42(1), 357–359. 10.1007/s10072-020-04582-4

Brust, J. C. M., McGowan, J. P., Fine, S. M., Merrick, S. T., Radix, A. E., Vail, R. M., Stevens, L. C., Hoffmann, C. J., & Gonzalez, C. J. (2021). Management of Immune Reconstitution Inflammatory Syndrome (IRIS). In PubMed. Johns Hopkins University. https://www.ncbi.nlm.nih.gov/books/NBK570544/

Barkhof, F., & Koeller, K. K. (2020). Demyelinating Diseases of the CNS (Brain and Spine) (J. Hodler, R. A. Kubik-Huch, & G. K. von Schulthess, Eds.). PubMed; Springer. https://www.ncbi.nlm.nih.gov/books/NBK554329/

Carson, K. R., Evens, A. M., Richey, E. A., Habermann, T. M., Focosi, D., Seymour, J. F., Laubach, J., Bawn, S. D., Gordon, L. I., Winter, J. N., Furman, R. R., Vose, J. M., Zelenetz, A. D., Mamtani, R., Raisch, D. W., Dorshimer, G. W., Rosen, S. T., Muro, K., Gottardi-Littell, N. R., & Talley, R. L. (2009). Progressive multifocal leukoencephalopathy after rituximab therapy in HIV-negative patients: a report of 57 cases from the Research on Adverse Drug Events and Reports project. Blood, 113(20), 4834–4840. https://doi.org/10.1182/blood-2008-10-186999

Bernard‐Valnet, R., Koralnik, I. J., & Du Pasquier, R. (2021). Advances in Treatment of Progressive Multifocal Leukoencephalopathy. Annals of Neurology, 90(6), 865–873. https://doi.org/10.1002/ana.26198

Harypursat, V., Zhou, Y., Tang, S., & Chen, Y. (2020). JC Polyomavirus, progressive multifocal leukoencephalopathy and immune reconstitution inflammatory syndrome: a review. AIDS Research and Therapy, 17(1). https://doi.org/10.1186/s12981-020-00293-0

Thapa, S., & Shrestha, U. (2022). Immune Reconstitution Inflammatory Syndrome. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK567803/

Downloads

Published

04/01/2024

How to Cite

Paz, J. V. C. da, Santiago, S. K. A. ., Gomes, T. M. ., Silveira , J. M. S. ., Rosário, L. C. V. do ., Araújo, J. G. G. ., Sousa, G. M. A. de ., Rodrigues , C. C. ., Beckman , L. F., Alves, A. A. G. ., Cruz, J. A. da ., Freitas, C. M. de ., Giacomo, B. S. A. ., Alves, A. P. D. ., Ribeiro, M. C. R. L. de M. ., Paixão, R. K. M. ., Reis, S. O. dos ., Alves, L. O. ., Martins , B. C. ., Sousa, K. M. M. de ., Luz, M. A. P. ., Mendes, G. C. O. ., Salgado, D. R. G. B. ., & Fialho, L. F. . (2024). Progressive multifocal leukoencephalopathy and its association with JC virus (John Cunningham): A bibliographical review from diagnosis to therapeutic strategies. E-Acadêmica, 5(1), e0251529. https://doi.org/10.52076/eacad-v5i1.529

Issue

Vol. 5 No. 1 (2024)

Section

Health and Biological Sciences

License

Copyright (c) 2024 João Victor Carvalho da Paz; Solano Kaluangila Andrelino Santiago; Thamires Mendes Gomes; Johana Mirela Shikama Silveira ; Letícia Chaves Véras do Rosário; João Gabriel Gomes Araújo; Gabriel Mesquita Almeida de Sousa; Carla Castro Rodrigues ; Lucas Frota Beckman ; Alexandre Augusto Gomes Alves; Janice Alves da Cruz; Camila Melo de Freitas; Brenda Santana Araujo Giacomo; Ana Paula Diniz Alves; Maria Clara Rego Lima de Medeiros Ribeiro; Rafaella Keila Moreira Paixão; Sayure Oliveira dos Reis; Luanna Oliveira Alves; Berthone Colins Martins ; Karina Marques Milhomem de Sousa; Mariah Aparecida Pessoa Luz; Geyza Cristine Oliveira Mendes; Denise Ribeiro Guimaraes Borges Salgado; Lucas Freire Fialho

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Autores que publicam nesta revista concordam com os seguintes termos:

1) Autores mantém os direitos autorais e concedem à revista o direito de primeira publicação, com o trabalho simultaneamente licenciado sob a Licença Creative Commons Attribution que permite o compartilhamento do trabalho com reconhecimento da autoria e publicação inicial nesta revista.

2) Autores têm autorização para assumir contratos adicionais separadamente, para distribuição não-exclusiva da versão do trabalho publicada nesta revista (ex.: publicar em repositório institucional ou como capítulo de livro), com reconhecimento de autoria e publicação inicial nesta revista.

3) Autores têm permissão e são estimulados a publicar e distribuir seu trabalho online (ex.: em repositórios institucionais ou na sua página pessoal) a qualquer ponto antes ou durante o processo editorial, já que isso pode gerar alterações produtivas, bem como aumentar o impacto e a citação do trabalho publicado.