Fatal PML associated with efalizumab therapy: insights into integrin αLβ2 in JC virus control.

ABSTRACT:

Objectives

Progressive multifocal leukoencephalopathy (PML) has become much more common with monoclonal antibody treatment for multiple sclerosis and other immune-mediated disorders.

Methods

We report 2 patients with severe psoriasis and fatal PML treated for ≥3 years with efalizumab, a neutralizing antibody to αLβ2-leukointegrin (LFA-1). In one patient, we conducted serial studies of peripheral blood and CSF including analyses of leukocyte phenotypes, migration ex vivo, and CDR3 spectratypes with controls coming from HIV-infected patients with PML. Extensive pathologic and histologic analysis was done on autopsy CNS tissue of both patients.

Results

Both patients developed progressive cognitive and motor deficits, and JC virus was identified in CSF. Despite treatment

SUBMITTER: Schwab N 

PROVIDER: S-EPMC3280052 | biostudies-literature | 2012 Feb

REPOSITORIES: biostudies-literature