Natalizumab therapy is associated with an increased risk of progressive multifocal leukoencephalopathy (PML). Since the prognosis of PML is extremely poor, identification of patients highly susceptible to the disease may improve outcomes. Our paper tries to find out if new positive result or increased JCV DNA concentration in urine samples may represent a good marker of viral reactivation. Secondary objectives are to assess the effects of therapy on leucocyte serum levels and evaluate drug efficacy. Every month, we evaluated leucocyte level, JCV and BKV DNA serum and urine concentration in 33 patient with multiple sclerosis under Natalizumab treatment. We did not notice any variation in JCV DNA concentration, nor new positive results. We noticed an increasing trend in the average BKV DNA concentration in urine. Fifteen out of 33 patients were treated for a period of 12 months. In this subgroup we noticed an increasing trend in leucyte serum levels and a BKV DNA new positive result in urine sample. After one year patients showed a significant decrease in relapse rate compared to the previous year and an improvement in EDSS. Monitoring urine JCV DNA concentration does not seem an effective marker for viral reactivation. A good marker could be BKV DNA urine level.
DNA di poliomavirus in pazienti con sclerosi multipla in terapia con Natalizumab
CERONI, MAURO
2011-01-01
Abstract
Natalizumab therapy is associated with an increased risk of progressive multifocal leukoencephalopathy (PML). Since the prognosis of PML is extremely poor, identification of patients highly susceptible to the disease may improve outcomes. Our paper tries to find out if new positive result or increased JCV DNA concentration in urine samples may represent a good marker of viral reactivation. Secondary objectives are to assess the effects of therapy on leucocyte serum levels and evaluate drug efficacy. Every month, we evaluated leucocyte level, JCV and BKV DNA serum and urine concentration in 33 patient with multiple sclerosis under Natalizumab treatment. We did not notice any variation in JCV DNA concentration, nor new positive results. We noticed an increasing trend in the average BKV DNA concentration in urine. Fifteen out of 33 patients were treated for a period of 12 months. In this subgroup we noticed an increasing trend in leucyte serum levels and a BKV DNA new positive result in urine sample. After one year patients showed a significant decrease in relapse rate compared to the previous year and an improvement in EDSS. Monitoring urine JCV DNA concentration does not seem an effective marker for viral reactivation. A good marker could be BKV DNA urine level.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
