PMID- 26160817
OWN - NLM
STAT- MEDLINE
DCOM- 20151009
LR  - 20201229
IS  - 1881-6096 (Print)
IS  - 1881-6096 (Linking)
VI  - 67
IP  - 7
DP  - 2015 Jul
TI  - [Neuropathology of Natalizumab-Associated Progressive Multifocal 
      Leukoencephalopathy].
PG  - 891-901
LID - 10.11477/mf.1416200228 [doi]
AB  - The pathological findings of natalizumab-associated progressive multifocal 
      leukoencephalopathy (PML) are reviewed. In addition to the classical pathology of 
      PML including the presence of enlarged abnormal astrocytes, intranuclear 
      inclusions mainly found within large swollen oligodendrocytes and abundant 
      myelin-laden macrophages/microglia, massive perivascular and parenchymal 
      mononuclear cell infiltration was observed. The latter pathologic picture is that 
      of immune reconstitution inflammatory syndrome (IRIS), and most of these 
      infiltrating cells are CD8-positive T cells. Because IRIS inevitably occurs after 
      the cessation of natalizumab therapy due to the development of PML and subsequent 
      plasma exchange, most of the published pathologic pictures of 
      natalizumab-associated PML patients were a mixture of PML and PML-IRIS. PML-IRIS 
      is also characterized by fewer oligodendroglial viral inclusions and fewer cells 
      that are immunoreactive against anti-JCV antibodies. These findings suggest the 
      effective removal of JCV after the return of normal immune-surveillance in the 
      central nervous system, but clinicians should be aware that JCV elimination is 
      not complete under the IRIS condition, and the immunosuppressive therapy against 
      IRIS should be carefully performed. Mononuclear cell infiltration in 
      natalizumab-associated PML-IRIS patients was much more prominent than that in 
      HIV-associated PML-IRIS patients, reflecting the retained, even enhanced, 
      systemic immunities in patients treated by natalizumab.
FAU - Kanda, Takashi
AU  - Kanda T
AD  - Department of Neurology and Clinical Neuroscience, Yamaguchi University Graduate 
      School of Medicine.
LA  - jpn
PT  - English Abstract
PT  - Journal Article
PL  - Japan
TA  - Brain Nerve
JT  - Brain and nerve = Shinkei kenkyu no shinpo
JID - 101299709
RN  - 0 (Antibodies, Monoclonal, Humanized)
RN  - 0 (Natalizumab)
RN  - 143198-26-9 (Integrin alpha4)
SB  - IM
MH  - Antibodies, Monoclonal, Humanized/*adverse effects
MH  - Autopsy
MH  - Blood-Brain Barrier
MH  - Female
MH  - Humans
MH  - Integrin alpha4/immunology
MH  - Leukoencephalopathy, Progressive Multifocal/etiology/immunology/*pathology
MH  - Male
MH  - Middle Aged
MH  - Natalizumab
EDAT- 2015/07/15 06:00
MHDA- 2015/10/10 06:00
CRDT- 2015/07/11 06:00
PHST- 2015/07/11 06:00 [entrez]
PHST- 2015/07/15 06:00 [pubmed]
PHST- 2015/10/10 06:00 [medline]
AID - 1416200228 [pii]
AID - 10.11477/mf.1416200228 [doi]
PST - ppublish
SO  - Brain Nerve. 2015 Jul;67(7):891-901. doi: 10.11477/mf.1416200228.