JC Virus in CD34 and CD19 cells in MS patients treated with natalizumab

In this prospective study, 26 multiple sclerosis (MS) patients starting natalizumab therapy were recruited to investigate the link between natalizumab treatment and the presence of JCV in lymphoid cells.

To isolate sufficient CD34+ and CD19+ cells, 120-mL blood samples were collected immediately before the first infusion (baseline) and then at approximately three-month intervals to 10 months during the course of natalizumab infusions. Single 120-mL samples were collected from 23 MS patients undergoing more than 24 infusions and 150-mL samples of blood were collected from 18 healthy volunteers.

The blood samples were separated using flow cytometry into CD34+, CD19+, and CD3+ cell subsets; DNA templates were prepared using quantitative polymerase chain reaction for JCV DNA identification. Plasma samples were tested for anti-JCV antibodies.

A total of 92 samples from patients cohort (four samples of 120 mL each) underwent analysis. Thirteen of the 26 patients (50%) with baseline and follow-up blood samples had detectable viral DNA in at least one cell compartment at one or more points. Ten of the 23 patients (44%) receiving treatment for more than 24 months and three of the 18 healthy volunteers (17%) also had detectable viral DNA in one or more cell compartment. Fifteen of the 49 MS patients (31%) were confirmed to harbour JCV in CD34+ cells and 12 of 49 (24%) in CD19+ cells. Only one of 18 healthy volunteers were viremic in CD34+ cells and none in CD19+ cells. Nine patients and one healthy volunteer were viremic but had seronegative test results for JCV antibodies.

Authors: Frohman EM, Monaco MC
Source: JAMA Neurol. 2014 May 1;71(5):596-602. doi: 10.1001/jamaneurol.2014.63.
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