Warnke C, Adams O, Gold R, Hartung H-P, Hohlfeld R, Wiendl H, Kieseier B C
Neurologische Klinik, Heinrich-Heine-Universität, Moorenstr. 5, 40225, Düsseldorf.
Nervenarzt. 2011 Apr;82(4):475-80. doi: 10.1007/s00115-010-3091-8.
Natalizumab (Tysabri®) is the first monoclonal antibody approved for the treatment of relapsing forms of multiple sclerosis (MS) but while treatment is highly efficient, it carries the risk of progressive multifocal leukoencephalopathy (PML). Based on reports of confirmed cases of PML, the risk of PML might increase beyond 24 months of treatment. Thus, attempts to stratify patients treated with natalizumab into those carrying higher or lower risk for developing PML are currently being undertaken. Among these strategies JC virus serology might potentially be the first tool available. As a large variety of methods have been published resulting in controversial results for JC virus seroprevalence, standardized testing will be mandatory when applying this method in clinical practice. In addition, risk management strategies for the seropositive majority of patients need to be redefined and optimized further.
那他珠单抗（Tysabri®）是首个被批准用于治疗复发型多发性硬化症（MS）的单克隆抗体，尽管治疗效果显著，但存在进展性多灶性白质脑病（PML）的风险。根据确诊的PML病例报告，PML风险可能在治疗超过24个月后增加。因此，目前正在尝试将接受那他珠单抗治疗的患者分为发生PML风险较高或较低的两类。在这些策略中，JC病毒血清学可能是首个可用的工具。由于已发表了大量方法，导致JC病毒血清阳性率的结果存在争议，因此在临床实践中应用此方法时，标准化检测将是必不可少的。此外，对于大多数血清阳性患者的风险管理策略需要进一步重新定义和优化。
