Department of Medicine, Monash University, Alfred Hospital, Australia.
Pathology. 2011 Jun;43(4):362-7. doi: 10.1097/PAT.0b013e3283463558.
Progressive multifocal leukoencephalopathy (PML) is caused by reactivation of JC polyomavirus (JCV). Increased JCV reactivation in kidney, as indicated by JCV viruria is reported during immunosuppression; however, the relevance of systemic to neural reactivation remains unknown.
Brain and kidney tissue from 138 non-PML patients (78 immunocompetent; 60 immunosuppressed) was assessed for JCV large T (LT) and viral protein (VP)1 DNA with nested PCR. Immunohistochemistry was performed to detect presence of JCV protein. Autopsy findings were reviewed and all brains underwent neuropathological examination.
JCV LT DNA was detected in 31% of kidney and 30% of brain from non-PML patients. Of non-PML patients with brain JCV LT DNA, 66% did not have kidney JCV LT DNA, indicating brain JCV LT DNA was independent of kidney JCV LT DNA (p = 0.69). JCV VP1 DNA was detected in 12% of non-PML kidney and 8% of non-PML brain. JCV LT DNA was more likely to be found in the kidney (p < 0.001) and brain (p = 0.009) of immunosuppressed than immunocompetent patients. HIV/AIDS patients with brain JCV LT DNA had lower CD4 counts than those without brain JCV LT DNA (p = 0.05).
Immunosuppression drives increased brain JCV latency independent of systemic latency.
进行性多灶性白质脑病（PML）是由 JC 多瘤病毒（JCV）再激活引起的。免疫抑制期间，肾 JCV 病毒尿症表明 JCV 再激活增加；然而，全身到神经再激活的相关性尚不清楚。
用巢式 PCR 检测来自 138 例非 PML 患者（78 例免疫功能正常；60 例免疫抑制）的脑和肾组织中的 JCV 大 T（LT）和病毒蛋白（VP）1 DNA。进行免疫组织化学检测以检测 JCV 蛋白的存在。回顾尸检结果，并对所有大脑进行神经病理学检查。
31%的非 PML 患者的肾脏和 30%的大脑中检测到 JCV LT DNA。非 PML 患者的大脑 JCV LT DNA 中，66%的患者肾脏中没有 JCV LT DNA，表明大脑 JCV LT DNA 与肾脏 JCV LT DNA 无关（p = 0.69）。12%的非 PML 患者的肾脏和 8%的非 PML 患者的大脑中检测到 JCV VP1 DNA。免疫抑制患者的肾脏（p < 0.001）和大脑（p = 0.009）中更有可能发现 JCV LT DNA。有大脑 JCV LT DNA 的 HIV/AIDS 患者的 CD4 计数低于没有大脑 JCV LT DNA 的患者（p = 0.05）。
免疫抑制会增加大脑 JCV 潜伏，而与全身潜伏无关。
