Department of Neurology (N.S., T.S.-H., J.B., C.C.G., K.G., H.W.), University of Münster, Germany; and Pole des Neurosciences Centre Hospitalier Universitaire Toulouse (B.P., D.B.), CPTP INSERM UMR 1043 et Université de Toulouse, UPS, Toulouse, France. D.B. also represents the BioNAT Study Group.
Neurol Neuroimmunol Neuroinflamm. 2016 Jan 27;3(1):e195. doi: 10.1212/NXI.0000000000000195. eCollection 2016 Feb.
The aim of the study was to analyze John Cunningham virus (JCV) serology in natalizumab-treated patients over time and assess whether they are influenced by natalizumab treatment.
German (n = 1,921; 525 longitudinally) and French (n = 1,259; 711 longitudinally) patients were assessed for JCV serology alongside their therapy with natalizumab.
JCV serostatus changed in 69 of 525 longitudinally followed German patients (13.1%) over 14.8 months. Seroconversion according to serostatus was seen in 43 of 339 initially JCV- German patients (12.7% in 14.8 months; 10.3% per year) and 41 of 243 initially JCV- French patients (16.9% in 24 months; 8.5% per year). JCV index values could be reproduced (R (2) = 0.89) with the caveat of 8 of 50 samples (16%) being set into different risk categories between 2 assessments. Index values of JCV+ patients rose over time (p = 0.009) but not because of aging. Treatment with natalizumab was associated with a 15.9% increase of value in JCV+ patients in 14.8 months (12.9% per year).
JCV seroconversion and index values may be influenced by treatment with natalizumab. It is therefore important to monitor patients' JCV serology but also to incorporate additional risk factors into the progressive multifocal leukoencephalopathy risk stratification.
本研究旨在分析长期接受那他珠单抗治疗的患者的约翰·坎宁安病毒（JCV）血清学，并评估其是否受那他珠单抗治疗的影响。
德国（n=1921；525 例纵向）和法国（n=1259；711 例纵向）患者在接受那他珠单抗治疗的同时，评估了 JCV 血清学情况。
14.8 个月内，525 例纵向随访的德国患者中有 69 例（13.1%）JCV 血清学状态发生改变。根据血清学状态，43 例初始 JCV-德国患者（14.8 个月时为 12.7%；每年 10.3%）和 41 例初始 JCV-法国患者（24 个月时为 16.9%；每年 8.5%）发生血清转换。JCV 指数值可以复制（R²=0.89），但需要注意的是，在 2 次评估中有 8 个（16%）样本被归入不同的风险类别。JCV+患者的指数值随时间升高（p=0.009），但不是因为年龄增长。14.8 个月内，接受那他珠单抗治疗的 JCV+患者的指数值增加了 15.9%（每年 12.9%）。
JCV 血清转换和指数值可能受那他珠单抗治疗的影响。因此，监测患者的 JCV 血清学很重要，但也需要将其他危险因素纳入进行性多灶性白质脑病的风险分层。
