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日本多发性硬化症患者的血清抗 JCV 抗体指数:随芬戈莫德治疗时间的延长而升高。

Serum anti-JCV antibody indexes in Japanese patients with multiple sclerosis: elevations along with fingolimod treatment duration.

机构信息

Chiba University School of Medicine, 1-8-1, Inohana, Chuo-ku, Chiba, 260-8670, Japan.

Department of Neurology, Graduate School of Medicine, Chiba University, 1-8-1, Inohana, Chuo-ku, Chiba, 260-8670, Japan.

出版信息

J Neurol. 2018 May;265(5):1145-1150. doi: 10.1007/s00415-018-8813-z. Epub 2018 Mar 12.

Abstract

BACKGROUND

The risk of developing progressive multifocal leukoencephalopathy in natalizumab-treated multiple sclerosis (MS) patients is related to serum anti-JCV antibody (JCVAb) index. However, the correlation of JCVAb index with other disease-modifying treatments (DMTs) is not well understood.

OBJECTIVE

In this study, we investigated the JCVAb seropositivity rate/JCVAb indexes and its correlation with clinical profiles in Japanese MS patients, and the relationship between JCVAb indexes and DMTs.

METHODS

JCVAb indexes were measured in 149 serum samples from 105 patients with MS. JCVAb indexes and seropositivity, and their correlation with age, sex, disease duration, Kurtzke expanded disability status scale and the duration of the DMTs were evaluated in each patient.

RESULTS

JCVAb was positive in 73 of 105 MS patients. Within 40 fingolimod-treated patients, 27 were positive for JCVAb and JCVAb indexes were positively correlated with the duration of fingolimod treatment. No significant relation was found between JCVAb indexes and the duration of treatment for the other disease-modifying drugs.

CONCLUSION

JCVAb seropositivity was comparatively high in Japanese MS patients. Fingolimod treatment is likely to increase serum JCVAb index, possibly leading to the development of PML. Therefore, it is advised that JCVAb index should be serially monitored during fingolimod treatment to decrease PML risk.

摘要

背景

纳武利尤单抗治疗多发性硬化症(MS)患者发生进行性多灶性脑白质病的风险与血清抗 JCV 抗体(JCVAb)指数相关。然而,JCVAb 指数与其他疾病修正治疗(DMT)的相关性尚不清楚。

目的

本研究旨在调查日本 MS 患者的 JCVAb 血清阳性率/JCVAb 指数及其与临床特征的相关性,以及 JCVAb 指数与 DMT 之间的关系。

方法

检测了 105 例 MS 患者的 149 份血清样本中的 JCVAb 指数。在每位患者中评估了 JCVAb 指数和阳性率及其与年龄、性别、疾病持续时间、Kurtzke 扩展残疾状况量表和 DMT 持续时间的相关性。

结果

105 例 MS 患者中有 73 例 JCVAb 阳性。在 40 例接受芬戈莫德治疗的患者中,27 例 JCVAb 阳性,且 JCVAb 指数与芬戈莫德治疗持续时间呈正相关。未发现 JCVAb 指数与其他疾病修正药物治疗持续时间之间存在显著关系。

结论

日本 MS 患者 JCVAb 血清阳性率较高。芬戈莫德治疗可能会增加血清 JCVAb 指数,从而导致 PML 的发生。因此,建议在芬戈莫德治疗期间定期监测 JCVAb 指数,以降低 PML 的风险。

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