Kim Su Hyun, Kim Yeseul, Jung Ji Yun, Park Na Young, Jang Hyunmin, Hyun Jae Won, Kim Ho Jin
Department of Neurology, Research Institute and Hospital of National Cancer Center, Goyang, Korea.
J Clin Neurol. 2019 Oct;15(4):454-460. doi: 10.3988/jcn.2019.15.4.454.
The anti-John-Cunningham virus (JCV)-antibody serostatus and index are used in the risk stratification of progressive multifocal leukoencephalopathy (PML) in multiple sclerosis (MS) patients treated with natalizumab. However, little information on these parameters is available for Asian countries. The purpose of this study was to determine the rate of seropositivity, index, and longitudinal index evolution in Korean patients with MS.
The antibody seroprevalence was analyzed in 355 samples from 187 patients with clinically isolated syndrome or MS using a second-generation, two-step, enzyme-linked immunosorbent assay. A 4-year longitudinal evaluation was applied to 66 patients.
The overall antibody seroprevalence was 80% (=149). Among antibody-positive patients, the index had a median value of 3.27 (interquartile range, 1.52-4.18), with 77% (=114) and 56% (=83) of patients having indices >1.5 and >3.0, respectively. The serostatus of 59 (89%) of the 66 patients did not change during the longitudinal analysis, while 3 (6%) of the 53 patients who were initially seropositive reverted to seronegativity, and 2 (15%) of the 13 patients who were initially seronegative converted to seropositivity. All patients with a baseline index >0.9 maintained seropositivity, and 92% of patients with a baseline index >1.5 maintained this index over 4 years. No patients developed PML (median disease duration, 8 years).
The seroprevalence and index of anti-JCV antibodies in Korean patients with MS may be higher than those in Western countries.
抗约翰·坎宁安病毒（JCV）抗体血清状态及指数用于接受那他珠单抗治疗的多发性硬化（MS）患者进行性多灶性白质脑病（PML）的风险分层。然而，关于这些参数在亚洲国家的信息较少。本研究旨在确定韩国MS患者的血清阳性率、指数及指数的纵向变化情况。
使用第二代两步酶联免疫吸附试验分析了187例临床孤立综合征或MS患者的355份样本中的抗体血清流行率。对66例患者进行了为期4年的纵向评估。
总体抗体血清流行率为80%（=149）。在抗体阳性患者中，指数的中位数为3.27（四分位间距，1.52 - 4.18），分别有77%（=114）和56%（=83）的患者指数>1.5和>3.0。在纵向分析期间，66例患者中有59例（89%）的血清状态未改变，而最初血清阳性的53例患者中有3例（6%）转为血清阴性，最初血清阴性的13例患者中有2例（15%）转为血清阳性。所有基线指数>0.9的患者均保持血清阳性，92%基线指数>1.5的患者在4年期间保持该指数。无患者发生PML（疾病中位病程8年）。
韩国MS患者中抗JCV抗体的血清流行率和指数可能高于西方国家。
