García Silvia, García-Martell Adriana, Quiñones-Aguilar Sandra, Sauri-Suárez Sergio, Téllez González Mario Antonio, García-Castillo Guillermo, Suárez-Cuenca Juan Antonio, Toledo-Lozano Christian Gabriel, Mondragón Terán Paul, Alcaraz-Estrada Sofia Lizeth
Clinical Research Department, National Medical Center "20 de Noviembre" Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Mexico City 03100, Mexico.
Neurology Department, National Medical Center "20 de Noviembre" Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Mexico City 03100, Mexico.
Biomedicines. 2024 Nov 29;12(12):2737. doi: 10.3390/biomedicines12122737.
: Multiple sclerosis (MS) is a disease characterized by demyelination and axonal damage of the central nervous system. Despite the observed benefits, highly effective treatment (HET)-based therapy has adverse effects, which include an increased risk of developing progressive multifocal leukoencephalopathy (PML). Additionally, the risk grows if the patient has antibodies for the John Cunningham virus (JCV). The appearance of PML is rare, and only one report has been found in Mexico. The objective of this research was to determine and analyze the immunological memory for JCV in a population of Mexican patients with MS under treatment. : All participants underwent a complete medical history and neurological evaluation. Once they signed their informed consent, a blood sample was taken to determine if antibodies against JCV were present in their serum. In total, 121 MS patients were analyzed, and the population consisted of 62.8% women and 37.2% men with an average age of 42.28. The three most common HETs received by the participants were natalizumab (67.76%), followed by teriflunomide and fingolimod. : The seropositivity was 62.8%, and in this group, the average duration of disease evolution was 152.33 ± 93.37 months. Natalizumab was the most used HET, and despite this, only a positive association between a positive JCV antibody index with duration of fingolimod and history of depression was found. Also, a positive correlation of the JCV Ab index within the forms of SPMS and PPMS compared to RRMS was observed. No differences were observed between populations, type, and duration of MS.
多发性硬化症(MS)是一种以中枢神经系统脱髓鞘和轴突损伤为特征的疾病。尽管观察到了其益处,但基于高效治疗(HET)的疗法存在不良反应,其中包括发生进行性多灶性白质脑病(PML)的风险增加。此外,如果患者有针对约翰·坎宁安病毒(JCV)的抗体,风险会进一步增加。PML的出现很罕见,在墨西哥仅发现过一份报告。本研究的目的是确定并分析接受治疗的墨西哥MS患者群体中针对JCV的免疫记忆。
所有参与者都接受了完整的病史和神经学评估。在他们签署知情同意书后,采集血样以确定其血清中是否存在抗JCV抗体。总共分析了121例MS患者,该群体中女性占62.8%,男性占37.2%,平均年龄为42.28岁。参与者接受的三种最常见的HET分别是那他珠单抗(67.76%),其次是特立氟胺和芬戈莫德。
血清阳性率为62.8%,在该组中,疾病演变的平均持续时间为152.33±93.37个月。那他珠单抗是使用最多的HET,尽管如此,仅发现JCV抗体指数阳性与芬戈莫德使用持续时间和抑郁病史之间存在正相关。此外,与复发缓解型多发性硬化症(RRMS)相比,继发进展型多发性硬化症(SPMS)和原发进展型多发性硬化症(PPMS)形式的JCV抗体指数存在正相关。在MS的人群、类型和持续时间之间未观察到差异。