[Progressive multifocal leukoencephalopathy. Demyelinating viral disease--common complication of AIDS]

K E Aström1

  • 1keastrom@swipnet.se

Lakartidningen
|October 30, 2001
PubMed

Insights

Progressive Multifocal Leukoencephalopathy (PML) is a fatal brain disease caused by the normally harmless JC virus (JCV). It becomes dangerous in immunocompromised individuals, leading to demyelination and neurological decline.

Area of Science:

  • Neurovirology
  • Immunology
  • Neuropathology

Context:

  • Progressive Multifocal Leukoencephalopathy (PML) is a rare, severe demyelinating disease of the central nervous system (CNS).
  • PML is caused by the human polyomavirus, John Cunningham virus (JCV), which is typically latent and harmless.
  • The disease manifests in individuals with compromised cell-mediated immunity, such as those with Acquired Immunodeficiency Syndrome (AIDS).

Purpose:

  • To elucidate the pathogenesis of Progressive Multifocal Leukoencephalopathy (PML).
  • To understand the role of John Cunningham virus (JCV) in opportunistic infections.
  • To describe the characteristic neuropathological findings in PML.

Summary:

  • PML is characterized by focal demyelination, nuclear inclusions in oligodendrocytes, and transformed astrocytes.
  • JCV, usually benign, becomes pathogenic in immunocompromised hosts, leading to a slow, viral, opportunistic infection.
  • The virus replicates in astrocytes and destroys oligodendrocytes, causing lysis and subsequent demyelination.

Impact:

  • The discovery of PML has significantly advanced research in neurovirology and opportunistic infections.
  • Understanding PML's mechanisms aids in developing diagnostic and therapeutic strategies for CNS viral diseases.
  • PML research contributes to the broader fields of immunology and neuropathology, particularly concerning viral pathogenesis in immunocompromised states.

Related Concept Videos

Arboviral Encephalitis01:25

Arboviral Encephalitis

Arboviral encephalitis refers to brain inflammation caused by arthropod-borne viruses, particularly those transmitted through mosquito vectors. Among these, West Nile virus (WNV), a member of the Flaviviridae family, is a significant public health concern. WNV is an enveloped, positive-sense, single-stranded RNA virus. Human infection typically begins when an infected mosquito introduces the virus into the dermis during feeding. The primary transmission cycle involves birds as amplifying hosts...
Cryptococcal Meningitis01:27

Cryptococcal Meningitis

Cryptococcal meningitis is a life-threatening opportunistic infection predominantly associated with HIV/AIDS, accounting for over 100,000 deaths annually worldwide. However, it also affects individuals with other forms of immunosuppression, including those undergoing immunosuppressive therapy, organ transplant recipients, patients with innate immunodeficiencies, and individuals with hematological disorders. The infection is caused mainly by Cryptococcus neoformans and Cryptococcus gattii,...
Encephalitis l: Introduction01:19

Encephalitis l: Introduction

Encephalitis is inflammation of the brain parenchyma, most often due to infections or autoimmune processes. It presents with neuropsychiatric features such as fever, altered mental status, behavioral changes, cognitive dysfunction, seizures, focal deficits, and sometimes autonomic instability. In some cases, the meninges are also involved, resulting in meningoencephalitis.Infectious CausesInfectious encephalitis is most commonly viral but can also result from bacterial, fungal, or parasitic...
Encephalitis ll: Pathophysiology01:26

Encephalitis ll: Pathophysiology

Encephalitis is inflammation of the brain parenchyma caused by direct viral invasion or immune-mediated mechanisms triggered by infections or tumors. Both processes lead to neuronal injury, disrupted neurotransmission, and diverse neurological symptoms, often with overlapping clinical and pathological features.Autoimmune EncephalitisIn autoimmune encephalitis, antibodies target neuronal antigens on cell surfaces, synapses, or within neurons. A key example is anti-NMDAR encephalitis, which can...
Multiple Sclerosis l: Introduction01:19

Multiple Sclerosis l: Introduction

Multiple sclerosis is a chronic autoimmune disease of the central nervous system (CNS) that affects the brain, spinal cord, and optic nerves. It is an inflammatory demyelinating disorder and a leading cause of neurological disability in young adults.EpidemiologyMS commonly begins between 20 and 40 years of age and is twice as common in women. Its exact cause remains unclear, but genetic susceptibility contributes, with higher risk in first-degree relatives and identical twins. A greater...
Hepatic Encephalopathy01:29

Hepatic Encephalopathy

DefinitionHepatic encephalopathy is a reversible neurologic syndrome that results from advanced liver dysfunction or portosystemic shunting. It leads to disturbances in cognition, behavior, and motor function due to the brain’s exposure to gut-derived toxins that the liver fails to detoxify.EtiologyThis condition develops either in the setting of acute fulminant hepatitis or progressively during chronic liver disease, such as cirrhosis and portal hypertension. Portosystemic shunting—including...