Elevation of myoinositol is associated with disease containment in progressive multifocal leukoencephalopathy
Rachel Katz-Brull1, Robert E Lenkinski, Renaud A Du Pasquier
1Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA.
Abstract:
MRI, 1H-MR spectroscopy, immunologic, and virologic studies were performed in search of prognostic factors of disease evolution in patients with progressive multifocal leukoencephalopathy (PML). Acute lesions of PML survivors showed twofold higher standard score of the ratio of myoinositol (a glial marker) to creatine compared with lesions in patients whose disease progressed. Concomitantly, JC virus-specific cytotoxic T lymphocytes were only detected in the blood of PML survivors. These results suggest that inflammation limits disease progression.
Insights
Prognostic factors for progressive multifocal leukoencephalopathy (PML) were identified. Survivors had higher glial markers and detected JC virus-specific T lymphocytes, suggesting inflammation limits disease progression.
Area of Science:
- Neuroimaging
- Immunology
- Virology
Background:
- Progressive multifocal leukoencephalopathy (PML) is a serious demyelinating disease.
- Identifying prognostic factors is crucial for managing PML patients.
Purpose of the Study:
- To investigate prognostic factors influencing disease evolution in PML.
- To correlate imaging and immunological markers with PML outcomes.
Main Methods:
- Utilized magnetic resonance imaging (MRI) and 1H-MR spectroscopy.
- Conducted immunologic and virologic studies, including T-lymphocyte detection.
- Compared markers in patients who survived versus those whose disease progressed.
Main Results:
- PML survivors showed a twofold higher ratio of myoinositol (glial marker) to creatine in acute lesions.
- JC virus-specific cytotoxic T lymphocytes were exclusively found in the blood of PML survivors.
Conclusions:
- Elevated glial markers and the presence of JC virus-specific T lymphocytes are associated with better outcomes in PML.
- Inflammation appears to play a protective role in limiting PML disease progression.
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