Related Experiment Video
Updated: Jul 14, 2026
09:29
Induction of Paralysis and Visual System Injury in Mice by T Cells Specific for Neuromyelitis Optica Autoantigen Aquaporin-4
Published on: August 21, 2017
"Thinking without thinking" about natalizumab and PML.
1Neuroinflammation Research Center, Department of Neurosciences, The Lerner Research Institute, The Cleveland Clinic Foundation, United States.
Journal of the Neurological Sciences
|May 25, 2007
Summary
Natalizumab, a multiple sclerosis (MS) therapy, was linked to progressive multifocal leukoencephalopathy (PML). This suggests PML may be mechanism-based, not due to general immunosuppression in MS patients.
Area of Science:
- Neuroimmunology
- Clinical Neurology
- Pharmacology
Background:
- Natalizumab is an effective therapy for multiple sclerosis (MS).
- Its use was complicated by the emergence of progressive multifocal leukoencephalopathy (PML).
- PML cases were observed in clinical trial participants, leading to a temporary suspension of the drug.
Purpose of the Study:
- To propose a hypothesis for the mechanism of PML in natalizumab-treated patients.
- To differentiate PML from generalized immunosuppression-related opportunistic infections.
Main Methods:
- Review of clinical data and adverse event reports.
- Analysis of the potential mechanism of action of natalizumab.
- Comparison of PML occurrence with other opportunistic infections.
Main Results:
- Natalizumab treatment was not associated with increased opportunistic infections, apart from PML.
- This observation suggests a specific mechanism rather than broad immunosuppression.
Conclusions:
- PML in natalizumab-treated patients is likely a mechanism-based adverse event.
- Further research is needed to elucidate the precise mechanism linking natalizumab to PML.
Related Concept Videos
01:23Immunological Memory
Immunological memory, a pivotal pillar of the adaptive immune system, is responsible for the body's ability to remember and respond more swiftly and effectively to previously encountered pathogens. This remarkable feature is what makes vaccines so effective in preventing diseases.
What is Immunological Memory?
Immunological memory is an integral function of the immune system that allows it to recognize and react more rapidly and effectively to pathogens previously encountered. This feature is...
What is Immunological Memory?
Immunological memory is an integral function of the immune system that allows it to recognize and react more rapidly and effectively to pathogens previously encountered. This feature is...
01:27Cryptococcal 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,...
01:19Multiple 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...
01:27Cytomegalovirus Disease
Cytomegalovirus (CMV) disease is caused by human cytomegalovirus, a double-stranded DNA virus of the Herpesviridae family. While primary CMV infection is often asymptomatic in immunocompetent individuals, the virus can cause severe disease in neonates and immunocompromised patients. CMV is the most common cause of congenital viral infection in the United States, and a major pathogen in solid organ and hematopoietic stem cell transplant recipients.CMV is transmitted via bodily fluids, sexual...
01:19Encephalitis 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...
01:26Encephalitis 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...