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Disease-modifying drugs for multiple sclerosis and JC virus expression.
Craig S Miller1, Sidney A Houff, Jason Hopper
1College of Dentistry, University of Kentucky, Lexington, KY 40536-0284, USA.
Journal of Neurovirology
|May 16, 2012
Summary
This study investigated if multiple sclerosis (MS) disease-modifying drugs (DMDs) affect John Cunningham virus (JCV) prevalence. Results show DMDs, including interferon-β, do not alter JCV levels in blood or urine.
Area of Science:
- Neuroimmunology
- Virology
- Pharmacology
Background:
- Progressive multifocal leukoencephalopathy (PML) is a rare, serious risk associated with natalizumab in multiple sclerosis (MS).
- Concerns arose regarding potential interactions between natalizumab and interferon β1a, leading to recommendations against their combined use.
- Type I interferons possess antiviral properties, prompting investigation into their role concerning John Cunningham virus (JCV).
Purpose of the Study:
- To test the hypothesis that MS disease-modifying drugs (DMDs) alter the prevalence and viral load of JCV.
- To evaluate the qualitative and quantitative effects of DMDs on JCV DNA in peripheral blood mononuclear cells (PBMCs) and urine of MS patients.
Main Methods:
- A cross-sectional study of 239 MS patients and a longitudinal study of 37 newly diagnosed, treatment-naïve MS patients were conducted.
- Real-time quantitative polymerase chain reaction (PCR) was used to detect and quantify JCV DNA in PBMCs and urine specimens.
- Specimens were collected at a single time point for the cross-sectional study and at diagnosis and 6 months post-treatment for the longitudinal study.
Main Results:
- JCV DNA was detected in PBMCs of only 2 patients (0.07%) but was commonly found in urine (46.8%).
- No significant effect of glatiramer acetate or interferon-β therapies on JCV prevalence or viral copy numbers in blood or urine was observed.
- Limited data on other therapies precluded definitive conclusions, but platform DMDs showed no obvious effect on JCV prevalence.
Conclusions:
- Current disease-modifying drugs for MS, including interferon-β therapies, do not appear to qualitatively or quantitatively affect JCV prevalence or viral load in PBMCs or urine.
- The study suggests that the risk of PML associated with MS treatments may not be directly linked to altered JCV replication or shedding influenced by these common DMDs.
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