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Published on: July 13, 2019
New insights on human polyomavirus JC and pathogenesis of progressive multifocal leukoencephalopathy
Anna Bellizzi1, Elena Anzivino, Donatella Maria Rodio
1Department of Public Health and Infectious Diseases, Sapienza University of Rome, P.le Aldo Moro, 5-00185 Rome, Italy.
Abstract:
John Cunningham virus (JCV) is a member of the Polyomaviridae family. It was first isolated from the brain of a patient with Hodgkin disease in 1971, and since then the etiological agent of the progressive multifocal leukoencephalopathy (PML) was considered. Until the human immunodeficiency virus (HIV) pandemic, PML was rare: in fact HIV-induced immunodeficiency is the most common predisposing factor accounting for 85% of all instances of PML. This data led to intense research on JCV infection and resulted in better understanding of epidemiology and clinic-pathologic spectrum. Recently, cases of PML have been observed after the introduction of monoclonal antibodies, such as natalizumab, rituximab, efalizumab, and infliximab, in the treatment of autoimmune disease, underlining the important role of host immunity in PML pathogenesis. In this review current understanding of the JCV infection and the new findings relating to the pathogenesis of PML has been comprehensively revised, focusing our attention on the interaction between the cellular and viral molecular pathways implicated in the JCV infection and the modulating role of host immune surveillance in the viral reactivation from a latent state.
Insights
John Cunningham virus (JCV) causes progressive multifocal leukoencephalopathy (PML). Research now explores JCV infection, its link to immune status, and PML pathogenesis, especially with new therapies.
Area of Science:
- Virology
- Immunology
- Neurology
Background:
- John Cunningham virus (JCV), a polyomavirus, is the causative agent of progressive multifocal leukoencephalopathy (PML).
- PML was historically rare but became more prevalent with the human immunodeficiency virus (HIV) pandemic, with HIV-induced immunodeficiency being the primary risk factor.
- Recent observations link PML to treatments involving monoclonal antibodies for autoimmune diseases, highlighting the role of host immunity.
Purpose of the Study:
- To comprehensively review current understanding of JCV infection.
- To examine new findings on PML pathogenesis.
- To focus on molecular interactions in JCV infection and immune surveillance's role in viral reactivation.
Main Methods:
- Literature review of JCV infection and PML pathogenesis.
- Analysis of epidemiological and clinic-pathologic data.
- Focus on cellular and viral molecular pathways and host immune modulation.
Main Results:
- JCV is the etiological agent of PML.
- HIV-induced immunodeficiency is the most common predisposing factor for PML.
- Monoclonal antibody therapies for autoimmune diseases are associated with increased PML cases.
Conclusions:
- Host immunity plays a critical role in PML pathogenesis.
- Understanding the interplay between cellular pathways, viral factors, and immune surveillance is key to managing JCV infection and PML.
- Further research is needed to elucidate the mechanisms of viral reactivation and disease development.
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