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Related Experiment Video

Updated: Sep 16, 2025

Induction of Paralysis and Visual System Injury in Mice by T Cells Specific for Neuromyelitis Optica Autoantigen Aquaporin-4

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Natalizumab-associated progressive multifocal leukoencephalopathy.

Trevor Glenn¹, Joseph R Berger², Caleb R S McEntire¹

¹Department of Neurology, Mass General Brigham, Boston, MA, United States.

Frontiers in Neurology

|July 7, 2025

Summary

This summary is machine-generated.

Progressive multifocal leukoencephalopathy (PML) is a brain disease caused by JC virus (JCV) in immunocompromised individuals. A JCV antibody index helps manage PML risk in patients treated with natalizumab.

Keywords:

JC virus demyelimating diseases natalizumab progressive multifocal leukoencephalopathy relapsing remitting multiple sclerosis

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Published on: May 11, 2022

Area of Science:

Neuroimmunology
Infectious Diseases
Neurology

Background:

Progressive multifocal leukoencephalopathy (PML) is a rare, fatal demyelinating disease of the central nervous system.
PML is caused by the JC virus (JCV) and typically occurs in patients with compromised cell-mediated immunity.
The incidence of PML increased with the use of natalizumab, a monoclonal antibody for multiple sclerosis and Crohn's disease.

Purpose of the Study:

To review risk stratification, diagnosis, and treatment of PML in patients receiving natalizumab.
To discuss the role of the JCV antibody index in managing PML risk.
To provide an overview of PML in the context of natalizumab therapy.

Main Methods:

Review of existing literature on PML, JCV, and natalizumab.
Analysis of risk factors and mitigation strategies for PML development.
Discussion of diagnostic approaches and treatment options for PML.

Main Results:

The JCV antibody index is a key tool for stratifying PML risk in natalizumab-treated patients.
Risk levels are categorized based on the JCV antibody index: negative (<0.4), low (0.4-0.9), medium (0.9-1.5), and high (>1.5).
Understanding risk factors and implementing mitigation strategies are crucial for managing PML.

Conclusions:

Effective risk stratification using the JCV antibody index is essential for PML prevention in natalizumab users.
Early diagnosis and appropriate management are critical for improving outcomes in PML patients.
Continued research and vigilance are necessary to combat PML in immunosuppressed populations.