Analysis of the Systemic and Intrathecal Humoral Immune Response in Progressive Multifocal Leukoencephalopathy

Progressive multifocal leukoencephalopathy (PML) is a subacute viral infection of oligodendrocytes by JC virus occurring almost exclusively in immunocompromised patients. By use of partially purified recombinant VP1 as antigen, the IgG response was analyzed by a quantitative ELISA of paired cerebros...

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Bibliographic Details
Published in:The Journal of infectious diseases 1997-07, Vol.176 (1), p.250-254
Main Authors: Weber, Thomas, Trebst, Corinna, Frye, Stephan, Cinque, Paola, Vago, Luca, Sindic, Christian J. M., Schulz-Schaeffer, Walter Joachim, Kretzschmar, Hans Arthur, Enzensberger, Wolfgang, Hunsmann, Gerhard, Lüke, Wolfgang
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Antibodies
Antibodies, Viral - biosynthesis
Biological and medical sciences
Capsid - immunology
Capsid Proteins
Central nervous system
Cerebrospinal fluid
Child
Child, Preschool
Concise Communications
Enzyme linked immunosorbent assay
Female
Human viral diseases
Humans
Immune response
Immunoglobulin G - biosynthesis
Infectious diseases
JC virus
JC Virus - immunology
Leukoencephalopathy, Progressive Multifocal - immunology
Male
Medical sciences
Middle Aged
Multiple sclerosis
Polymerase chain reaction
Progressive multifocal leukoencephalopathy
Spinal Cord - immunology
Viral diseases
Viral diseases of the nervous system
Viruses
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Summary:Progressive multifocal leukoencephalopathy (PML) is a subacute viral infection of oligodendrocytes by JC virus occurring almost exclusively in immunocompromised patients. By use of partially purified recombinant VP1 as antigen, the IgG response was analyzed by a quantitative ELISA of paired cerebrospinal fluid (CSF) and serum samples. An intrathecal immune response to VP1, defined as an antibody-specificity index of CSF to serum antibody titers ⩾1.5, was found in 76% of PML patients (47/62) but in only 3.2% of controls (5/155) (P < .001). Intra-blood-brain barrier synthesis of VP1-specific IgG antibodies is 76% sensitive and 96.8% specific for the diagnosis of PML. Furthermore, the excellent correlation (r =.985) between the plasma cell count in brain tissue and the humoral intrathecal immune response to VP1 in PML patients suggests a role for B cells in this disorder.
ISSN:0022-1899
1537-6613
DOI:10.1086/514032