Massive intracerebral Epstein-Barr virus reactivation in lethal multiple sclerosis relapse after natalizumab withdrawal

Journal of Neuroimmunology
Barbara SerafiniFrancesca Aloisi

Abstract

Rebound of disease activity in multiple sclerosis patients after natalizumab withdrawal is a potentially life-threatening event. To verify whether highly destructive inflammation after natalizumab withdrawal is associated with Epstein-Barr virus (EBV) reactivation in central nervous system infiltrating B-lineage cells and cytotoxic immunity, we analyzed post-mortem brain tissue from a patient who died during a fulminating MS relapse following natalizumab withdrawal. Numerous EBV infected B cells/plasma cells and CD8+ T cells infiltrated all white matter lesions; the highest frequency of EBV lytically infected cells and granzyme B+ CD8+ T cells was observed in actively demyelinating lesions. These results may encourage switching to B-cell depleting therapy after natalizumab discontinuation.

Citations

Aug 31, 2018·Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova·O V BoykoA N Boyko
Sep 14, 2018·Brain : a Journal of Neurology·David BakerKlaus Schmierer
May 29, 2019·Annals of Neurology·Jamie van LangelaarMarvin M van Luijn
May 28, 2020·Frontiers in Immunology·Jamie van LangelaarMarvin M van Luijn
Nov 6, 2020·Expert Review of Clinical Immunology·Klemens Ruprecht
Dec 6, 2019·Journal of Neuroimmunology·Samuel B Marcucci, Ahmed Z Obeidat
May 4, 2021·Journal of Neuroimmunology·Kancha NareshRohit Ninan Benjamin
Dec 19, 2018·Molecular Immunology·Elie DeebaChristina Christodoulou
May 25, 2021·Multiple Sclerosis and Related Disorders·Vinícius O BoldriniAlessandro S Farias
Jul 27, 2021·Frontiers in Immunology·Caterina Veroni, Francesca Aloisi
Jan 28, 2020·Journal of Neuroimmunology·Vinícius O BoldriniAlessandro S Farias

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