Refractory T-Cell Anergy and Rapidly Fatal Progressive Multifocal Leukoencephalopathy After Prolonged CTLA4 Therapy.

Autor:	Dekeyser M; Institut National de la Santé et de la Recherche Médicale (INSERM) U1184, Immunology of Viral Infection and Auto-immune Diseases, Normal and Pathological T Memory, Faculté de Médecine Paris-Sud, le Kremlin-Bicêtre.; Institut Francilien de Techerche en Néphrologie et Transplantation, Department of Nephrology and Transplantation, Hôpitaux Universitaires Paris-Sud, France; and., de Goër de Herve MG; Institut National de la Santé et de la Recherche Médicale (INSERM) U1184, Immunology of Viral Infection and Auto-immune Diseases, Normal and Pathological T Memory, Faculté de Médecine Paris-Sud, le Kremlin-Bicêtre., Hendel-Chavez H; Institut National de la Santé et de la Recherche Médicale (INSERM) U1184, Immunology of Viral Infection and Auto-immune Diseases, Normal and Pathological T Memory, Faculté de Médecine Paris-Sud, le Kremlin-Bicêtre., Labeyrie C; Department of Neurology., Adams D; Department of Neurology., Nasser GA; Department of Radiology, and., Gasnault J; Institut National de la Santé et de la Recherche Médicale (INSERM) U1184, Immunology of Viral Infection and Auto-immune Diseases, Normal and Pathological T Memory, Faculté de Médecine Paris-Sud, le Kremlin-Bicêtre.; Department of Internal Medicine, Unit of Neuro-Virological Diseases., Durrbach A; Institut Francilien de Techerche en Néphrologie et Transplantation, Department of Nephrology and Transplantation, Hôpitaux Universitaires Paris-Sud, France; and.; INSERM UMR 1197, Interactions between stem cells and their niches in physiology, tumors and tissue repair - Stem cells, Transplantation, Immunoregulation, Hôpitaux Universitaires Paris-Sud, Villejuif, France., Taoufik Y; Institut National de la Santé et de la Recherche Médicale (INSERM) U1184, Immunology of Viral Infection and Auto-immune Diseases, Normal and Pathological T Memory, Faculté de Médecine Paris-Sud, le Kremlin-Bicêtre.
Jazyk:	angličtina
Zdroj:	Open forum infectious diseases [Open Forum Infect Dis] 2017 May 16; Vol. 4 (2), pp. ofx100. Date of Electronic Publication: 2017 May 16 (Print Publication: 2017).
DOI:	10.1093/ofid/ofx100
Abstrakt:	Progressive multifocal leukoencephalopathy (PML) is a deadly demyelinating disease due to central nervous system replication of the human polyomavirus JC virus (JCV) in immunosuppressed patients. The only effective therapeutic approach is to restore anti-JCV T-cell responses. In this study, we describe a case of rapidly fatal PML with JCV T-cell anergy in a renal transplant patient treated with CTLA4-Ig (belatacept, a CD28-B7 costimulation blocker and T-cell anergy inducer). T-cell anergy could not be reversed despite several therapeutic approaches. Progressive multifocal leukoencephalopathy secondary to biotherapy-induced T-cell anergy may thus represent a subset of PML with major resistance to anti-JCV immune recovery.
Databáze:	MEDLINE
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