Early years of biological agents therapy in Crohn's disease and risk of the human polyomavirus JC reactivation

Anna Bellizzi, Valentina Barucca, Daniela Fioriti, Maria T. Colosimo, Monica Mischitelli, Elena Anzivino, Fernanda Chiarini, Valeria Pietropaolo

Research output: Contribution to journalArticlepeer-review


Although the remarkable efficacy of biological therapy has resulted in significant success in inflammatory bowel disease (IBD) management, susceptibility to infections remains a concern. The biological agents include the tumor necrosis factor-α (TNF-α) inhibitors, for instance infliximab, and other immunomodulating agents, such as natalizumab. Progressive multifocal leukoencephalopathy (PML), a rare butmostly fatal opportunistic brain infection caused by reactivation of the human polyomavirus JC virus (JCV), has been found in two patients with multiple sclerosis and one patient with Crohn's disease (CD), linked to treatment with natalizumab. After these cases of PML, the commercial and investigational use of natalizumab was suspended in February 2005 but was subsequently resumed for multiple sclerosis and for CD, only through a special restricted distribution program. This review, starting from an extensive literature search by the PubMed database, resumes the clinical aspects and pathophysiology of CD and focuses on the biologics in current use in CD (infliximab, adalimumab, and natalizumab), in order to provide a reference and gateway to prevention, recognition, and management of JCV, in the early years of biological agents therapy. It also proposed to provide an overview on the hypothetical mechanism of reactivation of JC virus related to the use of these drugs.

Original languageEnglish
Pages (from-to)316-326
Number of pages11
JournalJournal of Cellular Physiology
Issue number2
Publication statusPublished - Aug 2010

ASJC Scopus subject areas

  • Clinical Biochemistry
  • Cell Biology
  • Physiology


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