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

Barbara Serafini, Eleonora Scorsi, Barbara Rosicarelli, Valérie Rigau, Eric Thouvenot, Francesca Aloisi

Research output: Contribution to journalArticle

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.

Original languageEnglish
Pages (from-to)14-17
Number of pages4
JournalJournal of Neuroimmunology
Volume307
DOIs
Publication statusPublished - Jun 15 2017

Keywords

  • Cytotoxic T lymphocytes
  • Epstein-Barr virus
  • Histopathology
  • Multiple sclerosis
  • Natalizumab
  • Post-mortem

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Neurology
  • Clinical Neurology

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