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

doi:10.1016/j.jneuroim.2017.03.013

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

Istituto Superiore di Sanita'

Research output: Contribution to journal › Article › peer-review

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 language	English
Pages (from-to)	14-17
Number of pages	4
Journal	Journal of Neuroimmunology
Volume	307
DOIs	https://doi.org/10.1016/j.jneuroim.2017.03.013
Publication status	Published - 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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10.1016/j.jneuroim.2017.03.013

Cite this

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title = "Massive intracerebral Epstein-Barr virus reactivation in lethal multiple sclerosis relapse after natalizumab withdrawal",

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.",

keywords = "Cytotoxic T lymphocytes, Epstein-Barr virus, Histopathology, Multiple sclerosis, Natalizumab, Post-mortem",

author = "Barbara Serafini and Eleonora Scorsi and Barbara Rosicarelli and Val{\'e}rie Rigau and Eric Thouvenot and Francesca Aloisi",

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doi = "10.1016/j.jneuroim.2017.03.013",

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T1 - Massive intracerebral Epstein-Barr virus reactivation in lethal multiple sclerosis relapse after natalizumab withdrawal

AU - Serafini, Barbara

AU - Scorsi, Eleonora

AU - Rosicarelli, Barbara

AU - Rigau, Valérie

AU - Thouvenot, Eric

AU - Aloisi, Francesca

PY - 2017/6/15

Y1 - 2017/6/15

N2 - 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.

AB - 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.

KW - Cytotoxic T lymphocytes

KW - Epstein-Barr virus

KW - Histopathology

KW - Multiple sclerosis

KW - Natalizumab

KW - Post-mortem

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

Abstract

Keywords

ASJC Scopus subject areas

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