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Open Access 01-12-2013 | Research

Human Polyomavirus JC monitoring and noncoding control region analysis in dynamic cohorts of individuals affected by immune-mediated diseases under treatment with biologics: an observational study

Authors: Anna Bellizzi, Elena Anzivino, Donatella Maria Rodio, Sara Cioccolo, Rossana Scrivo, Manuela Morreale, Simona Pontecorvo, Federica Ferrari, Giovanni Di Nardo, Lucia Nencioni, Silvia Carluccio, Guido Valesini, Ada Francia, Salvatore Cucchiara, Anna Teresa Palamara, Valeria Pietropaolo

Published in: Virology Journal | Issue 1/2013

Abstract

Background

Progressive multifocal leukoencephalopathy (PML) onset, caused by Polyomavirus JC (JCPyV) in patients affected by immune-mediated diseases during biological treatment, raised concerns about the safety profile of these agents. Therefore, the aims of this study were the JCPyV reactivation monitoring and the noncoding control region (NCCR) and viral protein 1 (VP1) analysis in patients affected by different immune-mediated diseases and treated with biologics.

Methods

We performed JCPyV-specific quantitative PCR of biological samples collected at moment of recruitment (t0) and every 4 months (t1, t2, t3, t4). Subsequently, rearrangements’ analysis of NCCR and VP1 was carried out. Data were analyzed using χ² test.

Results

Results showed that at t0 patients with chronic inflammatory rheumatic diseases presented a JCPyV load in the urine significantly higher (p≤0.05) than in patients with multiple sclerosis (MS) and Crohn’s disease (CD). It can also be observed a significant association between JC viruria and JCPyV antibodies after 1 year of natalizumab (p=0.04) in MS patients. Finally, NCCR analysis showed the presence of an archetype-like sequence in all urine samples, whereas a rearranged NCCR Type IR was found in colon-rectal biopsies collected from 2 CD patients after 16 months of infliximab. Furthermore, sequences isolated from peripheral blood mononuclear cells (PBMCs) of 2 MS patients with JCPyV antibody at t0 and t3, showed a NCCR Type IIR with a duplication of a 98 bp unit and a 66 bp insert, resulting in a boxB deletion and 37 T to G transversion into the Spi-B binding site. In all patients, a prevalence of genotypes 1A and 1B, the predominant JCPyV genotypes in Europe, was observed.

Conclusions

It has been important to understand whether the specific inflammatory scenario in different immune-mediated diseases could affect JCPyV reactivation from latency, in particular from kidneys. Moreover, for a more accurate PML risk stratification, testing JC viruria seems to be useful to identify patients who harbor JCPyV but with an undetectable JCPyV-specific humoral immune response. In these patients, it may also be important to study the JCPyV NCCR rearrangement: in particular, Spi-B expression in PBMCs could play a crucial role in JCPyV replication and NCCR rearrangement.

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ClustalW2 - multiple sequence alignment http://www.ebi.ac.uk/Tools/msa/clustalw2/

Title: Human Polyomavirus JC monitoring and noncoding control region analysis in dynamic cohorts of individuals affected by immune-mediated diseases under treatment with biologics: an observational study
Authors: Anna Bellizzi
Elena Anzivino
Donatella Maria Rodio
Sara Cioccolo
Rossana Scrivo
Manuela Morreale
Simona Pontecorvo
Federica Ferrari
Giovanni Di Nardo
Lucia Nencioni
Silvia Carluccio
Guido Valesini
Ada Francia
Salvatore Cucchiara
Anna Teresa Palamara
Valeria Pietropaolo
Publication date: 01-12-2013
Publisher: BioMed Central
Published in: Virology Journal / Issue 1/2013
Electronic ISSN: 1743-422X
DOI: https://doi.org/10.1186/1743-422X-10-298

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