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01-03-2015 | Correspondence

High CCR5 expression in natalizumab-associated progressive multifocal leukoencephalopathy immune reconstitution inflammatory syndrome supports treatment with the CCR5 inhibitor maraviroc

Authors: Lidia Stork, Wolfgang Brück, Amit Bar-Or, Imke Metz

Published in: Acta Neuropathologica | Issue 3/2015

Excerpt

Natalizumab (ntz) treatment for multiple sclerosis (MS) is in rare cases complicated by development of progressive multifocal leukoencephalopathy (PML), an opportunistic viral brain infection. Withdrawal of natalizumab leads to an overwhelming inflammatory reaction targeting the virus. However, this immune reconstitution inflammatory syndrome (IRIS) can itself contribute to clinical deterioration and even death. A recent report has suggested that the CCR5 inhibitor maraviroc is beneficial in treating ntz-associated PML IRIS [1]. CCR5 is expressed predominantly on T cells and macrophages and less on B lineage cells. It is involved in immune cell chemotaxis and CCR5+ cells are found in varying numbers in inflammatory CNS lesions [4]. …

Giacomini PS, Rozenberg A, Metz I, Araujo D, Arbour N, Bar-Or A; Maraviroc in Multiple Sclerosis-Associated PML–IRIS (MIMSAPI) Group (2014) Maraviroc and JC virus-associated immune reconstitution inflammatory syndrome. N Engl J Med 370:486–488. doi:10.1056/NEJMc1304828 CrossRef

Martin-Blondel G, Cuzin L, Delobel P, Cuvinciuc V, Dumas H, Alvarez M, Massip P, Marchou B (2009) Is maraviroc beneficial in paradoxical progressive multifocal leukoencephalopathy-immune reconstitution inflammatory syndrome management? AIDS 23:2545–2546. doi:10.1097/QAD.0b013e32833365f4 CrossRefPubMed

Metz I, Radue EW, Oterino A, Kümpfel T, Wiendl H, Schippling S, Kuhle J, Sahraian MA, Gray F, Jakl V, Häusler D, Brück W (2012) Pathology of immune reconstitution inflammatory syndrome in multiple sclerosis with natalizumab-associated progressive multifocal leukoencephalopathy. Acta Neuropathol 123:235–245. doi:10.1007/s00401-011-0900-5 CrossRefPubMedCentralPubMed

Trebst C, Staugaitis SM, Tucky B, Wei T, Suzuki K, Aldape KD, Pardo CA, Troncoso J, Lassmann H, Ransohoff RM (2003) Chemokine receptors on infiltrating leucocytes in inflammatory pathologies of the central nervous system (CNS). Neuropathol Appl Neurobiol 29:584–595CrossRefPubMed

Title: High CCR5 expression in natalizumab-associated progressive multifocal leukoencephalopathy immune reconstitution inflammatory syndrome supports treatment with the CCR5 inhibitor maraviroc
Authors: Lidia Stork
Wolfgang Brück
Amit Bar-Or
Imke Metz
Publication date: 01-03-2015
Publisher: Springer Berlin Heidelberg
Published in: Acta Neuropathologica / Issue 3/2015
Print ISSN: 0001-6322
Electronic ISSN: 1432-0533
DOI: https://doi.org/10.1007/s00401-015-1391-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

High CCR5 expression in natalizumab-associated progressive multifocal leukoencephalopathy immune reconstitution inflammatory syndrome supports treatment with the CCR5 inhibitor maraviroc

Excerpt

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Excerpt

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