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Immune surveillance and response to JC virus infection and PML

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Abstract

The ubiquitous human polyomavirus JC virus (JCV) is the established etiological agent of the debilitating and often fatal demyelinating disease, progressive multifocal leukoencephalopathy (PML). Most healthy individuals have been infected with JCV and generate an immune response to the virus, yet remain persistently infected at subclinical levels. The onset of PML is rare in the general population, but has become an increasing concern in immunocompromised patients, where reactivation of JCV leads to uncontrolled replication in the CNS. Understanding viral persistence and the normal immune response to JCV provides insight into the circumstances which could lead to viral resurgence. Further, clues on the potential mechanisms of reactivation may be gleaned from the crosstalk among JCV and HIV-1, as well as the impact of monoclonal antibody therapies used for the treatment of autoimmune disorders, including multiple sclerosis, on the development of PML. In this review, we will discuss what is known about viral persistence and the immune response to JCV replication in immunocompromised individuals to elucidate the deficiencies in viral containment that permit viral reactivation and spread.

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Acknowledgments

This manuscript was sponsored in part by NIH grants awarded to JG and by a Ruth L. Kirchstein National Research Service Award (1T32MH079785) providing support to SB. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Conflict of interest

The authors SB and JG have declared that no competing interests exist and have no conflicts of interest to declare.

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Beltrami, S., Gordon, J. Immune surveillance and response to JC virus infection and PML. J. Neurovirol. 20, 137–149 (2014). https://doi.org/10.1007/s13365-013-0222-6

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