A more accurate risk biomarkers recognition for Progressive Multifocal Leukoencephalopathy (PML) caused by JC virus in patients with multiple sclerosis during treatment with disease-modifying therapies (DMTs): an ongoing clinical challenge.
JC virus (JCV) is the aetiological agent of a fatal demyelinating disease known as Progressive Multifocal Leukoencephalopathy (PML). The increased use of disease-modifying therapies (DMTs) for treatments of Multiple Sclerosis (MS), has expanded the patients at risk for developing PML. The metrics used to predict risk of PML could be implemented if, viral localization, viral genetic strain and host systemic immunity, were taken into account. In this regard it will be proposed to: evaluate JC viral load variations during DMTs; detect viral variants and specific genotypes circulating within the study cohorts; find out the effect of the treatments on the concentration of the circulating cytokines/chemokines and explore their role in establishing a balance between subpopulations of T helper cells. Improved approaches to PML risk stratification, are needed to guide treatment choices, surveillance of patients with MS and optimization of healthcare resources.