Possible JC Virus Vaccination Offers Important Implications for MS Treatment
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Two studies recently published in the journal Science Translational Medicine, revealed a possible new vaccine treatment for JC virus with important implications for multiple sclerosis (MS) treatment. The studies are entitled “JC polyomavirus mutants escape antibody-mediated neutralization” and “Broadly neutralizing human monoclonal JC polyomavirus VP1–specific antibodies as candidate therapeutics for progressive multifocal leukoencephalopathy.” The research was led by an international team of scientists at the National Cancer Institute in the United States, San Raffaele Scientific Institute in Italy, and University Hospital Zurich, University of Zurich, and Neurimmune Holding AG in Switzerland.
The JC virus is usually not harmful, unless the infected person has a weakened immune system, as is the case of MS patients under immunosuppressive medications. In these cases, the JC virus can opportunistically infect the brain and induce a rare, often fatal brain disease called progressive multifocal leukoencephalopathy (PML), which is characterized by inflammation and progressive damage of the white matter of the brain.
“In healthy people, the disease never breaks out as the immune system keeps it well under control. Once the immune system is compromised, however, such as in patients with tumors, leukemia, AIDS, autoimmune diseases and certain immunosuppressive treatments, the JC virus is able to alter its genetic information and infect the brain,” explained the co-author of both studies Dr. Roland Martin from the University of Zurich in a news release.
One well-known case is the use of the humanized monoclonal antibody Tysabri (natalizumab) as a therapy for MS, which has been associated with the development of PML. It is thought that while the antibody prevents immune cells from reaching the brain, it also blocks its immunosurveillance system. It is estimated that more than 560 MS patients in the world have developed PML, and of these, 20% died from the disease, as there is no treatment available for JC virus infection.
Now, researchers report that there is a possible vaccination approach to preventing PML, or, if a person’s brain is already infected, a treatment with virus-specific human antibodies.
In one of the studies, researchers found that antibodies in PML patients are often unable to recognize the JC virus strain that has infected the individual due to viral genetic mutations that make the virus “invisible” to the host’s immune system. In the second study, authors offer a solution, as they show that the use of broadly neutralizing antibodies obtained from a particular PML patient who recovered from the disease can be an effective therapeutic strategy for PML and JC virus infection.
The discovery of these specific antibodies allowed the development of a vaccine based on the coating protein of the JC virus. Using mouse models and 3 PML patients, researchers showed that vaccination triggers a very strong antibody immune response — a response so effective that patients were able to eliminate the JC virus from their brains.
“We made a major breakthrough,” Dr. Martin said. “We managed to isolate antibody-producing cells from a patient who survived PML and use them to produce neutralizing antibodies against the JC virus. These human antibodies have a major advantage: they recognize the most important mutants of the JC virus that can cause PML. They now make promising candidates for the development of a treatment for PML.”
Steven Izard
Yes, I tested positive for the JC Virus, and am currently taking infusions of Tysabri every 4 weeks. Last August would have been my one year for the drug, and I was wondering how much longer I could continue this medication without seriously jeopardizing my exposure to PML? I am going to see my Neurologist in January, and will discuss possibly going on Gylennia (Oral Drug), after Tysabri.
Denise Brown
I was taken off Tysabri three years ago because I tested positive for the JC virus. I was then referred to take Gilenya. I don't really feel that drug is working for me either. I can still walk but always tired a lot. I feel I was doing better one Tysabri. What do I do now? See doctor the end of the month.
Patricia Silva, PhD
Hello Steven and Denise, these are topics and options that vary from person-to-person, so only your doctor is eligible to discuss them with you and together decide on the best treatment option.
debbie
My mum was diagnosed in November 2015 with PML and there was no reason for her to get this virus. I am hoping someone can explain to me how you get this disease with no known cause. She was 66 and passed away December 22, 2015. She was relatively healthy up to this point
Sheila
Can I please ask you a question I just went to a new neurologist and he did blood work and it shows I have a 1.53 postive for. Bcc
The virus he didn't say anything I went on line to see test results found should I worry about it
Thank you
Debbie
I am hoping someone can explain to me how you get PML for no known reason. My mum was diagnosed November 2015 and passed away December 22 2015. Before this she was relatively healthy. Just trying to make sense of this horrible situation.
Jess C
I am 29 years old and live in Western Australia, I have been diagnosed with MS and have just received my 4th does of tysabri and just told that I am positive with the JCV with a count of 2.07 apparently I can stay on tysabri for a total time of 24 months but with then have to change medications now I have the fun of trying to find a medication to change to?
Emmie
Hi Jess, I am 29 also from Tasmania. I tested positive for JC but not sure at what count. I have had only one tysabri infusion, and that's the only treatment I've had. How are you going with it? I am in the same boat, I don't want tysabri to work for me when I can only stay on it for 24 months. I currently have no problems, I am scared of the rebound effect once I stop and having to start a new drug that may not be as effective and end up worse than when I began. Have you talked to your doctors about it any more?
R. croft
see your neuroligist from what i have read gilenya seems to be the drug often used. my son has been on this drug since being diagnosed 4 to five years ago. he has rrms and it seems to have been of benefit in slowing the progession.
Arden Heights
Was on copaxone for 3 years, then the neurologist switched me to gilenya. Just shy of a month in my girlfriend is talking to my mother about my erratic mood swings. I find this out and immediately stop the drug and go to the doc. I tell them what's going on; The doc and the nurse both look at each other and nod then they tell me the first sign of pml is drastic changes in behaviour. So they put me back on the copaxone; my mother and girlfriend said how nice it was to have me back about a week later. So whether or not you like what you hear, listen and heed any outside perspectives about yourself or your demeanor when it comes to changing MS medications.
Roxanne
I was diagnosed with ms 12years ago and just recently was told that I have the JCV. I have had about 101 infusions of tysabri and have been doing wonderful with no problems and now I don't know what is going to change with my treatment if anything. I still need to get my MRI and blood work done again to show me were my markers are at.
Donna
How close is the medical community on the development of the vaccine for JCV? Will it be coming out in 2016? My son just started talking tysabri with the hopes of getting the vaccine before he had a chance to develop JCV. Do you have a timeline when this will happen?
TANYA HAGLER
My husband and I are really "lucky." He has Wegeners and I have MS. He takes rituxumab and I have taken tysabri. I tried tecfidera after tysabri. I was on it for about a year. It did not work well for me. Am looking at Lemtrada and Zinbryta. So far we are both JC neg, but who knows when it might change. I saw where PML is indicated with techfidera. How is that possible? Could it be that the patient (s) were previously on a mab and the PML just wasn't seen until after the techfidera started? Looking forward to a JC vaccine!!
Cas
I have been on Gilenya for about 4 years. I just tested positive for the JVC virus. I had the symtoms of the virus. Cant take
Shots so not sure what
I will do. Im not incline to take anything that could lead me to get PML
Mary Ritcherson
My Identical twin sister has had MS for over 20yrs. She is JVC+. She is on Gilenia for 7 yrs now. She just got her new test results which showed and increase 1.99 to 2.something. Also my 23 yo daughter was recently diagnosed with MS Nov. 2, 2017. She is negative for the virus and has had 2 infusions on Tysabri to date. Is there a vaccine on the horizon for the JVC virus????? I pray there is. PML is so scary and I know my sister is now more worried then ever. Has anyone heard of Kawalawala??? A client of mine has MS and takes it. I dont know anything about it, but curious.
Matt
New medicine in trial MD1003,, JC virus. Not sure where it's at.
Albert Whitehead
I have been searching for an answer to my sister's "Delirium -like"/severe alter mental state episodes which started after prescribed Tecfidora. She was on the med for approximately 6 months and taken off the med when lab work result demonstrated positive for the JC Virus. Since then she suffers from these episodes if not on a daily low dose of Bactrim. She had a battery of lab tests, even was tested for early dementia and Alzheimer disease, all negative. No physician can diagnosis the underlying cause of infection or why she has these episodes. These episodes are Since 2016, she has had 2 episodes, both when she has not taken Bactrim for 6-10If she isn't on a low dose of Bactrim taken every day, it takes 8-10 weeks. The episodes start with short-term memory loss and gradually evolves to severe agitation, and Delirium-like behavior even to the point of breaking hospital bed restraints and running through the halls. By that time, a CT scan shows encephalitis. Administration of IV antibiotics battles the infection, and in 2-3 days she is at her normal behavioral baseline - she struggles with short-term memory loss at times. Has anyone heard of someone with similar episodes? Could her episodes have something to do with the JC virus?
Maria Alfano
I started taking Tecfidera in 2016. Just last month I was diagnosed with the JC virus and my neurologist changed my medication to Abugiano and I am so nauseous on it and I had to stop taking it. What's next on the menu for the next medication. So disgusted.
Sheila Williams
I am on Abugiao now because of tecif jcv postive I was told by my Dr it would be infusion drug good luck God bless
Sonja McBride
I have had MS for 30years and was on Tysabry for 10 yrs and felt my best while on it. Unfortunately, I have the JC virus and my last no. was extremely high, 3.36. I have not been on any meds for almost a year because I have other health problems that prevent me from taking things like Lemtrada or Gilenya. I read they are coming out with a REAL new treatment for JCV.
Sheila Williams
This is Sheila can you tell me what are the signs of pml. And what number in blood work should I look for please help
God bless everyone that has to go thru MS
KISHA RIGNEY
I have been on Tysubri for 135 treatments. I tested positive in December for JCV, and my neurologist tried to convince me to switch DMT then, I am not very willing to consider this. This month however I got my JCV results, and I tested NEGATIVE. How is this possible? At what titre level of positive should I become concerned?