Immunological and clinical consequences of Tysabri

A board to discuss the newly-released drug Tysabri, (formerly known as Antegren) as a treatment for Multiple Sclerosis
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MSUK
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Immunological and clinical consequences of Tysabri

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Immunological and clinical consequences of treating a patient with natalizumab

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Abstract

Background: Long-term therapy with natalizumab increases the risk of progressive multifocal leukoencephalopathy (PML).

Objectives: We present a patient study through therapy, the diagnosis of PML (after 29 infusions), plasma exchange (PE) and development of immune reconstitution inflammatory syndrome (IRIS).... Read More - http://www.msrc.co.uk/index.cfm/fuseact ... ageid/1768
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NHE
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Re: Immunological and clinical consequences of Tysabri

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Additional info from the abstract...
With no clinical, routine laboratory or cerebrospinal fluid (CSF) changes, MRI 2 months after PE demonstrated progressive lesion development. Brain histopathology confirmed the presence of infiltrates indicative of IRIS without clinical signs, immunologically accompanied by CCR7/CCR5 recovery of peripheral monocytes.

Conclusion: Natalizumab-associated immunological changes accompanying PML were reversible after PE; IRIS can occur very late, remain asymptomatic and be elusive to CSF analysis.
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