Progressive multifocal leukoencephalopathy: a review of the pathology and pathogenesis

AJ Aksamit Jr - Microscopy research and technique, 1995 - Wiley Online Library
AJ Aksamit Jr
Microscopy research and technique, 1995Wiley Online Library
Progressive multifocal leukoencephalopathy is an important viral opportunistic infection of
oligodendrocytes leading to direct demyelination. Virus is likely disseminated to the brain via
the blood. However, the timing of that dissemination with relationship to clinical disease is
unknown. Important clues about viral pathogenesis have been learned by applying
molecular in situ techniques to diseased brain. The oligodendrocyte is the primary target for
JC virus infection, and its death is the primary reason for demyelination. Bizarre astrocytes …
Abstract
Progressive multifocal leukoencephalopathy is an important viral opportunistic infection of oligodendrocytes leading to direct demyelination. Virus is likely disseminated to the brain via the blood. However, the timing of that dissemination with relationship to clinical disease is unknown. Important clues about viral pathogenesis have been learned by applying molecular in situ techniques to diseased brain. The oligodendrocyte is the primary target for JC virus infection, and its death is the primary reason for demyelination. Bizarre astrocytes show limited viral DNA replication but are abortively infected. Although lymphoid organs can be infected by JC virus, there is no definitive evidence that lymphoid cells carry virus into the brain at the time of immunosuppression. JC virus may be reactivated from a latent state in both the brain and in non‐central nervous system (CNS) organs at the time of immunosuppression, leading to clinical disease. Future sensitive in situ studies will likely resolve controversies about pathogenesis. © 1995 Wiley‐Liss, Inc.
Wiley Online Library