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Erschienen in: DGNeurologie 2/2022

03.11.2021 | Arzneimitteltherapie

Allogene virusspezifische T‑Zellen als innovative Therapieoption

Behandlung der progressiven multifokalen Leukenzephalopathie mit allogenen virusspezifischen T‑Zellen

verfasst von: N. Möhn, L. Grote-Levi, F. Hopfner, B. Eiz-Vesper, B. Maecker-Kolhoff, C. Warnke, M. P. Wattjes, G. U. Höglinger, Prof. Dr. med. T. Skripuletz

Erschienen in: DGNeurologie | Ausgabe 2/2022

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Die progressive multifokale Leukenzephalopathie (PML) ist eine seltene opportunistische Infektion des Gehirns, die durch das humane Polyomavirus 2 (HPyV‑2, früher: JC-Polyomavirus) verursacht wird. Sie geht mit Behinderung einher und verläuft oftmals tödlich. Die Infektion mit HPyV‑2 erfolgt meist während der Kindheit, wobei der Anteil seropositiver Personen in der Bevölkerung mit dem Alter zunimmt und bei 70-Jährigen bei etwa 60–80 % liegt [1, 2]. Das humane Polyomavirus 2 erzeugt in der allgemeinen Bevölkerung üblicherweise asymptomatische, lebenslang persistierende oder latente Infektionen. Bei Patienten mit lang anhaltender und tiefgreifender Beeinträchtigung v. a. der zellulären Immunität kann HPyV‑2 reaktivieren und sequenzielle genomische Veränderungen durchlaufen. Diese virale Evolution innerhalb des Wirts ermöglicht es diesem ansonsten beim immunkompetenten Träger nicht krankheitsverursachenden Virus eine lytische Infektion von Oligodendrozyten und zu einem geringeren Anteil auch neuronalen Zellen mit daraus resultierender irreversibler Demyelinisierung und neuronaler Schädigung zu verursachen [3]. Die Diagnosestellung der PML beruht auf den 3 Säulen: typische klinische Präsentation, Nachweis demyelinisierender Veränderungen in der Bildgebung mittels Magnetresonanztomographie (MRT) und Virusnachweis im Liquor oder der Hirnbiopsie, wobei Letzterer für die Diagnose einer gesicherten PML unbedingt notwendig ist. …
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Metadaten
Titel
Allogene virusspezifische T‑Zellen als innovative Therapieoption
Behandlung der progressiven multifokalen Leukenzephalopathie mit allogenen virusspezifischen T‑Zellen
verfasst von
N. Möhn
L. Grote-Levi
F. Hopfner
B. Eiz-Vesper
B. Maecker-Kolhoff
C. Warnke
M. P. Wattjes
G. U. Höglinger
Prof. Dr. med. T. Skripuletz
Publikationsdatum
03.11.2021
Verlag
Springer Medizin
Erschienen in
DGNeurologie / Ausgabe 2/2022
Print ISSN: 2524-3446
Elektronische ISSN: 2524-3454
DOI
https://doi.org/10.1007/s42451-021-00392-w

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