Analysis of the systemic and intrathecal humoral immune response in progressive multifocal leukoencephalopathy

J Infect Dis. 1997 Jul;176(1):250-4. doi: 10.1086/514032.


Progressive multifocal leukoencephalopathy (PML) is a subacute viral infection of oligodendrocytes by JC virus occurring almost exclusively in immunocompromised patients. By use of partially purified recombinant VP1 as antigen, the IgG response was analyzed by a quantitative ELISA of paired cerebrospinal fluid (CSF) and serum samples. An intrathecal immune response to VP1, defined as an antibody-specificity index of CSF to serum antibody titers > or =1.5, was found in 76% of PML patients (47/62) but in only 3.2% of controls (5/155) (P < .001). Intra-blood-brain barrier synthesis of VP1-specific IgG antibodies is 76% sensitive and 96.8% specific for the diagnosis of PML. Furthermore, the excellent correlation (r = .985) between the plasma cell count in brain tissue and the humoral intrathecal immune response to VP1 in PML patients suggests a role for B cells in this disorder.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Antibodies, Viral / biosynthesis*
  • Capsid / immunology*
  • Capsid Proteins*
  • Child
  • Child, Preschool
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Humans
  • Immunoglobulin G / biosynthesis
  • JC Virus / immunology*
  • Leukoencephalopathy, Progressive Multifocal / immunology*
  • Male
  • Middle Aged
  • Spinal Cord / immunology*


  • Antibodies, Viral
  • Capsid Proteins
  • Immunoglobulin G
  • VP1 protein, polyomavirus