title: Pathogenesis of progressive multifocal leukoencephalopathy--revisited.
abstract: Progressive multifocal leukoencephalopathy (PML) is a demyelinating disease of the central nervous system that is rare even though the proven etiological agent of PML, the polyomavirus JC (JC virus), is ubiquitous within the human population. The common feature of PML cases appears to be underlying immunosuppression, and PML has gained clinical visibility because of its association with human immunodeficiency virus and AIDS and its occurrence as a side effect of certain immunomodulatory drugs. A hypothesis has gained general acceptance that JC virus causes a primary infection in childhood and enters a latent state, after which immunosuppression allows viral reactivation leading to PML. Nonetheless, many important aspects of PML pathogenesis remain unclear, including the molecular bases of latency and reactivation, the site(s) of latency, the relationship of archetype and prototype virus and the mode of virus transmission within the body and between individuals. In this review, we will revisit these areas and examine what the available evidence suggests.
authors.affiliation: Department of Neuroscience, Center for Neurovirology, Temple University School of Medicine, Philadelphia, Pennsylvania 19140, USA.
authors.forename: Martyn K
authors.initials: MK
authors.lastname: White
authors.forename: Kamel
authors.initials: K
authors.lastname: Khalili
mesh_terms: D000914:Antibodies, Viral / Q000097:blood; D006801:Humans; D007108:Immune Tolerance; D007577:JC Virus / Q000235:genetics / Q000276:immunology / Q000502:physiology*; D007968:Leukoencephalopathy, Progressive Multifocal / Q000453:epidemiology / Q000276:immunology / Q000635:transmission / Q000821:virology*; D014066:Palatine Tonsil / Q000821:virology; D014775:Virus Activation / Q000276:immunology; D017735:Virus Latency
chemical_list: D000914:Antibodies, Viral