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Departments of Neurology, Memorial Hospital and Cornell University Medical College, and Clinical Immunology Laboratory, Sloan-Kettering Institute, New York. NY (Drs. Willoughby. Price, and Dupont), and the Department of Medical Microbiology. University of Wisconsin Medical College. Madison (Drs. Padgett and Walker).
cell-mediated immunity was studied by in vitro tests in seven patients with progressive multifocal leukoencephalopathy (PML). Lymphocyte proliferation in response to mitogenic stimulation was reduced to a variable degree in all patients, indicating a general impairment of cell-mediated immune responsiveness, although mitogen-induced production of the lymphokine leukocyte migration inhibitory factor (LIF) was normal in most cases. Cell-mediated immunity to JC virus (JCV) was assessed by LIF production in response to JCV antigen. In the six PML patients tested, LIF production with JCV antigen was absent despite the presence of antibody to JCV in serum. This contrasted with positive LIF production in seropositive normal individuals and patients with other diseases. These results provide the first in vitro evidence of a depressed cell-mediated immune response to JCV in patients with PML, and support the hypothesis that PML is accompanied by a selective marked deficiency in cellular response to this virus in association with a general depression of cell-mediated immunity of variable severity.
Address correspondence and reprint requests to Dr. Price, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10021.
Accepted for publication August 13, 1979.
This study was supported by U. S. Public Health Service grants Nos. CA-22507, CA-08748, and AI-11217. Dr. Willoughby was the recipient of an Overseas Research Fellowship from the Medical Research Council of New Zealand.
Presented at the thirty-first annual meeting of the American Academy of Neurology, Chicago, April 1979.
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