WordNet

a harmful or corrupting agency; "bigotry is a virus that must not be allowed to spread"; "the virus of jealousy is latent in everyone"
(virology) ultramicroscopic infectious agent that replicates itself only within cells of living hosts; many are pathogenic; a piece of nucleic acid (DNA or RNA) wrapped in a thin coat of protein
a software program capable of reproducing itself and usually capable of causing great harm to files or other programs on the same computer; "a true virus cannot spread to another computer without human assistance" (同)computer virus
the 10th letter of the Roman alphabet (同)j

PrepTutorEJDIC

ビールス,ろ過性病原体
(連続するものの)10番目,第10番のもの

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2013/05/04 13:35:10」(JST)

wiki en

The JC virus or John Cunningham virus (JCV) is a type of human polyomavirus (formerly known as papovavirus) and is genetically similar to BK virus and SV40. It was discovered in 1971 and named using the two initials of a patient with progressive multifocal leukoencephalopathy (PML).^[1] The virus causes PML and other diseases only in cases of immunodeficiency, as in AIDS or during treatment with drugs intended to induce a state of immunosuppression (e.g., organ transplant patients).

Epidemiology

The virus is very common in the general population, infecting 70 to 90 percent of humans; most people acquire JCV in childhood or adolescence.^[2]^[3]^[4] It is found in high concentrations in urban sewage worldwide, leading some researchers to suspect contaminated water as a typical route of infection.^[5]

Minor genetic variations are found consistently in different geographic areas; thus, genetic analysis of JC virus samples has been useful in tracing the history of human migration.^[6] 14 subtypes or genotypes are recognised each associated with a specific geographical region. Three are found in Europe (a, b and c). A minor African type - Af1 - occurs in Central and West Africa. The major African type - Af2 - is found throughout Africa and also in West and South Asia. Several Asian types are recognised B1-a, B1-b, B1-d, B2, CY, MY and SC.

An alternative numbering scheme numbers the genotypes 1-8 with additional lettering. Types 1 and 4 are found in Europe and in indigenous populations in northern Japan, North-East Siberia and northern Canada. These two types are closely related. Types 3 and 6 are found in sub-Saharan Africa: type 3 was isolated in Ethiopia, Tanzania and South Africa. Type 6 is found in Ghana. Both types are also found in the Biaka Pygmies and Bantus from Central Africa. Type 2 has several variants: subtype 2A is found mainly in the Japanese population and native Americans (excluding Inuit); 2B is found in Eurasians; 2D is found in Indians and 2E is found in Australians and western Pacific populations. Subtype 7A is found in southern China and South-East Asia. Subtype 7B is found in northern China, Mongolia and Japan Subtype 7C is found in northern and southern China. Subtype 8 is found in Papua New Guinea and the Pacific Islands.

Infection and pathogenesis

The initial site of infection may be the tonsils,^[7] or possibly the gastrointestinal tract.^[5] The virus then remains latent in the gastrointestinal tract ^[8] and can also infect the tubular epithelial cells in the kidneys,^[9] where it continues to reproduce, shedding virus particles in the urine.

JCV can cross the blood–brain barrier into the central nervous system, where it infects oligodendrocytes and astrocytes, possibly through the 5-HT_2A serotonin receptor.^[10] JC viral DNA can be detected in both non-PML affected and PML-affected (see below) brain tissue.^[11]

Immunodeficiency or immunosuppression allows JCV to reactivate. In the brain it causes the usually fatal progressive multifocal leukoencephalopathy, or PML, by destroying oligodendrocytes. Whether this represents the reactivation of JCV within the CNS or seeding of newly reactivated JCV via blood or lymphatics is unknown.^[12] Several studies since 2000 have suggested that the virus is also linked to colorectal cancer, as JCV has been found in malignant colon tumors, but these findings are still controversial.^[13]

Drugs associated with reactivation

Since immunodeficiency causes this virus to progress to PML, immunosuppressants are contraindicative to those infected.

The boxed warning for the drug rituximab (Rituxan, co-marketed by Genentech BioOncology and Biogen Idec) includes a statement that JC virus infection resulting in progressive multifocal leukoencephalopathy, and death has been reported in patients treated with the drug.^[14]

The boxed warning for the drug natalizumab (Tysabri, marketed by Elan and developed by Biogen Idec) includes a statement that JC virus resulted in progressive multifocal leukoencephalopathy developing in three patients who received natalizumab in clinical trials.

The boxed warning was added on Feb. 19, 2009, for the drug efalizumab (Raptiva, marketed in the U.S. by Genentech, and marketed in Europe by Swiss drugmaker Merck Serono) includes a statement that JC virus, resulting in progressive multifocal leukoencephalopathy, developed in three patients who received efalizumab in clinical trials. The drug was pulled off the U.S. market because of the association with PML on April 10, 2009.

A boxed warning for brentuximab vedotin (Adcetris) was issued by the FDA on January 13, 2011 after two cases of PML were reported, bringing the total number of associated cases to three.^[15]

Treatments

In June 2010, the first case report appeared of a PML patient being successfully treated with mefloquine. Mefloquine is an antimalarial drug that can also act against the JC virus. Administration of mefloquine seemed to eliminate the virus from the patient's body and prevented further neurological deterioration.^[16]

On November 30, 2010, Cytheris announced that they had eradicated the JC virus from a PML patient, using their human interleukin-7 investigational drug (CYT107) combined with Chimerix's investigational, orally-available lipid conjugate prodrug of Cidofovir (CMX001).^[17]

References

^ BL, Walker DL et al. (1971). "Cultivation of papova-like virus from human brain with progressive multifocal leucoencephalopathy". Lancet 1 (7712): 1257–60. doi:10.1016/S0140-6736(71)91777-6. PMID 4104715.
^ Hansjügen T. Agostini, Caroline F. Ryschkewitsch, Rachel Mory, Elyse J. Singer and Gerald L. Stoner (1997). "JC Virus (JCV) genotypes in brain tissue from patients with progressive multifocal leukoencephalopathy (PML) and in urine from controls without PML: increased frequency of JCV Type 2 in PML". The Journal of Infectious Diseases (Oxford University Press) 176 (1): 1–8. doi:10.1086/514010. JSTOR 30107072.
^ Laura A. Shackelton, Andrew Rambaut, Oliver G. Pybus, and Edward C. Holmes (2006). "JC Virus evolution and its association with human populations". Journal of Virology (American Society for Microbiology) 80 (20): 9928–9933. doi:10.1128/JVI.00441-06. PMC 1617318. PMID 17005670.
^ Padgett, B.L. and Walker, D.L. (1973). "Prevalence of antibodies in human sera against JC virus, an isolate from a case of progressive multifocal leukoencephalopathy". J. Infect. Dis. 127 (4): 467–470. doi:10.1093/infdis/127.4.467. PMID 4571704.
^ ^a ^b Bofill-Mas, S., Formiga-Cruz, M., Clemente-Casares, P., Calafell, F. and Girones, R. (2001). "Potential transmission of human polyomaviruses through the gastrointestinal tract after exposure to virions or viral DNA". J. Virol. 75 (21): 10290–10299. doi:10.1128/JVI.75.21.10290-10299.2001. PMC 114603. PMID 11581397.
^ Pavesi, A. (2005). "Utility of JC polyomavirus in tracing the pattern of human migrations dating to prehistoric times". J. Gen. Virol. 86 (Pt 5): 1315–1326. doi:10.1099/vir.0.80650-0. PMID 15831942.
^ Monaco, M.C., Jensen, P.N., Hou, J., Durham, L.C. and Major, E.O. (1998). "Detection of JC virus DNA in human tonsil tissue: evidence for site of initial viral infection". J. Virol. 72 (12): 9918–9923. PMC 110504. PMID 9811728.
^ Ricciardiello, L., Laghi, L., Ramamirtham, P., Chang, C.L., Chang, D.K., Randolph, A.E. and Boland, C.R. (2000). "JC virus DNA sequences are frequently present in the human upper and lower gastrointestinal tract". Gastroenterology 119 (5): 1228–1235. doi:10.1053/gast.2000.19269. PMID 11054380.
^ Harvey, R. (2007) Microbiology Philadelphia, Lippincott Williams & Wilkins.
^ Elphick, G.F., Querbes, W., Jordan, J.A., Gee, G.V., Eash, S., Manley, K., Dugan, A., Stanifer, M., Bhatnagar, A., Kroeze, W.K., Roth, B.L. and Atwood, W.J. (2004). "The human polyomavirus, JCV, uses serotonin receptors to infect cells". Science 306 (5700): 1380–1383. doi:10.1126/science.1103492. PMID 15550673.
^ White, F.A., 3rd., Ishaq, M., Stoner, G.L. and Frisque, R.J. (1992). "JC virus DNA is present in many human brain samples from patients without progressive multifocal leukoencephalopathy". J. Virol. 66 (10): 5726–5734. PMC 241447. PMID 1326640.
^ http://www.emedicine.com/neuro/topic450.htm
^ Theodoropoulos, G., Panoussopoulos, D., Papaconstantinou, I., Gazouli, M., Perdiki, M., Bramis, J. and Lazaris, ACh. (2005). "Assessment of JC polyoma virus in colon neoplasms". Dis. Colon. Rectum. 48 (1): 86–91. doi:10.1007/s10350-004-0737-2. PMID 15690663.
^ gene.com/gene/products/information/pdf/rituxan-prescribing.pdf
^ "Adcetris (brentuximab vedotin): Drug Safety Communication - Progressive Multifocal Leukoencephalopathy and Pulmonary Toxicity". U.S. FDA. Retrieved 14 January 2012.
^ Gofton TE, Al-Khotani1 A, O'Farrell B, Ang LC, McLachlan RS (2010). "Mefloquine in the treatment of progressive multifocal leukoencephalopathy". J Neurol Neurosurg Psychiatry 82 (4): 452–455. doi:10.1136/jnnp.2009.190652. PMID 20562463.
^ "Cytheris Announces Publication of Clinical Case Study Combining Recombinant Human Interleukin-7 (CYT107) with Antiviral Agent CMX001 as Potential Treatment for Progressive Multifocal Leukoencephalopathy (PML)". BusinessWire. November 30, 2010. Retrieved October 22, 2011.

External links

NCBI - JC Virus Complete Genome
JC Brain infection MRI Diagnosis of PML

UpToDate Contents

全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.

1. 腎移植におけるBKウイルス（ポリオーマウイルス）腎症の臨床症状および診断 clinical manifestations and diagnosis of bk virus induced polyomavirus induced nephropathy in kidney transplantation
2. JCおよびBKウイルス感染の疫学 epidemiology of jc and bk virus infection
3. 腎移植におけるBKウイルス（ポリオーマウイルス）腎症の管理 management of bk virus induced polyomavirus induced nephropathy in kidney transplantation
4. JC、BKおよびその他のポリオーマウイルス感染の臨床症状、および診断 clinical manifestations and diagnosis of jc bk and other polyomavirus infections
5. 進行性多巣性白質脳症：疫学、臨床症状、および診断 progressive multifocal leukoencephalopathy epidemiology clinical manifestations and diagnosis

English Journal

Nuclear IRS-1 and cancer.

Reiss K, Del Valle L, Lassak A, Trojanek J.SourceNeurological Cancer Research, Stanley S. Scott Cancer Center, School of Medicine, LSU Health Sciences Center, New Orleans, Louisiana. kreiss@lsuhsc.edu.
Journal of cellular physiology.J Cell Physiol.2012 Aug;227(8):2992-3000. doi: 10.1002/jcp.24019.
The family of insulin receptor substrates (IRS) consists of four proteins (IRS-1-IRS-4), which were initially characterized as typical cytosolic adaptor proteins involved in insulin receptor (IR) and insulin-like growth factor I receptor (IGF-IR) signaling. The first cloned and characterized member
PMID 22454254

Analysis of the size of DNA packaged by the human JC virus-like particle.

Fang CY, Lin PY, Ou WC, Chen PL, Shen CH, Chang D, Wang M.SourceDepartment of Medical Research, Chiayi Christian Hospital, 539, Chung Hsiao Rd., Chiayi 60002, Taiwan.
Journal of virological methods.J Virol Methods.2012 Jun;182(1-2):87-92. Epub 2012 Mar 23.
Previously, it has been demonstrated that the JC virus-like particle (VLP) is able to package DNA in E. coli and deliver the DNA into human colon cancer cells for gene expression. In this study, the maximum size of DNA packaged by the VLP was determined further. Plasmid DNAs with various sizes were
PMID 22465254

Japanese Journal

血液腫瘍患者の診療とprogressive multifocal leukoencephalopathy(PML) (特集血液腫瘍診療と感染症 : 現状と対策)

横山洋紀
血液内科 62(5), 575-580, 2011-05
NAID 40019064370

Efficient propagation of progressive multifocal leukoencephalopathy-type JC virus in COS-7-derived cell lines stably expressing Tat protein of human immunodeficiency virus type 1

NUKUZUMA Souichi,NAKAMICHI Kazuo,KAMEOKA Masanori,SUGIURA Shigeki,NUKUZUMA Chiyoko,MIYOSHI Isao,TAKEGAMI Tsutomu
Microbiology and immunology 54(12), 758-762, 2010-12-20
NAID 10029546579

Related Pictures

★リンクテーブル★

リンク元	「髄膜炎」「JCウイルス」「human polyomavirus JC」「JC polyomavirus」「JCV」
拡張検索	「JC virus infection」
関連記事	「J」「virus」

「髄膜炎」

JC virus
	Immunohistochemical detection of JC virus protein (stained brown) in a brain biopsy (glial cells demonstrating progressive multifocal leukoencephalopathy (PML))
Virus classification
Group:	Group I (dsDNA)
Family:	Polyomaviridae
Genus:	Polyomavirus
Species:	JC polyomavirus

　　[★]

英: meningitis
同: 脳脊髄膜炎、
関: 蛋白細胞解離

病因

感染症(細菌、ウイルス、真菌など)、悪性腫瘍の浸潤　→　髄膜の炎症

分類

病原体

細菌性髄膜炎

菌血症→脳脈絡叢→髄腔
菌体成分(LPSなど)→BBB, 上衣細胞、脳細胞の障害。神経膠細胞による炎症サイトカインの分泌

無菌性髄膜炎

血行性、あるいは神経軸索によりウイルスが髄腔に波及。

細菌性髄膜炎：様々
ウイルス性髄膜炎：コクサッキーウイルス、エコーウイルス、ムンプスウイルス、単純ヘルペスウイルス、風疹ウイルス、麻疹ウイルス、水痘・帯状疱疹ウイルス
真菌性髄膜炎：クリプトコッカス髄膜炎
結核性髄膜炎：結核菌
梅毒性髄膜炎：梅毒菌

臨床経過

宿主要因と髄膜炎に関わる病原体

頻度・年齢階層が資料によって異なるため混乱しないように注意。

YN.J-137改変

4ヶ月未満	B群溶連菌(50%)	大腸菌(25%)	インフルエンザ菌(20%)	リステリア菌(1%)
4ヶ月～6歳未満	インフルエンザ菌(70%)	肺炎球菌(25%)
6歳～50歳未満	肺炎球菌(65%)	インフルエンザ菌(10%)	髄膜炎菌
50歳以上	肺炎球菌(80%)	黄色ブドウ球菌
免疫不全者	クレブシエラ	連鎖球菌	緑膿菌	黄色ブドウ球菌	真菌

first aid step1 2006 p.161

Newborn (0–6 mos)	Children (6 mos–6 yrs)	6–60 yrs	60 yrs +
Streptococcus agalactiae	Streptococcus pneumoniae	Neisseria meningitidis	Streptococcus pneumoniae
Escherichia coli	Neisseria meningitidis	Enteroviruses	Gram-negative rods
Listeria	Haemophilus influenzae type B	Streptococcus pneumoniae	Listeria
	Enteroviruses	HSV

HIV: Cryptococcus, CMV, toxoplasmosis (brain abscess), JC virus (PML)

incidence of H. influenzae meningitis has ↓ greatly with introduction of H. influenzae vaccine in last 10–15 years.

CBT QB vol2 p.562

	1位	2位	3位
新生児	大腸菌	B群溶連菌	リステリア菌
小児期(6歳以下)	インフルエンザ菌	肺炎球菌
成人	肺炎球菌	髄膜炎菌

IMD.1042

年齢	病原体
3ヶ月未満	B群溶連菌	大腸菌	リステリア菌
3ヶ月以上の乳小児	インフルエンザ菌	肺炎球菌
成人	肺炎球菌	髄膜炎菌
高齢者	肺炎球菌	グラム陰性桿菌	リステリア菌

小児細菌性髄膜炎起炎菌(PED.606)

		<3か月	3か月≦
グラム陽性	球菌	Streptococcus agalactiae Streptococcus pneumoniae Staphylococcus Enterococcus faecalis	Streptococcus pneumoniae(PSSP/PISP/PRSP)
グラム陽性	桿菌	Listeria monocytogenes	Listeria monocytogenes
グラム陰性	球菌	Neisseria meningitidis	Neisseria meningitidis
グラム陰性	桿菌	Escherichia coli Enterobacter cloacae Serratia marcescens	Haemophilus influenzae type b

新生児

Streptococcus agalactiaeは産道感染
Escherichia coliもおそらく産道感染

新生児と老人

Listeria monocytogenesは産道感染するので新生児に多い。新生児と老人に多いのは通性細胞内寄生菌で細胞性免疫の弱い宿主に感染やすいため？

乳児～幼児

Haemophilus influenzae type B

乳児～大人

Enteroviruses
Neisseria meningitidis

小児～大人

Herpes simplex virus

乳児～老人

Streptococcus pneumoniae

老人

グラム陰性桿菌は老人

髄膜炎の鑑別

	細菌性髄膜炎	ウイルス性髄膜炎	結核性髄膜炎	真菌性髄膜炎	癌性髄膜炎
外観	混濁	clear	水様～キサントクロミー日光微塵	clear～日光微塵	clear～キサントクロミー
圧 70-180 (mmH2O)	↑↑ 200～800以上	↑ 200～300	↑ 200～800	↑ 200～800	↑ 200～300
細胞 0-5 (/mm3)	500～数百万	10～1,000	25～1,000	25～1,000	25～500
細胞 0-5 (/mm3)	好中球	リンパ球	リンパ球	リンパ球	好中球
タンパク 15-45 mg/dl	↑↑ 50～1,500	↑ 正常～100	↑ 50～500	↑ 100～500	↑ 50～500
糖 50-80 mg/dl	↓↓ 0～40	→ 正常	↓↓ ～40	↓↓ ～40	↓ ～40