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The blockade of the integrin very late antigen-4 (VLA-4) with the monoclonal antibody natalizumab has become the most effective therapy against MS since its approval in 2004. It is assumed that the inhibition of VLA-4-mediated immune cell adhesion to the endothelium of the blood\u2013brain barrier (BBB) alleviates pathogenic processes of MS and, therefore, reduces disease severity and burden. Not all approaches to treat additional immune-mediated disorders (e.g. Rasmussen encephalitis and neuromyelitis optica) with natalizumab have been successful, but allowed researchers to gain additional insight into mechanisms of specific immune cell subsets\u2019 migration through the BBB in the human system. While the long-term efficacy and general tolerability of natalizumab in MS are clear, the over 400 cases of natalizumab-associated progressive multifocal leukoencephalopathy (PML) have been of great concern and methods of risk stratification in patients have become a major area of research. Modern risk stratification includes established factors such as treatment duration, previous immune-suppressive therapy, and anti-John Cunningham virus (JCV) antibody seropositivity, but also experimental factors such as anti-JCV antibody titers and levels of L-selectin. Today, anti-VLA-4 therapy is reserved for patients with highly active relapsing-remitting MS and patients are monitored closely for early signs of potential PML.<\/jats:p>","DOI":"10.1093\/intimm\/dxu096","type":"journal-article","created":{"date-parts":[[2014,10,18]],"date-time":"2014-10-18T06:12:04Z","timestamp":1413612724000},"page":"47-53","source":"Crossref","is-referenced-by-count":57,"title":["Therapeutic uses of anti-\u03b14-integrin (anti-VLA-4) antibodies in multiple sclerosis"],"prefix":"10.1093","volume":"27","author":[{"given":"Nicholas","family":"Schwab","sequence":"first","affiliation":[{"name":"Department of Neurology, University of M\u00fcnster , Albert-Schweitzer-Campus 1, 48149 M\u00fcnster , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tilman","family":"Schneider-Hohendorf","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of M\u00fcnster , Albert-Schweitzer-Campus 1, 48149 M\u00fcnster , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heinz","family":"Wiendl","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of M\u00fcnster , Albert-Schweitzer-Campus 1, 48149 M\u00fcnster , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2014,10,17]]},"reference":[{"key":"2022072021385315700_CIT0001","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1002\/j.1875-9114.1991.tb03595.x","article-title":"Muromonab CD-3: a review of its pharmacology, pharmacokinetics, and clinical use in transplantation","volume":"11","author":"Hooks","year":"1991","journal-title":"Pharmacotherapy"},{"key":"2022072021385315700_CIT0002","doi-asserted-by":"crossref","first-page":"475","DOI":"10.5812\/numonthly.1806","article-title":"Efficacy of anti-interleukin-2 receptor antibody (daclizumab) in reducing the incidence of acute rejection after renal transplantation","volume":"4","author":"Saghafi","year":"2012","journal-title":"Nephrourol. 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