{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,28]],"date-time":"2026-06-28T10:38:29Z","timestamp":1782643109744,"version":"3.54.5"},"reference-count":10,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2020,7,20]],"date-time":"2020-07-20T00:00:00Z","timestamp":1595203200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Mult Scler"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Progressive multifocal leukoencephalopathy (PML) among multiple sclerosis (MS) patients receiving dimethyl fumarate (DMF) is associated with iatrogenic lymphopenia, predominating on CD8+ T-cells.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives and Methods:<\/jats:title>\n                    <jats:p>\n                      We report an unusual case of DMF-related PML in a 66-year-old MS patient with preserved lymphocyte count (nadir: 810\/mm\n                      <jats:sup>3<\/jats:sup>\n                      ) and normal CD8+ T-cells count.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>A massive overexpression of the inhibitory receptor Programmed Cell Death 1 (PD-1) on CD8+ and memory effector T-cells together with an impaired anti-JC virus (JCV) specific T-cells response were found, compatible with exhaustion. Following DMF withdrawal, PML progressively regressed, PD-1 was downregulated, and a functional anti-JCV response was established.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>T-cells exhaustion may favor PML onset on DMF independently of lymphocyte count.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1352458520942201","type":"journal-article","created":{"date-parts":[[2020,7,20]],"date-time":"2020-07-20T07:18:09Z","timestamp":1595229489000},"page":"640-644","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":12,"title":["Progressive multifocal leukoencephalopathy on dimethyl fumarate with preserved lymphocyte count but deep T-cells exhaustion"],"prefix":"10.1177","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2099-210X","authenticated-orcid":false,"given":"Jeanne","family":"Garcia","sequence":"first","affiliation":[{"name":"Saint Antoine Hospital, Assistance Publique des H\u00f4pitaux de Paris (APHP), Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Houria","family":"Hendel-Chavez","sequence":"additional","affiliation":[{"name":"Paris Sud Medecine University, INSERM U1184, Kremlin Bic\u00eatre Hospital, Le Kremlin-Bic\u00eatre, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie-Ghislaine","family":"De-Goer","sequence":"additional","affiliation":[{"name":"Paris Sud Medecine University, INSERM U1184, Kremlin Bic\u00eatre Hospital, Le Kremlin-Bic\u00eatre, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne Sophie","family":"L\u2019Honneur","sequence":"additional","affiliation":[{"name":"Department of Virology, Cochin Hospital, Assistance Publique des H\u00f4pitaux de Paris (APHP), Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne Laure","family":"Dubessy","sequence":"additional","affiliation":[{"name":"Saint Antoine Hospital, Assistance Publique des H\u00f4pitaux de Paris (APHP), Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yassine","family":"Taoufik","sequence":"additional","affiliation":[{"name":"Paris Sud Medecine University, INSERM U1184, Kremlin Bic\u00eatre Hospital, Bic\u00eatre, France\/Hematology Department, Kremlin Bic\u00eatre Hospital, Le Kremlin-Bic\u00eatre, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno","family":"Stankoff","sequence":"additional","affiliation":[{"name":"Saint Antoine Hospital, Assistance Publique des H\u00f4pitaux de Paris (APHP), Paris, France\/Sorbonne University, UPMC, Brain and Spinal Cord Institute (ICM), INSERM UMR-S 1127, CNRS UMR 7225, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2020,7,20]]},"reference":[{"key":"bibr1-1352458520942201","doi-asserted-by":"publisher","DOI":"10.1016\/j.msard.2017.01.006"},{"key":"bibr2-1352458520942201","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-017-8509-9"},{"key":"bibr3-1352458520942201","doi-asserted-by":"publisher","DOI":"10.1128\/JVI.00131-13"},{"key":"bibr4-1352458520942201","doi-asserted-by":"publisher","DOI":"10.1177\/1352458519852100"},{"key":"bibr5-1352458520942201","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-018-8931-7"},{"key":"bibr6-1352458520942201","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000007262"},{"key":"bibr7-1352458520942201","doi-asserted-by":"publisher","DOI":"10.1128\/JVI.02506-10"},{"key":"bibr8-1352458520942201","doi-asserted-by":"publisher","DOI":"10.1177\/1352458518775550"},{"key":"bibr9-1352458520942201","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0b013e31825a313c"},{"key":"bibr10-1352458520942201","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1815039"}],"container-title":["Multiple Sclerosis Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1352458520942201","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/1352458520942201","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1352458520942201","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T04:04:11Z","timestamp":1777694651000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1352458520942201"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,7,20]]},"references-count":10,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2021,4]]}},"alternative-id":["10.1177\/1352458520942201"],"URL":"https:\/\/doi.org\/10.1177\/1352458520942201","relation":{},"ISSN":["1352-4585","1477-0970"],"issn-type":[{"value":"1352-4585","type":"print"},{"value":"1477-0970","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,7,20]]}}}