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The most impactful result was his response to rituximab treatment after the systematic failure of prior treatments. Although the expression of endogenous retroviral proteins has been associated with autoimmunity, the patient did not show increased expression of the toxic protein HERV (human endogenous retrovirus)-W ENV, a target of the ongoing clinical trials with temelimab in MS and long COVID-19 cases. However, genome-wide HERV transcriptome analysis by high density microarrays clearly revealed a distinct profile in the patient\u2019s blood supportive of an altered immune system. Limitations of the study include sub-optimal frequency of magnetic resonance imaging to monitor lesion progression, and similarly for reassessment of HERV profiles after rituximab. Overall, the coincidence of HERV alterations and the impactful response to rituximab presents the possibility of additional, more specific, therapeutic targets encoded by other HERV elements yet to be discovered.<\/jats:p>","DOI":"10.3390\/ijms26104885","type":"journal-article","created":{"date-parts":[[2025,5,20]],"date-time":"2025-05-20T04:48:18Z","timestamp":1747716498000},"page":"4885","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["HERV Dysregulation in a Case of Myalgic Encephalomyelitis and Multiple Sclerosis Responsive to Rituximab"],"prefix":"10.3390","volume":"26","author":[{"given":"Eva","family":"Mart\u00edn-Mart\u00ednez","sequence":"first","affiliation":[{"name":"National Health Service, Manises Hospital, 46940 Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Gil-Perotin","sequence":"additional","affiliation":[{"name":"Neurology, Hospital Universitario y Polit\u00e9cnico La Fe, 46026 Valencia, Spain"},{"name":"Multiple Sclerosis Unit, Neurology, Hospital Universitario y Polit\u00e9cnico La Fe, 46026 Valencia, Spain"},{"name":"CIBER, Instituto de Salud Carlos III, 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9790-7327","authenticated-orcid":false,"given":"Karen","family":"Gim\u00e9nez-Orenga","sequence":"additional","affiliation":[{"name":"Escuela de Doctorado, Universidad Cat\u00f3lica de Valencia San Vicente M\u00e1rtir, 46001 Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2504-6673","authenticated-orcid":false,"given":"Lucas","family":"Barea-Moya","sequence":"additional","affiliation":[{"name":"Research Group in Immunotherapy and Biomodels for Autoimmunity, Health Research Institute, Hospital Universitario y Polit\u00e9cnico La Fe, 46026 Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0598-2907","authenticated-orcid":false,"given":"Elisa","family":"Oltra","sequence":"additional","affiliation":[{"name":"Department of Pathology, School of Medicine and Health Sciences, Universidad Cat\u00f3lica de Valencia San Vicente M\u00e1rtir, 46001 Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1186\/s12911-021-01534-6","article-title":"ICD-11: An international classification of diseases for the twenty-first century","volume":"21","author":"Harrison","year":"2021","journal-title":"BMC Med. 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