A recent report demonstrated that JCV employs serotonin receptor 2A (5HT 2A R) to infect the glial cells. To assess the ability of a potent 5HT 2A R blocker, risperidone, to inhibit JCV infection, we treated primary human fetal glial (PHFG) cells in-vitro with risperidone for 24 hr and inoculated with JCV(Mad1). There was no significant difference in JCV genome copies or mRNA transcripts and protein expression in treatment-naive and risperidone-treated PHFG cells. This data indicate that risperidone does not inhibit JCV(Mad1) attachment, internalization and replication in PHFG cells, and 5HT 2A R blockers may not be effective in treating progressive multifocal leukoencephalopathy (PML).
KeywordsJCV; human polyomavirus; PML; serotonin receptor; risperidone; mirtazapine Progressive multifocal leukoencephalopathy (PML), a fatal, subacute demyelinating disease of the central nervous system (CNS), is caused by human polyomavirus JC (JCV) (Padgett et al, 1971). Although, some AIDS-associated PML patients had survival benefit when treated with highly active antiretroviral therapy (HAART) (Antinori et al, 2003;Lima et al, 2007), in the post-HAART era incidence of PML has not significantly changed , and PML currently is the second most frequently diagnosed neurological disorder among AIDS patients . Few reports have demonstrated beneficial effect of cytosine arabinoside (Aksamit, 2001;De Luca et al, 1999;Elphick et al, 2004) and cidofovir in treating PML patients, however studies have concluded that cytosine arabinoside (Enting and Portegies, 2000) and cidofovir (Marra et al, 2002;Wyen et al, 2004) therapy have no significant therapeutic benefit. Although, clinical outcome among PML patients treated with interferon is controversial (Colosimo et al, 1992;Geschwind et al, 2001;Huang et al, 1998;Nath et al, 2006), IFN is effective in in-vitro inhibition of JCV replication and intrathecal infusion of IFN may be beneficial as an adjunct therapy for PML (Co et al, 2007). It is important to note that there is currently no proven therapy or vaccine available for treatment and prevention of the fatal disease, PML.A recent study demonstrated that the chimera polyomavirus JC (Mad-1/SVEΔ) consisting of JCV-SV40 promoter enhancer sequences in the backbone of JCV coding region sequences employs the 5HT 2A R to infect SVG-A cells, a subclone of transformed human fetal glial cells by an origin-defective SV40 mutant (Elphick et al, 2004). Altschuler and Kast (2005), have suggested that newer safer antipsychotic drugs such as risperidone, ziprasidone and olanzapine with significantly more potent 5HT 2A R receptor antagonist activity, may be useful in treating or preventing PML. Since, half of the healthy adult population shed large amounts of JCV in the urine (Agostini et al, 2001;Agostini et al, 1997;Agostini et al, 1996;Shah et al, 1997), this provides an unique opportunity to test safe and easy-to-tolerate drugs such as, risperidone and mirtazapine for anti-JCV activity, using urinary tract clearance of JCV as an additional su...