Figure 2.

Proposed pathophysiology of natalizumab‐associated melanoma. Natalizumab promotes invasive melanoma by blocking α4 integrin. Normal melanocytes do not express α4β1 integrin; however, α4β1 integrin is expressed on melanoma cells. Downregulation of α4β1 integrin has been shown to be involved in melanoma invasion 32. Thus we hypothesize that natalizumab binding of α4 would promote melanoma through this mechanism.