HTLV-1 -associated Myelopathy

نویسنده

  • Shukuro Araki
چکیده

Chronic progressive spastic paraparesis occurring in tropical areas and southwest Japan is frequently associated with high antibody titers to HTLV-1 in serum and cerebrospinal fluid.12 We recently reported that T-lymphocyte alveolitis occurred in patients with HTLV-1-associated myelopathy (HAM).3 The presence of such pulmonary lesions were also described by Vernant and associates in patients with HTLV-1-associated tropical spastic paraparesis (HTLV1ITSP).4 In the present study, bronchoalveolar lavage (BAL) fluid had an increased proportion of lymphocytes in patients with HAM (ten women and three men, 50 ± 17 percent), compared to HTLV-1negative normal control subjects (ten nonsmoking male volunteers, 14 ± 3 percent). Increased BAL lymphocytes consisted mainly of CD3 + cells (78 ± 17 percent) and CD4 + /CD8 + ratios (1.5 ± 0.8) were similar to those ofnormal control subjects (1.3 ±0.7). Serum levels ofsoluble interleukin-2 receptors (IL-2R), a marker of T-cell activation,5 were significantly elevated in patients with HAM compared to normal control subjects (685 ± 210 vs 286 ± 49 U/mI, p<O.Ol). Soluble IL-2R levels were detectable in BAL fluid from HAM patients and BAL levels were approximately 13 times higher than those in serum (166± 103 vs 18± 13 U/mg albumin, p = 0.001). BAL IL-2R levels in HAM patients correlated well with the number of lymphocytes and T-cells in BAL fluid (r=0.68, p<0.05 and r=0.64, p<O.O5, respectively). These results suggest that T-lymphocytes infiltrating the lungs of HAM patients are activated locally to produce IL-2R. Our data show that bronchoalveolar T-Iymphocytosis occurs in patients with HAM ,suggesting that immunologic mechanisms play an important role in the development of pulmonary lesions in HAM.

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تاریخ انتشار 2006