Matsuyama W, Kawabata M, Mizoguchi A, Iwami F, Wakimoto J, Osame M
Third Department of Internal Medicine, Kagoshima University Faculty of Medicine, Kagoshima, Japan.
Clin Exp Immunol. 2003 Sep;133(3):397-403. doi: 10.1046/j.1365-2249.2003.02240.x.
Human T lymphotrophic virus type-I (HTLV-I), a human retrovirus, infects CD4+ lymphocytes and is thought to modify their function; a possible association with pulmonary diseases has also been suggested. However, little is known about the influence of HTLV-I on cryptogenic fibrosing alveolitis (CFA), a chronic inflammatory interstitial lung disease of unknown aetiology. In order to clarify the influence of HTLV-I infection on CFA, 72 CFA patients with and without HTLV-I infection were examined. HTLV-I positive CFA patients were likely to have larger affected areas and to show traction bronchiectasis with honeycombing change. An imbalance of matrix metalloproteinases and tissue inhibitor of metalloproteinases were also observed in the BALF of HTLV-I positive CFA patients. CD3+/CD25+ lymphocyte percentage was significantly higher in the BALF of HTLV-I positive patients compared to negative patients. MIP-1alpha, IP-10 and sICAM levels in BALF were also significantly higher in HTLV-I positive patients than in negative patients. The levels of MCP-1 and IL-8 were not significantly different. In HTLV-I positive patients, the MIP-1alpha and IP-10 levels showed a significant positive correlation with percentage of CD3+/CD25 lymphocytes. HTLV-I positive CFA patients showed a larger lesion than negative patients and exhibited increased levels of certain cytokines that correlated with activated T cells in the BALF. We suggest that HTLV-I infection may contribute to the development of CFA via activation of T cells. We also propose that these features should be taken into consideration in the treatment of CFA in HTLV-I infected individuals.
人类嗜T淋巴细胞病毒I型（HTLV-I）是一种人类逆转录病毒，可感染CD4+淋巴细胞，并被认为会改变其功能；也有人提出它可能与肺部疾病有关。然而，关于HTLV-I对隐源性纤维性肺泡炎（CFA）的影响却知之甚少，CFA是一种病因不明的慢性炎症性间质性肺病。为了阐明HTLV-I感染对CFA的影响，我们对72例有或无HTLV-I感染的CFA患者进行了检查。HTLV-I阳性的CFA患者受累面积可能更大，并表现出牵引性支气管扩张伴蜂窝状改变。在HTLV-I阳性的CFA患者的支气管肺泡灌洗液（BALF）中也观察到基质金属蛋白酶和金属蛋白酶组织抑制剂的失衡。与阴性患者相比，HTLV-I阳性患者BALF中的CD3+/CD25+淋巴细胞百分比显著更高。HTLV-I阳性患者BALF中的MIP-1α、IP-10和sICAM水平也显著高于阴性患者。MCP-1和IL-8水平无显著差异。在HTLV-I阳性患者中，MIP-1α和IP-10水平与CD3+/CD25淋巴细胞百分比呈显著正相关。HTLV-I阳性的CFA患者比阴性患者的病变更大，并且某些细胞因子水平升高，这些细胞因子与BALF中活化的T细胞相关。我们认为HTLV-I感染可能通过激活T细胞促进CFA的发展。我们还建议在治疗HTLV-I感染个体的CFA时应考虑这些特征。
