成人 T 细胞白血病/淋巴瘤（ATL）、HTLV-I 相关脊髓病（HAM-TSP）与健康携带者中 HTLV-I 前病毒载量的比较。
Comparison of HTLV-I Proviral Load in Adult T Cell Leukemia/Lymphoma (ATL), HTLV-I-Associated Myelopathy (HAM-TSP) and Healthy Carriers.
机构信息
Inflammation and inflammatory research centre, Medical School, Mashhad University of Medical Science, Mashhad- Iran.
Inflammation and inflammatory research centre, Medical School, Mashhad University of Medical Science, Mashhad- Iran ; Internal medicine Dept. Medical School, Mashhad University of Medical Science, Mashhad- Iran.
出版信息
Iran J Basic Med Sci. 2013 Mar;16(3):208-12.
OBJECTIVE(S): Human T Lymphocyte Virus Type one (HTLV-I) is a retrovirus that infects about 10-20 million people worldwide. Khorasan province in Iran is an endemic area. The majority of HTLV-I-infected individuals sustain healthy carriers but small proportion of infected population developed two progressive diseases: HAM/TSP and ATL. The proviral load could be a virological marker for disease monitoring, therefore in the present study HTLV-I proviral load has been evaluated in ATL and compared to HAM/TSP and healthy carriers.
MATERIALS AND METHODS
In this case series study, 47 HTLV-I infected individuals including 13 ATL, 23 HAM/TSP and 11 asymptomatic subjects were studied. Peripheral blood mononuclear cells (PBMCs) were investigated for presence of HTLV-I DNA provirus by PCR using LTR and Tax fragments. Then in infected subjects, HTLV-I proviral load was measured using real time PCR TaqMan method.
RESULTS
The average age of patients in ATL was 52±8, in HAM/TSP 45.52±15.17 and in carrier's 38.65±14.9 years which differences were not statistically significant. The analysis of data showed a significant difference in mean WBC among study groups (ATL vs HAM/TSP and carriers P=0.0001). Moreover, mean HTLV-I proviral load was 11967.2 ± 5078, 409 ± 71.3 and 373.6 ± 143.3 in ATL, HAM/TSP and Healthy Carriers, respectively. The highest HTLV-I proviral load was measured in ATL group that had a significant correlation with WBC count (R=0.495, P=0.001). The proviral load variations between study groups was strongly significant (ATL vs carrier P=0.0001; ATL vs HAM/TSP P= 0.0001 and HAM/TSP vs carriers P< 0.05). Conclusion : The present study demonstrated that HTLV-I proviral load was higher in ATL group in comparison with HAM/TSP and healthy carriers. Therefore, HTLV-I proviral load is a prognostic factor for development of HTLV-I associated diseases and can be used as a monitoring marker for the efficiency of therapeutic regime.
目的
人类 T 淋巴细胞病毒 1 型（HTLV-1）是一种逆转录病毒，全球约有 1000 万至 2000 万人感染。伊朗的霍拉桑省是一个地方性流行区。大多数 HTLV-1 感染者为健康携带者，但一小部分感染者会发展为两种进行性疾病：HAM/TSP 和 ATL。前病毒载量可作为疾病监测的病毒学标志物，因此本研究评估了 ATL 中的 HTLV-1 前病毒载量，并与 HAM/TSP 和健康携带者进行了比较。
材料和方法
在这项病例系列研究中，研究了 47 名 HTLV-1 感染者，包括 13 名 ATL 患者、23 名 HAM/TSP 患者和 11 名无症状患者。使用 LTR 和 Tax 片段的 PCR 检测外周血单个核细胞（PBMCs）中 HTLV-1 DNA 前病毒的存在。然后，使用实时 PCR TaqMan 法测量感染患者的 HTLV-1 前病毒载量。
结果
ATL 患者的平均年龄为 52±8 岁，HAM/TSP 患者为 45.52±15.17 岁，携带者为 38.65±14.9 岁，差异无统计学意义。数据分析显示，研究组间白细胞计数（WBC）存在显著差异（ATL 与 HAM/TSP 和携带者相比，P=0.0001）。此外，ATL、HAM/TSP 和健康携带者的 HTLV-1 前病毒载量分别为 11967.2±5078、409±71.3 和 373.6±143.3。ATL 组的 HTLV-1 前病毒载量最高，与 WBC 计数呈显著正相关（R=0.495，P=0.001）。研究组间前病毒载量的变化具有统计学意义（ATL 与携带者相比，P=0.0001；ATL 与 HAM/TSP 相比，P=0.0001；HAM/TSP 与携带者相比，P<0.05）。结论：本研究表明，与 HAM/TSP 和健康携带者相比，ATL 组的 HTLV-1 前病毒载量更高。因此，HTLV-1 前病毒载量是 HTLV-1 相关疾病发展的预后因素，可作为治疗效果监测的标志物。
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