Sugimoto M, Nakashima H, Matsumoto M, Uyama E, Ando M, Araki S
First Department of Internal Medicine, Kumamoto University Medical School, Japan.
Am Rev Respir Dis. 1989 Jun;139(6):1329-35. doi: 10.1164/ajrccm/139.6.1329.
A chronic spastic myelopathy associated with HTLV-I infection (HTLV-I-associated myelopathy: HAM) shows subclinical pulmonary involvement with bronchoalveolar T lymphocytosis. In the present study, we investigated 18 patients with HAM: five HTLV-I carriers without myelopathy and 13 normal control subjects seronegative for HTLV-I to determine if soluble IL-2 receptors (IL-2R), a marker of lymphocyte activation, were increased in serum and bronchoalveolar lavage (BAL) fluid from HAM patients. Serum IL-2R levels were significantly increased in patients with HAM as compared to normal control subjects (HAM versus control subjects: 633 +/- 395 versus 278 +/- 53 U/ml, p less than 0.01). There was also an increase of serum IL-2R levels in one of five HTLV-I carriers. BAL levels of soluble IL-2R were low but detectable in four normal control subjects and in one HTLV-I carrier. In HAM patients, however, soluble IL-2R levels in BAL fluid were remarkably elevated (173 +/- 110 U/mg of albumin) and were nearly 13 times higher on average than in serum (BAL fluid/serum ratio: 13 +/- 10). In patients with HAM, lavage IL-2R levels correlated well with the number of T lymphocytes (CD3+ cells) and CD4+ cells in BAL fluid (p less than 0.01). Furthermore, BAL lymphocytes obtained from HAM patients synthesized DNA spontaneously when cultured in vitro. These results suggest that, in HAM, T lymphocytes increased in the lung are activated locally to produce soluble IL-2R. Based on the results of this study, we conclude that immunologic mechanism(s) may play an important role in the development of pulmonary lesions in HAM patients.
一种与人类嗜T淋巴细胞病毒I型（HTLV-I）感染相关的慢性痉挛性脊髓病（HTLV-I相关脊髓病：HAM）表现为伴有支气管肺泡T淋巴细胞增多的亚临床肺部受累。在本研究中，我们调查了18例HAM患者、5例无脊髓病的HTLV-I携带者以及13例HTLV-I血清学阴性的正常对照受试者，以确定淋巴细胞活化标志物可溶性白细胞介素-2受体（IL-2R）在HAM患者的血清和支气管肺泡灌洗（BAL）液中是否升高。与正常对照受试者相比，HAM患者的血清IL-2R水平显著升高（HAM组与对照组：633±395对278±53 U/ml，p<0.01）。5例HTLV-I携带者中有1例血清IL-2R水平也升高。可溶性IL-2R的BAL水平较低，但在4例正常对照受试者和1例HTLV-I携带者中可检测到。然而，在HAM患者中，BAL液中的可溶性IL-2R水平显著升高（173±110 U/mg白蛋白），平均比血清中高近13倍（BAL液/血清比值：13±10）。在HAM患者中灌洗IL-2R水平与BAL液中T淋巴细胞（CD3+细胞）和CD4+细胞数量密切相关（p<0.01）。此外，从HAM患者获得的BAL淋巴细胞在体外培养时可自发合成DNA。这些结果表明，在HAM中，肺内增多的T淋巴细胞被局部激活以产生可溶性IL-2R？根据本研究结果，我们得出结论，免疫机制可能在HAM患者肺部病变的发生中起重要作用。
