Gabbai A A, Wiley C A, Oliveira A S, Smith R, Schmidt B, Nóbrega J A, Bordin J O, Román G C
Department of Neurology, Escola Paulista de Medicina, Brazil.
Muscle Nerve. 1994 Aug;17(8):923-30. doi: 10.1002/mus.880170812.
The frequency of muscle involvement in TSP/HAM is not known, nor is the precise role that HTLV-1 and the diverse cytokines play in the genesis of HTLV-1-associated diseases. In order to better define the frequency and characteristics of the skeletal muscle involvement in TSP/HAM, we studied 11 affected patients. EMG was performed in 9 patients and muscle biopsy was performed in all 11. Muscle tissue was analyzed using: reverse transcriptase PCR for interleukin-1 in 8; PCR for HTLV-1 proviral DNA in 5; and electron microscopy for viral particles in 3. We found pathologic alterations in all 11 patients. Four patients (36%) had a neurogenic process, while a primary muscle involvement was observed in the rest (64%). Four patients (36%) had polymyositis, and 3 (27%) had a noninflammatory myopathy. Muscle weakness in the upper limbs was significantly associated with inflammation in the muscle biopsy. EMG was abnormal in only 2 of 9 patients. Reverse transcriptase PCR did not demonstrate message for interleukin-1 in any sample examined. PCR did identify HTLV-1 proviral DNA in the muscle of 3 patients. Retroviral-like particles were found, by EM, in only one biopsy. HTLV-1 may play an important role in the pathogenesis of the frequent myopathies associated with HAM/TSP.
热带痉挛性截瘫/人类T淋巴细胞病毒I型相关脊髓病（TSP/HAM）中肌肉受累的频率尚不清楚，人类T淋巴细胞病毒I型（HTLV-1）及多种细胞因子在HTLV-1相关疾病发生过程中的确切作用也不清楚。为了更好地明确TSP/HAM中骨骼肌受累的频率及特征，我们研究了11例受累患者。9例患者进行了肌电图（EMG）检查，所有11例患者均进行了肌肉活检。对肌肉组织进行了如下分析：8例采用逆转录酶聚合酶链反应（PCR）检测白细胞介素-1；5例采用PCR检测HTLV-1前病毒DNA；3例采用电子显微镜检查病毒颗粒。我们发现所有11例患者均有病理改变。4例患者（36%）存在神经源性病变，其余患者（64%）观察到原发性肌肉受累。4例患者（36%）患有多发性肌炎，3例患者（27%）患有非炎性肌病。上肢肌肉无力与肌肉活检中的炎症显著相关。9例患者中仅2例EMG异常。逆转录酶PCR在任何检测样本中均未显示白细胞介素-1的信息。PCR在3例患者的肌肉中鉴定出HTLV-1前病毒DNA。通过电子显微镜仅在1例活检中发现了逆转录病毒样颗粒。HTLV-1可能在与HAM/TSP相关的常见肌病的发病机制中起重要作用。
