Mita S, Sugimoto M, Nakamura M, Murakami T, Tokunaga M, Uyama E, Araki S
First Department of Internal Medicine, Kumamoto University School of Medicine, Japan.
Am J Trop Med Hyg. 1993 Feb;48(2):170-7. doi: 10.4269/ajtmh.1993.48.170.
Human T lymphotropic virus type-1 (HTLV-1)-associated myelopathy/tropical spastic paraparesis (HAM/TSP) is endemic in tropical areas and in southwestern Japan, and has now been identified among risk groups in the United States and some European countries. Patients with HAM/TSP may also have T lymphocyte alveolitis related to the HTLV-1 infection. To quantify proportions of HTLV-1-infected cells, a fragment of HTLV-1 proviral DNA was amplified from peripheral blood mononuclear cells (PBMC) and bronchoalveolar lavage (BAL) cells obtained from patients with HAM/TSP, non-HAM/TSP HTLV-1 carriers with chronic pulmonary inflammation, and asymptomatic HTLV-1 carriers. The proportion of HTLV-1-infected cells in PBMC from patients with HAM/TSP was much higher (3-30%) than that from asymptomatic HTLV-1 carriers (mostly < 1%), based on findings with the quantitative polymerase chain reaction. In non-HAM/TSP carriers with chronic pulmonary inflammation, HTLV-1-infected cells in PBMC were also increased, but not as markedly as that seen in patients with HAM/TSP. Integration of HTLV-1 was also noted in BAL cells from patients with HAM/TSP or non-HAM/TSP carriers with chronic pulmonary inflammation. However, in patients with HAM/TSP, there was a marked increase in HTLV-1-infected cells in the lung (7.5-30% of BAL cells), as compared with findings in non-HAM/TSP carriers (< 5%). These results suggest that increased HTLV-1 proviral DNA loading may play an important role in the development of T lymphocyte alveolitis and myelopathy in patients with HAM/TSP.
人类嗜T淋巴细胞病毒1型（HTLV-1）相关脊髓病/热带痉挛性截瘫（HAM/TSP）在热带地区和日本西南部呈地方性流行，目前在美国和一些欧洲国家的风险人群中也已被发现。HAM/TSP患者还可能患有与HTLV-1感染相关的T淋巴细胞肺泡炎。为了量化HTLV-1感染细胞的比例，从HAM/TSP患者、患有慢性肺部炎症的非HAM/TSP HTLV-1携带者以及无症状HTLV-1携带者的外周血单个核细胞（PBMC）和支气管肺泡灌洗（BAL）细胞中扩增出HTLV-1前病毒DNA片段。基于定量聚合酶链反应的结果，HAM/TSP患者PBMC中HTLV-1感染细胞的比例（3%-30%）远高于无症状HTLV-1携带者（大多<1%）。在患有慢性肺部炎症的非HAM/TSP携带者中，PBMC中的HTLV-1感染细胞也有所增加，但不如HAM/TSP患者明显。在HAM/TSP患者或患有慢性肺部炎症的非HAM/TSP携带者的BAL细胞中也发现了HTLV-1的整合。然而，与非HAM/TSP携带者（<5%）相比，HAM/TSP患者肺部的HTLV-1感染细胞显著增加（占BAL细胞的7.5%-30%）。这些结果表明，HTLV-1前病毒DNA载量的增加可能在HAM/TSP患者的T淋巴细胞肺泡炎和脊髓病的发展中起重要作用。
