Matsui M, Nagumo F, Tadano J, Kuroda Y
Department of Internal Medicine, Saga Medical School, Japan.
J Neurol Sci. 1995 Jun;130(2):183-9. doi: 10.1016/0022-510x(95)00036-2.
In HTLV-I-associated myelopathy or tropical spastic paraparesis (HAM/TSP) immunopathological processes in the central nervous system (CNS) have not been clarified. We compared the humoral and cellular immunity within the CNS and in the systemic circulation of 24 patients with HAM/TSP (8 men and 16 women) to 6 asymptomatic HTLV-I carriers, 7 patients with active multiple sclerosis, 6 patients with acute viral encephalitis, and 39 patients with other non-inflammatory neurological diseases. Significant differences were observed between the HAM/TSP patients and one or more of the control groups: HAM/TSP cerebrospinal fluids (CSF) exhibited higher levels of IgG, IgG index, de novo IgG synthesis rate, and beta 2-microglobulin, and also a predominance of CD8+ cells that expressed CD11a and CD45RO but lacked CD28 antigens. Results in the 6 patients with acute viral encephalitis suggested that the CD8+ population in the CSF which is positive for CD28 and CD45RO is important for the elimination of virus from infected CNS tissues. Therefore, potentially cytotoxic T cells of a unique CD8+CD11a+CD45RO+CD28- phenotype may play a key role in the CNS pathogenesis of HAM/TSP.
在人类嗜T细胞病毒I型（HTLV-I）相关脊髓病或热带痉挛性截瘫（HAM/TSP）中，中枢神经系统（CNS）的免疫病理过程尚未阐明。我们将24例HAM/TSP患者（8例男性和16例女性）中枢神经系统和全身循环中的体液免疫和细胞免疫与6例无症状HTLV-I携带者、7例活动性多发性硬化症患者、6例急性病毒性脑炎患者以及39例其他非炎性神经系统疾病患者进行了比较。HAM/TSP患者与一个或多个对照组之间存在显著差异：HAM/TSP患者的脑脊液（CSF）显示出更高水平的IgG、IgG指数、新生IgG合成率和β2-微球蛋白，并且还以表达CD11a和CD45RO但缺乏CD28抗原的CD8+细胞为主。6例急性病毒性脑炎患者的结果表明，CSF中CD28和CD45RO阳性的CD8+细胞群对于从受感染的CNS组织中清除病毒很重要。因此，具有独特CD8+CD11a+CD45RO+CD28-表型的潜在细胞毒性T细胞可能在HAM/TSP的CNS发病机制中起关键作用。
