Ijichi S, Nakagawa M, Umehara F, Higuchi I, Arimura K, Izumo S, Osame M
Third Department of Internal Medicine, Faculty of Medicine, Kagoshima University, Japan.
J Acquir Immune Defic Syndr Hum Retrovirol. 1996;13 Suppl 1:S26-32. doi: 10.1097/00042560-199600001-00006.
Neurologic diseases associated with human T-cell lymphotropic virus type I (HTLV-I) infection have a clinical spectrum that includes myelopathy (HTLV-I-associated myelopathy/tropical spastic paraparesis, HAM/TSP) as the central manifestation. Many clinical signs of involvement outside the central nervous system (CNS) have been described in some patients with HAM/TSP and have triggered and advanced the discovery of some HTLV-I-associated concepts in HTLV-I-infected individuals without signs of CNS involvement. Most of these HTLV-I-associated diseases exhibit common viroimmunologic characteristics that include a distributional bias of HTLV-I activation between the blood flow and the affected lesions and accumulated cellular immune responses in the lesions. These facts suggest that the vulnerable tissue(s) in some HTLV-I-infected individuals may not be defined by an exclusive tissue specificity, but that common steps of HTLV-I-versus-host interactions may have an important role in the pathologic process(es) in these diseases. This review summarizes the recent perspectives of the clinical spectrum and the pathogenesis of HAM/TSP in Japan. Furthermore, the feasible pathogenic involvement of cellular interactions between infected cells and responding immunocompetent cells in the affected tissues is emphasized.
与I型人类嗜T细胞病毒（HTLV-I）感染相关的神经系统疾病具有一系列临床症状，其中以脊髓病（HTLV-I相关脊髓病/热带痉挛性截瘫，HAM/TSP）为主要临床表现。在一些HAM/TSP患者中，已经描述了中枢神经系统（CNS）以外受累的许多临床体征，这些体征引发并推动了在无CNS受累迹象的HTLV-I感染个体中一些HTLV-I相关概念的发现。大多数这些HTLV-I相关疾病表现出共同的病毒免疫学特征，包括HTLV-I在血流和受影响病变之间激活的分布偏差以及病变中累积的细胞免疫反应。这些事实表明，一些HTLV-I感染个体中的易损组织可能不是由排他性的组织特异性定义的，而是HTLV-I与宿主相互作用的共同步骤可能在这些疾病的病理过程中起重要作用。本综述总结了日本对HAM/TSP临床症状范围和发病机制的最新观点。此外，还强调了受影响组织中感染细胞与反应性免疫活性细胞之间细胞相互作用可能的致病作用。
