Fujihara K, Goldman B, Oseroff A R, Glenister N, Jaffe E S, Bisaccia E, Pincus S, Greenberg S J
Department of Neurology, Roswell Park Cancer Institute, Buffalo, New York 14263, USA.
Immunol Invest. 1997 Jan-Feb;26(1-2):231-42. doi: 10.3109/08820139709048929.
An array of neurologic, oncologic, and autoimmune disorders are associated with infection with the human pathogenic retroviruses human T-cell leukemia virus types I and II (HTLV-I, II), as well as the human immunodeficiency viruses (HIV). The cutaneous T-cell lymphomas, mycosis fungoides (MF) and its hematogenous variant Sezary Syndrome (SS), share similar clinical and pathological features to HTLV-I-associated adult T-cell leukemia (ATL) and speculation of a retroviral link to MF and SS, especially in areas non-endemic for ATL, has lead to an intensified search for HTLV- and HIV-like agents in these diseases. To further explore a potential role for human retroviruses in MF and SS, skin biopsy-derived or peripheral blood mononuclear cell-derived DNA from 17 patients (MF, n = 7; erythrodermic MF (EMF), n = 5; SS, n = 5) from the North Eastern United States were screened using gene amplification by PCR and a liquid hybridization detection assay. Previously published primers and probes for HTLV-I (LTR, gag, pol, env, and pX), and our own primers and probes for HTLV-I (gag, pol, and env), HTLV-II (pol and env) and HIV-I (gag and pol) were employed. Serum antibodies to HTLV-I were negative in all but one EMF patient. The single HTLV-I seropositive patient carrying a diagnosis of EMF generated positive amplified signals for all of the eight HTLV-I regions tested. Ultimately, this individual evolved to exhibit clinical manifestations indistinguishable from ATL. The other 16 patients were negative for all 12 HTLV and HIV retroviral regions. Our findings suggest that none of the known prototypic human retroviruses are associated with seronegative MF and SS. The uniformly positive results for HTLV-I in the seropositive patient suggests that this patient initially presented with a smoldering form of ATL and illustrates the difficulty that sometimes may be encountered in the differential diagnosis of MF, SS, and ATL based solely on clinical and histopathological criteria.
一系列神经、肿瘤和自身免疫性疾病与人类致病性逆转录病毒——人类T细胞白血病病毒I型和II型（HTLV-I、II）以及人类免疫缺陷病毒（HIV）感染有关。皮肤T细胞淋巴瘤、蕈样肉芽肿（MF）及其血行播散型赛塞里综合征（SS），与HTLV-I相关的成人T细胞白血病（ATL）具有相似的临床和病理特征，并且推测逆转录病毒与MF和SS存在关联，尤其是在非ATL流行地区，这促使人们加强了对这些疾病中HTLV和HIV样病原体的搜寻。为了进一步探究人类逆转录病毒在MF和SS中的潜在作用，我们使用聚合酶链反应（PCR）基因扩增和液相杂交检测法，对来自美国东北部的17例患者（MF患者7例；红皮病型MF（EMF）患者5例；SS患者5例）的皮肤活检组织或外周血单个核细胞来源的DNA进行了筛查。我们采用了先前发表的针对HTLV-I的引物和探针（长末端重复序列、gag、pol、env和pX），以及我们自己设计的针对HTLV-I（gag、pol和env）、HTLV-II（pol和env）和HIV-I（gag和pol）的引物和探针。除1例EMF患者外，所有患者的HTLV-I血清抗体均为阴性。这位被诊断为EMF的HTLV-I血清学阳性患者，在检测的所有8个HTLV-I区域均产生了阳性扩增信号。最终，该患者发展出了与ATL难以区分的临床表现。其他16例患者在所有12个HTLV和HIV逆转录病毒区域检测均为阴性。我们的研究结果表明，已知的人类原型逆转录病毒均与血清学阴性的MF和SS无关。血清学阳性患者中HTLV-I的一致阳性结果表明，该患者最初表现为隐匿型ATL，这也说明了仅基于临床和组织病理学标准来鉴别MF、SS和ATL有时可能会遇到困难。
