Intrinsic and Extrinsic Cell Apoptotic Pathways in Patients with HTLV-1-Associated Myelopathy/Tropical Spastic Paraparesis: A Systematic Review

HTLV-1 is frequently associated with myelopathy/tropical spastic paraparesis (HAM/TSP), which in turn brings several functional alterations to the individual, including changes in gait. Objective: To systematize the scientific findings on the temporo-spatial gait parameters in individuals with HTLV-1. Methodology: This is a systematic review of the scientific literature. The primary search of the articles was performed in the Pubmed, Scielo and Bireme databases, and observational studies were included that evaluated gait changes in individuals with HTLV-1. The search strategy was conducted by two researchers apart and the divergences resolved by consensus. Results: Firstly, it has found 40 studies and considering them, it was included two studies that investigated the changes in gait performance among the individuals with HTLV-1, within a total of 97 individuals. Conclusion: This systematic review identified changes in gait pattern among individuals with tropical spastic paraparesis/myelopathy associated to HTLV-1; functional changes in muscle groups of the lower limbs and slowing gait speed are among the main findings, but the lack of published work on the subject makes it difficult to access information. Therefore, it is suggested that new approaches be made for a better understanding of this topic.

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The Role of Human T-Lymphotropic Virus Type 1 (HTLV-1)-Infected Dendritic Cells in the Development of HTLV-1-Associated Myelopathy/Tropical Spastic Paraparesis

Journal of Virology ◽

10.1128/jvi.73.6.4575-4581.1999 ◽

1999 ◽

Vol 73 (6) ◽

pp. 4575-4581 ◽

Cited By ~ 61

Author(s):

Masahiko Makino ◽

Satoshi Shimokubo ◽

Shin-Ichi Wakamatsu ◽

Shuji Izumo ◽

Masanori Baba

Keyword(s):

T Cells ◽

Dendritic Cells ◽

Virus Type ◽

Spastic Paraparesis ◽

Tropical Spastic Paraparesis ◽

Normal Donor ◽

Dependent Manner ◽

T Lymphotropic Virus

ABSTRACT The development of human T-lymphotropic virus type 1 (HTLV-1)-associated myelopathy/tropical spastic paraparesis (HAM/TSP) is closely associated with the activation of T cells which are HTLV-1 specific but may cross-react with neural antigens (Ags). Immature dendritic cells (DCs), differentiated from normal donor monocytes by using recombinant granulocyte-macrophage colony-stimulating factor and recombinant interleukin-4, were pulsed with HTLV-1 in vitro. The pulsed DCs contained HTLV-1 proviral DNA and expressed HTLV-1 Gag Ag on their surface 6 days after infection. The DCs matured by lipopolysaccharides stimulated autologous CD4+ T cells and CD8+ T cells in a viral dose-dependent manner. However, the proliferation level of CD4+ T cells was five- to sixfold higher than that of CD8+ T cells. In contrast to virus-infected DCs, DCs pulsed with heat-inactivated virions activated only CD4+ T cells. To clarify the role of DCs in HAM/TSP development, monocytes from patients were cultured for 4 days in the presence of the cytokines. The expression of CD86 Ag on DCs was higher and that of CD1a Ag was more down-regulated than in DCs generated from normal monocytes. DCs from two of five patients expressed HTLV-1 Gag Ag. Furthermore, both CD4+ and CD8+ T cells from the patients were greatly stimulated by contact with autologous DCs pulsed with inactivated viral Ag as well as HTLV-1-infected DCs. These results suggest that DCs are susceptible to HTLV-1 infection and that their cognate interaction with T cells may contribute to the development of HAM/TSP.

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