Usefulness of proviral load measurement for monitoring of disease activity in individual patients with human T-lymphotropic virus type I-associated myelopathy/tropical spastic paraparesis
Usefulness of proviral load measurement for monitoring of disease activity in individual patients with human T-lymphotropic virus type I-associated myelopathy/tropical spastic paraparesis
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DOI：
10.1080/13550280390173418
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发表时间：
2003-01-01
影响因子：
3.2
通讯作者：
Izumo, S
中科院分区：
文献类型：
--
作者：
Takenouchi, N;Yamano, Y;Izumo, S
据报道，HTLV-I 相关脊髓病/热带痉挛性截瘫 (HAM/TSP) 患者的外周血单核细胞 (PBMC) 中人类 T 淋巴细胞病毒 I 型 (HTLV-I) 前病毒载量较高，并且据报道，个别患者在病程中前病毒载量存在波动。临床症状通常在经过一段长时间的症状进展后变得稳定。然而，作者也遇到过一些患者在病程中临床表现突然恶化的情况。为了阐明高前病毒载量及其波动在 HAM/TSP 发病机制中的作用，作者测量了长期随访中连续采集的 PBMC 以及 HAM/TSP 患者脑脊液 (CSF) 细胞的前病毒载量，并将其与临床表现进行比较。原病毒载量分布广泛，从 0.3 到 37.8 拷贝/100 个 PBMC；然而，个别患者的前病毒载量在疾病过程中相对稳定。 83% 的临床恶化患者在记录临床恶化时或之前的时间点表现出前病毒载量增加。个别患者脑脊液细胞中的前病毒载量高于 PBMC 中的前病毒载量。 CSF 细胞/PBMC 中前病毒载量的比率（而非绝对载量）与临床进展性疾病以及 HAM/TSP 的近期发作显着相关。这些发现表明 HAM/TSP 的临床进展与中枢神经系统中 HTLV-I 感染的淋巴细胞增殖或迁移增加有关。
High human T-lymphotropic virus type I (HTLV-I) proviral load in peripheral blood mononuclear cells (PBMCs) has been reported in patients with HTLV-I-associated myelopathy/tropical spastic paraparesis (HAM/TSP) and the proviral load has been reported to fluctuate in individual patients during the course of the disease. Clinical symptoms usually became stable after a prolonged period of symptom progression. However, the authors have experienced having some patients whose clinical manifestations suddenly became worse during the course of the disease. To clarify the role of high proviral load and its fluctuation in the pathogenesis of HAM/TSP, the authors measured the proviral load of serially taken PBMCs as well as of cerebrospinal fluid (CSF) cells from patients with HAM/TSP on long-term follow-up and compared these with their clinical manifestations. There was a wide distribution of proviral load, from 0.3 to 37.8 copies/100 PBMCs; however, the proviral load in individual patients was relatively stable during the course of the disease. Eighty-three percent of the patients with clinical worsening showed an increase in proviral load at the time point when clinical worsening was recorded, or at the preceding time point. The proviral loads in CSF cells were higher than those in PBMCs in individual patients. The ratio of proviral loads in CSF cells/in PBMCs, but not the absolute load, in either compartment, was significantly associated with clinically progressive disease and with recent onset of HAM/TSP. These findings indicate that clinical progression of HAM/TSP is associated with increased proliferation or immigration of HTLV-I-infected lymphocytes in the central nervous system.