An update on human T-cell leukemia virus type I (HTLV-1)-associated myelopathy/tropical spastic paraparesis (HAM/TSP) focusing on clinical and laboratory biomarkers.
An update on human T-cell leukemia virus type I (HTLV-1)-associated myelopathy/tropical spastic paraparesis (HAM/TSP) focusing on clinical and laboratory biomarkers.
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人类 T 细胞白血病病毒 I 型 (HTLV-1) 相关脊髓病/热带痉挛性截瘫 (HAM/TSP) 的最新进展，重点关注临床和实验室生物标志物。
DOI：
10.1016/j.pharmthera.2020.107669
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发表时间：
2021
期刊：
影响因子：
--
通讯作者：
Yamano Y.
中科院分区：
文献类型：
--
作者：
Yamauchi J;Araya N;Yagishita N;Sata t;Yamano Y.
人类t细胞白血病病毒I型（HTLV-1）相关脊髓病/热带痉挛性截瘫（HAM/TSP）是一种罕见的炎症性疾病，引起持续和进行性神经系统疾病，如痉挛性截瘫、神经源性膀胱和下肢感觉障碍。虽然没有治愈方法，但免疫调节剂如皮质类固醇被广泛用于减缓疾病进展。由于该疾病的缓慢进展性，预测功能预后和评估治疗效果具有挑战性，因此应确定用于临床评估HAM/TSP的生物标志物。替代生物标志物的缺乏也阻碍了新药的临床试验。本文综述了用于HAM/TSP患者临床评估的候选生物标志物。大多数已报道的候选生物标志物与病毒成分或炎症介质有关，因为htlf -1感染引起的免疫失调被认为会导致HAM/TSP患者的慢性炎症和脊髓损伤。虽然大多数已报道的生物标志物的诊断准确性信息不足，但一些分子，包括脑脊液中的炎症介质，如CXCL10和新蝶呤，已被认为是功能预后和治疗反应的潜在生物标志物。目前正在进行几项针对HAM/TSP的临床试验，我们希望这些研究不仅能提供有关治疗的证据，还能提供有关生物标志物在该疾病中的应用的新发现。临床生物标志物的建立将改善患者的护理，促进HAM/TSP治疗方法的发展。
Human T-cell leukemia virus type I (HTLV-1)-associated myelopathy/tropical spastic paraparesis (HAM/TSP) is a rare inflammatory disease causing unremitting and progressive neurological disorders, such as spastic paraparesis, neurogenic bladder, and sensory disturbance of the lower extremities. Although there is no cure, immune-modulating agents such as corticosteroids are most widely used to slow disease progression. Biomarkers for the clinical assessment of HAM/TSP should be identified because the prediction of functional prognosis and the assessment of treatment efficacy are challenging due to the slowly progressive nature of the disease. The lack of surrogate biomarkers also hampers clinical trials of new drugs. This review summarizes biomarker candidates for the clinical assessment of patients with HAM/TSP. Most of the reported biomarker candidates are associated with viral components or inflammatory mediators because immune dysregulation provoked by HTLV-1 infection is thought to cause chronic inflammation and damage the spinal cord of patients with HAM/TSP. Although information on the diagnostic accuracy of most of the reported biomarkers is insufficient, several molecules, including inflammatory mediators such as CXCL10 and neopterin in the cerebrospinal fluid, have been suggested as potential biomarkers of functional prognosis and treatment response. Several clinical trials for HAM/TSP are currently underway, and we expect that these studies will provide not only evidence pertaining to treatment, but also novel findings regarding the utility of biomarkers in this disease. The establishment of clinical biomarkers will improve patient care and promote the development of therapies for HAM/TSP.
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