Studies on the Mechanism and Epidemiology of Mother-To-Child HTLV-I Transmission by the Use of PCR (Polymerase Chain Reaction) Method.

这些研究的目的是探讨HTLV-I母婴传播的真正机制和流行病学的真实的特征，制定母婴传播的预防措施和婴儿的最佳喂养。研究结果如下：1.建立了检测HTLV-I携带者初乳淋巴细胞中前病毒DNA的PCR方法，该方法可同时检测HTLV-I携带者外周血淋巴细胞中的前病毒DNA，并建立了前病毒拷贝数的半定量检测方法.建立了一种快速、简便的全血DNA纯化方法.对不同喂养方式的HTLV携带者母亲所生儿童进行HTLV-Ⅰ血清学检测。结果，正常母乳喂养组的血清阳性率为6.1%，冻融母乳喂养组为7.7%，奶瓶喂养组为0。人外周血淋巴细胞中HTLV-Ⅰ型前病毒的拷贝数 关于我们 携带者母亲与接受其母乳的婴儿的血清转化最相关。根据这一结果，对上述前病毒拷贝数的半定量测定进行了修改，并建立了定量测定。携带<tax>者母亲P40抗体阳性率与儿童阳转率相关，但无统计学意义.正常母乳喂养组与非母乳喂养组血清阳转率差异无统计学意义.冲绳孕妇中HTLV-I抗体的总体患病率为6.5%。经产组抗体阳性率明显高于经产组（P &lt; 0.05）。从以上结果来看，正常母乳喂养组的血清阳转率相对较低，这对完全停止母乳喂养的政策提出了质疑。携带者母亲外周血淋巴细胞中HTLV-Ⅰ型前病毒拷贝数与母乳喂养婴儿的血清转化率相关性最高，可作为母婴传播的一个有用指标。少

These studies aim at investigating what is the true mechanism of mother-to-child HTLV-I transmission and real feature of the epidemiology and establishing preventive measures against mother-to-child transmission and the best feeding for the infants. The results are as follows :1. A method for detecting proviral DNA in the lymphocytes of colostrum from HTLV-I carriers with the PCR was developed, by which proviral DNA in the peripheral lymphocytes from carriers could also be detected and semi-quantitative assay for provirus copy number was established.2. A rapid and simplified method for purifying DNA from whole blood was established.3. The seroprevalence of HTLV-I in children born to carrier-mothers was surveyed from the blood sample of different feeding group. As a results, the seroprevalence in a normal breast feeding group was 6.1%, 7.7% in a group fed with freez-thawed breast milk and none in a bottle-fed group. The copy number of the HTLV-I provirus in the peripheral lymphocytes of … More the carrier-mothers was most correlated to the seroconversion of the infants who received breast milk from them. From this result, the semi-quantitative assay fro provirus copy number mentioned above, was modified and a quantitative assay was established. P40^<tax> antibody-positivity of the carrier-mothers was relevant to the seroconversion rate in children, which was not significant statistically.4. The difference between the seroconversion rate for the normal breast feeding group and others was statistically insignificant.5. The overall prevalence of HTLV-I antibodies in pregnant women was 6.5% in Okinawa. The antibody-positive rate was significantly higher in multiparous patients than in primiparous patients(p < 0.05). From the results above, the seroconversion rate for the normal breast feeding group was relatively low compared to the reports by other investigators, which cast some doubt on the policy for totally stopping the breast feeding. The copy number of the HTLV-I provirus in the peripheral lymphocytes of the carrier mothers was most correlated to the seroconversion of the infants who received breast milk from them, which can be a useful index for the mother-to-child transmission. Less