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

这些研究旨在探讨HTLV-I母婴传播的真正机制和流行病学的真实特征，制定预防母婴传播的措施和婴儿的最佳喂养方法。研究结果如下：1。建立了一种用PCR方法检测htlv - 1携带者初乳淋巴细胞原病毒DNA的方法，该方法还可以检测携带者外周血淋巴细胞的原病毒DNA，并建立了半定量检测原病毒拷贝数的方法。建立了一种快速、简便的纯化全血DNA的方法。采用不同喂养组的血液样本，调查了带菌母亲所生儿童HTLV-I的血清阳性率。结果，正常母乳喂养组的血清阳性率为6.1%，用冻融母乳喂养组的血清阳性率为7.7%，而奶瓶喂养组的血清阳性率为零。携带者母亲外周血淋巴细胞HTLV-I原病毒拷贝数与接受其母乳的婴儿血清转化最相关。在此基础上，对上述原病毒拷贝数的半定量分析方法进行了改进，建立了定量分析方法。携带者母亲P40^< 0.01抗体阳性与儿童血清转换率相关，差异无统计学意义。正常母乳喂养组血清转换率与其他组比较差异无统计学意义。冲绳孕妇HTLV-I抗体的总体流行率为6.5%。多产患者抗体阳性率明显高于初产患者（p < 0.05）。从以上结果来看，正常母乳喂养组的血清转化率与其他研究者的报告相比相对较低，这让人对完全停止母乳喂养的政策产生了一定的怀疑。携带母亲外周血淋巴细胞中HTLV-I前病毒的拷贝数与接受母乳喂养的婴儿的血清转化最相关，这可以作为母婴传播的有用指标。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