Early detection and evaluation of HTLV-1-associated neuro-inflammation and damage

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A virus known as HTLV-1 infects approximately 10 million persons worldwide causing a progressive paralysis in about 300,000. Due to the relative rarity of this disease, called HTLV-1-associated myelopathy (HAM), formerly known as Tropical Spastic Paraparesis (TSP), in high income countries it has been neglected. The UK uniquely provides a National Centre for the care of patients with HAM which has led to advances in diagnosis and treatment and the potential for early detection of brain inflammation before it becomes obvious. Colleagues in Brazil, where this infection is more common, are demonstrating that disease occurs more frequently than previously thought and are describing mild forms in up to 30% of HTLV-1 infected persons.This study brings together the expertise of Neurochemists at University College London, Neurologists in Brazil and Virologists of the Department of Infectious Disease, Imperial College London to find ways to detect inflammation and nerve damage in patients infected with HTLV-1 who do not yet show signs of disease. Our aim is to do this through blood tests rather than having to perform a spinal tap to examine the fluid which bathes the brain and spinal cord.Work leading up to this proposal has identified a number of proteins detected in blood that may be suitable markers. This will now be tested using a larger number of HTLV-1 infected persons in the UK and in Brazil. Identifying these proteins will allow healthcare professionals to detect brain inflammation which is not obvious, to target such patients for more intense investigation to confirm this and to initiate treatment to suppress the inflammation, ideally in clinical trials of treatment. The results of this study of persons known to be infected with a virus that causes brain and spinal cord inflammation may also provide new insights into other neurological diseases where the cause is not known and those at risk cannot be so readily identified and investigated.