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

一种名为HTLV-1的病毒感染了全球约1000万人，导致约30万人进行性瘫痪。由于这种疾病相对罕见，被称为HTLV-1相关性脊髓病(HAM)，以前被称为热带痉挛麻痹(TSP)，在高收入国家被忽视。英国独一无二地提供了一个治疗HAM患者的国家中心，这导致了诊断和治疗的进步，并有可能在脑部炎症变得明显之前及早发现它。在这种感染更常见的巴西，同事们正在证明疾病发生的频率比之前认为的更高，并描述了高达30%的HTLV-1感染者的轻微形式。这项研究汇集了伦敦大学学院的神经化学家、巴西的神经学家和伦敦帝国理工学院传染病系的病毒学家的专业知识，以找到检测感染HTLV-1的患者的炎症和神经损伤的方法，这些患者尚未显示出疾病的迹象。我们的目标是通过血液测试来做到这一点，而不是必须进行脊椎抽液来检查沐浴在大脑和脊髓中的液体。导致这一提议的工作已经确定了在血液中检测到的一些蛋白质可能是合适的标志物。现在将在英国和巴西使用更多的HTLV-1感染者进行测试。识别这些蛋白质将使医疗保健专业人员能够检测到不明显的脑部炎症，针对这些患者进行更严格的调查以证实这一点，并启动治疗以抑制炎症，最好是在治疗的临床试验中。这项对已知感染了导致大脑和脊髓炎症的病毒的人的研究结果，也可能为其他神经系统疾病提供新的见解，在这些疾病中，病因未知，处于危险之中的人不容易被识别和调查。

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.