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HTLV‐I‐associated myelopathy
Author(s) -
Izumo Shuji,
Umehara Fujio,
Osame Mitsuhiro
Publication year - 2000
Publication title -
neuropathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.701
H-Index - 61
eISSN - 1440-1789
pISSN - 0919-6544
DOI - 10.1046/j.1440-1789.2000.00320.x
Subject(s) - tropical spastic paraparesis , provirus , myelopathy , t cell leukemia , pathology , cytotoxic t cell , retrovirus , myelin , medicine , infiltration (hvac) , peripheral blood mononuclear cell , immunology , biology , virology , virus , spinal cord , central nervous system , gene , in vitro , biochemistry , physics , thermodynamics , genome , psychiatry , endocrinology
HTLV‐I was first described as a pathogenic human retrovirus that causes adult T‐cell leukemia (ATL). Soon after the discovery of HTLV‐I, an association of this virus with a slowly progressive neurological disorder was found independently in Japan and Caribbean islands, and this new clinical entity (HTLV‐I‐associated myelopathy with tropical spastic paraparesis) was named HAM/TSP. Autopsy findings clarified the chronic inflammatory nature of the disease. Detailed neuropathological analysis demonstrated: (i) T‐cell‐dominant mononuclear cell infiltration; (ii) diffuse and symmetrical degeneration of the antero‐lateral and inner portion of the posterior columns involving both myelin and axons; (iii) the presence of cytotoxic T cells and apoptosis of helper/inducer T cells; (iv) in vivo localization of HTLV‐I provirus in the perivascular infiltrated T cells; and (v) accentuation of inflammatory lesions at the site with slow blood flow. From these findings it is suggested that a T‐cell‐mediated chronic inflammatory process targeting the HTLV‐I‐infected T cells is the primary pathogenic mechanism of HAM/TSP.