Volume 8 Supplement 1

15th International Conference on Human Retroviruses: HTLV and Related Viruses

Open Access

Clinical subtype of HAM/TSP based on clinical course and laboratory findings

  • Yoshihisa Yamano1Email author,
  • Tomoo Sato1,
  • Natsumi Araya1,
  • Naoko Yagishita1,
  • Yukiko Shimizu1,
  • Hitoshi Ando1,
  • Atae Utsunomiya2,
  • Shuji Izumo3,
  • Steven Jacobson4 and
  • Noboru Suzuki1
Retrovirology20118(Suppl 1):A42

DOI: 10.1186/1742-4690-8-S1-A42

Published: 6 June 2011

The clinical course and disease activity of patients with HTLV-1 associated myelopathy / tropical spastic paraparesis (HAM/TSP) are different among patients. Therefore, the treatment plan should be designed based on these backgrounds of patients. However, there is little information about the natural history of HAM/TSP and biomarkers of disease activity that is associated with prognosis.

As the candidate for biomarkers to evaluate the disease activity in HAM/TSP, HTLV-1 proviral load in PBMC, several cytokines and chemokines in serum or cerebrospinal fluid (CSF) are known to be increased in HAM/TSP patients. However, little is known which parameter of these candidates is most associated with disease severity.

Therefore, we investigated the clinical course of 30 HAM/TSP patients without any history of treatment. Furthermore, we measured quantitatively the concentration of a series of cytokines and chemokines in serum and CSF, and HTLV-1 proviral DNA load in PBMC. Then, the level of these markers was evaluated for the correlation with disease severity.

In HAM/TSP patients, the level of CXCL10/IP-10 and neopterin in CSF was strongly correlated with disease severity. Interestingly, the level of soluble IL-2 receptor and CXCL10/IP-10 in serum was also correlated with disease severity with statistical significance. Furthermore, based on the clinical course and laboratory findings, HAM/TSP was classified into 4 different clinical subtypes as follows; (1) Rapidly progressive (active), (2-A) Chronic progressive (active), (2-B) Chronic progressive (inactive), (3) Chronic mild (inactive). This classification might be useful to determine the therapeutic strategy for patients with HAM/TSP.

Authors’ Affiliations

(1)
Institute of Medical Science, St. Marianna University School of Medicine
(2)
Department of Hematology, Imamura Bun-in Hospital
(3)
Molecular Pathology, Center for Chronic Viral Diseases, Graduate School of Medical and Dental Sciences, Kagoshima University
(4)
Viral Immunology Section, Neuroimmunology Branch, National Institute of Health

Copyright

© Yamano et al; licensee BioMed Central Ltd. 2011

This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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