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CXCL10 and neopterin in CSF are candidate prognostic biomarkers for HTLV-1-associated myelopathy/tropical spastic paraparesis

Human T-lymphotropic virus type 1 (HTLV-1) -associated myelopathy/tropical spastic paraparesis (HAM/TSP) is a chronic neuroinflammatory disease. Since the disease course of HAM/TSP varies among patients, there is a dire need for biomarkers capable of predicting the rate of disease progression for earlier detection of high-risk patients. However, there have been no studies to date that have compared the prognostic values of multiple potential biomarkers for HAM/TSP. Peripheral blood and cerebrospinal fluid (CSF) samples from HAM/TSP patients and HTLV-1-infected control subjects were obtained and tested for several potential biomarkers, including chemokines and other cytokines, and 8 optimal candidates were selected based on receiver operating characteristic (ROC) analysis. Next, we evaluated the relationship between these candidates and the rate of disease progression in HAM/TSP patients, beginning with a Training Set of 30 patients and proceeding to a Test Set of 23 patients. We defined “deteriorating HAM/TSP” as distinctly worsening function (≥ 3 grades on Osame’s Motor Disability Score (OMDS)) over 4 y and “stable HAM/TSP” as unchanged or only slightly worsened function (1 grade on OMDS) over 4 y, and we compared the levels of the candidate biomarkers in patients divided into these 2 groups. The CSF levels of chemokine (C-X-C motif) ligand 10 (CXCL10), neopterin and the CSF cell count were well-correlated with disease progression, better even than HTLV-1 proviral load in PBMCs. Importantly, these results were cross-validated using the Test Set. Therefore, the CSF levels of CXCL10 and neopterin represent the most viable candidates for HAM/TSP prognostic biomarkers.

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Correspondence to Yoshihisa Yamano.

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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 (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.

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Yamano, Y., Sato, T., Ando, H. et al. CXCL10 and neopterin in CSF are candidate prognostic biomarkers for HTLV-1-associated myelopathy/tropical spastic paraparesis. Retrovirology 11 (Suppl 1), P18 (2014).

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