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Sato T, Coler-Reilly ALG, Yagishita N, Araya N, Inoue E, Furuta R, Watanabe T, Uchimaru K, Matsuoka M, Matsumoto N, Hasegawa Y, Yamano Y. Mogamulizumab (Anti-CCR4) in HTLV-1-Associated Myelopathy. N Engl J Med 2018; 378:529-538. [PMID: 29414279 DOI: 10.1056/nejmoa1704827] [Citation(s) in RCA: 65] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Human T-lymphotropic virus type 1 (HTLV-1) causes the debilitating neuroinflammatory disease HTLV-1-associated myelopathy-tropical spastic paraparesis (HAM-TSP) as well as adult T-cell leukemia-lymphoma (ATLL). In patients with HAM-TSP, HTLV-1 infects mainly CCR4+ T cells and induces functional changes, ultimately causing chronic spinal cord inflammation. We evaluated mogamulizumab, a humanized anti-CCR4 monoclonal antibody that targets infected cells, in patients with HAM-TSP. METHODS In this uncontrolled, phase 1-2a study, we assessed the safety, pharmacokinetics, and efficacy of mogamulizumab in patients with glucocorticoid-refractory HAM-TSP. In the phase 1 dose-escalation study, 21 patients received a single infusion of mogamulizumab (at doses of 0.003 mg per kilogram of body weight, 0.01 mg per kilogram, 0.03 mg per kilogram, 0.1 mg per kilogram, or 0.3 mg per kilogram) and were observed for 85 days. Of those patients, 19 continued on to the phase 2a study and received infusions, over a period of 24 weeks, of 0.003 mg per kilogram, 0.01 mg per kilogram, or 0.03 mg per kilogram at 8-week intervals or infusions of 0.1 mg per kilogram or 0.3 mg per kilogram at 12-week intervals. RESULTS The side effects of mogamulizumab did not limit administration up to the maximum dose (0.3 mg per kilogram). The most frequent side effects were grade 1 or 2 rash (in 48% of the patients) and lymphopenia and leukopenia (each in 33%). The dose-dependent reduction in the proviral load in peripheral-blood mononuclear cells (decrease by day 15 of 64.9%; 95% confidence interval [CI], 51.7 to 78.1) and inflammatory markers in cerebrospinal fluid (decrease by day 29 of 37.3% [95% CI, 24.8 to 49.8] in the CXCL10 level and of 21.0% [95% CI, 10.7 to 31.4] in the neopterin level) was maintained with additional infusions throughout the phase 2a study. A reduction in spasticity was noted in 79% of the patients and a decrease in motor disability in 32%. CONCLUSIONS Mogamulizumab decreased the number of HTLV-1-infected cells and the levels of inflammatory markers. Rash was the chief side effect. The effect of mogamulizumab on clinical HAM-TSP needs to be clarified in future studies. (Funded by the Japan Agency for Medical Research and Development and the Ministry of Health, Labor, and Welfare; UMIN trial number, UMIN000012655 .).
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MESH Headings
- Adult
- Aged
- Antibodies, Monoclonal, Humanized/administration & dosage
- Antibodies, Monoclonal, Humanized/adverse effects
- Antibodies, Monoclonal, Humanized/pharmacokinetics
- Antineoplastic Agents/administration & dosage
- Antineoplastic Agents/adverse effects
- Antineoplastic Agents/pharmacokinetics
- Area Under Curve
- Dose-Response Relationship, Drug
- Drug Administration Schedule
- Exanthema/chemically induced
- Female
- Human T-lymphotropic virus 1/isolation & purification
- Humans
- Male
- Middle Aged
- Paraparesis, Tropical Spastic/drug therapy
- Paraparesis, Tropical Spastic/immunology
- Receptors, CCR4/antagonists & inhibitors
- T-Lymphocytes/immunology
- Viral Load
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Affiliation(s)
- Tomoo Sato
- From the Department of Rare Diseases Research, Institute of Medical Science (T.S., A.L.G.C.-R., N.Y., N.A., Y.Y.), Medical Informatics (E.I.), and the Departments of Pharmacology (N.M.) and Neurology (Y.H.), St. Marianna University School of Medicine, and the Department of Advanced Medical Innovation, St. Marianna University Graduate School of Medicine (T.W., Y.Y.), Kawasaki, the Laboratory of Virus Control, Institute for Virus Research, Kyoto University, Kyoto (R.F., M.M.), the Department of Computational Biology and Medical Sciences, Graduate School of Frontier Sciences, University of Tokyo, Tokyo (K.U.), and the Department of Hematology, Rheumatology, and Infectious Diseases, Graduate School of Medical Sciences, Faculty of Life Sciences, Kumamoto University, Kumamoto (M.M.) - all in Japan
| | - Ariella L G Coler-Reilly
- From the Department of Rare Diseases Research, Institute of Medical Science (T.S., A.L.G.C.-R., N.Y., N.A., Y.Y.), Medical Informatics (E.I.), and the Departments of Pharmacology (N.M.) and Neurology (Y.H.), St. Marianna University School of Medicine, and the Department of Advanced Medical Innovation, St. Marianna University Graduate School of Medicine (T.W., Y.Y.), Kawasaki, the Laboratory of Virus Control, Institute for Virus Research, Kyoto University, Kyoto (R.F., M.M.), the Department of Computational Biology and Medical Sciences, Graduate School of Frontier Sciences, University of Tokyo, Tokyo (K.U.), and the Department of Hematology, Rheumatology, and Infectious Diseases, Graduate School of Medical Sciences, Faculty of Life Sciences, Kumamoto University, Kumamoto (M.M.) - all in Japan
| | - Naoko Yagishita
- From the Department of Rare Diseases Research, Institute of Medical Science (T.S., A.L.G.C.-R., N.Y., N.A., Y.Y.), Medical Informatics (E.I.), and the Departments of Pharmacology (N.M.) and Neurology (Y.H.), St. Marianna University School of Medicine, and the Department of Advanced Medical Innovation, St. Marianna University Graduate School of Medicine (T.W., Y.Y.), Kawasaki, the Laboratory of Virus Control, Institute for Virus Research, Kyoto University, Kyoto (R.F., M.M.), the Department of Computational Biology and Medical Sciences, Graduate School of Frontier Sciences, University of Tokyo, Tokyo (K.U.), and the Department of Hematology, Rheumatology, and Infectious Diseases, Graduate School of Medical Sciences, Faculty of Life Sciences, Kumamoto University, Kumamoto (M.M.) - all in Japan
| | - Natsumi Araya
- From the Department of Rare Diseases Research, Institute of Medical Science (T.S., A.L.G.C.-R., N.Y., N.A., Y.Y.), Medical Informatics (E.I.), and the Departments of Pharmacology (N.M.) and Neurology (Y.H.), St. Marianna University School of Medicine, and the Department of Advanced Medical Innovation, St. Marianna University Graduate School of Medicine (T.W., Y.Y.), Kawasaki, the Laboratory of Virus Control, Institute for Virus Research, Kyoto University, Kyoto (R.F., M.M.), the Department of Computational Biology and Medical Sciences, Graduate School of Frontier Sciences, University of Tokyo, Tokyo (K.U.), and the Department of Hematology, Rheumatology, and Infectious Diseases, Graduate School of Medical Sciences, Faculty of Life Sciences, Kumamoto University, Kumamoto (M.M.) - all in Japan
| | - Eisuke Inoue
- From the Department of Rare Diseases Research, Institute of Medical Science (T.S., A.L.G.C.-R., N.Y., N.A., Y.Y.), Medical Informatics (E.I.), and the Departments of Pharmacology (N.M.) and Neurology (Y.H.), St. Marianna University School of Medicine, and the Department of Advanced Medical Innovation, St. Marianna University Graduate School of Medicine (T.W., Y.Y.), Kawasaki, the Laboratory of Virus Control, Institute for Virus Research, Kyoto University, Kyoto (R.F., M.M.), the Department of Computational Biology and Medical Sciences, Graduate School of Frontier Sciences, University of Tokyo, Tokyo (K.U.), and the Department of Hematology, Rheumatology, and Infectious Diseases, Graduate School of Medical Sciences, Faculty of Life Sciences, Kumamoto University, Kumamoto (M.M.) - all in Japan
| | - Rie Furuta
- From the Department of Rare Diseases Research, Institute of Medical Science (T.S., A.L.G.C.-R., N.Y., N.A., Y.Y.), Medical Informatics (E.I.), and the Departments of Pharmacology (N.M.) and Neurology (Y.H.), St. Marianna University School of Medicine, and the Department of Advanced Medical Innovation, St. Marianna University Graduate School of Medicine (T.W., Y.Y.), Kawasaki, the Laboratory of Virus Control, Institute for Virus Research, Kyoto University, Kyoto (R.F., M.M.), the Department of Computational Biology and Medical Sciences, Graduate School of Frontier Sciences, University of Tokyo, Tokyo (K.U.), and the Department of Hematology, Rheumatology, and Infectious Diseases, Graduate School of Medical Sciences, Faculty of Life Sciences, Kumamoto University, Kumamoto (M.M.) - all in Japan
| | - Toshiki Watanabe
- From the Department of Rare Diseases Research, Institute of Medical Science (T.S., A.L.G.C.-R., N.Y., N.A., Y.Y.), Medical Informatics (E.I.), and the Departments of Pharmacology (N.M.) and Neurology (Y.H.), St. Marianna University School of Medicine, and the Department of Advanced Medical Innovation, St. Marianna University Graduate School of Medicine (T.W., Y.Y.), Kawasaki, the Laboratory of Virus Control, Institute for Virus Research, Kyoto University, Kyoto (R.F., M.M.), the Department of Computational Biology and Medical Sciences, Graduate School of Frontier Sciences, University of Tokyo, Tokyo (K.U.), and the Department of Hematology, Rheumatology, and Infectious Diseases, Graduate School of Medical Sciences, Faculty of Life Sciences, Kumamoto University, Kumamoto (M.M.) - all in Japan
| | - Kaoru Uchimaru
- From the Department of Rare Diseases Research, Institute of Medical Science (T.S., A.L.G.C.-R., N.Y., N.A., Y.Y.), Medical Informatics (E.I.), and the Departments of Pharmacology (N.M.) and Neurology (Y.H.), St. Marianna University School of Medicine, and the Department of Advanced Medical Innovation, St. Marianna University Graduate School of Medicine (T.W., Y.Y.), Kawasaki, the Laboratory of Virus Control, Institute for Virus Research, Kyoto University, Kyoto (R.F., M.M.), the Department of Computational Biology and Medical Sciences, Graduate School of Frontier Sciences, University of Tokyo, Tokyo (K.U.), and the Department of Hematology, Rheumatology, and Infectious Diseases, Graduate School of Medical Sciences, Faculty of Life Sciences, Kumamoto University, Kumamoto (M.M.) - all in Japan
| | - Masao Matsuoka
- From the Department of Rare Diseases Research, Institute of Medical Science (T.S., A.L.G.C.-R., N.Y., N.A., Y.Y.), Medical Informatics (E.I.), and the Departments of Pharmacology (N.M.) and Neurology (Y.H.), St. Marianna University School of Medicine, and the Department of Advanced Medical Innovation, St. Marianna University Graduate School of Medicine (T.W., Y.Y.), Kawasaki, the Laboratory of Virus Control, Institute for Virus Research, Kyoto University, Kyoto (R.F., M.M.), the Department of Computational Biology and Medical Sciences, Graduate School of Frontier Sciences, University of Tokyo, Tokyo (K.U.), and the Department of Hematology, Rheumatology, and Infectious Diseases, Graduate School of Medical Sciences, Faculty of Life Sciences, Kumamoto University, Kumamoto (M.M.) - all in Japan
| | - Naoki Matsumoto
- From the Department of Rare Diseases Research, Institute of Medical Science (T.S., A.L.G.C.-R., N.Y., N.A., Y.Y.), Medical Informatics (E.I.), and the Departments of Pharmacology (N.M.) and Neurology (Y.H.), St. Marianna University School of Medicine, and the Department of Advanced Medical Innovation, St. Marianna University Graduate School of Medicine (T.W., Y.Y.), Kawasaki, the Laboratory of Virus Control, Institute for Virus Research, Kyoto University, Kyoto (R.F., M.M.), the Department of Computational Biology and Medical Sciences, Graduate School of Frontier Sciences, University of Tokyo, Tokyo (K.U.), and the Department of Hematology, Rheumatology, and Infectious Diseases, Graduate School of Medical Sciences, Faculty of Life Sciences, Kumamoto University, Kumamoto (M.M.) - all in Japan
| | - Yasuhiro Hasegawa
- From the Department of Rare Diseases Research, Institute of Medical Science (T.S., A.L.G.C.-R., N.Y., N.A., Y.Y.), Medical Informatics (E.I.), and the Departments of Pharmacology (N.M.) and Neurology (Y.H.), St. Marianna University School of Medicine, and the Department of Advanced Medical Innovation, St. Marianna University Graduate School of Medicine (T.W., Y.Y.), Kawasaki, the Laboratory of Virus Control, Institute for Virus Research, Kyoto University, Kyoto (R.F., M.M.), the Department of Computational Biology and Medical Sciences, Graduate School of Frontier Sciences, University of Tokyo, Tokyo (K.U.), and the Department of Hematology, Rheumatology, and Infectious Diseases, Graduate School of Medical Sciences, Faculty of Life Sciences, Kumamoto University, Kumamoto (M.M.) - all in Japan
| | - Yoshihisa Yamano
- From the Department of Rare Diseases Research, Institute of Medical Science (T.S., A.L.G.C.-R., N.Y., N.A., Y.Y.), Medical Informatics (E.I.), and the Departments of Pharmacology (N.M.) and Neurology (Y.H.), St. Marianna University School of Medicine, and the Department of Advanced Medical Innovation, St. Marianna University Graduate School of Medicine (T.W., Y.Y.), Kawasaki, the Laboratory of Virus Control, Institute for Virus Research, Kyoto University, Kyoto (R.F., M.M.), the Department of Computational Biology and Medical Sciences, Graduate School of Frontier Sciences, University of Tokyo, Tokyo (K.U.), and the Department of Hematology, Rheumatology, and Infectious Diseases, Graduate School of Medical Sciences, Faculty of Life Sciences, Kumamoto University, Kumamoto (M.M.) - all in Japan
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Neco HVPDC, Teixeira VGDS, da Trindade ACL, Magalhães PMR, de Lorena VMB, Castellano LRC, de Souza JR, Vasconcelos LR, de Moura PMMF, de Morais CNL. Mediators Go Together: High Production of CXCL9, CXCL10, IFN-γ, and TNF-α in HTLV-1-Associated Myelopathy/Tropical Spastic Paraparesis. AIDS Res Hum Retroviruses 2017. [PMID: 28648091 DOI: 10.1089/aid.2016.0296] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) is a chronic demyelinating and disabling syndrome caused by human T lymphotropic virus 1 (HTLV-1). Although the pathogenic mechanisms that lead to HAM/TSP outcome have not been elucidated, genetic and immunological factors may be involved in the myelopathy occurrence. This study aimed to compare cytokines, chemokines, and nitric oxide (NO) levels in asymptomatic and HAM/TSP HTLV-1-infected patients. The study group consisted of 21 HAM/TSP and 48 asymptomatic HTLV-1 patients. Chemokines (CCL5, CCL2, CXCL8, CXCL9, and CXCL10) and cytokines [IL-2, interferon gamma (IFN-γ), tumor necrosis factor alpha (TNF-α), IL-4, IL-6, and IL-10] were measured using cytometric bead array, whereas NO production was measured after reaction of supernatants with nitrate reduction solution. CXCL9 and CXCL10 chemokines levels were found to be higher in the HAM/TSP group. CXCL9 was also strongly correlated with CXCL10 and both CXCL9 and CXCL10 were moderately correlated with CCL2 and CCL5 levels, in both HAM/TSP and asymptomatic groups. There was no significant difference related to NO, IL-4, IL-6, and IL-10 levels between the clinical groups but TNF-α and IFN-γ levels were increased in HAM/TSP patients. Thus, factors such as CXCL9, CXCL10, TNF-α, and IFN-γ could be good prognostic biomarker candidates, and further studies may help to clarify their association with HAM/TSP immunopathogenesis.
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Affiliation(s)
- Heytor Victor Pereira da Costa Neco
- Department of Virology and Experimental Therapy (LaViTE), Aggeu Magalhães Institute (IAM), Oswaldo Cruz Foundation (Fiocruz), Recife, Brazil
| | | | | | | | | | | | - Joelma Rodrigues de Souza
- Health Technical School, Federal University of Paraíba (UFPB), João Pessoa, Brazil
- Department of Physiology and Pathology, Health Science Center, Federal University of Paraíba (UFPB), João Pessoa, Brazil
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da Silva-Malta MCF, Sales CC, Guimarães JC, de Cássia Gonçalves P, Chaves DG, Santos HC, da Costa Pereira A, Ribas JG, de Freitas Carneiro-Proietti AB, Martins ML. The Duffy null genotype is associated with a lower level of CCL2, leukocytes and neutrophil count but not with the clinical outcome of HTLV-1 infection. J Med Microbiol 2017; 66:1207-1216. [DOI: 10.1099/jmm.0.000539] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Affiliation(s)
| | - Camila Campos Sales
- Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte, Minas, Gerais, Brazil
| | | | | | - Daniel Gonçalves Chaves
- Serviço de Pesquisa, Fundação Hemominas, Belo Horizonte, Minas Gerais, Brazil
- Interdisciplinary HTLV Research Group (GIPH), Brazil
| | - Hadassa Campos Santos
- Laboratório de Genética e Cardiologia Molecular, Instituto do Coração, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Alexandre da Costa Pereira
- Laboratório de Genética e Cardiologia Molecular, Instituto do Coração, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | | | | | - Marina Lobato Martins
- Interdisciplinary HTLV Research Group (GIPH), Brazil
- Serviço de Pesquisa, Fundação Hemominas, Belo Horizonte, Minas Gerais, Brazil
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Abstract
This chapter provides an overview of infectious syndromes, pathogens, and diagnostic testing modalities for central nervous system infections in the immunocompromised host.
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Kubota R. Pathogenesis of human T-lymphotropic virus type 1-associated myelopathy/tropical spastic paraparesis. ACTA ACUST UNITED AC 2017. [DOI: 10.1111/cen3.12395] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Ryuji Kubota
- Division of Molecular Pathology; Center for Chronic Viral Diseases; Graduate School of Medical and Dental Sciences; Kagoshima University; Kagoshima Japan
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Takatani M, Crispim ME, Fraiji N, Stefani MMA, Kiesslich D. Clinical and laboratory features of HTLV-I asymptomatic carriers and patients with HTLV-I-associated myelopathy/tropical spastic paraparesis from the Brazilian Amazon. Rev Inst Med Trop Sao Paulo 2017; 59:e5. [PMID: 28380116 PMCID: PMC5441156 DOI: 10.1590/s1678-9946201759005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Accepted: 09/22/2016] [Indexed: 11/30/2022] Open
Abstract
Clinical and laboratory parameters including blood and cerebrospinal fluid (CSF) neopterin were investigated in human-T-lymphotropic-virus-type-I associated-myelopathy/tropical-spastic-paraparesis-HAM/TSP and in HTLV-I carriers. HAM/TSP (n = 11, 2 males/9 females, median age = 48 years), recently diagnosed HTLV-I carriers (n = 21, 15 females/6 males, median age = 44 years), healthy individuals (n = 20, 10 males/10 females, median age = 34.6 years) from the Brazilian Amazon (Manaus, Amazonas State) were investigated. Neopterin was measured (IBL ELISA Neopterin, Germany) in serum samples of all the participants, in CSF of 9 HAM/TSP patients as well as in 6 carriers. In HAM/TSP patients, CSF cell counts, protein and glucose were measured, the Osame’s motor-disability-score/OMDS was determined, and brain/spinal cord magnetic-resonance-imaging (MRI) was performed. HAM/TSP patients had normal CSF glucose, leukocyte counts; and normal protein levels predominated. Brain-MRI showed white-matter lesions in 7 out of 11 HAM/TSP patients. OMDS varied from 2-8: 9 were able to walk, 2 were wheel-chair-users. The median serum neopterin concentration in HAM/TSP patients was 6.6 nmol/ L; min. 2.8- max. 12.5 nmol/ L); was lower in carriers (4.3 nmol/L; min. 2.7- max. 7.2 nmol/ L) as well as in healthy participants (4.7 nmol/ L; min. 2.7- max. 8.0 nmol/ L) (p < 0.05). CSF neopterin concentrations in HAM/TSP patients were higher than in serum samples, and higher compared to carriers (p < 0.05). Carriers had similar serum-CSF neopterin concentrations compared to healthy participants. Variable clinical and laboratory profiles were seen in HAM/TSP patients, however our results support the neopterin measurement as a potential biomarker of disease activity.
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Affiliation(s)
- Massanobu Takatani
- Universidade Federal do Amazonas, Faculdade de Medicina, Departamento de Clínica Cirúrgica, Manaus, Amazonas, Brazil
| | - Myuki Esashika Crispim
- Fundação Hospitalar de Hemoterapia e Hematologia do Amazonas (FHEMOAM), Manaus, Amazonas, Brazil
| | - Nelson Fraiji
- Fundação Hospitalar de Hemoterapia e Hematologia do Amazonas (FHEMOAM), Manaus, Amazonas, Brazil
| | | | - Dagmar Kiesslich
- Fundação Hospitalar de Hemoterapia e Hematologia do Amazonas (FHEMOAM), Manaus, Amazonas, Brazil
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Araya N, Sato T, Coler-Reilly A, Yagishita N, Yamano Y. Developing novel treatments for HTLV-1-associated myelopathy (HAM) by investigating molecular pathomechanisms. ACTA ACUST UNITED AC 2017; 39:207-12. [PMID: 27320936 DOI: 10.2177/jsci.39.207] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
A small percentage of those infected with human T-lymphotropic virus type 1 (HTLV-1) develop HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP), a debilitating neurodegenerative disease. This disease impacts essential bodily functions, and since currently available treatments are considered to be poorly effective, there is a dire need to develop a truly effective treatment to suppress disease progression. Recently, the authors and others have determined that HTLV-1 in HAM/TSP patients primarily infects T cells expressing the chemokine receptor CCR4. The authors postulated that HTLV-1 causes these T cells to develop Th1-like functions that are critical for the pathogenesis of HAM/TSP. They described an inflammatory positive feedback loop in which cross-talk between these abnormal Th1-like cells and astrocytes produce and maintain spinal cord lesions in HAM/TSP patients. When an anti-CCR4 antibody was tested against cells from HAM/TSP patients, the antibody instigated the destruction of the CCR4-positive cells, reducing the number of infected cells and the amount of inflammatory activity. Thus, the anti-CCR4 antibody is expected to become a fundamentally new treatment for HAM/TSP that directly targets infected cells. The treatment is currently being tested in clinical trials.
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Affiliation(s)
- Natsumi Araya
- Department of Advanced Medical Innovation, Institute of Medical Science, St. Marianna University School of Medicine
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Lima LM, Cardoso LS, Santos SB, Oliveira RR, Oliveira SC, Góes AM, Loukas A, Araujo MI. Schistosoma antigens downregulate CXCL9 production by PBMC of HTLV-1-infected individuals. Acta Trop 2017; 167:157-162. [PMID: 28040482 DOI: 10.1016/j.actatropica.2016.12.030] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Revised: 12/08/2016] [Accepted: 12/23/2016] [Indexed: 01/06/2023]
Abstract
HTLV-1 is the causal agent of Adult T cell Leukemia/lymphoma (ATLL) and HTLV-1-associated Myelopathy/Tropical Spastic Paraparesis (HAM/TSP). The immune response to HTLV-1-infection is polarized to the Th1-type, and the presence of CXCL9/CXCL10 chemokines may lead to an increase in the recruitment of pro-inflammatory molecules in spinal cord tissue, contributing to the damage observed in the development of HAM/TSP. It has been observed that in chronic helminth-infections, such as schistosomiasis, there is a deviation toward the Th2/regulatory immune response. OBJECTIVE To evaluate the ability of Schistosoma spp. proteins to decrease the in vitro CXCL9 and CXCL10 production by PBMC of HTLV-1-infected individuals. METHODS The Schistosoma proteins rSm29, rSh-TSP-2 and PIII were added to PBMC cultures of HTLV-1-infected individuals and the levels of chemokines in the supernatants were measured using a sandwich ELISA method. RESULTS The addition of rSm29 to the cultures resulted in decreased production of CXCL9 in all the analyzed individuals and HAM/TSP group (18167±9727pg/mL, p=0.044; 20237±6023pg/mL, p=0.028, respectively) compared to the levels in unstimulated cultures (19745±9729pg/mL; 25078±2392pg/mL, respectively). The addition of rSh-TSP-2 decreased the production of CXCL9 in all studied individuals and carriers group (16136±9233pg/mL, p=0.031; 13977±8857pg/mL, p=0.026) vs unstimulated cultures (19745±9729pg/mL; 18121±10508pg/mL, respectively). Addition of PIII did not alter the results. There was no significant change in the levels of CXCL10 by the addition of the studied proteins. CONCLUSION The Schistosoma proteins used in this study were able to down modulate the production of CXCL9, a chemokine associated with the inflammatory process in HTLV-1-infection.
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HTLV-1 induces a Th1-like state in CD4+CCR4+ T cells that produces an inflammatory positive feedback loop via astrocytes in HAM/TSP. J Neuroimmunol 2017; 304:51-55. [DOI: 10.1016/j.jneuroim.2016.08.012] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2015] [Revised: 07/15/2016] [Accepted: 08/10/2016] [Indexed: 01/02/2023]
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Terada Y, Kamoi K, Ohno-Matsui K, Miyata K, Yamano C, Coler-Reilly A, Yamano Y. Treatment of rheumatoid arthritis with biologics may exacerbate HTLV-1-associated conditions: A case report. Medicine (Baltimore) 2017; 96:e6021. [PMID: 28178142 PMCID: PMC5312999 DOI: 10.1097/md.0000000000006021] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Revised: 12/28/2016] [Accepted: 12/29/2016] [Indexed: 11/25/2022] Open
Abstract
RATIONALE There are roughly 5 to 10 million persons infected with human T-lymphotropic virus type 1 (HTLV-1) worldwide, and the safety of treating this population with biologics remains poorly understood. PATIENT CONCERNS AND DIAGNOSIS An HTLV-1-infected 66-year-old female with HTLV-1 uveitis (HU) and HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP). Her HU had been in remission and her HAM/TSP symptoms had been managed effectively with oral steroids for years. However, she developed severe rheumatoid arthritis (RA) after failing to respond well to conventional anti-rheumatic agents. INTERVENTIONS She was administered two intravenous 8mg/kg doses of the biologic tocilizumab. OUTCOMES Subsequently, her RA symptoms resolved, but she suffered a recurrence of HU and exacerbation of HAM/TSP symptoms. When she was switched back to steroid-based treatment, HU and HAM symptoms both improved, but RA symptoms again worsened. Finally, an attempt to substitute the biologic abatacept and reduce the steroids failed when HAM/TSP symptoms again became aggravated. LESSONS To the best of our knowledge, this represents the first report worldwide of a biologic aggravating HTLV-1-associated conditions. This report suggests that caution is advised when using biologics to treat HTLV-1-infected patients, though further research is required to clarify the situation.
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Affiliation(s)
- Yukiko Terada
- Department of Ophthalmology and Visual Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
- Department of Ophthalmology, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo
| | - Koju Kamoi
- Department of Ophthalmology and Visual Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
| | - Kyoko Ohno-Matsui
- Department of Ophthalmology and Visual Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
| | | | | | - Ariella Coler-Reilly
- Department of Rare Diseases Research, Institute of Medical Science, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Yoshihisa Yamano
- Department of Rare Diseases Research, Institute of Medical Science, St. Marianna University School of Medicine, Kanagawa, Japan
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Chaves DG, Sales CC, de Cássia Gonçalves P, da Silva-Malta MCF, Romanelli LC, Ribas JG, de Freitas Carneiro-Proietti AB, Martins ML. Plasmatic proinflammatory chemokines levels are tricky markers to monitoring HTLV-1 carriers. J Med Virol 2016; 88:1438-47. [DOI: 10.1002/jmv.24481] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2016] [Indexed: 12/14/2022]
Affiliation(s)
- Daniel Gonçalves Chaves
- Research Service; Minas Gerais State Blood Center (Fundação Hemominas); Belo Horizonte Brazil
| | - Camila Campos Sales
- Pharmacy College; Federal University of Minas Gerais (UFMG); Belo Horizonte Brazil
| | | | | | - Luiz Cláudio Romanelli
- Research Service; Minas Gerais State Blood Center (Fundação Hemominas); Belo Horizonte Brazil
- GIPH (Interdisciplinary HTLV Research Group); Belo Horizonte Minas Gerais Brazil
| | - João Gabriel Ribas
- GIPH (Interdisciplinary HTLV Research Group); Belo Horizonte Minas Gerais Brazil
| | - Anna Bárbara de Freitas Carneiro-Proietti
- Research Service; Minas Gerais State Blood Center (Fundação Hemominas); Belo Horizonte Brazil
- GIPH (Interdisciplinary HTLV Research Group); Belo Horizonte Minas Gerais Brazil
| | - Marina Lobato Martins
- Research Service; Minas Gerais State Blood Center (Fundação Hemominas); Belo Horizonte Brazil
- GIPH (Interdisciplinary HTLV Research Group); Belo Horizonte Minas Gerais Brazil
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Human T Cell Leukemia Virus Type 1 Infection of the Three Monocyte Subsets Contributes to Viral Burden in Humans. J Virol 2015; 90:2195-207. [PMID: 26608313 DOI: 10.1128/jvi.02735-15] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Accepted: 11/10/2015] [Indexed: 12/22/2022] Open
Abstract
UNLABELLED Because the viral DNA burden correlates with disease development, we investigated the contribution of monocyte subsets (classical, intermediate, and nonclassical monocytes) to the total viral burden in 22 human T cell leukemia virus type 1 (HTLV-1)-infected individuals by assessing their infectivity status, frequency, as well as chemotactic and phagocytic functions. All three monocyte subsets sorted from HTLV-1-infected individuals were positive for viral DNA, and the frequency of classical monocytes was lower in the blood of HTLV-1-infected individuals than in that of uninfected individuals, while the expression levels of the chemokine receptors CCR5, CXCR3, and CX3CR1 in classical monocytes were higher in HTLV-1-infected individuals than uninfected individuals; the percentage of intermediate monocytes and their levels of chemokine receptor expression did not differ between HTLV-1-infected and uninfected individuals. However, the capacity of intermediate monocytes to migrate to CCL5, the ligand for CCR5, was higher, and a higher proportion of nonclassical monocytes expressed CCR1, CXCR3, and CX3CR1. The level of viral DNA in the monocyte subsets correlated with the capacity to migrate to CCL2, CCL5, and CX3CL1 for classical monocytes, with lower levels of phagocytosis for intermediate monocytes, and with the level of viral DNA in CD8(+) and CD4(+) T cells for nonclassical monocytes. These data suggest a model whereby HTLV-1 infection augments the number of classical monocytes that migrate to tissues and become infected and the number of infected nonclassical monocytes that transmit virus to CD4(+) and CD8(+) T cells. These results, together with prior findings in a macaque model of HTLV-1 infection, support the notion that infection of monocytes by HTLV-1 is likely a requisite for viral persistence in humans. IMPORTANCE Monocytes have been implicated in immune regulation and disease progression in patients with HTLV-1-associated inflammatory diseases. We detected HTLV-1 DNA in all three monocyte subsets and found that infection impacts surface receptor expression, migratory function, and subset frequency. The frequency of nonclassical patrolling monocytes is increased in HTLV-1-infected individuals, and they have increased expression of CCR1, CXCR3, and CX3CR1. The viral DNA level in nonclassical monocytes correlated with the viral DNA level in CD4(+) and CD8(+) T cells. Altogether, these data suggest an increased recruitment of classical monocytes to inflammation sites that may result in virus acquisition and, in turn, facilitate virus dissemination and viral persistence. Our findings thus provide new insight into the importance of monocyte infection in viral spread and suggest targeting of monocytes for therapeutic intervention.
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Gudo ES, Silva-Barbosa SD, Linhares-Lacerda L, Ribeiro-Alves M, Real SC, Bou-Habib DC, Savino W. HAM/TSP-derived HTLV-1-infected T cell lines promote morphological and functional changes in human astrocytes cell lines: possible role in the enhanced T cells recruitment into Central Nervous System. Virol J 2015; 12:165. [PMID: 26458945 PMCID: PMC4603815 DOI: 10.1186/s12985-015-0398-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Accepted: 10/01/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The mechanisms through which HTLV-1 leads to and maintains damage in the central nervous system of patients undergoing HTLV-1 associated myelopathy/tropical spastic paraparesis (HAM/TSP) are still poorly understood. In recent years, increasing evidence indicates that, not only lymphocytes but also glial cells, in particular astrocytes, play a role in the pathophysiology of HAM/TSP. In this study we used a model of co-culture between human HTLV-1-infected (CIB and C91PL) and non-infected (CEM) T lymphocyte cell lines and astrocyte (U251 and U87) cell lines to mimic the in vivo T cell-astrocyte interactions. RESULTS We first observed that CIB and C91PL adhere strongly to cultured astrocytes cell lines, and that co-cultures of HTLV-1 infected and astrocyte cell lines cells resulted in rapid syncytium formation, accompanied by severe morphological alterations and increased apoptotic cell death of astrocyte cells. Additionally, cultures of astrocyte cell lines in presence of supernatants harvested from HTLV-1-infected T cell cultures resulted in significant increase in the mRNA of CCL2, CXCL1, CXCL2, CXCL3, CXCL10, IL-13, IL-8, NFKB1, TLR4, TNF, MMP8 and VCAM1, as compared with the values obtained when we applied supernatants of non-infected T- cell lines. Lastly, soluble factors secreted by cultured astrocytic cell lines primed through 1-h interaction with infected T cell lines, further enhanced migratory responses, as compared to the effect seen when supernatants from astrocytic cell lines were primed with non-infected T cell lines. CONCLUSION Collectively, our results show that HTLV-1 infected T lymphocyte cell lines interact strongly with astrocyte cell lines, leading to astrocyte damage and increased secretion of attracting cytokines, which in turn may participate in the further attraction of HTLV-1-infected T cells into central nervous system (CNS), thus amplifying and prolonging the immune damage of CNS.
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Affiliation(s)
- Eduardo Samo Gudo
- National Institute of Health, Ministry of Health, Av. Eduardo Mondlane, 1008, Maputo, Mozambique. .,Laboratory on Thymus Research, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.
| | | | - Leandra Linhares-Lacerda
- Laboratory on Thymus Research, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.
| | - Marcelo Ribeiro-Alves
- Laboratory on Thymus Research, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.
| | - Suzana Corte Real
- Laboratory of Structural Biology, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.
| | - Dumith Chequer Bou-Habib
- Laboratory on Thymus Research, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.
| | - Wilson Savino
- Laboratory on Thymus Research, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.
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Martin F, Taylor GP, Jacobson S. Inflammatory manifestations of HTLV-1 and their therapeutic options. Expert Rev Clin Immunol 2015; 10:1531-46. [PMID: 25340428 DOI: 10.1586/1744666x.2014.966690] [Citation(s) in RCA: 84] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Human T lymphotropic virus type 1 (HTLV-1) is one of the most intriguing retroviruses infecting humans. Most commonly, infection remains undetected, since it does not cause obvious harm, yet in 4-9% of patients, this infection can be devastating, causing adult T-cell leukemia/lymphoma and/or HTLV-1 associated myelopathy/tropical spastic paraparesis (HAM/TSP). This review concentrates on all inflammatory aspects of HTLV-1 infection: HAM/TSP, HTLV-1 associated uveitis, HTLV-1 associated conjunctivitis, sicca syndrome and interstitial keratitis, HTLV-1 associated Sjögren's syndrome, Hashimoto's thyroiditis and Graves' disease, HTLV-1 associated pulmonary disease, infective dermatitis associated with HTLV-1, HTLV-1 associated inflammatory myositis and HTLV-1 associated arthritis. With the exception of HAM/TSP treatment, studies of these conditions are sparse and even for HAM/TSP, the level of evidence is limited. While control or elimination of infection remains a goal, most therapy beyond symptomatic management is directed at the immune response to HTLV-1.
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Affiliation(s)
- Fabiola Martin
- Department of Biology, Hull and York Medical School, Center for Immunology and Infection, University of York, YO10 5DD, UK
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Abstract
Human T-lymphotropic virus 1 (HTLV-1)-associated myelopathy/tropical spastic paraparesis (HAM/TSP) is a progressive disease of the CNS that causes weakness or paralysis of the legs, lower back pain and urinary symptoms. HAM/TSP was first described in Jamaica in the nineteenth century, but the aetiology of the condition, infection with the retrovirus HTLV-1, was only identified in the 1980s. HAM/TSP causes chronic disability and, accordingly, imposes a substantial health burden in areas where HTLV-1 infection is endemic. Since the discovery of the cause of HAM/TSP, considerable advances have been made in the understanding of the virology, immunology, cell biology and pathology of HTLV-1 infection and its associated diseases. However, progress has been limited by the lack of accurate animal models of the disease. Moreover, the treatment of HAM/TSP remains highly unsatisfactory: antiretroviral drugs have little impact on the infection and, although potential disease-modifying therapies are widely used, their value is unproved. At present, clinical management is focused on symptomatic treatment and counselling. Here, we summarize current knowledge on the epidemiology, pathogenesis and treatment of HAM/TSP and identify areas in which further research is needed. For an illustrated summary of this Primer, visit: http://go.nature.com/tjZCFM.
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A case of post-transplant adult T-cell leukemia/lymphoma presenting myelopathy similar to but distinct from human T-cell leukemia virus type I (HTLV- I)-associated myelopathy. SPRINGERPLUS 2014; 3:581. [PMID: 25332881 PMCID: PMC4197197 DOI: 10.1186/2193-1801-3-581] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/15/2014] [Accepted: 09/22/2014] [Indexed: 01/11/2023]
Abstract
INTRODUCTION Adult T-cell leukemia/lymphoma (ATL) responds poorly to conventional chemotherapy, but allogeneic stem cell transplantation (allo-SCT) may improve disease prognosis. Herein, we report a female patient with human T-cell leukemia virus type I (HTLV-I)-associated myelopathy (HAM)-like myelopathy following allo-SCT for ATL. CASE REPORT She developed crural paresis 14 months after allo-SCT. Initially, she was diagnosed with central nervous system (CNS) relapse of ATL and treated with intrathecal injection and whole brain and spine irradiation. Her symptoms recurred 5 months later, when a cerebrospinal fluid (CSF) specimen showed increased CD4 + CXCR3 + CCR4+ cell numbers and levels of neopterin and CXCL10 (IP-10). DISCUSSION These results suggest the possible involvement of a certain immunological mechanism such as HAM in her symptoms, irrespective of the lack of anti-HTLV-I antibody in her CSF. Because a definitive diagnosis of CNS manifestation of ATL is sometimes difficult, multi-modal laboratory data are required for differential diagnosis.
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Araya N, Sato T, Ando H, Tomaru U, Yoshida M, Coler-Reilly A, Yagishita N, Yamauchi J, Hasegawa A, Kannagi M, Hasegawa Y, Takahashi K, Kunitomo Y, Tanaka Y, Nakajima T, Nishioka K, Utsunomiya A, Jacobson S, Yamano Y. HTLV-1 induces a Th1-like state in CD4+CCR4+ T cells. J Clin Invest 2014; 124:3431-42. [PMID: 24960164 PMCID: PMC4109535 DOI: 10.1172/jci75250] [Citation(s) in RCA: 74] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2014] [Accepted: 05/08/2014] [Indexed: 12/14/2022] Open
Abstract
Human T-lymphotropic virus type 1 (HTLV-1) is linked to multiple diseases, including the neuroinflammatory disease HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) and adult T cell leukemia/lymphoma. Evidence suggests that HTLV-1, via the viral protein Tax, exploits CD4+ T cell plasticity and induces transcriptional changes in infected T cells that cause suppressive CD4+CD25+CCR4+ Tregs to lose expression of the transcription factor FOXP3 and produce IFN-γ, thus promoting inflammation. We hypothesized that transformation of HTLV-1-infected CCR4+ T cells into Th1-like cells plays a key role in the pathogenesis of HAM/TSP. Here, using patient cells and cell lines, we demonstrated that Tax, in cooperation with specificity protein 1 (Sp1), boosts expression of the Th1 master regulator T box transcription factor (T-bet) and consequently promotes production of IFN-γ. Evaluation of CSF and spinal cord lesions of HAM/TSP patients revealed the presence of abundant CD4+CCR4+ T cells that coexpressed the Th1 marker CXCR3 and produced T-bet and IFN-γ. Finally, treatment of isolated PBMCs and CNS cells from HAM/TSP patients with an antibody that targets CCR4+ T cells and induces cytotoxicity in these cells reduced both viral load and IFN-γ production, which suggests that targeting CCR4+ T cells may be a viable treatment option for HAM/TSP.
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MESH Headings
- Adult
- Aged
- Antibodies, Monoclonal/therapeutic use
- CD4-Positive T-Lymphocytes/immunology
- CD4-Positive T-Lymphocytes/virology
- Cell Line
- Cytotoxicity, Immunologic
- Female
- Gene Products, tax/immunology
- Human T-lymphotropic virus 1/immunology
- Human T-lymphotropic virus 1/pathogenicity
- Humans
- Immunotherapy
- Interferon-gamma/biosynthesis
- Interferon-gamma/genetics
- Male
- Middle Aged
- Paraparesis, Tropical Spastic/genetics
- Paraparesis, Tropical Spastic/immunology
- Paraparesis, Tropical Spastic/virology
- Receptors, CCR4/antagonists & inhibitors
- Receptors, CCR4/immunology
- Receptors, CCR4/metabolism
- Sp1 Transcription Factor/immunology
- T-Box Domain Proteins/genetics
- T-Box Domain Proteins/immunology
- T-Lymphocytes, Regulatory/immunology
- T-Lymphocytes, Regulatory/virology
- Th1 Cells/immunology
- Th1 Cells/virology
- Viral Load/immunology
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Affiliation(s)
- Natsumi Araya
- Department of Rare Diseases Research, Institute of Medical Science, St. Marianna University School of Medicine, Kanagawa, Japan. Department of Pathology, Hokkaido University Graduate School of Medicine, Hokkaido, Japan. Institute for Medical Science of Aging, Aichi Medical University, Aichi, Japan. Department of Immunotherapeutics, Tokyo Medical and Dental University, Graduate School, Tokyo, Japan. Department of Neurology, St. Marianna University School of Medicine, Kanagawa, Japan. Department of Immunology, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan. Institute of Medical Science and Center for Clinical Research, Tokyo Medical University, Tokyo, Japan. Department of Hematology, Imamura Bun-in Hospital, Kagoshima, Japan. Viral Immunology Section, Neuroimmunology Branch, National Institutes of Health, Bethesda, Maryland, USA
| | - Tomoo Sato
- Department of Rare Diseases Research, Institute of Medical Science, St. Marianna University School of Medicine, Kanagawa, Japan. Department of Pathology, Hokkaido University Graduate School of Medicine, Hokkaido, Japan. Institute for Medical Science of Aging, Aichi Medical University, Aichi, Japan. Department of Immunotherapeutics, Tokyo Medical and Dental University, Graduate School, Tokyo, Japan. Department of Neurology, St. Marianna University School of Medicine, Kanagawa, Japan. Department of Immunology, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan. Institute of Medical Science and Center for Clinical Research, Tokyo Medical University, Tokyo, Japan. Department of Hematology, Imamura Bun-in Hospital, Kagoshima, Japan. Viral Immunology Section, Neuroimmunology Branch, National Institutes of Health, Bethesda, Maryland, USA
| | - Hitoshi Ando
- Department of Rare Diseases Research, Institute of Medical Science, St. Marianna University School of Medicine, Kanagawa, Japan. Department of Pathology, Hokkaido University Graduate School of Medicine, Hokkaido, Japan. Institute for Medical Science of Aging, Aichi Medical University, Aichi, Japan. Department of Immunotherapeutics, Tokyo Medical and Dental University, Graduate School, Tokyo, Japan. Department of Neurology, St. Marianna University School of Medicine, Kanagawa, Japan. Department of Immunology, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan. Institute of Medical Science and Center for Clinical Research, Tokyo Medical University, Tokyo, Japan. Department of Hematology, Imamura Bun-in Hospital, Kagoshima, Japan. Viral Immunology Section, Neuroimmunology Branch, National Institutes of Health, Bethesda, Maryland, USA
| | - Utano Tomaru
- Department of Rare Diseases Research, Institute of Medical Science, St. Marianna University School of Medicine, Kanagawa, Japan. Department of Pathology, Hokkaido University Graduate School of Medicine, Hokkaido, Japan. Institute for Medical Science of Aging, Aichi Medical University, Aichi, Japan. Department of Immunotherapeutics, Tokyo Medical and Dental University, Graduate School, Tokyo, Japan. Department of Neurology, St. Marianna University School of Medicine, Kanagawa, Japan. Department of Immunology, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan. Institute of Medical Science and Center for Clinical Research, Tokyo Medical University, Tokyo, Japan. Department of Hematology, Imamura Bun-in Hospital, Kagoshima, Japan. Viral Immunology Section, Neuroimmunology Branch, National Institutes of Health, Bethesda, Maryland, USA
| | - Mari Yoshida
- Department of Rare Diseases Research, Institute of Medical Science, St. Marianna University School of Medicine, Kanagawa, Japan. Department of Pathology, Hokkaido University Graduate School of Medicine, Hokkaido, Japan. Institute for Medical Science of Aging, Aichi Medical University, Aichi, Japan. Department of Immunotherapeutics, Tokyo Medical and Dental University, Graduate School, Tokyo, Japan. Department of Neurology, St. Marianna University School of Medicine, Kanagawa, Japan. Department of Immunology, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan. Institute of Medical Science and Center for Clinical Research, Tokyo Medical University, Tokyo, Japan. Department of Hematology, Imamura Bun-in Hospital, Kagoshima, Japan. Viral Immunology Section, Neuroimmunology Branch, National Institutes of Health, Bethesda, Maryland, USA
| | - Ariella Coler-Reilly
- Department of Rare Diseases Research, Institute of Medical Science, St. Marianna University School of Medicine, Kanagawa, Japan. Department of Pathology, Hokkaido University Graduate School of Medicine, Hokkaido, Japan. Institute for Medical Science of Aging, Aichi Medical University, Aichi, Japan. Department of Immunotherapeutics, Tokyo Medical and Dental University, Graduate School, Tokyo, Japan. Department of Neurology, St. Marianna University School of Medicine, Kanagawa, Japan. Department of Immunology, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan. Institute of Medical Science and Center for Clinical Research, Tokyo Medical University, Tokyo, Japan. Department of Hematology, Imamura Bun-in Hospital, Kagoshima, Japan. Viral Immunology Section, Neuroimmunology Branch, National Institutes of Health, Bethesda, Maryland, USA
| | - Naoko Yagishita
- Department of Rare Diseases Research, Institute of Medical Science, St. Marianna University School of Medicine, Kanagawa, Japan. Department of Pathology, Hokkaido University Graduate School of Medicine, Hokkaido, Japan. Institute for Medical Science of Aging, Aichi Medical University, Aichi, Japan. Department of Immunotherapeutics, Tokyo Medical and Dental University, Graduate School, Tokyo, Japan. Department of Neurology, St. Marianna University School of Medicine, Kanagawa, Japan. Department of Immunology, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan. Institute of Medical Science and Center for Clinical Research, Tokyo Medical University, Tokyo, Japan. Department of Hematology, Imamura Bun-in Hospital, Kagoshima, Japan. Viral Immunology Section, Neuroimmunology Branch, National Institutes of Health, Bethesda, Maryland, USA
| | - Junji Yamauchi
- Department of Rare Diseases Research, Institute of Medical Science, St. Marianna University School of Medicine, Kanagawa, Japan. Department of Pathology, Hokkaido University Graduate School of Medicine, Hokkaido, Japan. Institute for Medical Science of Aging, Aichi Medical University, Aichi, Japan. Department of Immunotherapeutics, Tokyo Medical and Dental University, Graduate School, Tokyo, Japan. Department of Neurology, St. Marianna University School of Medicine, Kanagawa, Japan. Department of Immunology, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan. Institute of Medical Science and Center for Clinical Research, Tokyo Medical University, Tokyo, Japan. Department of Hematology, Imamura Bun-in Hospital, Kagoshima, Japan. Viral Immunology Section, Neuroimmunology Branch, National Institutes of Health, Bethesda, Maryland, USA
| | - Atsuhiko Hasegawa
- Department of Rare Diseases Research, Institute of Medical Science, St. Marianna University School of Medicine, Kanagawa, Japan. Department of Pathology, Hokkaido University Graduate School of Medicine, Hokkaido, Japan. Institute for Medical Science of Aging, Aichi Medical University, Aichi, Japan. Department of Immunotherapeutics, Tokyo Medical and Dental University, Graduate School, Tokyo, Japan. Department of Neurology, St. Marianna University School of Medicine, Kanagawa, Japan. Department of Immunology, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan. Institute of Medical Science and Center for Clinical Research, Tokyo Medical University, Tokyo, Japan. Department of Hematology, Imamura Bun-in Hospital, Kagoshima, Japan. Viral Immunology Section, Neuroimmunology Branch, National Institutes of Health, Bethesda, Maryland, USA
| | - Mari Kannagi
- Department of Rare Diseases Research, Institute of Medical Science, St. Marianna University School of Medicine, Kanagawa, Japan. Department of Pathology, Hokkaido University Graduate School of Medicine, Hokkaido, Japan. Institute for Medical Science of Aging, Aichi Medical University, Aichi, Japan. Department of Immunotherapeutics, Tokyo Medical and Dental University, Graduate School, Tokyo, Japan. Department of Neurology, St. Marianna University School of Medicine, Kanagawa, Japan. Department of Immunology, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan. Institute of Medical Science and Center for Clinical Research, Tokyo Medical University, Tokyo, Japan. Department of Hematology, Imamura Bun-in Hospital, Kagoshima, Japan. Viral Immunology Section, Neuroimmunology Branch, National Institutes of Health, Bethesda, Maryland, USA
| | - Yasuhiro Hasegawa
- Department of Rare Diseases Research, Institute of Medical Science, St. Marianna University School of Medicine, Kanagawa, Japan. Department of Pathology, Hokkaido University Graduate School of Medicine, Hokkaido, Japan. Institute for Medical Science of Aging, Aichi Medical University, Aichi, Japan. Department of Immunotherapeutics, Tokyo Medical and Dental University, Graduate School, Tokyo, Japan. Department of Neurology, St. Marianna University School of Medicine, Kanagawa, Japan. Department of Immunology, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan. Institute of Medical Science and Center for Clinical Research, Tokyo Medical University, Tokyo, Japan. Department of Hematology, Imamura Bun-in Hospital, Kagoshima, Japan. Viral Immunology Section, Neuroimmunology Branch, National Institutes of Health, Bethesda, Maryland, USA
| | - Katsunori Takahashi
- Department of Rare Diseases Research, Institute of Medical Science, St. Marianna University School of Medicine, Kanagawa, Japan. Department of Pathology, Hokkaido University Graduate School of Medicine, Hokkaido, Japan. Institute for Medical Science of Aging, Aichi Medical University, Aichi, Japan. Department of Immunotherapeutics, Tokyo Medical and Dental University, Graduate School, Tokyo, Japan. Department of Neurology, St. Marianna University School of Medicine, Kanagawa, Japan. Department of Immunology, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan. Institute of Medical Science and Center for Clinical Research, Tokyo Medical University, Tokyo, Japan. Department of Hematology, Imamura Bun-in Hospital, Kagoshima, Japan. Viral Immunology Section, Neuroimmunology Branch, National Institutes of Health, Bethesda, Maryland, USA
| | - Yasuo Kunitomo
- Department of Rare Diseases Research, Institute of Medical Science, St. Marianna University School of Medicine, Kanagawa, Japan. Department of Pathology, Hokkaido University Graduate School of Medicine, Hokkaido, Japan. Institute for Medical Science of Aging, Aichi Medical University, Aichi, Japan. Department of Immunotherapeutics, Tokyo Medical and Dental University, Graduate School, Tokyo, Japan. Department of Neurology, St. Marianna University School of Medicine, Kanagawa, Japan. Department of Immunology, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan. Institute of Medical Science and Center for Clinical Research, Tokyo Medical University, Tokyo, Japan. Department of Hematology, Imamura Bun-in Hospital, Kagoshima, Japan. Viral Immunology Section, Neuroimmunology Branch, National Institutes of Health, Bethesda, Maryland, USA
| | - Yuetsu Tanaka
- Department of Rare Diseases Research, Institute of Medical Science, St. Marianna University School of Medicine, Kanagawa, Japan. Department of Pathology, Hokkaido University Graduate School of Medicine, Hokkaido, Japan. Institute for Medical Science of Aging, Aichi Medical University, Aichi, Japan. Department of Immunotherapeutics, Tokyo Medical and Dental University, Graduate School, Tokyo, Japan. Department of Neurology, St. Marianna University School of Medicine, Kanagawa, Japan. Department of Immunology, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan. Institute of Medical Science and Center for Clinical Research, Tokyo Medical University, Tokyo, Japan. Department of Hematology, Imamura Bun-in Hospital, Kagoshima, Japan. Viral Immunology Section, Neuroimmunology Branch, National Institutes of Health, Bethesda, Maryland, USA
| | - Toshihiro Nakajima
- Department of Rare Diseases Research, Institute of Medical Science, St. Marianna University School of Medicine, Kanagawa, Japan. Department of Pathology, Hokkaido University Graduate School of Medicine, Hokkaido, Japan. Institute for Medical Science of Aging, Aichi Medical University, Aichi, Japan. Department of Immunotherapeutics, Tokyo Medical and Dental University, Graduate School, Tokyo, Japan. Department of Neurology, St. Marianna University School of Medicine, Kanagawa, Japan. Department of Immunology, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan. Institute of Medical Science and Center for Clinical Research, Tokyo Medical University, Tokyo, Japan. Department of Hematology, Imamura Bun-in Hospital, Kagoshima, Japan. Viral Immunology Section, Neuroimmunology Branch, National Institutes of Health, Bethesda, Maryland, USA
| | - Kusuki Nishioka
- Department of Rare Diseases Research, Institute of Medical Science, St. Marianna University School of Medicine, Kanagawa, Japan. Department of Pathology, Hokkaido University Graduate School of Medicine, Hokkaido, Japan. Institute for Medical Science of Aging, Aichi Medical University, Aichi, Japan. Department of Immunotherapeutics, Tokyo Medical and Dental University, Graduate School, Tokyo, Japan. Department of Neurology, St. Marianna University School of Medicine, Kanagawa, Japan. Department of Immunology, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan. Institute of Medical Science and Center for Clinical Research, Tokyo Medical University, Tokyo, Japan. Department of Hematology, Imamura Bun-in Hospital, Kagoshima, Japan. Viral Immunology Section, Neuroimmunology Branch, National Institutes of Health, Bethesda, Maryland, USA
| | - Atae Utsunomiya
- Department of Rare Diseases Research, Institute of Medical Science, St. Marianna University School of Medicine, Kanagawa, Japan. Department of Pathology, Hokkaido University Graduate School of Medicine, Hokkaido, Japan. Institute for Medical Science of Aging, Aichi Medical University, Aichi, Japan. Department of Immunotherapeutics, Tokyo Medical and Dental University, Graduate School, Tokyo, Japan. Department of Neurology, St. Marianna University School of Medicine, Kanagawa, Japan. Department of Immunology, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan. Institute of Medical Science and Center for Clinical Research, Tokyo Medical University, Tokyo, Japan. Department of Hematology, Imamura Bun-in Hospital, Kagoshima, Japan. Viral Immunology Section, Neuroimmunology Branch, National Institutes of Health, Bethesda, Maryland, USA
| | - Steven Jacobson
- Department of Rare Diseases Research, Institute of Medical Science, St. Marianna University School of Medicine, Kanagawa, Japan. Department of Pathology, Hokkaido University Graduate School of Medicine, Hokkaido, Japan. Institute for Medical Science of Aging, Aichi Medical University, Aichi, Japan. Department of Immunotherapeutics, Tokyo Medical and Dental University, Graduate School, Tokyo, Japan. Department of Neurology, St. Marianna University School of Medicine, Kanagawa, Japan. Department of Immunology, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan. Institute of Medical Science and Center for Clinical Research, Tokyo Medical University, Tokyo, Japan. Department of Hematology, Imamura Bun-in Hospital, Kagoshima, Japan. Viral Immunology Section, Neuroimmunology Branch, National Institutes of Health, Bethesda, Maryland, USA
| | - Yoshihisa Yamano
- Department of Rare Diseases Research, Institute of Medical Science, St. Marianna University School of Medicine, Kanagawa, Japan. Department of Pathology, Hokkaido University Graduate School of Medicine, Hokkaido, Japan. Institute for Medical Science of Aging, Aichi Medical University, Aichi, Japan. Department of Immunotherapeutics, Tokyo Medical and Dental University, Graduate School, Tokyo, Japan. Department of Neurology, St. Marianna University School of Medicine, Kanagawa, Japan. Department of Immunology, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan. Institute of Medical Science and Center for Clinical Research, Tokyo Medical University, Tokyo, Japan. Department of Hematology, Imamura Bun-in Hospital, Kagoshima, Japan. Viral Immunology Section, Neuroimmunology Branch, National Institutes of Health, Bethesda, Maryland, USA
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Fuzii HT, da Silva Dias GA, de Barros RJS, Falcão LFM, Quaresma JAS. Immunopathogenesis of HTLV-1-assoaciated myelopathy/tropical spastic paraparesis (HAM/TSP). Life Sci 2014; 104:9-14. [DOI: 10.1016/j.lfs.2014.03.025] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2013] [Revised: 03/10/2014] [Accepted: 03/25/2014] [Indexed: 10/25/2022]
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