The efficacy of combined therapy of arsenic trioxide and alpha interferon in human T-cell leukemia virus type-1-infected squirrel monkeys (Saimiri sciureus)

STLV-1 as a model for studying HTLV-1 infection

Few years after HTLV-1 identification and isolation in humans, STLV-1, its simian counterpart, was discovered. It then became clear that STLV-1 is present almost in all simian species. Subsequent molecular epidemiology studies demonstrated that, apart from HTLV-1 subtype A, all human subtypes have a simian homolog. As HTLV-1, STLV-1 is the etiological agent of ATL, while no case of TSP/HAM has been described. Given its similarities with HTLV-1, STLV-1 represents a unique tool used for performing clinical studies, vaccine studies as well as basic science.

Controversies in targeted therapy of adult T cell leukemia/lymphoma: ON target or OFF target effects?

Adult T cell leukemia/lymphoma (ATL) represents an ideal model for targeted therapy because of intrinsic chemo-resistance of ATL cells and the presence of two well identified targets: the HTLV-I retrovirus and the viral oncoprotein Tax. The combination of zidovudine (AZT) and interferon-alpha (IFN) has a dramatic impact on survival of ATL patients. Although the mechanism of action remains unclear, arguments in favor or against a direct antiviral effect will be discussed. Yet, most patients relapse and alternative therapies are mandatory. IFN and arsenic trioxide induce Tax proteolysis, synergize to induce apoptosis in ATL cells and cure Tax-driven ATL in mice through specific targeting of leukemia initiating cell activity. These results provide a biological basis for the clinical success of arsenic/IFN/AZT therapy in ATL patients and suggest that both extinction of viral replication (AZT) and Tax degradation (arsenic/IFN) are needed to cure ATL.

Complete remission of a relapsing adult T cell leukaemia following treatment of a secondary acute promyelocytic leukaemia: towards a reappraisal of arsenic trioxide and all-transretinoic acid?

Despite improvements in therapeutic options, human T cell lymphotropic virus type 1 (HTLV-1)-related adult T cell leukaemia/lymphoma (ATLL) has a dismal prognosis. The present report concerns the case of a multirelapsing ATLL that reached a complete remission following the treatment of a secondary acute promyelocytic leukaemia with cytarabine, anthracyclin, all-transretinoic acid and arsenic trioxide. This unexpected result with a multitreated/chemorefractory disease led us to reconsider the potential therapeutic benefits of arsenic trioxide, which has demonstrated efficacy against ATLL cells.

Immunological changes and cytokine gene expression during primary infection with human T-cell leukaemia virus type 1 in squirrel monkeys (Saimiri sciureus)

We have developed an animal model of experimental HTLV-1 infection in Saimiri sciureus monkeys in order to study both the immunological and the virological aspects of the infection. As cytokines expressed by immune cells play an essential role during viral infection, we have studied the correlation between the expression of some Th1/Th2 cytokines, including IL-2, IL-5, IL-6, IL-10, and IFN-gamma, and immunological dynamics during primary and chronic HTLV-1 infection in this model. We first demonstrated that, during primary infection, IFN-gamma, IL-2 and IL-10 are expressed at different times and levels. The expression of these cytokines is concomitant with the increase in the numbers of CD4(+), CD8(+) and CD16(+) cells and with the presence of tax/rex viral mRNA. These data indicate the involvement of various cell types in the antiviral immune response. Subsequently, we showed that peripheral blood mononuclear cells freshly isolated from chronically infected monkeys express IFN-gamma and IL-6 at higher levels than those from uninfected animals. IFN-gamma expression is quantitatively correlated to the proviral load and to the presence of circulating effector T-cells against Tax peptide, as detected by Elispot. Further studies will be needed to determine the effective role of these cytokines and other immune system modulators in the control of viral replication during primary HTLV-1 infection or latency.