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Olindo S, Jeannin S, Lezin A. Manifestazioni neurologiche legate all’“human T-cell leukemia/lymphoma virus” tipo 1 (HTLV-1). Neurologia 2021. [DOI: 10.1016/s1634-7072(21)44999-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Abstract
Human T-cell leukemia virus type 1 (HTLV-1) was the first retrovirus described as a causative agent for human disease. In the field of ophthalmology, a close relationship between HTLV-1 infection and uveitis was identified through a series of clinical and laboratory studies in the late 1980s-1990s. Since then, HTLV-1-related ocular manifestations such as keratoconjunctivitis sicca, interstitial keratitis, optic neuritis and adult T-cell leukemia/lymphoma (ATL)-related ocular manifestations have continuously been reported. During the three decades since the association between HTLV-1 and ocular pathologies was discovered, ophthalmic practice and research have advanced with the incorporation of new technologies into the field of ophthalmology. Accordingly, new findings from recent research have provided many insights into HTLV-1-associated ocular diseases. Advanced molecular technologies such as multiplex polymerase chain reaction (PCR)/broad-range PCR using ocular samples have enabled rapid and accurate diagnosis. Advanced ophthalmic technologies such as widefield fundus camera and optical coherence tomography (OCT) have clarified various features of HTLV-1-associated ocular manifestations, and identified characteristics such as the "knob-like ATL cell multiple ocular infiltration" (KAMOI) sign. Advanced drug delivery methods such as intravitreal injection and sub-Tenon injection have led to progress in preventing disease progression. This article describes global topics and the latest research findings for HTLV-1-associated ocular diseases, with reference to a large-scale nationwide survey of ophthalmologists. Current approaches and unmet needs for HTLV-1 infection in ophthalmology are also discussed.
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Affiliation(s)
- Koju Kamoi
- Department of Ophthalmology and Visual Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.,HTLV-1 Uveitis/ATL-Related Ocular Disease Clinic, Research Hospital, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan.,Department of Hematology/Oncology, Research Hospital, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
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Merle H, Hage R, Jeannin S, Cabre P, Olindo S. Retinal Nerve Fiber Layer Thickness in Human T-cell Lymphotropic Virus Type 1 Patients. Curr Eye Res 2017; 42:1644-1649. [PMID: 28985098 DOI: 10.1080/02713683.2017.1329443] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE To determine whether there is an optic neuropathy (ON) in patients with human T-cell lymphotropic virus type 1 (HTLV-1) infection. METHODS We included HTLV-1 asymptomatic carriers (a.c.HTLV-1) and tropical spastic paraparesis/HTLV-1 associated myelopathy (TSP/HAM) patients between January 1st, 2014 and March 31st, 2015. All patients had complete eye examination. The visual acuity (VA) and retinal nerve fiber layer (RNFL) thickness were measured and compared to age- and sex-matched control groups including patients seen in our refraction clinic with no previous medical or surgical history. RESULTS Thirty-one a.c.HTLV-1 (group 1) and 29 TSP/HAM patients (group 2) were included. The average RNFL thickness was 99.9 ± 14.3 µm in group 1 and 87.8 ± 19.2 µm in group 2. The average RFNL thicknesses were lower in both groups, when compared to controls. The difference was significant in patients with TSP/HAM (87.8 ± 19.2 µm vs. 97 ± 7.8 µm; p = 0.003) who also had significantly decreased VA. CONCLUSIONS We report here the first study about the RNFL thickness in patients with TSP/HAM. In these patients, there is decrease of the RNFL thickness with subtle but definite decrease of VA. This suggests that subclinical ON occurs in the natural history of the disease. The diagnosis of TSP/HAM must be evoked as a differential of primary progressive multiple sclerosis in a population at risk. Moreover, RNFL thinning with no evidence of glaucoma should raise suspicion for HTLV-1 infection and TSP/HAM in a population at risk.
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Affiliation(s)
- Harold Merle
- a Department of Ophthalmology , Centre Hospitalier Universitaire de Fort-de-France , Martinique , France (French West Indies)
| | - Rabih Hage
- a Department of Ophthalmology , Centre Hospitalier Universitaire de Fort-de-France , Martinique , France (French West Indies)
| | - Séverine Jeannin
- b Department of Neurology , Centre Hospitalier Universitaire de Fort-de-France , Martinique , France (French West Indies)
| | - Philippe Cabre
- b Department of Neurology , Centre Hospitalier Universitaire de Fort-de-France , Martinique , France (French West Indies)
| | - Stéphane Olindo
- b Department of Neurology , Centre Hospitalier Universitaire de Fort-de-France , Martinique , France (French West Indies)
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Collongues N, Kremer S, de Sèze J. Mielopatie acute. Neurologia 2017. [DOI: 10.1016/s1634-7072(17)83854-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Bhigjee AI, Moodley AA, Roos I, Wells CL, Ramdial P, Esser M. The neuromyelitis optica presentation and the aquaporin-4 antibody in HIV-seropositive and seronegative patients in KwaZulu-Natal, South Africa. South Afr J HIV Med 2017; 18:684. [PMID: 29568625 PMCID: PMC5843081 DOI: 10.4102/sajhivmed.v18i1.684] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Accepted: 11/14/2016] [Indexed: 11/24/2022] Open
Abstract
Background The association of the anti-aquaporin-4 (AQP-4) water channel antibody with neuromyelitis optica (NMO) syndrome has been described from various parts of the world. There has been no large study describing this association from southern Africa, an HIV endemic area. HIV patients often present with visual disturbance or features of a myelopathy but seldom both either simultaneously or consecutively. We report our experience of NMO in the era of AQP-4 testing in HIV-positive and HIV-negative patients seen in KwaZulu-Natal, South Africa. Methods A retrospective chart review was undertaken of NMO cases seen from January 2005 to April 2016 in two neurology units serving a population of 7.1 million adults. The clinical, radiological and relevant laboratory data were extracted from the files and analysed. Results There were 12 HIV-positive patients (mean age 33 years), 9 (75%) were women and all 12 were black patients. Of the 17 HIV-negative patients (mean age 32 years), 15 (88%) were women and 10 (59%) were black people. The clinical features in the two groups ranged from isolated optic neuritis, isolated longitudinally extensive myelitis or combinations. Recurrent attacks were noted in six HIV-positive patients and six HIV-negative patients. The AQP-4 antibody was positive in 4/10 (40%) HIV-positive patients and 11/13 (85%) HIV-negative patients. The radiological changes ranged from longitudinal hyperintense spinal cord lesions and long segment enhancing lesions of the optic nerves. Three patients, all HIV-positive, had tumefactive lesions with incomplete ring enhancement. Conclusion This study confirms the presence of AQP-4-positive NMO in southern Africa in both HIV-positive and HIV-negative patients. The simultaneous or consecutive occurrence of optic neuritis and myelitis in an HIV-positive patient should alert the clinician to test for the AQP-4 antibody. It is important to recognise this clinical syndrome as specific therapy is available. We further postulate that HIV itself may act as a trigger for an autoimmune process.
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Affiliation(s)
- Ahmed I Bhigjee
- Department of Neurology, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, South Africa
| | - Anandan A Moodley
- Department of Neurology, Greys Hospital, Pietermaritzburg, South Africa.,Department of Neurology, University of KwaZulu-Natal, South Africa
| | - Izanne Roos
- Department of Neurology, Inkosi Albert Luthuli Central Hospital, University of KwaZulu-Natal, South Africa
| | - Cait-Lynn Wells
- Department of Neurology, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, South Africa
| | - Pratistadevi Ramdial
- Department of Anatomical Pathology, NHLS, Inkosi Albert Luthuli Central Hospital, South Africa
| | - Monika Esser
- Immunology Unit, NHLS Tygerberg, Tygerberg Hospital, South Africa
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Pereira WLDCJ, Reiche EMV, Kallaur AP, Kaimen-Maciel DR. Epidemiological, clinical, and immunological characteristics of neuromyelitis optica: A review. J Neurol Sci 2015; 355:7-17. [PMID: 26050520 DOI: 10.1016/j.jns.2015.05.034] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Revised: 05/27/2015] [Accepted: 05/28/2015] [Indexed: 01/16/2023]
Abstract
The aim of this study was to review the epidemiological and clinical characteristics of neuromyelitis optica (NMO) and the immunopathological mechanisms involved in the neuronal damage. NMO is an inflammatory demyelinating autoimmune disease of the central nervous system that most commonly affects the optic nerves and spinal cord. NMO is thought to be more prevalent among non-Caucasians and where multiple sclerosis (MS) prevalence is low. NMO follows a relapsing course in more than 80-90% of cases, which is more commonly in women. It is a complex disease with an interaction between host genetic and environmental factors and the main immunological feature is the presence of anti-aquaporin 4 (AQP4) antibodies in a subset of patients. NMO is frequently associated with multiple other autoantibodies and there is a strong association between NMO with other systemic autoimmune diseases. AQP4-IgG can cause antibody-dependent cellular cytotoxicity (ADCC) when effector cells are present and complement-dependent cytotoxicity (CDC) when complement is present. Acute therapies, including corticosteroids and plasma exchange, are designed to minimize injury and accelerate recovery. Several aspects of NMO pathogenesis remain unclear. More advances in the understanding of NMO disease mechanisms are needed in order to identify more specific biomarkers to NMO diagnosis.
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Affiliation(s)
- Wildéa Lice de Carvalho Jennings Pereira
- Health Sciences Postgraduate Program, Health Sciences Center, State University of Londrina, Londrina, Paraná 86038-440, Brazil; Outpatient Clinic for Demyelinating Diseases, University Hospital, State University of Londrina, Londrina, Paraná 86061-335, Brazil.
| | - Edna Maria Vissoci Reiche
- Department of Pathology, Clinical Analysis and Toxicology, Health Sciences Center, State University of Londrina, Londrina, Paraná 86038-440, Brazil.
| | - Ana Paula Kallaur
- Health Sciences Postgraduate Program, Health Sciences Center, State University of Londrina, Londrina, Paraná 86038-440, Brazil.
| | - Damacio Ramón Kaimen-Maciel
- Outpatient Clinic for Demyelinating Diseases, University Hospital, State University of Londrina, Londrina, Paraná 86061-335, Brazil; Department of Clinical Medicine, Health Sciences Center, State University of Londrina, Londrina, Paraná 86038-440, Brazil.
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[Recurrent facial palsy revealing Human T-lymphotropic virus type 1 (HTLV-1) infection]. Rev Med Interne 2015; 36:701-5. [PMID: 25636977 DOI: 10.1016/j.revmed.2014.11.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2014] [Revised: 10/10/2014] [Accepted: 11/23/2014] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Neurological involvement of Human T-lymphotropic virus type 1 (HTLV-1) mainly results in myelopathy (tropical spastic paraparesis). However, cranial nerve impairment, including facial nerve damage, is rare in patients with HTLV-1 infection. OBSERVATION We report the case of a patient, originally from Caribbean islands, who developed recurrent bilateral facial palsy (six recurrences during the 7-year follow-up). Both blood and cerebrospinal fluid serologies were positive for HTLV-1. The diagnosis of recurring bilateral facial palsy revealing HTLV-1 infection was made. CONCLUSION Our case report underscores that HTLV-1 infection should be considered in patients, coming from endemic areas (Caribbean islands, South America, Japan and Africa), who exhibit recurrent bilateral facial palsy. Our data therefore indicate that HTLV-1 serology should be routinely performed in these patients.
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Manifestazioni neurologiche associate al virus HTLV-1. Neurologia 2014. [DOI: 10.1016/s1634-7072(14)67222-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Collongues N, Papeix C, Zéphir H, Audoin B, Cotton F, Durand-dubief F, Vukusic S, Brassat D, Laplaud D, Marignier R. Cadre nosologique et stratégie diagnostique de la myélite aiguë transverse longitudinalement étendue. Rev Neurol (Paris) 2014; 170:6-12. [DOI: 10.1016/j.neurol.2013.04.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2013] [Accepted: 04/05/2013] [Indexed: 12/14/2022]
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von Glehn F, Jarius S, Penalva de Oliveira AC, Brandão CO, Farias AS, Damasceno A, Casseb J, Moraes AS, Longhini ALF, Wandinger KP, Damasceno BP, Wildemann B, Santos LMB. Aquaporin-4 antibodies are not related to HTLV-1 associated myelopathy. PLoS One 2012; 7:e39372. [PMID: 22808032 PMCID: PMC3393709 DOI: 10.1371/journal.pone.0039372] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2012] [Accepted: 05/20/2012] [Indexed: 11/19/2022] Open
Abstract
Introduction The seroprevalence of human T-cell leukemia virus type 1 (HTLV-1) is very high among Brazilians (∼1∶200). HTLV-1 associated myelopathy or tropical spastic paraparesis (HAM/TSP) is the most common neurological complication of HTLV-1 infection. HAM/TSP can present with an acute/subacute form of longitudinally extensive myelitis, which can be confused with lesions seen in aquaporin-4 antibody (AQP4-Ab) positive neuromyelitis optica spectrum disorders (NMOSD) on MRI. Moreover, clinical attacks in patients with NMOSD have been shown to be preceded by viral infections in around 30% of cases. Objective To evaluate the frequency of AQP4-Ab in patients with HAM/TSP. To evaluate the frequency of HTLV-1 infection in patients with NMOSD. Patients and Methods 23 Brazilian patients with HAM/TSP, 20 asymptomatic HTLV-1+ serostatus patients, and 34 with NMOSD were tested for AQP4-Ab using a standardized recombinant cell based assay. In addition, all patients were tested for HTLV-1 by ELISA and Western blotting. Results 20/34 NMOSD patients were positive for AQP4-Ab but none of the HAM/TSP patients and none of the asymptomatic HTLV-1 infected individuals. Conversely, all AQP4-Ab-positive NMOSD patients were negative for HTLV-1 antibodies. One patient with HAM/TSP developed optic neuritis in addition to subacute LETM; this patient was AQP4-Ab negative as well. Patients were found to be predominantly female and of African descent both in the NMOSD and in the HAM/TSP group; Osame scale and expanded disability status scale scores did not differ significantly between the two groups. Conclusions Our results argue both against a role of antibodies to AQP4 in the pathogenesis of HAM/TSP and against an association between HTLV-1 infection and the development of AQP4-Ab. Moreover, the absence of HTLV-1 in all patients with NMOSD suggests that HTLV-1 is not a common trigger of acute attacks in patients with AQP4-Ab positive NMOSD in populations with high HTLV-1 seroprevalence.
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Affiliation(s)
- Felipe von Glehn
- Neuroimmunology Unit, Department of Genetics, Evolution and Bioagents, University of Campinas, Campinas, Brazil
- Department of Neurology, University of Campinas, Campinas, Brazil
- * E-mail: (FvG); (LMBS)
| | - Sven Jarius
- Division of Molecular Neuroimmunology, Department of Neurology, University of Heidelberg, Heidelberg, Germany
| | - Augusto C. Penalva de Oliveira
- Neuroinfectious Disease Unit, Department of Internal Medicine, University of Campinas, Campinas, Brazil
- Department of Neurology, Emilio Ribas Institute of Infectious Diseases, Sao Paulo, Brazil
| | - Carlos Otávio Brandão
- Neuroimmunology Unit, Department of Genetics, Evolution and Bioagents, University of Campinas, Campinas, Brazil
- Department of Neurology, University of Campinas, Campinas, Brazil
| | - Alessandro S. Farias
- Neuroimmunology Unit, Department of Genetics, Evolution and Bioagents, University of Campinas, Campinas, Brazil
| | | | - Jorge Casseb
- Department of Neurology, Emilio Ribas Institute of Infectious Diseases, Sao Paulo, Brazil
| | - Adriel S. Moraes
- Neuroimmunology Unit, Department of Genetics, Evolution and Bioagents, University of Campinas, Campinas, Brazil
| | - Ana Leda F. Longhini
- Neuroimmunology Unit, Department of Genetics, Evolution and Bioagents, University of Campinas, Campinas, Brazil
| | | | | | - Brigitte Wildemann
- Division of Molecular Neuroimmunology, Department of Neurology, University of Heidelberg, Heidelberg, Germany
| | - Leonilda M. B. Santos
- Neuroimmunology Unit, Department of Genetics, Evolution and Bioagents, University of Campinas, Campinas, Brazil
- * E-mail: (FvG); (LMBS)
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Tropical spastic paraparesis and HTLV-1 associated myelopathy: Clinical, epidemiological, virological and therapeutic aspects. Rev Neurol (Paris) 2012; 168:257-69. [DOI: 10.1016/j.neurol.2011.12.006] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2010] [Revised: 09/16/2011] [Accepted: 12/06/2011] [Indexed: 12/14/2022]
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