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Ahmadi Ghezeldasht S, Mosavat A, Rezaee SA. Novel insights into human T-lymphotropic virus type-1 (HTLV-1) pathogenesis-host interactions in the manifestation of HTLV-1-associated myelopathy/tropical spastic paraparesis. Rev Med Virol 2024; 34:e2567. [PMID: 38937135 DOI: 10.1002/rmv.2567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Revised: 04/16/2024] [Accepted: 06/19/2024] [Indexed: 06/29/2024]
Abstract
Human T-lymphotropic virus type-1 (HTLV-1) was the first discovered human oncogenic retrovirus, the etiological agent of two serious diseases have been identified as adult T-cell leukaemia/lymphoma malignancy and HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP), a debilitating chronic neuro-myelopathy. Despite more than 40 years of molecular, histopathological and immunological studies on HTLV-1-associated diseases, the virulence and pathogenicity of this virus are yet to be clarified. The reason why the majority of HTLV-1-infected individuals (∼95%) remain asymptomatic carriers is still unclear. The deterioration of the immune system towards oncogenicity and autoimmunity makes HTLV-1 a natural probe for the study of malignancy and neuro-inflammatory diseases. Additionally, its slow worldwide spreading has prompted public health authorities and researchers, as urged by the WHO, to focus on eradicating HTLV-1. In contrast, neither an effective therapy nor a protective vaccine has been introduced. This comprehensive review focused on the most relevant studies of the neuro-inflammatory propensity of HTLV-1-induced HAM/TSP. Such an emphasis on the virus-host interactions in the HAM/TSP pathogenesis will be critically discussed epigenetically. The findings may shed light on future research venues in designing and developing proper HTLV-1 therapeutics.
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Affiliation(s)
- Sanaz Ahmadi Ghezeldasht
- Blood Borne Infections Research Center, Academic Center for Education, Culture and Research (ACECR), Razavi Khorasan, Mashhad, Iran
| | - Arman Mosavat
- Blood Borne Infections Research Center, Academic Center for Education, Culture and Research (ACECR), Razavi Khorasan, Mashhad, Iran
| | - Seyed Abdolrahim Rezaee
- Inflammation and Inflammatory Diseases Division, Immunology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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Eades LE, Sines J, Hoi AY, Liddle R, Kandane-Rathnayake R, Morand EF, Brady S, Rischmueller M, Vincent FB. Autoimmune rheumatic disease in Australian Aboriginal and Torres Strait Islander Peoples: What do we know? Semin Arthritis Rheum 2024; 65:152354. [PMID: 38237231 DOI: 10.1016/j.semarthrit.2023.152354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 12/11/2023] [Accepted: 12/18/2023] [Indexed: 03/22/2024]
Abstract
Autoimmune rheumatic disease (AIRD) is a collective term, which comprises a group of multisystem inflammatory autoimmune diseases, including connective tissue disease, chronic inflammatory arthritis, sarcoidosis and systemic vasculitis. Some AIRD are prevalent in the general population, and all can cause significant morbidity and reduced quality of life, with some increasing the risk of premature mortality, such as systemic lupus erythematosus (SLE), a connective tissue disease that is more prevalent and severe in Australian Aboriginal and Torres Strait Islander Peoples with high mortality rates. To ensure that management of AIRD can be optimised for all Australians, it is important that we understand the prevalence and potential phenotypic variations of AIRD across the Australian population. However, to date there have been few described cases of AIRD other than SLE in Aboriginal and Torres Strait Islander Peoples. In this review, we summarise what is known about AIRD other than SLE in Aboriginal and Torres Strait Islander Peoples, particularly with regards to prevalence, phenotype and disease outcomes, and highlight the current gaps in knowledge.
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Affiliation(s)
- Laura E Eades
- Centre for Inflammatory Diseases, Monash University, Clayton, Victoria 3168, Australia; Rheumatology Department, Monash Health, Clayton, Victoria 3168, Australia
| | - Jason Sines
- Department of Rheumatology, Royal Prince Alfred Hospital, Sydney NSW 2001, Australia
| | - Alberta Y Hoi
- Centre for Inflammatory Diseases, Monash University, Clayton, Victoria 3168, Australia; Rheumatology Department, Monash Health, Clayton, Victoria 3168, Australia
| | - Ruaidhri Liddle
- Primary and Public Health Care Central Australia, Alice Springs, Northern Territory 0870, Australia
| | | | - Eric F Morand
- Centre for Inflammatory Diseases, Monash University, Clayton, Victoria 3168, Australia; Rheumatology Department, Monash Health, Clayton, Victoria 3168, Australia
| | - Stephen Brady
- Rheumatology Department, Alice Springs Hospital, The Gap, Northern Territory 0870, Australia
| | - Maureen Rischmueller
- Rheumatology Department, Alice Springs Hospital, The Gap, Northern Territory 0870, Australia; Rheumatology Department, Royal Darwin Hospital, Tiwi, Northern Territory 0810, Australia; Discipline of Medicine, University of Adelaide, South Australia 5011, Australia; Rheumatology Department, The Queen Elizabeth Hospital, Woodville, South Australia 5011, Australia
| | - Fabien B Vincent
- Centre for Inflammatory Diseases, Monash University, Clayton, Victoria 3168, Australia.
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Tu JJ, King E, Maksimova V, Smith S, Macias R, Cheng X, Vegesna T, Yu L, Ratner L, Green PL, Niewiesk S, Richner JM, Panfil AR. An HTLV-1 envelope mRNA vaccine is immunogenic and protective in New Zealand rabbits. J Virol 2024; 98:e0162323. [PMID: 38193692 PMCID: PMC10883802 DOI: 10.1128/jvi.01623-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 12/07/2023] [Indexed: 01/10/2024] Open
Abstract
Human T-cell leukemia virus type 1 (HTLV-1) is a retrovirus responsible for adult T-cell leukemia/lymphoma, a severe and fatal CD4+ T-cell malignancy. Additionally, HTLV-1 can lead to a chronic progressive neurodegenerative disease known as HTLV-1-associated myelopathy/tropical spastic paraparesis. Unfortunately, the prognosis for HTLV-1-related diseases is generally poor, and effective treatment options are limited. In this study, we designed and synthesized a codon optimized HTLV-1 envelope (Env) mRNA encapsulated in a lipid nanoparticle (LNP) and evaluated its efficacy as a vaccine candidate in an established rabbit model of HTLV-1 infection and persistence. Immunization regimens included a prime/boost protocol using Env mRNA-LNP or control green fluorescent protein (GFP) mRNA-LNP. After immunization, rabbits were challenged by intravenous injection with irradiated HTLV-1 producing cells. Three rabbits were partially protected and three rabbits were completely protected against HTLV-1 challenge. These rabbits were then rechallenged 15 weeks later, and two rabbits maintained sterilizing immunity. In Env mRNA-LNP immunized rabbits, proviral load and viral gene expression were significantly lower. After viral challenge in the Env mRNA-LNP vaccinated rabbits, an increase in both CD4+/IFN-γ+ and CD8+/IFN-γ+ T-cells was detected when stimulating with overlapping Env peptides. Env mRNA-LNP elicited a detectable anti-Env antibody response after prime/boost vaccination in all animals and significantly higher levels of neutralizing antibody activity. Neutralizing antibody activity was correlated with a reduction in proviral load. These findings hold promise for the development of preventive strategies and therapeutic interventions against HTLV-1 infection and its associated diseases.IMPORTANCEmRNA vaccine technology has proven to be a viable approach for effectively triggering immune responses that protect against or limit viral infections and disease. In our study, we synthesized a codon optimized human T-cell leukemia virus type 1 (HTLV-1) envelope (Env) mRNA that can be delivered in a lipid nanoparticle (LNP) vaccine approach. The HTLV-1 Env mRNA-LNP produced protective immune responses against viral challenge in a preclinical rabbit model. HTLV-1 is primarily transmitted through direct cell-to-cell contact, and the protection offered by mRNA vaccines in our rabbit model could have significant implications for optimizing the development of other viral vaccine candidates. This is particularly important in addressing the challenge of enhancing protection against infections that rely on cell-to-cell transmission.
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Affiliation(s)
- Joshua J. Tu
- Center for Retrovirus Research, Department of Veterinary Biosciences, College of Veterinary Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Emily King
- Center for Retrovirus Research, Department of Veterinary Biosciences, College of Veterinary Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Victoria Maksimova
- Center for Retrovirus Research, Department of Veterinary Biosciences, College of Veterinary Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Susan Smith
- Center for Retrovirus Research, Department of Veterinary Biosciences, College of Veterinary Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Ramon Macias
- Cellular and Molecular Biology Graduate Program, The Ohio State University, Columbus, Ohio, USA
| | - Xiaogang Cheng
- Department of Medicine, Washington University, St. Louis, Missouri, USA
| | - Tanmayee Vegesna
- Department of Microbiology and Immunology, University of Illinois-Chicago, Chicago, Illinois, USA
| | - Lianbo Yu
- Department of Biomedical Informatics, College of Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Lee Ratner
- Department of Medicine, Washington University, St. Louis, Missouri, USA
| | - Patrick L. Green
- Center for Retrovirus Research, Department of Veterinary Biosciences, College of Veterinary Medicine, The Ohio State University, Columbus, Ohio, USA
- Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio, USA
| | - Stefan Niewiesk
- Center for Retrovirus Research, Department of Veterinary Biosciences, College of Veterinary Medicine, The Ohio State University, Columbus, Ohio, USA
- Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio, USA
| | - Justin M. Richner
- Department of Microbiology and Immunology, University of Illinois-Chicago, Chicago, Illinois, USA
| | - Amanda R. Panfil
- Center for Retrovirus Research, Department of Veterinary Biosciences, College of Veterinary Medicine, The Ohio State University, Columbus, Ohio, USA
- Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio, USA
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Howarth TP, Jersmann HPA, Majoni SW, Mo L, Ben Saad H, Ford LP, Heraganahally SS. The 'ABC' of respiratory disorders among adult Indigenous people: asthma, bronchiectasis and COPD among Aboriginal Australians - a systematic review. BMJ Open Respir Res 2023; 10:e001738. [PMID: 37451702 PMCID: PMC10351270 DOI: 10.1136/bmjresp-2023-001738] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 06/23/2023] [Indexed: 07/18/2023] Open
Abstract
BACKGROUND Aboriginal Australians are reported to have higher presence of chronic respiratory diseases. However, comprehensive evidence surrounding this is sparse. Hence, a systematic review was undertaken to appraise the current state of knowledge on respiratory health in the adult Aboriginal Australians, in particular among the three most common respiratory disorders: asthma, bronchiectasis and chronic obstructive pulmonary disease (COPD). METHODS A systematic review of primary literature published between January 2012 and October 2022, using the databases PubMed and Scopus, was conducted. Studies were included if they reported adult Aboriginal Australian prevalence's or outcomes related to asthma, bronchiectasis or COPD, and excluded if adult data were not reported separately, if Aboriginal Australian data were not reported separately or if respiratory disorders were combined into a single group. Risk of bias was assessed by both Joanne Briggs Institute checklists and Hoys' bias assessment. Summary data pertaining to prevalence, lung function, symptoms, sputum cultures and mortality for each of asthma, bronchiectasis and COPD were extracted from the included studies. RESULTS Thirty-seven studies were included, involving approximately 33 364 participants (71% female). Eighteen studies reported on asthma, 21 on bronchiectasis and 30 on COPD. The majority of studies (94%) involved patients from hospitals or respiratory clinics and were retrospective in nature. Across studies, the estimated prevalence of asthma was 15.4%, bronchiectasis was 9.4% and COPD was 13.7%, although there was significant geographical variation. Only a minority of studies reported on clinical manifestations (n=7) or symptoms (n=4), and studies reporting on lung function parameters (n=17) showed significant impairment, in particular among those with concurrent bronchiectasis and COPD. Airway exacerbation frequency and hospital admission rates including mortality are high. DISCUSSION Although risk of bias globally was assessed as low, and study quality as high, there was limited diversity of studies with most reporting on referred populations, and the majority originating from two centres in the Northern Territory. The states with the greatest Aboriginal Australian population (Victoria and New South Wales) reported the lowest number of studies and patients. This limits the generalisability of results to the wider Aboriginal Australian population due to significant environmental, cultural and socioeconomic variation across the population. Regardless, Aboriginal Australians appear to display a high prevalence, alongside quite advanced and complex chronic respiratory diseases. There is however significant heterogeneity of prevalence, risk factors and outcomes geographically and by patient population. Further collaborative efforts are required to address specific diagnostic and management pathways in order to close the health gap secondary to respiratory disorders in this population.
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Affiliation(s)
- Timothy P Howarth
- College of Health and Human Sciences, Charles Darwin University, Darwin, Northern Territory, Australia
- Darwin Respiratory and Sleep Health, Darwin private Hospital, Tiwi, Darwin, Northern Territory, Australia
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland
| | - Hubertus P A Jersmann
- Department of Respiratory and sleep Medicine, Royal Adelaide Hospital, Central Adelaide Local Health Network, Adelaide, South Australia, Australia
- The University of Adelaide, Faculty of Health and Medical Sciences, Adelaide, South Australia, Australia
| | - Sandawana W Majoni
- Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
- College of Medicine and Public Health, Flinders University, Northern Territory Medical program, Darwin, Northern Territory, Australia
- Department of Nephrology, Royal Darwin Hospital, Darwin, Northern Territory, Australia
| | - Lin Mo
- College of Medicine and Public Health, Flinders University, Northern Territory Medical program, Darwin, Northern Territory, Australia
- Department of Respiratory and Sleep Medicine, Royal Darwin Hospital, Darwin, Northern Territory, Australia
| | - Helmi Ben Saad
- University of Sousse, Farhat HACHED Hospital, Heart Failure (LR12SP09) Research Laboratory, Sousse, Tunisia
| | - Linda P Ford
- Northern Institute, Faculty of Arts & Society, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Subash S Heraganahally
- Darwin Respiratory and Sleep Health, Darwin private Hospital, Tiwi, Darwin, Northern Territory, Australia
- College of Medicine and Public Health, Flinders University, Northern Territory Medical program, Darwin, Northern Territory, Australia
- Department of Respiratory and Sleep Medicine, Royal Darwin Hospital, Darwin, Northern Territory, Australia
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Dias ÁRN, Falcão LFM, Quaresma JAS. An Overview of Human T-Lymphotropic Virus Type 1 Lung Injury. Front Immunol 2022; 13:914498. [PMID: 35844492 PMCID: PMC9285117 DOI: 10.3389/fimmu.2022.914498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 06/07/2022] [Indexed: 11/13/2022] Open
Abstract
Previous studies have demonstrated the development of pulmonary impairment in individuals infected with human T-lymphotropic virus type 1 (HTLV-1). Complications, such as alveolitis and bronchiectasis, were found in individuals who developed tropical spastic paraparesis/HTLV-1-associated myelopathy (TSP-HAM) due to chronic inflammation. These patients exhibited increased levels of lymphocytes (CD4+ and CD25+), cytokines (IL-2, IL-12, and IFN-γ), inflammatory chemokines (MIP-1α and IP-10), and cell adhesion molecules (ICAM-1) in the bronchoalveolar lavage fluid, with the result of chronic inflammation and lung injury. The main lesions observed at Chest high-resolution computed tomography were centrilobular nodules, parenchymal bands, lung cysts, bronchiectasis, ground-glass opacity, mosaic attenuation, and pleural thickening. It can lead to progressive changes in pulmonary function with the development of restrictive and obstructive diseases. Recent studies suggest a causal relationship between HTLV-1 and pulmonary diseases, with intensification of lesions and progressive decrease in pulmonary function. This summary updates a previous publication and addresses the general lack of knowledge regarding the relationship between TSP-HAM and pulmonary disease, providing direction for future work and the management of these individuals.
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Affiliation(s)
- Ápio Ricardo Nazareth Dias
- Health and Biologic Center, State University of Pará, Belém, Brazil
- Tropical Medicine Centre, Federal University of Pará, Belém, Brazil
| | - Luiz Fábio Magno Falcão
- Health and Biologic Center, State University of Pará, Belém, Brazil
- University of São Paulo, São Paulo, Brazil
| | - Juarez Antônio Simões Quaresma
- Health and Biologic Center, State University of Pará, Belém, Brazil
- Tropical Medicine Centre, Federal University of Pará, Belém, Brazil
- *Correspondence: Juarez Antônio Simões Quaresma,
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Fowler F, Einsiedel L. A Qualitative Study Exploring Perceptions to the Human T Cell Leukaemia Virus Type 1 in Central Australia: Barriers to Preventing Transmission in a Remote Aboriginal Population. Front Med (Lausanne) 2022; 9:845594. [PMID: 35572972 PMCID: PMC9100826 DOI: 10.3389/fmed.2022.845594] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 03/28/2022] [Indexed: 01/24/2023] Open
Abstract
Background Central Australia has the highest recorded prevalence of infection with the human T cell leukaemia virus type 1 (HTLV-1) worldwide. Each of the clinical diseases associated with HTLV-1 have been reported in this region, including deaths due to adult T cell leukaemia, which is causally linked to HTLV-1. Nevertheless, no public health response has been implemented to reduce HTLV-1 transmission among the affected Aboriginal population. In the first study to explore the perceptions of healthcare professionals along with those of Aboriginal people whose communities are actually impacted by HTLV-1, we sought to understand the barriers to preventing HTLV-1 transmission in this remote area. Methodology/Principal Findings Semi and un-structured interviews were conducted with 30 Australian Aboriginal people, 26 non-Aboriginal healthcare professionals and 3 non-Aboriginal community workers. The purpose of the interviews was to explore perceptions towards HTLV-1 in a health context with a focus on sexual and reproductive rights. Deductive and inductive analyses were applied to the data and a decolonizing lens brought peripheral stories to the fore. A major finding was the contrast between views expressed by Aboriginal participants and healthcare professionals regarding the provision of knowledge to those affected. Aboriginal participants consistently articulated that they and their communities should be informed of, and can hold, knowledges pertaining to HTLV-1. This finding controverted the perceptions of healthcare professionals that the complexities of the virus would not be well-understood by their Aboriginal patients and that sharing HTLV-1 knowledges might overwhelm Aboriginal people. Further analyses revealed a spectrum of understanding and clinical practice, while also delineating signs of an imagined public health response. Conclusions/Significance HTLV-1 remains a neglected infection in Australia. Knowledge of HTLV-1 is held by a privileged medical elite and does not flow to marginalised Aboriginal people living in affected communities. We demonstrate that differences in the perspectives of stakeholders presents a significant barrier to the development of cohesive, culturally safe prevention programs that foster a shared knowledge of HTLV-1. The interview data suggests that a successful public health program is likely to require a dual approach that includes clinical care and community-driven health promotion. Aspects of this approach, which would raise awareness and potentially reduce transmission and lower HTLV-1 prevalence in Central Australia, may be applicable to other endemic settings with similar conditions of social disadvantage, geographic remoteness, resource limitations and cross-cultural challenges.
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Affiliation(s)
- Fiona Fowler
- Department of Social Work, Alice Salomon University of Applied Sciences, Berlin, Germany
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NF-κB-Induced R-Loops and Genomic Instability in HTLV-1-Infected and Adult T-Cell Leukemia Cells. Viruses 2022; 14:v14050877. [PMID: 35632619 PMCID: PMC9147355 DOI: 10.3390/v14050877] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 04/20/2022] [Accepted: 04/21/2022] [Indexed: 02/04/2023] Open
Abstract
Human T-cell leukemia virus type 1 (HTLV-1) is a human delta retrovirus that causes adult T-cell leukemia/lymphoma (ATL) in 3–5% of the infected population after decades of clinical latency. HTLV-1 Tax is a potent activator of IKK/NF-κB and a clastogen. While NF-κB activities are associated with cell survival and proliferation, constitutive NF-κB activation (NF-κB hyperactivation) by Tax leads to senescence and oncogenesis. Until recently, the mechanisms underlying the DNA damage and senescence induced by Tax and NF-κB were unknown. Current data indicate that NF-κB hyperactivation by Tax causes the accumulation of a nucleic acid structure known as an R-loop. R-loop excision by the transcription-coupled nucleotide excision repair (TC-NER) endonucleases, Xeroderma pigmentosum F (XPF), and XPG, in turn, promotes DNA double-strand breaks (DSBs). NF-κB blockade prevents Tax-induced R-loop accumulation, DNA damage, and senescence. In the same vein, the silencing of XPF and XPG mitigates Tax senescence, while deficiency in either or both frequently occurs in ATL of all types. ATL cells maintain constitutively active NF-κB, accumulate R-loops, and resist Tax-induced senescence. These results suggest that ATL cells must have acquired adaptive changes to prevent senescence and benefit from the survival and proliferation advantages conferred by Tax and NF-κB. In this review, the roles of R-loops in Tax- and NF-κB-induced DNA DSBs, senescence, and ATL development, and the epigenetic and genetic alterations that arise in ATL to reduce R-loop-associated DNA damage and avert senescence will be discussed.
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Clinical and Public Health Implications of Human T-Lymphotropic Virus Type 1 Infection. Clin Microbiol Rev 2022; 35:e0007821. [PMID: 35195446 PMCID: PMC8941934 DOI: 10.1128/cmr.00078-21] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Human T-lymphotropic virus type 1 (HTLV-1) is estimated to affect 5 to 10 million people globally and can cause severe and potentially fatal disease, including adult T-cell leukemia/lymphoma (ATL) and HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP). The burden of HTLV-1 infection appears to be geographically concentrated, with high prevalence in discrete regions and populations. While most high-income countries have introduced HTLV-1 screening of blood donations, few other public health measures have been implemented to prevent infection or its consequences. Recent advocacy from concerned researchers, clinicians, and community members has emphasized the potential for improved prevention and management of HTLV-1 infection. Despite all that has been learned in the 4 decades following the discovery of HTLV-1, gaps in knowledge across clinical and public health aspects persist, impeding optimal control and prevention, as well as the development of policies and guidelines. Awareness of HTLV-1 among health care providers, communities, and affected individuals remains limited, even in countries of endemicity. This review provides a comprehensive overview on HTLV-1 epidemiology and on clinical and public health and highlights key areas for further research and collaboration to advance the health of people with and at risk of HTLV-1 infection.
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James IC, Mejía-Mertel J, Gil Artunduaga MA, Rojas-Hernández JP. Case Series: Pediatric Human T-Lymphotropic Virus Type 1 and Its Clinical Expression. FRONTIERS IN TROPICAL DISEASES 2022. [DOI: 10.3389/fitd.2021.824067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
PurposeHuman T-lymphotropic Virus type 1 (HTLV-1) was the first retrovirus to be identified and associated with oncogenic activity. It is estimated that approximately 10–20 million people in the world are infected with it. The clinical manifestations most commonly associated with HTLV-1 infection include T-cell leukemia/lymphoma and myelopathy associated to HTLV-1 infection. The purpose of this study is to describe clinical and demographic characteristics in pediatric patients with HTLV-1 infection.Methodology and PatientsAmbispective case series analysis, with collection of medical records and subsequent description of demographic data (sex, origin, age) and clinical characteristics in 16 patients with HTLV-1 infection were collected. Twelve of these patients were part of an initially reported cohort and four were recruited later in the study. The patients were collected between January 2017 and July 2021 in a pediatric institution in Cali, in a reference hospital in the southwest region of Colombia.ResultsThirteen of a total of sixteen patients came from the Colombian Pacific coast, where nine were with significant nutritional deficiencies. Seven showed dermatological compromise. Eight patients presented images compatible with inflammation and chronic lung injury, and six of the eight patients were with opportunistic infections. Coinfection with other microorganisms was also observed where one case presented with meningeal tuberculosis, another patient presented with simultaneous infections, namely, malaria, leptospirosis and toxoplasmosis, and a third patient presented intestinal parasitosis and soft tissue infection by Streptococcus pyogenes. Three patients had concomitant autoimmune diseases and a fourth patient was highly suspicious of having polymyositis.ConclusionsThe different clinical findings with simultaneous HTLV-1 infection broaden the panorama to suspect infection by this virus. More studies are required to achieve a direct association between structural lung disease, autoimmune diseases, immunodeficiency and HTLV-1 infection. This study aims to raise interest and awareness of an ancient but neglected disease.
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Abstract
HTLV-1 is a global infection with 5-20 million infected individuals. Although only a minority of infected individuals develop myelopathy, lymphoproliferative malignancy, or inflammatory disorders, infection is associated with immunosuppression and shorter survival. Transmission of HTLV-1 is through contaminated blood or needles, mother-to-child exposure through breast-feeding, and sexual intercourse. HTLV-1 is a delta retrovirus that expresses immunogenic Gag, Envelope, TAX, and Hbz proteins. Neutralizing antibodies have been identified directed against the surface envelope protein, and cytotoxic T-cell epitopes within TAX have been characterized. Thus far, there have been few investigations of vaccines directed against each of these proteins, with limited responses, thus far. However, with new technologies developed in the last few years, a renewed investigation is warranted in search for a safe and effective HTLV-1 vaccine.
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Computed tomography with 6-year follow-up demonstrates the evolution of HTLV-1 related lung injuries: A cohort study. PLoS One 2021; 16:e0261864. [PMID: 34965281 PMCID: PMC8716036 DOI: 10.1371/journal.pone.0261864] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 12/12/2021] [Indexed: 11/19/2022] Open
Abstract
Previous observational studies have demonstrated the development of pulmonary impairments in human T-lymphotropic virus type 1 (HTLV-1) infected individuals. The main observed lesions due to chronic inflammation of viral infection in situ are bronchiectasis and lung-scarring injuries. This lung inflammation may be the causal agent of restrictive and obstructive lung diseases, primarily in tropical spastic paraparesis/HTLV-1-associated myelopathy (TSP-HAM) patients. We conducted a prospective cohort study to compare spirometry and high-resolution computed tomography (HRCT) findings among 28 HTLV-1-carrier patients over the course of 6 years (2014–2019) (male/female: 7/21; mean age: 54.7 ± 9.5, range: 41–68 years). Chest HRCT exams revealed the development and evolution of lung lesions related to TSP-HAM: including centrilobular nodules, parenchymal bands, lung cysts, bronchiectasis, ground-glass opacity, mosaic attenuation, and pleural thickening. Spirometry exams showed maintenance of respiratory function, with few alterations in parameters suggestive of obstructive and restrictive disorders primarily in individuals with lung lesions and TSP-HAM. The findings of the present study indicate that pulmonary disease related to HTLV-1 is a progressive disease, with development of new lung lesions, mainly in individuals with TSP-HAM. To improve clinical management of these individuals, we recommend that individuals diagnosed with PET-MAH undergo pulmonary evaluation.
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Einsiedel L, Pham H, Talukder MR, Taylor K, Wilson K, Kaldor J, Gessain A, Woodman R. Very high prevalence of infection with the human T cell leukaemia virus type 1c in remote Australian Aboriginal communities: Results of a large cross-sectional community survey. PLoS Negl Trop Dis 2021; 15:e0009915. [PMID: 34879069 PMCID: PMC8654171 DOI: 10.1371/journal.pntd.0009915] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 10/14/2021] [Indexed: 11/18/2022] Open
Abstract
Infection with the human T cell leukaemia virus type 1 (HTLV-1) subtype C is endemic among Aboriginal people in central Australia. To provide insights into the risk factors for transmission, we conducted the first large-scale, community-based prevalence study in seven remote Aboriginal communities. Residents >2 years old were invited to participate in the study between August 2014 and June 2018. HTLV-1 infection was defined as a positive western blot (WB) test or a positive HTLV-1 PCR. 720 community residents participated in the study (children <15 years, 142; adults, 578). Prevalences for children and adults were 3.5% (5/142) and 36.8% (213/578), respectively, reaching 49.3% (106/215) for those older than 45 years. A wide range of proviral loads were measured for both asymptomatic and symptomatic participants with no difference within groups according to age or gender; however, median PVL was 1.34 log10 higher for symptomatic participants. The adult prevalence of HTLV-1 infection in central Australia is the highest reported worldwide. Sexual contact is likely to be the predominant mode of transmission.
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Affiliation(s)
- Lloyd Einsiedel
- Baker Heart and Diabetes Institute, Alice Springs, Northern Territory, Australia
- * E-mail:
| | - Hai Pham
- Baker Heart and Diabetes Institute, Alice Springs, Northern Territory, Australia
| | | | - Kerry Taylor
- Poche Centre for Indigenous Health and Wellbeing, Alice Springs, Northern Territory, Australia
| | - Kim Wilson
- National Serology Reference Laboratory, Melbourne, Australia
| | - John Kaldor
- Kirby Institute, University of New South Wales, Sydney, Australia
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Simonetti FR, Zhang H, Soroosh GP, Duan J, Rhodehouse K, Hill AL, Beg SA, McCormick K, Raymond HE, Nobles CL, Everett JK, Kwon KJ, White JA, Lai J, Margolick JB, Hoh R, Deeks SG, Bushman FD, Siliciano JD, Siliciano RF. Antigen-driven clonal selection shapes the persistence of HIV-1-infected CD4+ T cells in vivo. J Clin Invest 2021; 131:145254. [PMID: 33301425 DOI: 10.1172/jci145254] [Citation(s) in RCA: 102] [Impact Index Per Article: 34.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 12/01/2020] [Indexed: 12/23/2022] Open
Abstract
Clonal expansion of infected CD4+ T cells is a major mechanism of HIV-1 persistence and a barrier to achieving a cure. Potential causes are homeostatic proliferation, effects of HIV-1 integration, and interaction with antigens. Here, we show that it is possible to link antigen responsiveness, the full proviral sequence, the integration site, and the T cell receptor β-chain (TCRβ) sequence to examine the role of recurrent antigenic exposure in maintaining the HIV-1 reservoir. We isolated CMV- and Gag-responding CD4+ T cells from 10 treated individuals. Proviral populations in CMV-responding cells were dominated by large clones, including clones harboring replication-competent proviruses. TCRβ repertoires showed high clonality driven by converging adaptive responses. Although some proviruses were in genes linked to HIV-1 persistence (BACH2, STAT5B, MKL1), the proliferation of infected cells under antigenic stimulation occurred regardless of the site of integration. Paired TCRβ and integration site analysis showed that infection could occur early or late in the course of a clone's response to antigen and could generate infected cell populations too large to be explained solely by homeostatic proliferation. Together, these findings implicate antigen-driven clonal selection as a major factor in HIV-1 persistence, a finding that will be a difficult challenge to eradication efforts.
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Affiliation(s)
- Francesco R Simonetti
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Hao Zhang
- Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Garshasb P Soroosh
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Jiayi Duan
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Kyle Rhodehouse
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Alison L Hill
- Institute for Computational Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Subul A Beg
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Kevin McCormick
- Department of Microbiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Hayley E Raymond
- Department of Microbiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Christopher L Nobles
- Department of Microbiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - John K Everett
- Department of Microbiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Kyungyoon J Kwon
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Jennifer A White
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Jun Lai
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Joseph B Margolick
- Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Rebecca Hoh
- Division of HIV, Infectious Diseases, and Global Medicine, UCSF, San Francisco, California, USA
| | - Steven G Deeks
- Division of HIV, Infectious Diseases, and Global Medicine, UCSF, San Francisco, California, USA
| | - Frederic D Bushman
- Department of Microbiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Janet D Siliciano
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Robert F Siliciano
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,Howard Hughes Medical Institute, Baltimore, Maryland, USA
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14
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Journo C, Martin F. HTLV-1 Disease. Pathogens 2021; 10:pathogens10081001. [PMID: 34451465 PMCID: PMC8400599 DOI: 10.3390/pathogens10081001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 08/04/2021] [Indexed: 11/20/2022] Open
Affiliation(s)
- Chloé Journo
- CIRI, Centre International de Recherche en Infectiologie, Retroviral Oncogenesis Team, Univ Lyon, Inserm, U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, ENS de Lyon, F-69007 Lyon, France
- Correspondence: (C.J.); (F.M.)
| | - Fabiola Martin
- School of Public Health, University of Queensland, Brisbane, QLD 4006, Australia
- Stonewall Medical Centre, Brisbane, QLD 4030, Australia
- Correspondence: (C.J.); (F.M.)
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15
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Cachay R, Gil-Zacarias M, Watanabe-Tejada T, Schwalb A, Mejía F, Gayoso O, Gotuzzo E. Clinical, Radiological and Functional Characteristics of Pulmonary Diseases among HTLV-1 Infected Patients without Prior Active Tuberculosis Infection. Pathogens 2021; 10:pathogens10070895. [PMID: 34358045 PMCID: PMC8308839 DOI: 10.3390/pathogens10070895] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 06/22/2021] [Accepted: 06/25/2021] [Indexed: 11/24/2022] Open
Abstract
The lifelong infection with the human T lymphotropic virus type 1 (HTLV-1) has been associated with a variety of clinical manifestations; one of the less-explored is HTLV-1-associated pulmonary disease. Imaging of lung damage caused by the HTLV-1 hyperinflammatory cascade can be similar to sequelae from TB infection. Our study aims to describe the pulmonary lesions of HTLV-1-positive patients without past or current active TB and evaluate pulmonary function. We found that nine out of fourteen patients with no known TB disease history presented bronchiectasis, mainly found bilaterally while five presented pulmonary fibrosis. A normal pattern was found in most patients with a pulmonary functional test. Furthermore, there was no association between the PVL and the chest-CT scan findings, nor with spirometry results. However, the sample size was insufficient to conclude it.
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Affiliation(s)
- Rodrigo Cachay
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima 15102, Peru; (M.G.-Z.); (T.W.-T.); (A.S.); (F.M.); (O.G.); (E.G.)
- Alberto Hurtado School of Medicine, Universidad Peruana Cayetano Heredia, Lima 15102, Peru
- Correspondence:
| | - Marcela Gil-Zacarias
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima 15102, Peru; (M.G.-Z.); (T.W.-T.); (A.S.); (F.M.); (O.G.); (E.G.)
- Alberto Hurtado School of Medicine, Universidad Peruana Cayetano Heredia, Lima 15102, Peru
| | - Takashi Watanabe-Tejada
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima 15102, Peru; (M.G.-Z.); (T.W.-T.); (A.S.); (F.M.); (O.G.); (E.G.)
- Alberto Hurtado School of Medicine, Universidad Peruana Cayetano Heredia, Lima 15102, Peru
| | - Alvaro Schwalb
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima 15102, Peru; (M.G.-Z.); (T.W.-T.); (A.S.); (F.M.); (O.G.); (E.G.)
- Alberto Hurtado School of Medicine, Universidad Peruana Cayetano Heredia, Lima 15102, Peru
| | - Fernando Mejía
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima 15102, Peru; (M.G.-Z.); (T.W.-T.); (A.S.); (F.M.); (O.G.); (E.G.)
- Infectious, Tropical and Dermatological Diseases, Hospital Cayetano Heredia, Lima 15102, Peru
| | - Oscar Gayoso
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima 15102, Peru; (M.G.-Z.); (T.W.-T.); (A.S.); (F.M.); (O.G.); (E.G.)
- Alberto Hurtado School of Medicine, Universidad Peruana Cayetano Heredia, Lima 15102, Peru
- Pulmonology Service, Hospital Cayetano Heredia, Lima 15102, Peru
| | - Eduardo Gotuzzo
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima 15102, Peru; (M.G.-Z.); (T.W.-T.); (A.S.); (F.M.); (O.G.); (E.G.)
- Alberto Hurtado School of Medicine, Universidad Peruana Cayetano Heredia, Lima 15102, Peru
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16
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Einsiedel L, Chiong F, Jersmann H, Taylor GP. Human T-cell leukaemia virus type 1 associated pulmonary disease: clinical and pathological features of an under-recognised complication of HTLV-1 infection. Retrovirology 2021; 18:1. [PMID: 33407607 PMCID: PMC7789585 DOI: 10.1186/s12977-020-00543-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 10/13/2020] [Accepted: 10/28/2020] [Indexed: 12/14/2022] Open
Abstract
The lung is one of several organs that can be affected by HTLV-1 mediated inflammation. Pulmonary inflammation associated with HTLV-1 infection involves the interstitium, airways and alveoli, resulting in several clinical entities including interstitial pneumonias, bronchiolitis and alveolitis, depending on which structures are most affected. Augmentation of the inflammatory effects of HTLV-1 infected lymphocytes by recruitment of other inflammatory cells in a positive feedback loop is likely to underlie the pathogenesis of HTLV-1 associated pulmonary disease, as has been proposed for HTLV-1 associated myelopathy. In contrast to the conclusions of early case series, HTLV-1 associated pulmonary disease can be associated with significant parenchymal damage, which may progress to bronchiectasis where this involves the airways. Based on our current understanding of HTLV-1 associated pulmonary disease, diagnostic criteria are proposed.
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Affiliation(s)
- Lloyd Einsiedel
- Department of Medicine, Alice Springs Hospital, Alice Springs, Northern Territory, 0870, Australia.
| | - Fabian Chiong
- Department of Medicine, Alice Springs Hospital, Alice Springs, Northern Territory, 0870, Australia
| | - Hubertus Jersmann
- Department of Respiratory Medicine, Faculty of Medicine, Royal Adelaide Hospital, Adelaide, Australia
| | - Graham P Taylor
- Department of Infectious Diseases, Faculty of Medicine, Imperial College London, London, UK
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17
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Gordon CA, Shield JM, Bradbury RS, Muhi S, Page W, Judd JA, Lee R, Biggs BA, Ross K, Kurscheid J, Gray DJ, McManus DP. HTLV-I and Strongyloides in Australia: The worm lurking beneath. ADVANCES IN PARASITOLOGY 2021; 111:119-201. [PMID: 33482974 DOI: 10.1016/bs.apar.2020.11.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Strongyloidiasis and HTLV-I (human T-lymphotropic virus-1) are important infections that are endemic in many countries around the world with an estimated 370 million infected with Strongyloides stercoralis alone, and 5-10 million with HTVL-I. Co-infections with these pathogens are associated with significant morbidity and can be fatal. HTLV-I infects T-cells thus causing dysregulation of the immune system which has been linked to dissemination and hyperinfection of S. stercoralis leading to bacterial sepsis which can result in death. Both of these pathogens are endemic in Australia primarily in remote communities in Queensland, the Northern Territory, and Western Australia. Other cases in Australia have occurred in immigrants and refugees, returned travellers, and Australian Defence Force personnel. HTLV-I infection is lifelong with no known cure. Strongyloidiasis is a long-term chronic disease that can remain latent for decades, as shown by infections diagnosed in prisoners of war from World War II and the Vietnam War testing positive decades after they returned from these conflicts. This review aims to shed light on concomitant infections of HTLV-I with S. stercoralis primarily in Australia but in the global context as well.
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Affiliation(s)
- Catherine A Gordon
- Infectious Diseases Program, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia.
| | - Jennifer M Shield
- Department of Pharmacy and Biomedical Sciences, La Trobe University, Bendigo, VIC, Australia; Department of Medicine, The Peter Doherty Institute for Infection and Immunity, University of Melbourne and the Royal Melbourne Hospital, Melbourne, VIC, Australia
| | - Richard S Bradbury
- School of Health and Life Sciences, Federation University, Berwick, VIC, Australia
| | - Stephen Muhi
- Victorian Infectious Diseases Service, The Royal Melbourne Hospital, Parkville, VIC, Australia
| | - Wendy Page
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD, Australia
| | - Jenni A Judd
- School of Health Medical and Applied Sciences, Central Queensland University, Bundaberg, QLD, Australia; Centre for Indigenous Health Equity Research, Central Queensland University, Bundaberg, QLD, Australia
| | - Rogan Lee
- Westmead Clinical School, The University of Sydney, Westmead, NSW, Australia
| | - Beverley-Ann Biggs
- Department of Medicine, The Peter Doherty Institute for Infection and Immunity, University of Melbourne and the Royal Melbourne Hospital, Melbourne, VIC, Australia; Victorian Infectious Diseases Service, The Royal Melbourne Hospital, Parkville, VIC, Australia
| | - Kirstin Ross
- College of Science and Engineering, Flinders University, Adelaide, South Australia, Australia
| | - Johanna Kurscheid
- Department of Global Health, Research School of Population Health, Australian National University, Acton, ACT, Australia
| | - Darren J Gray
- Department of Global Health, Research School of Population Health, Australian National University, Acton, ACT, Australia
| | - Donald P McManus
- Infectious Diseases Program, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
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18
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Al Sharif S, Pinto DO, Mensah GA, Dehbandi F, Khatkar P, Kim Y, Branscome H, Kashanchi F. Extracellular Vesicles in HTLV-1 Communication: The Story of an Invisible Messenger. Viruses 2020; 12:E1422. [PMID: 33322043 PMCID: PMC7763366 DOI: 10.3390/v12121422] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 12/07/2020] [Accepted: 12/08/2020] [Indexed: 02/08/2023] Open
Abstract
Human T-cell lymphotropic virus type 1 (HTLV-1) infects 5-10 million people worldwide and is the causative agent of adult T-cell leukemia/lymphoma (ATLL) and HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) as well as other inflammatory diseases. A major concern is that the most majority of individuals with HTLV-1 are asymptomatic carriers and that there is limited global attention by health care officials, setting up potential conditions for increased viral spread. HTLV-1 transmission occurs primarily through sexual intercourse, blood transfusion, intravenous drug usage, and breast feeding. Currently, there is no cure for HTLV-1 infection and only limited treatment options exist, such as class I interferons (IFN) and Zidovudine (AZT), with poor prognosis. Recently, small membrane-bound structures, known as extracellular vesicles (EVs), have received increased attention due to their potential to carry viral cargo (RNA and proteins) in multiple pathogenic infections (i.e., human immunodeficiency virus type I (HIV-1), Zika virus, and HTLV-1). In the case of HTLV-1, EVs isolated from the peripheral blood and cerebral spinal fluid (CSF) of HAM/TSP patients contained the viral transactivator protein Tax. Additionally, EVs derived from HTLV-1-infected cells (HTLV-1 EVs) promote functional effects such as cell aggregation which enhance viral spread. In this review, we present current knowledge surrounding EVs and their potential role as immune-modulating agents in cancer and other infectious diseases such as HTLV-1 and HIV-1. We discuss various features of EVs that make them prime targets for possible vehicles of future diagnostics and therapies.
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Affiliation(s)
| | | | | | | | | | | | | | - Fatah Kashanchi
- Laboratory of Molecular Virology, George Mason University, Manassas, VA 20110, USA; (S.A.S.); (D.O.P.); (G.A.M.); (F.D.); (P.K.); (Y.K.); (H.B.)
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19
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Einsiedel L, Pham H, Talukder MRR, Liddle J, Taylor K, Wilson K, Jersmann H, Gessain A, Woodman R, Kaldor J. Pulmonary Disease Is Associated With Human T-Cell Leukemia Virus Type 1c Infection: A Cross-sectional Survey in Remote Aboriginal Communities. Clin Infect Dis 2020; 73:e1498-e1506. [DOI: 10.1093/cid/ciaa1401] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
The human T-cell leukemia virus type 1 (HTLV-1) subtype c is endemic to central Australia. We report the first large-scale, community-based, health survey of HTLV-1 and its disease associations in this setting.
Methods
Aboriginal community residents aged >2 years in 7 remote communities were invited to do a health survey that included a questionnaire, spirometry, and clinical examination by a physician blinded to HTLV-1 status, clinical records, and spirometry results. Blood was drawn for HTLV-1 serology and proviral load (PVL). Pulmonary disease was assessed clinically and spirometrically and, where records were available, radiologically after the clinical assessment. Associations between specific diseases and HTLV-1 status were determined using logistic regression, adjusting for available confounders.
Results
Overall, 579 residents (164 children aged 3–17 years; 415 adults) were examined (37.7% of the estimated resident population). HTLV-1 prevalences for children and adults were 6.1% and 39.3%, respectively. No associations were found between HTLV-1 and any assessed clinical condition among children. Chronic pulmonary disease and gait abnormalities were more common among adults with HTLV-1 infection. Adjusted odds ratios among participants with PVL ≥1000 per 105 peripheral blood leukocytes were 7.08 (95% confidence interval [CI], 2.67–18.74; P < .001), 9.81 (95% CI, 3.52–27.35; P < .001), and 14.4 (95% CI, 4.99–41.69; P < .001) for clinically defined chronic pulmonary disease, moderate-severe expiratory airflow limitation, and radiologically determined bronchiectasis/bronchiolitis, respectively, and 5.21 (95% CI, 1.50–18.07; P = .009) for gait abnormalities.
Conclusions
In the first study of HTLV-1 disease associations based on community recruitment and blinded assessment, HTLV-1 infection was strongly associated with pulmonary disease and gait abnormalities.
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Affiliation(s)
- Lloyd Einsiedel
- Baker Heart and Diabetes Institute, Alice Springs Hospital, Alice Springs, Australia
| | - Hai Pham
- Baker Heart and Diabetes Institute, Alice Springs Hospital, Alice Springs, Australia
| | | | - Joel Liddle
- Baker Heart and Diabetes Institute, Alice Springs Hospital, Alice Springs, Australia
| | - Kerry Taylor
- Poche Centre for Indigenous Health and Wellbeing, Alice Springs, Australia
| | - Kim Wilson
- National Serology Reference Laboratory, Melbourne, Australia
| | | | - Antoine Gessain
- Oncogenic virus epidemiology and pathophysiology Unit, Institut Pasteur, Paris, France
| | | | - John Kaldor
- Kirby Institute, University of New South Wales, Sydney, Australia
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20
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Mejía-Mertel J, Gómez-Banoy N, Rojas-Hernández JP, Gotuzzo-Herencia E. Clinical profile of human T-lymphotropic virus type I: a forgotten infection in pediatrics. INFECTIO 2020. [DOI: 10.22354/in.v25i1.905] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
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21
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Normando VMF, Dias ÁRN, da Silva ALSE, da Silva Pinto D, de Souza Santos MC, Rodrigues CL, de Oliveira EM, de Souza Filho LEC, de Brito Vieira W, Andriolo RB, Sousa RCM, Falcão LFM, Quaresma JAS. HTLV-I induces lesions in the pulmonary system: A systematic review. Life Sci 2020; 256:117979. [PMID: 32553930 DOI: 10.1016/j.lfs.2020.117979] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 06/03/2020] [Accepted: 06/12/2020] [Indexed: 01/11/2023]
Abstract
This study analyzed the relationship between infection by human T-cell lymphotropic virus type 1 (HTLV-1) and changes in the pulmonary system. Cohort and case-control study models that analyzed a causal association between HTLV-1 and changes in the pulmonary system were considered. There were no restrictions on language and publication period. The study was registered in the PROSPERO systematic analysis database (Protocol No. CRD42017078236) and was prepared according to the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The following databases were used: PubMed, BVS Regional Portal, Embase, CINAHL and Web of Science. We utilized the Newcastle-Ottawa Scale to assess the methodological quality of published studies and the Kappa coefficient to assess the agreement level between two reviewers. Of the total 1156 studies retrieved by the search strategy, 28 were considered potentially eligible (Kappa test = 0.928). Of the 28 studies, three fully met the inclusion criteria. These indicated that pulmonary lesions, such as bronchiectasis and bronchitis/bronchiolitis, were observed in patients with HTLV-1, with high-resolution computed tomography of the chest being the main method of diagnostic investigation. The analyzed cohort and case-control studies indicated an etiological relationship between HTLV-1 infection and the presence of lung lesions, with emphasis on bronchiectasis in the presence of high viral loads, as well as a higher mortality in these individuals compared with the general population.
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Affiliation(s)
- Valéria Marques Ferreira Normando
- Center for Tropical Medicine, Federal University of Pará, Belém, PA, Brazil; Center for Biological and Health Sciences, State University of Pará, Belém, PA, Brazil.
| | - Ápio Ricardo Nazareth Dias
- Center for Tropical Medicine, Federal University of Pará, Belém, PA, Brazil; Center for Biological and Health Sciences, State University of Pará, Belém, PA, Brazil.
| | | | | | | | | | | | | | - Waldônio de Brito Vieira
- Center for Tropical Medicine, Federal University of Pará, Belém, PA, Brazil; Santa Casa de Misericórdia Foundation, Belém, PA, Brazil.
| | - Regis Bruni Andriolo
- Center for Biological and Health Sciences, State University of Pará, Belém, PA, Brazil.
| | | | | | - Juarez Antônio Simões Quaresma
- Center for Tropical Medicine, Federal University of Pará, Belém, PA, Brazil; Center for Biological and Health Sciences, State University of Pará, Belém, PA, Brazil; Evandro Chagas Institute, Ministry of Health, Ananindeua, Belém, PA, Brazil.
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22
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Abstract
In the absence of clinical data on Human T leukaemia Type 1 and COVID-19 infection, we are providing guidance to clinicians who look after people living with HTLV-1.
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23
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Omsland M, Silic-Benussi M, Moles R, Sarkis S, Purcell DFJ, Yurick D, Khoury G, D'Agostino DM, Ciminale V, Franchini G. Functional properties and sequence variation of HTLV-1 p13. Retrovirology 2020; 17:11. [PMID: 32398094 PMCID: PMC7218495 DOI: 10.1186/s12977-020-00517-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 04/10/2020] [Indexed: 01/06/2023] Open
Abstract
Human T cell leukemia virus type-1 (HTLV-1) was the first retrovirus found to cause cancer in humans, but the mechanisms that drive the development of leukemia and other diseases associated with HTLV-1 infection remain to be fully understood. This review describes the functional properties of p13, an 87-amino acid protein coded by HTLV-1 open reading frame II (orf-II). p13 is mainly localized in the inner membrane of the mitochondria, where it induces potassium (K+) influx and reactive oxygen species (ROS) production, which can trigger either proliferation or apoptosis, depending on the ROS setpoint of the cell. Recent evidence indicates that p13 may influence the cell’s innate immune response to viral infection and the infected cell phenotype. Association of the HTLV-1 transcriptional activator, Tax, with p13 increases p13’s stability, leads to its partial co-localization with Tax in nuclear speckles, and reduces the ability of Tax to interact with the transcription cofactor CBP/p300. Comparison of p13 sequences isolated from HTLV-1-infected individuals revealed a small number of amino acid variations in the domains controlling the subcellular localization of the protein. Disruptive mutations of p13 were found in samples obtained from asymptomatic patients with low proviral load. p13 sequences of HTLV-1 subtype C isolates from indigenous Australian patients showed a high degree of identity among each other, with all samples containing a pattern of 5 amino acids that distinguished them from other subtypes. Further characterization of p13’s functional properties and sequence variants may lead to a deeper understanding of the impact of p13 as a contributor to the clinical manifestations of HTLV-1 infection.
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Affiliation(s)
- Maria Omsland
- Animal Models and Retroviral Vaccines Section, Vaccine Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | | | - Ramona Moles
- Animal Models and Retroviral Vaccines Section, Vaccine Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Sarkis Sarkis
- Animal Models and Retroviral Vaccines Section, Vaccine Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Damian F J Purcell
- Department of Microbiology and Immunology, The Peter Doherty Institute for Infection and Immunity, University of Melbourne, Parkville, VIC, Australia
| | - David Yurick
- Department of Microbiology and Immunology, The Peter Doherty Institute for Infection and Immunity, University of Melbourne, Parkville, VIC, Australia
| | - Georges Khoury
- Department of Microbiology and Immunology, The Peter Doherty Institute for Infection and Immunity, University of Melbourne, Parkville, VIC, Australia.,Division of Microbiology and Immunology, Yerkes National Primate Research Center, Emory University, Atlanta, GA, USA
| | | | - Vincenzo Ciminale
- Veneto Institute of Oncology IOV-IRCCS, Padua, Italy.,Department of Surgery, Oncology, and Gastroenterology, University of Padua, Padua, Italy
| | - Genoveffa Franchini
- Animal Models and Retroviral Vaccines Section, Vaccine Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
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24
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HTLV-1c associated bronchiolitis in an Aboriginal man from central Australia. IDCases 2020; 19:e00714. [PMID: 32123663 PMCID: PMC7037585 DOI: 10.1016/j.idcr.2020.e00714] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 02/07/2020] [Accepted: 02/07/2020] [Indexed: 02/03/2023] Open
Abstract
We describe the first case of HTLV associated bronchiolitis to be associated with HTLV-1c subtype infection. An Aboriginal man with HTLV-1 infection was repeatedly admitted to Alice Springs Hospital, central Australia, with hypercapnic respiratory failure from the age of 28 years. High resolution CT chest findings were consistent with bronchiolitis and large numbers of lymphocytes were found in bronchoalveolar lavage fluid (BALF). After extensive investigations failed to find a cause, he was tested for HTLV-1 and found to have a high HTLV-1c proviral load (6.8 %) in peripheral blood leukocytes and in BALF (4.7 %). The administration of systemic corticosteroids resulted in a rapid clinical response; however, he did not continue treatment after discharge and died due to respiratory failure in the community.
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Marcusso RMN, Van Weyenbergh J, de Moura JVL, Dahy FE, de Moura Brasil Matos A, Haziot MEJ, Vidal JE, Fonseca LAM, Smid J, Assone T, Casseb J, de Oliveira ACP. Dichotomy in Fatal Outcomes in a Large Cohort of People Living with HTLV-1 in São Paulo, Brazil. Pathogens 2019; 9:pathogens9010025. [PMID: 31888093 PMCID: PMC7168659 DOI: 10.3390/pathogens9010025] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 11/30/2019] [Accepted: 12/24/2019] [Indexed: 11/30/2022] Open
Abstract
Background: Despite its relatively low incidence of associated diseases, Human T-cell Leukemia Virus-1 (HTLV-1) infection was reported to carry a significant risk of mortality in several endemic areas. HTLV-1-associated diseases, adult T-cell leukemia/lymphoma (ATLL) and HTLV-1-associated myelopathy/tropical spastic paraperesis (HAM/TSP), as well as frequent coinfections with human immunodeficiency virus (HIV), hepatitis C virus (HCV), and Strongyloides stercoralis were associated to increased morbidity and mortality of HTLV-1 infection. Objective: To determine the mortality rate and its associated variables from an open cohort started in July 1997 at the HTLV Clinic, Emilio Ribas Institute (IIER), a major infectious disease hospital in São Paulo, Brazil. Methods: Since inception up to September 2018, we admitted 727 HTLV-1-infected individuals, with a rate of 30–50 new admissions per year. All patient data, including clinical and laboratory data, were regularly updated throughout the 21-year period, using a dedicated REDCap database. The Ethical Board of IIER approved the protocol. Results: During 21 years of clinical care to people living with HTLV-1 in the São Paulo region, we recruited 479 asymptomatic HTLV-1-infected individuals and 248 HAM/TSP patients, of which 632 remained under active follow-up. During a total of 3800 person-years of follow-up (maximum follow-up 21.5 years, mean follow-up 6.0 years), 27 individuals died (median age of 51.5 years), of which 12 were asymptomatic, one ATLL patient and 14 HAM/TSP patients. HAM/TSP diagnosis (but neither age nor gender) was a significant predictor of increased mortality by univariate and multivariate (hazard ratio (HR) 5.03, 95% CI [1.96–12.91], p = 0.001) Cox regression models. Coinfection with HIV/HCV was an independent predictor of increased mortality (HR 15.08; 95% CI [5.50–41.32]; p < 0.001), with AIDS-related infections as a more frequent cause of death in asymptomatics (6/13; p = 0.033). HIV/HCV-negative fatal HAM/TSP cases were all female, with urinary tract infection and decubitus ulcer-associated sepsis as the main cause of death (8/14, p = 0.002). Conclusions: All-cause mortality among people living with HTLV-1 in São Paulo differs between asymptomatic (2.9%) and HAM/TSP patients (7.3%), independent of age and gender. We observe a dichotomy in fatal cases, with HAM/TSP and HIV/HCV coinfection as independent risk factors for death. Our findings reveal an urgent need for public health actions, as the major causes of death, infections secondary to decubitus ulcers, and immune deficiency syndrome (AIDS)-related infections, can be targeted by preventive measures.
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Affiliation(s)
- Rosa Maria N. Marcusso
- Institute of Infectious Diseases “Emilio Ribas” (IIER) of São Paulo, São Paulo 01246-000, Brazil; (J.V.L.d.M.); (F.E.D.); (M.E.J.H.); (J.E.V.); (J.S.)
- Correspondence: (R.M.N.M.); (A.C.P.d.O.)
| | - Johan Van Weyenbergh
- Department of Microbiology, Immunology and Transplantation, Rega Institute for Medical Research, KU Leuven, 3000 Leuven, Belgium;
| | - João Victor Luisi de Moura
- Institute of Infectious Diseases “Emilio Ribas” (IIER) of São Paulo, São Paulo 01246-000, Brazil; (J.V.L.d.M.); (F.E.D.); (M.E.J.H.); (J.E.V.); (J.S.)
| | - Flávia Esper Dahy
- Institute of Infectious Diseases “Emilio Ribas” (IIER) of São Paulo, São Paulo 01246-000, Brazil; (J.V.L.d.M.); (F.E.D.); (M.E.J.H.); (J.E.V.); (J.S.)
| | | | - Michel E. J. Haziot
- Institute of Infectious Diseases “Emilio Ribas” (IIER) of São Paulo, São Paulo 01246-000, Brazil; (J.V.L.d.M.); (F.E.D.); (M.E.J.H.); (J.E.V.); (J.S.)
| | - Jose E. Vidal
- Institute of Infectious Diseases “Emilio Ribas” (IIER) of São Paulo, São Paulo 01246-000, Brazil; (J.V.L.d.M.); (F.E.D.); (M.E.J.H.); (J.E.V.); (J.S.)
- Institute of Tropical Medicine of São Paulo, São Paulo 05403-000, Brazil; (A.d.M.B.M.); (L.A.M.F.); (J.C.)
| | - Luiz Augusto M. Fonseca
- Institute of Tropical Medicine of São Paulo, São Paulo 05403-000, Brazil; (A.d.M.B.M.); (L.A.M.F.); (J.C.)
| | - Jerusa Smid
- Institute of Infectious Diseases “Emilio Ribas” (IIER) of São Paulo, São Paulo 01246-000, Brazil; (J.V.L.d.M.); (F.E.D.); (M.E.J.H.); (J.E.V.); (J.S.)
| | - Tatiane Assone
- Institute of Tropical Medicine of São Paulo, São Paulo 05403-000, Brazil; (A.d.M.B.M.); (L.A.M.F.); (J.C.)
- Laboratory of Dermatology and Immunodeficiencies, Department of Dermatology, Medical School, University of São Paulo Brazil, São Paulo 05403-000, Brazil
| | - Jorge Casseb
- Institute of Tropical Medicine of São Paulo, São Paulo 05403-000, Brazil; (A.d.M.B.M.); (L.A.M.F.); (J.C.)
- Laboratory of Dermatology and Immunodeficiencies, Department of Dermatology, Medical School, University of São Paulo Brazil, São Paulo 05403-000, Brazil
| | - Augusto César Penalva de Oliveira
- Institute of Infectious Diseases “Emilio Ribas” (IIER) of São Paulo, São Paulo 01246-000, Brazil; (J.V.L.d.M.); (F.E.D.); (M.E.J.H.); (J.E.V.); (J.S.)
- Correspondence: (R.M.N.M.); (A.C.P.d.O.)
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Moles R, Sarkis S, Galli V, Omsland M, Purcell DFJ, Yurick D, Khoury G, Pise-Masison CA, Franchini G. p30 protein: a critical regulator of HTLV-1 viral latency and host immunity. Retrovirology 2019; 16:42. [PMID: 31852501 PMCID: PMC6921414 DOI: 10.1186/s12977-019-0501-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Accepted: 11/29/2019] [Indexed: 12/24/2022] Open
Abstract
The extraordinarily high prevalence of HTLV-1 subtype C (HTLV-1C) in some isolated indigenous communities in Oceania and the severity of the health conditions associated with the virus impress the great need for basic and translational research to prevent and treat HTLV-1 infection. The genome of the virus’s most common subtype, HTLV-1A, encodes structural, enzymatic, and regulatory proteins that contribute to viral persistence and pathogenesis. Among these is the p30 protein encoded by the doubly spliced Tax-orf II mRNA, a nuclear/nucleolar protein with both transcriptional and post-transcriptional activity. The p30 protein inhibits the productive replication cycle via nuclear retention of the mRNA that encodes for both the viral transcriptional trans-activator Tax, and the Rex proteins that regulate the transport of incompletely spliced viral mRNA to the cytoplasm. In myeloid cells, p30 inhibits the PU-1 transcription factor that regulates interferon expression and is a critical mediator of innate and adaptive immunity. Furthermore, p30 alters gene expression, cell cycle progression, and DNA damage responses in T-cells, raising the hypothesis that p30 may directly contribute to T cell transformation. By fine-tuning viral expression while also inhibiting host innate responses, p30 is likely essential for viral infection and persistence. This concept is supported by the finding that macaques, a natural host for the closely genetically related simian T-cell leukemia virus 1 (STLV-1), exposed to an HTLV-1 knockout for p30 expression by a single point mutation do not became infected unless reversion and selection of the wild type HTLV-1 genotype occurs. All together, these data suggest that inhibition of p30 may help to curb and eventually eradicate viral infection by exposing infected cells to an effective host immune response.
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Affiliation(s)
- Ramona Moles
- Animal Models and Retroviral Vaccines Section, Vaccine Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Sarkis Sarkis
- Animal Models and Retroviral Vaccines Section, Vaccine Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Veronica Galli
- Animal Models and Retroviral Vaccines Section, Vaccine Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Maria Omsland
- Animal Models and Retroviral Vaccines Section, Vaccine Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Damian F J Purcell
- Department of Microbiology and Immunology, The Peter Doherty Institute for Infection and Immunity, University of Melbourne, Parkville, VIC, Australia
| | - David Yurick
- Department of Microbiology and Immunology, The Peter Doherty Institute for Infection and Immunity, University of Melbourne, Parkville, VIC, Australia
| | - Georges Khoury
- Department of Microbiology and Immunology, The Peter Doherty Institute for Infection and Immunity, University of Melbourne, Parkville, VIC, Australia
| | - Cynthia A Pise-Masison
- Animal Models and Retroviral Vaccines Section, Vaccine Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Genoveffa Franchini
- Animal Models and Retroviral Vaccines Section, Vaccine Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
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Sarkis S, Galli V, Moles R, Yurick D, Khoury G, Purcell DFJ, Franchini G, Pise-Masison CA. Role of HTLV-1 orf-I encoded proteins in viral transmission and persistence. Retrovirology 2019; 16:43. [PMID: 31852543 PMCID: PMC6921521 DOI: 10.1186/s12977-019-0502-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 12/03/2019] [Indexed: 02/07/2023] Open
Abstract
The human T cell leukemia virus type 1 (HTVL-1), first reported in 1980 by Robert Gallo's group, is the etiologic agent of both cancer and inflammatory diseases. Despite approximately 40 years of investigation, the prognosis for afflicted patients remains poor with no effective treatments. The virus persists in the infected host by evading the host immune response and inducing proliferation of infected CD4+ T-cells. Here, we will review the role that viral orf-I protein products play in altering intracellular signaling, protein expression and cell-cell communication in order to escape immune recognition and promote T-cell proliferation. We will also review studies of orf-I mutations found in infected patients and their potential impact on viral load, transmission and persistence. Finally, we will compare the orf-I gene in HTLV-1 subtypes as well as related STLV-1.
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Affiliation(s)
- Sarkis Sarkis
- Animal Models and Retroviral Vaccines Section, Vaccine Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Veronica Galli
- Animal Models and Retroviral Vaccines Section, Vaccine Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Ramona Moles
- Animal Models and Retroviral Vaccines Section, Vaccine Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - David Yurick
- Department of Microbiology and Immunology, The Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Parkville, VIC, Australia
| | - Georges Khoury
- Department of Microbiology and Immunology, The Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Parkville, VIC, Australia
| | - Damian F J Purcell
- Department of Microbiology and Immunology, The Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Parkville, VIC, Australia
| | - Genoveffa Franchini
- Animal Models and Retroviral Vaccines Section, Vaccine Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
| | - Cynthia A Pise-Masison
- Animal Models and Retroviral Vaccines Section, Vaccine Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
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Afonso PV, Cassar O, Gessain A. Molecular epidemiology, genetic variability and evolution of HTLV-1 with special emphasis on African genotypes. Retrovirology 2019; 16:39. [PMID: 31842895 PMCID: PMC6916231 DOI: 10.1186/s12977-019-0504-z] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 12/07/2019] [Indexed: 02/01/2023] Open
Abstract
Human T cell leukemia virus (HTLV-1) is an oncoretrovirus that infects at least 10 million people worldwide. HTLV-1 exhibits a remarkable genetic stability, however, viral strains have been classified in several genotypes and subgroups, which often mirror the geographic origin of the viral strain. The Cosmopolitan genotype HTLV-1a, can be subdivided into geographically related subgroups, e.g. Transcontinental (a-TC), Japanese (a-Jpn), West-African (a-WA), North-African (a-NA), and Senegalese (a-Sen). Within each subgroup, the genetic diversity is low. Genotype HTLV-1b is found in Central Africa; it is the major genotype in Gabon, Cameroon and Democratic Republic of Congo. While strains from the HTLV-1d genotype represent only a few percent of the strains present in Central African countries, genotypes -e, -f, and -g have been only reported sporadically in particular in Cameroon Gabon, and Central African Republic. HTLV-1c genotype, which is found exclusively in Australo-Melanesia, is the most divergent genotype. This reflects an ancient speciation, with a long period of isolation of the infected populations in the different islands of this region (Australia, Papua New Guinea, Solomon Islands and Vanuatu archipelago). Until now, no viral genotype or subgroup is associated with a specific HTLV-1-associated disease. HTLV-1 originates from a simian reservoir (STLV-1); it derives from interspecies zoonotic transmission from non-human primates to humans (ancient or recent). In this review, we describe the genetic diversity of HTLV-1, and analyze the molecular mechanisms that are at play in HTLV-1 evolution. Similar to other retroviruses, HTLV-1 evolves either through accumulation of point mutations or recombination. Molecular studies point to a fairly low evolution rate of HTLV-1 (between 5.6E−7 and 1.5E−6 substitutions/site/year), supposedly because the virus persists within the host via clonal expansion (instead of new infectious cycles that use reverse transcriptase).
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Affiliation(s)
- Philippe V Afonso
- Unité d'Epidémiologie et Physiopathologie des Virus Oncogènes, CRNS-UMR 3569, Département de Virologie, Institut Pasteur, Bâtiment Lwoff, 28 rue du Dr. Roux, 75724, Paris cedex 15, France.
| | - Olivier Cassar
- Unité d'Epidémiologie et Physiopathologie des Virus Oncogènes, CRNS-UMR 3569, Département de Virologie, Institut Pasteur, Bâtiment Lwoff, 28 rue du Dr. Roux, 75724, Paris cedex 15, France
| | - Antoine Gessain
- Unité d'Epidémiologie et Physiopathologie des Virus Oncogènes, CRNS-UMR 3569, Département de Virologie, Institut Pasteur, Bâtiment Lwoff, 28 rue du Dr. Roux, 75724, Paris cedex 15, France.
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29
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Schierhout G, McGregor S, Gessain A, Einsiedel L, Martinello M, Kaldor J. Association between HTLV-1 infection and adverse health outcomes: a systematic review and meta-analysis of epidemiological studies. THE LANCET. INFECTIOUS DISEASES 2019; 20:133-143. [PMID: 31648940 DOI: 10.1016/s1473-3099(19)30402-5] [Citation(s) in RCA: 132] [Impact Index Per Article: 26.4] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 07/05/2019] [Accepted: 07/05/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND Human T-cell lymphotropic virus type 1 (HTLV-1) is a human retrovirus that causes a lifelong infection. Several diseases, including an aggressive form of leukaemia, have been designated as associated with HTLV-1, whereby having HTLV-1 is a necessary condition for diagnosis. Beyond these diseases, there is uncertainty about other health effects of HTLV-1. We aimed to synthesise evidence from epidemiological studies on associations between health outcomes and HTLV-1. METHODS For this systematic review and meta-analysis, we searched Embase, MEDLINE, MEDLINE In-Process, and Global Health for publications from their inception to July, 2018. We included cohort, case-control, and controlled cross-sectional studies that compared mortality or morbidity between people with and without HTLV-1. We excluded studies of psychiatric conditions, of symptoms or clinical findings only, of people who had undergone blood transfusion or organ transplant, and of population groups defined by a behavioural characteristic putting them at increased risk of co-infection with another virus. We extracted the risk estimates (relative risks [RRs] or odds ratios [ORs]) that reflected the greatest degree of control for potential confounders. We did a random-effects meta-analysis for groups of effect estimates where case ascertainment methods, age groups, and confounders were similar, presenting pooled estimates with 95% CIs and prediction intervals. FINDINGS Of the 3318 identified studies, 39 met the inclusion criteria, examining 42 clinical conditions between them. The adjusted risk of death due to any cause was higher in people with HTLV-1 when compared with HTLV-1-negative counterparts (RR 1·57, 95% CI 1·37-1·80). From meta-analysis, HTLV-1 was associated with increased odds of seborrheic dermatitis (OR 3·95, 95% CI 1·99-7·81), Sjogren's syndrome (3·25, 1·85-5·70), and, inversely, with lower relative risk of gastric cancer (RR 0·45, 0·28-0·71). There were a further 14 diseases with significant associations or substantially elevated risk with HTLV-1 from single studies (eczema [children]; bronchiectasis, bronchitis and bronchiolitis [analysed together]; asthma [males]; fibromyalgia; rheumatoid arthritis; arthritis; tuberculosis; kidney and bladder infections; dermatophytosis; community acquired pneumonia; strongyloides hyperinfection syndrome; liver cancer; lymphoma other than adult T-cell leukaemia-lymphoma; and cervical cancer). INTERPRETATION There is a broad range of diseases studied in association with HTLV-1. However, the elevated risk for death among people with HTLV-1 is not explained by available studies of morbidity. Many of the diseases shown to be associated with HTLV-1 are not fatal, and those that are (eg, leukaemia) occur too rarely to account for the observed mortality effect. There are substantial research gaps in relation to HTLV-1 and cardiovascular, cerebrovascular, and metabolic disease. The burden of disease associated with the virus might be broader than generally recognised. FUNDING Commonwealth Department of Health, Australia.
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Affiliation(s)
- Gill Schierhout
- The Kirby Institute, University of New South Wales, Kensington, NSW, Australia; The George Institute for Global Health, Faculty of Medicine, University of New South Wales Newtown, NSW, Australia.
| | - Skye McGregor
- The Kirby Institute, University of New South Wales, Kensington, NSW, Australia
| | - Antoine Gessain
- Institut Pasteur, Unité d'Epidémiologie et Physiopathologie des Virus Oncogènes, Département de Virologie, Paris, France; CNRS, UMR3569, Paris, France
| | - Lloyd Einsiedel
- Baker Heart and Diabetes Institute Central Australia, Alice Springs, NT, Australia
| | - Marianne Martinello
- The Kirby Institute, University of New South Wales, Kensington, NSW, Australia
| | - John Kaldor
- The Kirby Institute, University of New South Wales, Kensington, NSW, Australia
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Einsiedel L, Pham H, Au V, Hatami S, Wilson K, Spelman T, Jersmann H. Predictors of non-cystic fibrosis bronchiectasis in Indigenous adult residents of central Australia: results of a case-control study. ERJ Open Res 2019; 5:00001-2019. [PMID: 31911928 PMCID: PMC6939737 DOI: 10.1183/23120541.00001-2019] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Accepted: 09/14/2019] [Indexed: 11/05/2022] Open
Abstract
The human T-cell leukaemia virus type 1 (HTLV-1) is associated with pulmonary inflammation. Indigenous Australians in central Australia have a very high prevalence of HTLV-1 infection and we hypothesised that this might contribute to high rates of bronchiectasis in this population. 80 Indigenous adults with confirmed bronchiectasis, each matched by age, sex and language to two controls without bronchiectasis, were recruited. Case notes and chest imaging were reviewed, HTLV-1 serology and the number of peripheral blood leukocytes (PBLs) infected with HTLV-1 (pro-viral load (PVL)) were determined, and radiological abnormality scores were calculated. Participants were followed for a mean±sd of 1.14±0.86 years and causes of death were determined. Median (interquartile range) HTLV-1 PVL for cases was 8-fold higher than controls (cases 213.8 (19.7-3776.3) copies per 105 PBLs versus controls 26.6 (0.9-361) copies per 105 PBLs; p=0.002). Radiological abnormality scores were higher for cases with HTLV-1 PVL ≥1000 copies per 105 PBLs and no cause of bronchiectasis other than HTLV-1 infection. Major predictors of bronchiectasis were prior severe lower respiratory tract infection (adjusted OR (aOR) 17.83, 95% CI 4.51-70.49; p<0.001) and an HTLV-1 PVL ≥1000 copies per 105 PBLs (aOR 12.41, 95% CI 3.84-40.15; p<0.001). Bronchiectasis (aOR 4.27, 95% CI 2.04-8.94; p<0.001) and HTLV-1 PVL ≥1000 copies per 105 PBLs (aOR 3.69, 95% CI 1.11-12.27; p=0.033) predicted death. High HTLV-1 PVLs are associated with bronchiectasis and with more extensive radiological abnormalities, which may result from HTLV-1-mediated airway inflammation.
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Affiliation(s)
- Lloyd Einsiedel
- Baker Heart and Diabetes Institute, Alice Springs, Australia
| | - Hai Pham
- Baker Heart and Diabetes Institute, Alice Springs, Australia
| | - Virginia Au
- Flinders Medical Centre, Adelaide, Australia
| | - Saba Hatami
- Flinders Medical Centre, Adelaide, Australia
| | - Kim Wilson
- National Serology Reference Laboratory, Melbourne, Australia
| | | | - Hubertus Jersmann
- Dept of Respiratory Medicine, Royal Adelaide Hospital, Adelaide, Australia
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Pinto DO, DeMarino C, Pleet ML, Cowen M, Branscome H, Al Sharif S, Jones J, Dutartre H, Lepene B, Liotta LA, Mahieux R, Kashanchi F. HTLV-1 Extracellular Vesicles Promote Cell-to-Cell Contact. Front Microbiol 2019; 10:2147. [PMID: 31620104 PMCID: PMC6759572 DOI: 10.3389/fmicb.2019.02147] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Accepted: 08/30/2019] [Indexed: 12/21/2022] Open
Abstract
Human T-cell leukemia virus-1 (HTLV-1) is a neglected and incurable retrovirus estimated to infect 5 to 10 million worldwide. Specific indigenous Australian populations report infection rates of more than 40%, suggesting a potential evolution of the virus with global implications. HTLV-1 causes adult T-cell leukemia/lymphoma (ATLL), and a neurological disease named HTLV-1 associated myelopathy/tropical spastic paraparesis (HAM/TSP). Even though HTLV-1 transmission primarily occurs from cell-to-cell, there is still a gap of knowledge regarding the mechanisms of viral spread and disease progression. We have recently shown that Extracellular Vesicles (EVs) ubiquitously produced by cells may be used by HTLV-1 to transport viral proteins and RNA, and elicit adverse effects on recipient uninfected cells. The viral proteins Tax and HBZ are involved in disease progression and impairment of autophagy in infected cells. Here, we show that activation of HTLV-1 via ionizing radiation (IR) causes a significant increase of intracellular Tax, but not EV-associated Tax. Also, lower density EVs from HTLV-1-infected cells, separated by an Iodixanol density gradient, are positive for gp61+++/Tax+++/HBZ+ proteins (HTLV-1 EVs). We found that HTLV-1 EVs are not infectious when tested in multiple cell lines. However, these EVs promote cell-to-cell contact of uninfected cells, a phenotype which was enhanced with IR, potentially promoting viral spread. We treated humanized NOG mice with HTLV-1 EVs prior to infection and observed an increase in viral RNA synthesis in mice compared to control (EVs from uninfected cells). Proviral DNA levels were also quantified in blood, lung, spleen, liver, and brain post-treatment with HTLV-1 EVs, and we observed a consistent increase in viral DNA levels across all tissues, especially the brain. Finally, we show direct implications of EVs in viral spread and disease progression and suggest a two-step model of infection including the release of EVs from donor cells and recruitment of recipient cells as well as an increase in recipient cell-to-cell contact promoting viral spread.
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Affiliation(s)
- Daniel O. Pinto
- Laboratory of Molecular Virology, School of Systems Biology, George Mason University, Manassas, VA, United States
| | - Catherine DeMarino
- Laboratory of Molecular Virology, School of Systems Biology, George Mason University, Manassas, VA, United States
| | - Michelle L. Pleet
- Laboratory of Molecular Virology, School of Systems Biology, George Mason University, Manassas, VA, United States
| | - Maria Cowen
- Laboratory of Molecular Virology, School of Systems Biology, George Mason University, Manassas, VA, United States
| | - Heather Branscome
- Laboratory of Molecular Virology, School of Systems Biology, George Mason University, Manassas, VA, United States
| | - Sarah Al Sharif
- Laboratory of Molecular Virology, School of Systems Biology, George Mason University, Manassas, VA, United States
| | - Jennifer Jones
- Vaccine Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, United States
| | - Helene Dutartre
- International Center for Research in Infectiology, Retroviral Oncogenesis Laboratory, INSERM U1111-Université Claude Bernard Lyon 1, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, Université de Lyon, Fondation pour la Recherche Médicale, Labex Ecofect, Lyon, France
| | | | - Lance A. Liotta
- Center for Applied Proteomics and Molecular Medicine, George Mason University, Manassas, VA, United States
| | - Renaud Mahieux
- International Center for Research in Infectiology, Retroviral Oncogenesis Laboratory, INSERM U1111-Université Claude Bernard Lyon 1, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, Université de Lyon, Fondation pour la Recherche Médicale, Labex Ecofect, Lyon, France
| | - Fatah Kashanchi
- Laboratory of Molecular Virology, School of Systems Biology, George Mason University, Manassas, VA, United States
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Barski MS, Minnell JJ, Maertens GN. Inhibition of HTLV-1 Infection by HIV-1 First- and Second-Generation Integrase Strand Transfer Inhibitors. Front Microbiol 2019; 10:1877. [PMID: 31474960 PMCID: PMC6705210 DOI: 10.3389/fmicb.2019.01877] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Accepted: 07/30/2019] [Indexed: 12/21/2022] Open
Abstract
More than 10 million people worldwide are infected with the retrovirus human T-cell lymphotropic virus type 1 (HTLV-1). Infection phenotypes can range from asymptomatic to severe adult T-cell leukemia/lymphoma (ATLL) and HTLV-1-associated myelopathy. HTLV-1, like human immunodeficiency virus type 1 (HIV-1), is a blood-borne pathogen and viral infection happens in a similar fashion, with the major mode of transmission through breastfeeding. There is a strong correlation between time of infection and disease development, with a higher incidence of ATLL in patients infected during childhood. There is no successful therapeutic or preventative regimen for HTLV-1. It is therefore essential to develop therapies to inhibit transmission or block the onset/development of HTLV-1 associated diseases. Recently, we have seen the overwhelming success of integrase strand transfer inhibitors (INSTIs) in the treatment of HIV-1. Previously, raltegravir was shown to inhibit HTLV-1 infection. Here, we tested FDA-approved and two Phase II HIV-1 INSTIs in vitro and in a cell-to-cell infection model and show that they are highly active in blocking HTLV-1 infection, with bictegravir (EC50 = 0.30 ± 0.17 nM) performing best overall. INSTIs, in particular bictegravir, are more potent in blocking HTLV-1 transmission than tenofovir disproxil fumarate (TDF), an RT inhibitor. Our data suggest that HIV-1 INSTIs could present a good clinical strategy in HTLV-1 management and justifies the inclusion of INSTIs in clinical trials.
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Affiliation(s)
- Michał S Barski
- Division of Infectious Diseases, Section of Molecular Virology, Department of Medicine, St Mary's Hospital, Imperial College London, London, United Kingdom
| | - Jordan J Minnell
- Division of Infectious Diseases, Section of Molecular Virology, Department of Medicine, St Mary's Hospital, Imperial College London, London, United Kingdom
| | - Goedele N Maertens
- Division of Infectious Diseases, Section of Molecular Virology, Department of Medicine, St Mary's Hospital, Imperial College London, London, United Kingdom
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Talukder MRR, Walley R, Pham H, Schinke S, Woodman R, Wilson K, Sajiv C, Einsiedel L. Higher human T‐cell leukaemia virus type 1 (HTLV‐1) proviral load is associated with end‐stage kidney disease in Indigenous Australians: Results of a case‐control study in central Australia. J Med Virol 2019; 91:1866-1872. [DOI: 10.1002/jmv.25532] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 06/11/2019] [Indexed: 11/09/2022]
Affiliation(s)
- Mohammad Radwanur R. Talukder
- Aboriginal Health, Baker Heart and Diabetes InstituteAlice Springs Hospital Alice Springs Northern Territory Australia
| | - Rebecca Walley
- Department of MedicineAlice Springs Hospital Northern Territory Australia
| | - Hai Pham
- Aboriginal Health, Baker Heart and Diabetes InstituteAlice Springs Hospital Alice Springs Northern Territory Australia
| | - Shane Schinke
- Aboriginal Health, Baker Heart and Diabetes InstituteAlice Springs Hospital Alice Springs Northern Territory Australia
| | - Richard Woodman
- Flinders Centre for Epidemiology and BiostatisticsFlinders University Adelaide Australia
| | - Kim Wilson
- NRL TestingNational Serology Reference Laboratory Melbourne Victoria Australia
| | - Cherian Sajiv
- Central Australia Renal ServicesAlice Springs Hospital Alice Springs Northern Territory Australia
| | - Lloyd Einsiedel
- Aboriginal Health, Baker Heart and Diabetes InstituteAlice Springs Hospital Alice Springs Northern Territory Australia
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Acuna-Villaorduna A, Gonzalez-Lugo J, Ye BH, Adrianzen Herrera DA, Sica RA, Shah U, Shah N, Kornblum N, Braunschweig I, Derman O, Mantzaris I, Shastri A, Wang Y, Verma A, Zalta B, Janakiram M. High prevalence of pulmonary findings in computed tomographies of HTLV-1-infected patients with and without adult-T cell leukemia/lymphoma - implications for staging. Leuk Lymphoma 2019; 60:3272-3276. [PMID: 31204876 DOI: 10.1080/10428194.2019.1627543] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Lung involvement has been reported in HTLV-1 carriers and in patients with ATLL. Whether there are differences in the pattern of lung involvement between ATLL and HTLV carriers in North American patients is unknown. We aimed to compare CT pulmonary findings among patients with HTLV-1 infection with and without ATLL. Among 140 patients with HTLV-1 diagnosis, 97 had CT chest available. Of these, 72 (74.2%) had ATLL and 25 (25.8%) did not have ATLL. CT chest abnormalities were present in 90 (92.8%) participants (94.4% in ATLL; 88% in non-ATLL). Higher rates of lymphadenopathy (69.4% versus 24%, p < .01) and lower rates of bronchiectasis (25% versus 48%, p = .04) were seen in ATLL compared to non-ATLL. Our study supports that staging of lung involvement in ATLL should consider HTLV-associated pulmonary findings as not all CT chest abnormalities necessarily represent malignant infiltration.
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Affiliation(s)
| | | | - B Hilda Ye
- Yeshiva University Albert Einstein College of Medicine, Bronx, NY, USA
| | | | | | - Urvi Shah
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Nishi Shah
- Montefiore Hospital and Medical Center, Bronx, NY, USA
| | - Noah Kornblum
- Department of Oncology, Montefiore Medical Center, Bronx, NY, USA
| | | | - Olga Derman
- Department of Oncology, Montefiore Medical Center, Bronx, NY, USA
| | | | - Aditi Shastri
- Department of Oncology, Montefiore Medical Center, Bronx, NY, USA
| | - Yanhua Wang
- Department of Pathology, Montefiore Medical Center, Bronx, NY, USA
| | - Amit Verma
- Department of Oncology, Montefiore Einstein Center for Cancer Care, Bronx, NY, USA
| | | | - Murali Janakiram
- Department of Oncology, Montefiore Medical Center, Bronx, NY, USA
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35
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Molecular detection of human T-lymphotropic virus type 1 infection among oncology patients in Germany: A retrospective view. PLoS One 2019; 14:e0217560. [PMID: 31136642 PMCID: PMC6538170 DOI: 10.1371/journal.pone.0217560] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Accepted: 05/14/2019] [Indexed: 11/30/2022] Open
Abstract
Human T-cell lymphotropic virus (HTLV) belongs to a larger group of primate T-cell lymphotropic viruses (PTLVs) within the family Retroviridae. It is estimated that 10 to 20 million people worldwide may be infected with HTLV-1. Although most of them are asymptomatic, around 5% of infected individuals may develop either HTLV-1 Associated Myelopathy/Tropical Spastic Paraparesis (HAM/TSP) or Adult T-cell Leukaemia/Lymphoma (ATLL). Public Health authorities in many countries have implemented routine blood-donor tests for HTLV-specific antibodies; but this is not the case for Germany since the reported prevalence is very low (7/100,000). With the aim to evaluate retrospectively the presence of HTLV-1 among oncology patients in this country, samples stored at the Universitätsklinikum Freiburg, were analyzed. For this purpose, two different nested-PCR (n-PCR) protocols have been modified and set up for HTLV-1 detection. One positive case was detected by n-PCR among 406 samples (0,25%) in a period of 5 years (2008–2012) corresponding to a T-Cell Lymphoma. Despite the low prevalence, this virus is circulating in Germany, probably due to the increasing numbers of immigrants in these last years. Physicians should consider HTLV-1 infection and suspect it taking in account the ethnic and relation to endemic regions regardless the patient's residence.
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Abstract
It has been nearly 40 years since human T-cell leukemia virus-1 (HTLV-1), the first oncogenic retrovirus in humans and the first demonstrable cause of cancer by an infectious agent, was discovered. Studies indicate that HTLV-1 is arguably one of the most carcinogenic agents to humans. In addition, HTLV-1 causes a diverse array of diseases, including myelopathy and immunodeficiency, which cause morbidity and mortality to many people in the world, including the indigenous population in Australia, a fact that was emphasized only recently. HTLV-1 can be transmitted by infected lymphocytes, from mother to child via breast feeding, by sex, by blood transfusion, and by organ transplant. Therefore, the prevention of HTLV-1 infection is possible but such action has been taken in only a limited part of the world. However, until now it has not been listed by the World Health Organization as a sexually transmitted organism nor, oddly, recognized as an oncogenic virus by the recent list of the National Cancer Institute/National Institutes of Health. Such underestimation of HTLV-1 by health agencies has led to a remarkable lack of funding supporting research and development of treatments and vaccines, causing HTLV-1 to remain a global threat. Nonetheless, there are emerging novel therapeutic and prevention strategies which will help people who have diseases caused by HTLV-1. In this review, we present a brief historic overview of the key events in HTLV-1 research, including its pivotal role in generating ideas of a retrovirus cause of AIDS and in several essential technologies applicable to the discovery of HIV and the unraveling of its genes and their function. This is followed by the status of HTLV-1 research and the preventive and therapeutic developments of today. We also discuss pending issues and remaining challenges to enable the eradication of HTLV-1 in the future.
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Affiliation(s)
- Yutaka Tagaya
- Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, 21201, USA
| | - Masao Matsuoka
- Department of Hematology, Rheumatology and Infectious Diseases, Faculty of Life Sciences, Kumamoto University, Kumamoto, 860-0811, Japan
| | - Robert Gallo
- Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, 21201, USA
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Turpin J, Yurick D, Khoury G, Pham H, Locarnini S, Melamed A, Witkover A, Wilson K, Purcell D, Bangham CRM, Einsiedel L. Impact of Hepatitis B Virus Coinfection on Human T-Lymphotropic Virus Type 1 Clonality in an Indigenous Population of Central Australia. J Infect Dis 2019; 219:562-567. [PMID: 30307560 PMCID: PMC6350946 DOI: 10.1093/infdis/jiy546] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Accepted: 10/02/2018] [Indexed: 12/19/2022] Open
Abstract
The prevalence of human T-cell lymphotropic virus type 1 (HTLV-1) and hepatitis B virus (HBV) coinfection is high in certain Indigenous Australian populations, but its impact on HTLV-1 has not been described. We compared 2 groups of Indigenous adults infected with HTLV-1, either alone or coinfected with HBV. The 2 groups had a similar HTLV-1 proviral load, but there was a significant increase in clonal expansion of HTLV-1-infected lymphocytes in coinfected asymptomatic individuals. The degree of clonal expansion was correlated with the titer of HBV surface antigen. We conclude that HTLV-1/HBV coinfection may predispose to HTLV-1-associated malignant disease.
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Affiliation(s)
- Jocelyn Turpin
- Section of Virology, Division of Infectious Diseases, Imperial College, London, United Kingdom
| | - David Yurick
- Department of Microbiology and Immunology, University of Melbourne, Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria
| | - Georges Khoury
- Department of Microbiology and Immunology, University of Melbourne, Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria
| | - Hai Pham
- Baker Heart and Diabetes Institute Central Australia, Alice Springs Hospital, Northern Territory, Melbourne, Victoria, Australia
| | - Stephen Locarnini
- Victorian Infectious Diseases Reference Laboratory, Doherty Institute, Melbourne, Victoria, Australia
| | - Anat Melamed
- Section of Virology, Division of Infectious Diseases, Imperial College, London, United Kingdom
| | - Aviva Witkover
- Section of Virology, Division of Infectious Diseases, Imperial College, London, United Kingdom
| | - Kim Wilson
- National Serological Reference Laboratory, Melbourne, Victoria, Australia
| | - Damian Purcell
- Department of Microbiology and Immunology, University of Melbourne, Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria
| | - Charles R M Bangham
- Section of Virology, Division of Infectious Diseases, Imperial College, London, United Kingdom
| | - Lloyd Einsiedel
- Baker Heart and Diabetes Institute Central Australia, Alice Springs Hospital, Northern Territory, Melbourne, Victoria, Australia
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38
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Performance of Commercially Available Serological Screening Tests for Human T-Cell Lymphotropic Virus Infection in Brazil. J Clin Microbiol 2018; 56:JCM.00961-18. [PMID: 30232131 PMCID: PMC6258847 DOI: 10.1128/jcm.00961-18] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Accepted: 08/28/2018] [Indexed: 11/20/2022] Open
Abstract
Serological screening for human T-cell lymphotropic virus type 1 (HTLV-1) is usually performed using enzyme-linked immunosorbent assay (ELISA), particle agglutination, or chemiluminescence assay kits. Due to an antigen matrix improvement entailing the use of new HTLV antigens and changes in the format of HTLV screening tests, as well as newly introduced chemiluminescence assays (CLIAs), a systematic evaluation of the accuracy of currently available commercial tests is warranted. We aimed to assess the performance of commercially available screening tests for HTLV infection diagnosis. A diagnostic accuracy study was conducted on a panel of 397 plasma samples: 200 HTLV-negative plasma samples, 170 HTLV-positive plasma samples, and 27 plasma samples indeterminate by Western blotting (WB). WB-indeterminate samples (i.e., those yielding no specific bands for HTLV-1 and/or HTLV-2) were assessed by PCR, and the results were used to compare agreement among the commercially available ELISA screening tests. For performance analysis, WB-indeterminate samples were excluded, resulting in a final study panel of 370 samples. Three ELISA kits (Murex HTLV-1/2 [Murex], anti-HTLV-1/2 SYM Solution [SYM Solution], and Gold ELISA HTLV-1/2 [Gold ELISA]) and one CLIA kit (Architect rHTLV-1/2) were evaluated. All screening tests demonstrated 100% sensitivity. Concerning the HTLV-negative samples, the SYM Solution and Gold ELISA kits had specificity values of >99.5%, while the Architect rHTLV-1/2 test presented 98.1% specificity, followed by Murex, which had a specificity of 92.0%. Regarding the 27 samples with WB-indeterminate results, after PCR confirmation, all ELISA kits showed 100% sensitivity but low specificity. Accuracy findings were corroborated by the use of Cohen's kappa value, which evidenced slight and fair agreement between PCR analysis and ELISAs for HTLV infection diagnosis. Based on the data, we believe that all evaluated tests can be safely used for HTLV infection screening.
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Dias ARN, Falcão LFM, Falcão ASC, Normando VMF, Quaresma JAS. Human T Lymphotropic Virus and Pulmonary Diseases. Front Microbiol 2018; 9:1879. [PMID: 30154781 PMCID: PMC6103007 DOI: 10.3389/fmicb.2018.01879] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 07/26/2018] [Indexed: 12/14/2022] Open
Abstract
Human T lymphotropic virus type 1 (HTLV-1) is the etiological agent of HTLV-1-associated myelopathy, and adult T cell lymphoma/leukemia (ATL/L). Pulmonary complications such as alveolitis and bronchiectasis were found in individuals who develop TSP/HAM due to chronic inflammation. These individuals showed image anomalies in CT scans and changes in pulmonary function parameters distinctive of pulmonary disease. Furthermore, infected individuals have a greater susceptibility to pulmonary tuberculosis either due to changes in the innate immune response, in asymptomatic carriers, or to an opportunistic disease linked to immunodepression, in individuals who develop ATL/L. This summary addresses the general lack of knowledge regarding the relationship between HTLV-1 and pulmonary diseases and provides direction for future work.
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Affiliation(s)
- Apio R N Dias
- Tropical Medicine Center, Federal University of Pará, Belém, Brazil.,Center of Health and Biological Sciences, State University of Pará, Belém, Brazil
| | - Luiz F M Falcão
- Center of Health and Biological Sciences, State University of Pará, Belém, Brazil.,Graduate Program of Virology, Evandro Chagas Institute, Ministry of Health, Ananindeua, Brazil
| | - Aline S C Falcão
- Graduate Program of Virology, Evandro Chagas Institute, Ministry of Health, Ananindeua, Brazil
| | - Valéria M F Normando
- Tropical Medicine Center, Federal University of Pará, Belém, Brazil.,Center of Health and Biological Sciences, State University of Pará, Belém, Brazil
| | - Juarez A S Quaresma
- Tropical Medicine Center, Federal University of Pará, Belém, Brazil.,Center of Health and Biological Sciences, State University of Pará, Belém, Brazil.,Graduate Program of Virology, Evandro Chagas Institute, Ministry of Health, Ananindeua, Brazil
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