HAM/TSP: recent perspectives in Japan.
Neurologic diseases associated with human T-cell lymphotropic virus type I (HTLV-I) infection have a clinical spectrum that includes myelopathy (HTLV-I-associated myelopathy/tropical spastic paraparesis, HAM/TSP) as the central manifestation. Many clinical signs of involvement outside the central nervous system (CNS) have been described in some patients with HAM/TSP and have triggered and advanced the discovery of some HTLV-I-associated concepts in HTLV-I-infected individuals without signs of CNS involvement. Most of these HTLV-I-associated diseases exhibit common viroimmunologic characteristics that include a distributional bias of HTLV-I activation between the blood flow and the affected lesions and accumulated cellular immune responses in the lesions. These facts suggest that the vulnerable tissue(s) in some HTLV-I-infected individuals may not be defined by an exclusive tissue specificity, but that common steps of HTLV-I-versus-host interactions may have an important role in the pathologic process(es) in these diseases. This review summarizes the recent perspectives of the clinical spectrum and the pathogenesis of HAM/TSP in Japan. Furthermore, the feasible pathogenic involvement of cellular interactions between infected cells and responding immunocompetent cells in the affected tissues is emphasized.
Ijichi
S
S
Third Department of Internal Medicine, Faculty of Medicine, Kagoshima University, Japan.
Nakagawa
M
M
Umehara
F
F
Higuchi
I
I
Arimura
K
K
Izumo
S
S
Osame
M
M
D000328:Adult; D001172:Arthritis, Rheumatoid / Q000821:virology; D005260:Female; D015490:HTLV-I Infections / Q000175:diagnosis / Q000209:etiology* / Q000821:virology; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D015493:Paraparesis, Tropical Spastic / Q000175:diagnosis / Q000209:etiology* / Q000821:virology; D017285:Polymyositis / Q000821:virology; D012859:Sjogren's Syndrome / Q000821:virology; D014605:Uveitis / Q000821:virology