The significance of immune disorder in tropical spastic paraparesis.
The reports of the occurrence of HTLV-1 infection and/or HTLV-1 associated myelopathy (HAM/tropical spastic paraparesis (TSP) in patients with certain organ-specific and nonorgan-specific autoimmune diseases prompted us to assess the relationship between TSP and humoral autoimmunity. Blood samples from 76 TSP patients, 60 asymptomatic HTLV-1 carriers and 100 HTLV-1 seronegative blood donors were examined for the presence of organ-specific and nonorgan-specific autoantibodies, reactive serological tests for syphilis, immunoglobulin and complement concentrations as well as immunecomplexes. High prevalences of autoantibodies (39/76, 51%), reactive serological tests for syphilis (23/76; 30%), hypergammaglobulinaemia (69/76, 90%) and complement fixing immune complexes (44/76, 58%) were found in the TSP patients. These indicators of immunological disorder were found in statistically significantly lower prevalences in asymptomatic HTLV-1 carriers (12/60, 20%; p < 0.001; 6/60, 10%; p < 0.05; 32/60, 53%; p < 0.001 and 8/60, 13%; p < 0.001, respectively) and HTLV-1 seronegative blood donors (8/100, 8%; p < 0.001; 3/100, 3%; p < 0.001; 15/100, 15%; p < 0.001 and 5/100, 5%; p < 0.001, respectively). The profiles of autoimmune phenomena observed in the patient and control groups revealed that they were associated with TSP rather than mere HTLV-1 infection and consequently pathogenetic significance. The array of immunological features present in TSP was suggestive of autoimmune disease resulting from immune dysfunction. Studies which explore the possible existence of HTLV-1 induced autoantibodies with specificity for antigens of the spinal cord in TSP might be useful in elucidating its pathogenesis.
Department of Medical Microbiology, University of the West Indies Mona, Kingston, Jamaica.
M F
MF
Smikle
E N
EN
Barton
O C
OC
Morgan
J
J
Luseko
V E
VE
Bailey
E M
EM
Williams
D000293:Adolescent; D000328:Adult; D000368:Aged; D000936:Antigen-Antibody Complex / Q000032:analysis; D001323:Autoantibodies / Q000097:blood; D003165:Complement System Proteins / Q000032:analysis; D005260:Female; D015368:Human T-lymphotropic virus 1 / Q000302:isolation & purification; D006801:Humans; D007136:Immunoglobulins / Q000097:blood; D008297:Male; D008875:Middle Aged; D015493:Paraparesis, Tropical Spastic / Q000276:immunology*
D000936:Antigen-Antibody Complex; D001323:Autoantibodies; D007136:Immunoglobulins; D003165:Complement System Proteins