title: Safety of long-term treatment of HAM/TSP patients with valproic acid.
abstract: HTLV-associated myelopathy/tropical spastic paraparesis (HAM/TSP) is a neurodegenerative disease of the central nervous system induced by human T-lymphotropic virus type 1. As a potential therapeutic approach, we previously suggested reducing the proviral load by modulating lysine deacetylase activity using valproic acid (VPA) and exposing virus-positive cells to the host immune response. We conducted a single-center, 2-year, open-label trial, with 19 HAM/TSP volunteers treated with oral VPA. Proviral load, CD38/HLA-DR expression, and CD8(+) lysis efficiency were not significantly affected by VPA. Mean scores of HAM/TSP disability did not differ between baseline and final visit. Walking Time Test increased significantly (> 20%) in 3 patients and was in keeping with minor VPA side effects (drowsiness and tremor). Walking Time Test improved rapidly after VPA discontinuation. We conclude that long-term treatment with VPA is safe in HAM/TSP.
authors: Service de Neurologie, Centre Hospitalier Universitaire de Fort-de-France, Martinique, France.
authors: Stéphane
authors: S
authors: Olindo
authors: Gildas
authors: G
authors: Belrose
authors: Nicolas
authors: N
authors: Gillet
authors: Sabrina
authors: S
authors: Rodriguez
authors: Mathieu
authors: M
authors: Boxus
authors: Olivier
authors: O
authors: Verlaeten
authors: Becca
authors: B
authors: Asquith
authors: Charles
authors: C
authors: Bangham
authors: Aïssatou
authors: A
authors: Signaté
authors: Didier
authors: D
authors: Smadja
authors: Agnès
authors: A
authors: Lezin
authors: Raymond
authors: R
authors: Césaire
authors: Luc
authors: L
authors: Willems
mesh_terms: D000328:Adult; D000368:Aged; D015496:CD4-Positive T-Lymphocytes / Q000187:drug effects / Q000378:metabolism; D018414:CD8-Positive T-Lymphocytes / Q000187:drug effects / Q000378:metabolism; D057899:Cytophagocytosis / Q000187:drug effects; D004791:Enzyme Inhibitors / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D015368:Human T-lymphotropic virus 1 / Q000187:drug effects; D006801:Humans; D007111:Immunity, Cellular / Q000187:drug effects; D008213:Lymphocyte Activation / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D015493:Paraparesis, Tropical Spastic / Q000097:blood / Q000188:drug therapy* / Q000276:immunology* / Q000821:virology; D011533:Proviruses / Q000187:drug effects; D012720:Severity of Illness Index; D013602:T-Lymphocytes, Cytotoxic / Q000187:drug effects / Q000276:immunology; D013997:Time Factors; D014635:Valproic Acid / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D019562:Viral Load / Q000187:drug effects
chemical_list: D004791:Enzyme Inhibitors; D014635:Valproic Acid