HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP): still an obscure disease.
Human T-cell leukemia virus type 1 (HTLV-1) is the ethiologic agent of the neurological disorder HTLV-1- associated myelopathy/tropical spastic paraparesis (HAM/TSP). Although the majority of HTLV-1-infected individuals remain asymptomatic during their lifetime, approximately one percent of this population develops a myelopathy consisting of a chronic inflammation of the white and gray matter of the spinal cord. Glucocorticoids are widely used for treatment because of their anti-inflammatory properties, improving symptoms mainly in those patients with only a few years from onset of the disease, when inflammation is more prominent. Interferon-alpha and vitamin C are other therapies presenting some benefits in clinical practice, probably due to their anti-viral and immunomodulatory activities observed ex vivo. Furthermore, inhibitors of histone deacetylase, which increase virus expression but result in a substantial decline in the proviral load, have also been proposed. This review is intended to bridge the gap between clinical and basic science by presenting recent findings on HAM/TSP disease, mechanisms of drug action, and benefits of these therapies in HAM/TSP patients.
Department of Biochemistry, Institute of Chemistry, University of São Paulo, USP, São Paulo, SP, Brazil.
Micheli Mainardi
MM
Pillat
Moisés Evandro
ME
Bauer
Augusto Cesar Penalva
AC
de Oliveira
Henning
H
Ulrich
Jorge
J
Casseb
D000818:Animals; D002908:Chronic Disease; D005938:Glucocorticoids / Q000627:therapeutic use; D015490:HTLV-I Infections / Q000453:epidemiology / Q000628:therapy / Q000821:virology; D015368:Human T-lymphotropic virus 1 / Q000472:pathogenicity*; D006801:Humans; D007249:Inflammation / Q000453:epidemiology / Q000628:therapy / Q000821:virology; D015493:Paraparesis, Tropical Spastic / Q000453:epidemiology / Q000628:therapy* / Q000821:virology*; D013118:Spinal Cord Diseases / Q000453:epidemiology / Q000628:therapy* / Q000821:virology*
D005938:Glucocorticoids