The impact of interferon-alpha treatment on clinical and immunovirological aspects of HTLV-1-associated myelopathy in northeast of Iran.
Human T-lymphotropic virus type 1 (HTLV-1)-associated myelopathy/tropical spastic paraparesis (HAM/TSP) is a chronic inflammatory myelopathy. The pathophysiology of HAM/TSP is not yet fully understood; therefore, effective therapy remains a challenging issue. This study was designed to evaluate the efficacy of interferon-alpha (IFN-α) in HAM/TSP patients in the Northeast of Iran. Forty-nine patients with a definite diagnosis of HAM/TSP were enrolled in this clinical trial. For six months, the patients received three million international units of subcutaneous IFN-α-2b per each injection. The dose regimen was daily injection for the first month, three times administration per week for the months 2 and 3, twice weekly injection for the months 4 and 5 and weekly injection for the sixth month. The clinical and laboratory responses were evaluated based on neurologic examinations and immunovirological markers. IFN-α had significant but temporary effect on the motor and urinary functions of the patients. Comparing to the baseline values, proviral load was significantly decreased one month after treatment in responders (495.20±306.87 to 262.69±219.24 p=0.02) and non-responders (624.86±261.90 to 428.28±259.88 p=0.03). Anti-HTLV-1 antibody titers were significantly decreased among responders (1152.1±200.5 to 511.6±98.2 p=0.009) and non-responders (1280.1±368.1 to 537.6±187 p=0.007). Flow cytometry showed no significant changes in CD4, CD8, CD4CD25 and CD16CD56 counts with IFN-α. The positive impact of IFN-α was observed during the treatment period with significant effects on some clinical aspects of HAM/TSP.
Inflammation and Inflammatory Diseases Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Houshang
H
Rafatpanah
Abdolrahim
A
Rezaee
Mohammad Mehdi
MM
Etemadi
Reza Farid
RF
Hosseini
Bita
B
Khorram
Leila
L
Afsahr
Graham
G
Taylor
Naghmeh
N
Mokhber
Mahmoud
M
Mahmoudi
Mohammad Reza
MR
Abbaszadegan
Mohsen
M
Foroghipor
Peyman
P
Hashemi
Amin
A
Amiri
Mohsen
M
Tehrani
Amir
A
Azarpazhooh
Mahmoud Reza
MR
Azarpazhooh
D000328:Adult; D005260:Female; D005434:Flow Cytometry; D015368:Human T-lymphotropic virus 1; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use*; D016130:Immunophenotyping; D016898:Interferon-alpha / Q000627:therapeutic use*; D007492:Iran; D008297:Male; D015493:Paraparesis, Tropical Spastic / Q000188:drug therapy* / Q000276:immunology / Q000821:virology; D020127:Recovery of Function; D013601:T-Lymphocytes / Q000187:drug effects*; D019562:Viral Load / Q000187:drug effects*
D007155:Immunologic Factors; D016898:Interferon-alpha