title: The effect of HTLV-1 virulence factors (HBZ, Tax, proviral load), HLA class I and plasma neopterin on manifestation of HTLV-1 associated myelopathy tropical spastic paraparesis.
abstract: Previous studies have suggested debatable roles of Tax and HBZ gene expression in the pathogenesis of HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP). In this study, HTLV-1 and host interactions in the manifestation of HAM/TSP were evaluated.
  
  
  
  A cross-sectional study was conducted on 33 HAM/TSP patients and 38 HTLV-1 asymptomatic carriers (ACs). HTLV-1-Tax, HBZ gene expression, and proviral load (PVL) were assessed using the quantitative real-time PCR (TaqMan), host plasma neopterin level, and HLA-I, and the clinical manifestation were evaluated.
  
  
  
  The HTLV-1 PVLs in HAM/TSP and ACs were 306±360.741 copies/104PBMCs and 250.98±629.94 copies/104PBMCs, respectively; the PVL was higher in HAM/TSP than that in ACs (p=0.004). HTLV-1 Tax and HBZ expression in HAM/TSP was higher than that in ACs, wherein only the Tax expression was statistically significant (p=0.039). In contrast to Japanese HTLV-1-infected subjects, HLA-A*02, HLA-A*24, HLA-Cw*08, and HLA-B*5401 did not exhibit preventive effects for HAM/TSP manifestation. The plasma neopterin level was significantly higher in HAM/TSPs than that in ACs; furthermore, there was a strong significant correlation between plasma neopterin and PVL (R=0.76, p=0.001). Moreover, there were significant correlation between urinary disturbances and haematological indices, including the RBC count (R=-0.61, p=0.01) and Hematocrit (Ht) index (R=-0.75, p=0.002), and between mobility disturbances with Tax expression (R=-0.58, p=0.02) and WBC counts (R=-0.54, p=0.04), and finally, a significant association was found between the sensory disturbances and PVL (p=0.05).
  
  
  
  Overall, HTLV-1 PVL and Tax may be the valid predictors of disease development, and the neopterin level may be a valid predictor of disease progression. In addition, Tax and neopterin are more helpful than PVL for the monitoring of HTLV-1-infected patients.
authors.affiliation: Immunology Research Center, Inflammation and Inflammatory diseases division, Medical School, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Hanieh
authors.initials: H
authors.lastname: Tarokhian
authors.affiliation: Immunology Research Center, Inflammation and Inflammatory diseases division, Medical School, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Mahdi
authors.initials: M
authors.lastname: Taghadosi
authors.affiliation: Immunology Research Center, Inflammation and Inflammatory diseases division, Medical School, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Hushang
authors.initials: H
authors.lastname: Rafatpanah
authors.affiliation: Immunology Research Center, Inflammation and Inflammatory diseases division, Medical School, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Taraneh
authors.initials: T
authors.lastname: Rajaei
authors.affiliation: Neurology Dept, Ghaem Hospital, Medical School, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Mahmoud Reza
authors.initials: MR
authors.lastname: Azarpazhooh
authors.affiliation: Immunology Research Center, Inflammation and Inflammatory diseases division, Medical School, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Narges
authors.initials: N
authors.lastname: Valizadeh
authors.affiliation: Immunology Research Center, Inflammation and Inflammatory diseases division, Medical School, Mashhad University of Medical Sciences, Mashhad, Iran. Electronic address: rezaeer@mums.ac.ir.
authors.forename: S A Rahim
authors.initials: SAR
authors.lastname: Rezaee
mesh_terms: D000328:Adult; D050976:Basic-Leucine Zipper Transcription Factors / Q000235:genetics; D001772:Blood Cell Count; D003430:Cross-Sectional Studies; D004909:Erythrocyte Indices; D005260:Female; D015967:Gene Expression Regulation, Viral; D005805:Genes, MHC Class I; D016355:Genes, pX; D015490:HTLV-I Infections / Q000097:blood / Q000235:genetics* / Q000821:virology*; D006650:Histocompatibility Testing; D015368:Human T-lymphotropic virus 1 / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019798:Neopterin / Q000097:blood*; D015493:Paraparesis, Tropical Spastic / Q000175:diagnosis* / Q000209:etiology*; D011533:Proviruses / Q000235:genetics; D012191:Retroviridae Proteins / Q000235:genetics; D063189:Symptom Assessment; D019562:Viral Load; D037521:Virulence Factors / Q000235:genetics
chemical_list: D050976:Basic-Leucine Zipper Transcription Factors; C479751:HBZ protein, human T-cell leukemia virus type I; D012191:Retroviridae Proteins; D037521:Virulence Factors; D019798:Neopterin
keywords: HAM/TSP; HBZ; HLA; Neopterin; Proviral load; Tax