title: Clinical and laboratory features of HTLV-I asymptomatic carriers and patients with HTLV-I-associated myelopathy/tropical spastic paraparesis from the Brazilian Amazon.
abstract: Clinical and laboratory parameters including blood and cerebrospinal fluid (CSF) neopterin were investigated in human-T-lymphotropic-virus-type-I associated-myelopathy/tropical-spastic-paraparesis-HAM/TSP and in HTLV-I carriers. HAM/TSP (n = 11, 2 males/9 females, median age = 48 years), recently diagnosed HTLV-I carriers (n = 21, 15 females/6 males, median age = 44 years), healthy individuals (n = 20, 10 males/10 females, median age = 34.6 years) from the Brazilian Amazon (Manaus, Amazonas State) were investigated. Neopterin was measured (IBL ELISA Neopterin, Germany) in serum samples of all the participants, in CSF of 9 HAM/TSP patients as well as in 6 carriers. In HAM/TSP patients, CSF cell counts, protein and glucose were measured, the Osame's motor-disability-score/OMDS was determined, and brain/spinal cord magnetic-resonance-imaging (MRI) was performed. HAM/TSP patients had normal CSF glucose, leukocyte counts; and normal protein levels predominated. Brain-MRI showed white-matter lesions in 7 out of 11 HAM/TSP patients. OMDS varied from 2-8: 9 were able to walk, 2 were wheel-chair-users. The median serum neopterin concentration in HAM/TSP patients was 6.6 nmol/ L; min. 2.8- max. 12.5 nmol/ L); was lower in carriers (4.3 nmol/L; min. 2.7- max. 7.2 nmol/ L) as well as in healthy participants (4.7 nmol/ L; min. 2.7- max. 8.0 nmol/ L) (p < 0.05). CSF neopterin concentrations in HAM/TSP patients were higher than in serum samples, and higher compared to carriers (p < 0.05). Carriers had similar serum-CSF neopterin concentrations compared to healthy participants. Variable clinical and laboratory profiles were seen in HAM/TSP patients, however our results support the neopterin measurement as a potential biomarker of disease activity.
authors.affiliation: Universidade Federal do Amazonas, Faculdade de Medicina, Departamento de Clínica Cirúrgica, Manaus, Amazonas, Brazil.
authors.forename: Massanobu
authors.initials: M
authors.lastname: Takatani
authors.affiliation: Fundação Hospitalar de Hemoterapia e Hematologia do Amazonas (FHEMOAM), Manaus, Amazonas, Brazil.
authors.forename: Myuki Esashika
authors.initials: ME
authors.lastname: Crispim
authors.affiliation: Fundação Hospitalar de Hemoterapia e Hematologia do Amazonas (FHEMOAM), Manaus, Amazonas, Brazil.
authors.forename: Nelson
authors.initials: N
authors.lastname: Fraiji
authors.affiliation: Universidade Federal de Goiás, Instituto de Patologia Tropical e Saúde Pública, Goiânia, Goiás, Brazil.
authors.forename: Mariane Martins Araujo
authors.initials: MM
authors.lastname: Stefani
authors.affiliation: Fundação Hospitalar de Hemoterapia e Hematologia do Amazonas (FHEMOAM), Manaus, Amazonas, Brazil.
authors.forename: Dagmar
authors.initials: D
authors.lastname: Kiesslich
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood / Q000134:cerebrospinal fluid; D001938:Brazil; D002353:Carrier State; D016022:Case-Control Studies; D005260:Female; D015368:Human T-lymphotropic virus 1; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019798:Neopterin / Q000097:blood* / Q000134:cerebrospinal fluid*; D015493:Paraparesis, Tropical Spastic / Q000097:blood* / Q000134:cerebrospinal fluid*
chemical_list: D015415:Biomarkers; D019798:Neopterin