Molecular Pathology of Htlv-i-associated Myelopathy/tropical Spastic Paraparesis

摘要

Human T lymphotropic virus type I (HTLV-I) is associated with adult T cell leukemia (ATL) and a chronic progressive disease of the central nervous system (CNS) termed HTLVT-asso dated myelopathy (HAM)/tropical spastic paraparesis (TSP) (4, T6). The pathological analysis indicates that the disease affects the spinal cord, predominantly at the thoracic level. Macroscopic findings revealed atrophy of the spinal cord in the lateral column of the thoracic level. In the spinal cord, degeneration of the lateral corticospinal tract as well as of the spinocerebeliar or spinotha-lamic tract of the lateral column also showed degeneration (Fig. 1A). These lesions are associated with perivascular and parenchymal lymphocytic infiltration with the presence of foamy macrophages, proliferation of astrocytes, and fibrillary gliosis (Fig. IB) (7, 13, 14), There is widespread loss of myelin and axons, particularly in the corticospinal tracts of the spinal cord. Damage is most severe in the lower thoracic to lumbar regions. These findings are consistent with a patient's neurological symptoms of paraparesis, spasticity, hyperreflexia or Babinski's sign. In this chapter, we discuss the immunological and molecular analysis of the CNS lesions of HAM/TSP.