HTLV-1 antibodies in serum and cerebrospinal fluid in tropical spastic paraparesis in Brazil

Spina-França, A.; Livramento, J. A.; Machado, L. R.; Gomes, H. R.; Vianna, L. S.; Castro, L. H. M.; Nobrega, J. P. S.; Baciheschi, L. A.

doi:10.1590/S0004-282X1990000400007

Abstracts

HTLV-l antibodies were investigated in serum and in CSF of 150 patients with neurologic disorders mainly myelopathies. The patients were considered into three groups according to the possible relationship of their disease to the presence of HTLV-l antibodies: no relationship risk (control group), occasional risk group, and possible risk group. In this latter are 56 patients with crural spastic paraparesis or paraplegia of unknown etiology (SP). HTLV-l antibodies were tested by the passive particle-agglutination method for anti-ATLA antibody detection. The search was negative in all patients of the control group, and positive (serum and/or CSF) in 16.5% of the patients from the second group and in 55.4% of the SP patients group. Clinical patterns in SP cases with HTLV-l antibodies were those of tropical spastic paraparesis (TSP). CSF patterns considered (cytology, protein content and gamma-globulins rate) were different between TSP group with HTLV-l antibodies in CSF and SP group with no HTLV-l antibodies detection either in serum or in CSF. The difference was significant. Results of this investigation confirm the high incidence of TSP in Brazil, and bring additional indication for searching HTLV-l antibodies in the CSF.

Foi pesquisada a presença de HTLV-l anticorpos no soro e no LCR de 150 pacientes com afeccões do sistema nervoso, particularmente mielopatias. Os pacientes foram considerados segundo três grupos, de acordo com a possível relação entre a doença e a presença de HTLV-l anticorpos: sem risco de relação (grupo controle); grupo de risco ocasional; grupo de risco possível. Este último abrange 56 pacientes com paraparesia ou paraplegia crural espástica de etiologia não esclarecida (PE). Foi utilizada para a pesquisa a técnica de aglutinação passiva de partículas para anti-ATLA anticorpo, sendo obtidos os seguintes resultados: não foram detectados HTLV-l anticorpos no grupo controle e foram detectados (soro e/ou LCR) em 16,5% dos pacientes do segundo grupo e em 55,4% daqueles do terceiro grupo. O quadro clínico dos pacientes com PE e HTLV-l anticorpos era compatível a paraparesia espática tropical (PET). Foi verificada diferença significativa quanto a dados do exame de LCR (citologia, concentração proteica e teor de globulinas gama) ao se compararem os pacientes com PET com HTLV-l anticorpos no LCR àqueles com PE em que tais anticorpos não foram detectados nem no soro e nem no LCR. Os resultados deste estudo confirmam a elevada incidência da PET no Brasil o ilustram a necessidade da pesquisa desses anticorpos também no LCR.

A. Spina-França^I; J. A. Livramento^II; L. R. Machado^II; H. R. Gomes^III; L. S. Vianna^III; L. H. M. Castro^III; J. P. S. Nobrega^II; L. A. Baciheschi^II

^IFull Professor - Neurology Research Center, Department of Neurology, São Paulo University Medical School

^IIAssistant Professor - Neurology Research Center, Department of Neurology, São Paulo University Medical School

^IIINeurologist Researcher - Neurology Research Center, Department of Neurology, São Paulo University Medical School

SUMMARY

HTLV-l antibodies were investigated in serum and in CSF of 150 patients with neurologic disorders mainly myelopathies. The patients were considered into three groups according to the possible relationship of their disease to the presence of HTLV-l antibodies: no relationship risk (control group), occasional risk group, and possible risk group. In this latter are 56 patients with crural spastic paraparesis or paraplegia of unknown etiology (SP). HTLV-l antibodies were tested by the passive particle-agglutination method for anti-ATLA antibody detection. The search was negative in all patients of the control group, and positive (serum and/or CSF) in 16.5% of the patients from the second group and in 55.4% of the SP patients group. Clinical patterns in SP cases with HTLV-l antibodies were those of tropical spastic paraparesis (TSP). CSF patterns considered (cytology, protein content and gamma-globulins rate) were different between TSP group with HTLV-l antibodies in CSF and SP group with no HTLV-l antibodies detection either in serum or in CSF. The difference was significant. Results of this investigation confirm the high incidence of TSP in Brazil, and bring additional indication for searching HTLV-l antibodies in the CSF.

RESUMO

Foi pesquisada a presença de HTLV-l anticorpos no soro e no LCR de 150 pacientes com afeccões do sistema nervoso, particularmente mielopatias. Os pacientes foram considerados segundo três grupos, de acordo com a possível relação entre a doença e a presença de HTLV-l anticorpos: sem risco de relação (grupo controle); grupo de risco ocasional; grupo de risco possível. Este último abrange 56 pacientes com paraparesia ou paraplegia crural espástica de etiologia não esclarecida (PE). Foi utilizada para a pesquisa a técnica de aglutinação passiva de partículas para anti-ATLA anticorpo, sendo obtidos os seguintes resultados: não foram detectados HTLV-l anticorpos no grupo controle e foram detectados (soro e/ou LCR) em 16,5% dos pacientes do segundo grupo e em 55,4% daqueles do terceiro grupo. O quadro clínico dos pacientes com PE e HTLV-l anticorpos era compatível a paraparesia espática tropical (PET). Foi verificada diferença significativa quanto a dados do exame de LCR (citologia, concentração proteica e teor de globulinas gama) ao se compararem os pacientes com PET com HTLV-l anticorpos no LCR àqueles com PE em que tais anticorpos não foram detectados nem no soro e nem no LCR. Os resultados deste estudo confirmam a elevada incidência da PET no Brasil o ilustram a necessidade da pesquisa desses anticorpos também no LCR.

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Dr. A. SpinaFr-ança - Caixa Postal 5199 - 01051 São Paulo SP - Brasil.

1. Aboulafia DM, Saxton EM, Koga H, Diagne A, Rosenblatt JD - A patient with progressive myelopathy and antibodies to human T-cell leukemia virus type 1 and human immunodeficiency virus type 1 in serum and cerebrospinal fluid. Arch Neurol 47:477, 1990.
2. Bhagavati S, Ehrlich G, Kula RW Kwork S, Sninsky J, Udani V, Poiesz B - Detection of human T-cell lymphoma/leukemia type I DNA and antigen in spinal fluid and blood of patients with chronic progressive myelopathy. N Engl J Med 318:1141, 1988.
3. Castro LHM, Chaves CJ, Callegaro D, Nobrega JPS, Scaff M - HTL.V-1 associated myelopathy in Brazil: a preliminary report. Arq NeuroPsiquiat (São Paulo) 47:501, 1989.
4. Cortes E, Detels R, Aboulafia D, Li XL, Moudgil T, Alam M, Bonecker C, Gonzaga A, Oyafuso L, Tondo M Boite C, Hammaershlak N, Capitani C, Slamon DJ, Ho DD - HIV-1, HIV-2 and HTLV-l infection in high-risk groups in Brazil. N Engl J Med 320:953, 1989.
5. Costa CMC, Salgueiro MR, Carton H, Vale OC, Arruda AM - Tropical spactic paraparesis in northeastern Brazil. Arq Neuro-Psiquiat (São Paulo) 47:134, 1989.
6. Cruickshank JK, Richardson JH, Morgan O StC, Porter J, Klenerman P, Knight J, Newell AL, Rudge P, Dalgleish AG - Screening for prolonged incubation of HTLV-l infection in british and Jamaican relatives of british patients with tropical spactic paraparesis. Br Med J 300:300, 1990.
7. Cruickshank JK Rudge P, Dalgleish AG, Newton M, McLean BN, Barnard RO, Kendall BE, Miller DH - Tropical spastic paraparesis and human T cell lymphotropic virus type 1 in the United Kingdom. Brain 112:1057, 1989.
8. DeRossi A, Gallo P, Tavolato B, Callegaro D, Chieco-Bianchi L - Search for HTLV-1 and LAV/HTLV-III antibodies in serum and CSF of multiple sclerosis patients. Acta Neurol Scand 74:161, 1986.
9. Gout O, Baulac M, Gessain A, Semah F, Saal F, Péries J, Cabrol C, Foucault-Fretz C, Laplane D, Sigaux F, DeThé G - Rapid development after HTLV-1 infection acquired by transfusion during cardiac transplantation. N Engl J Med 322:383, 1990.
10. Gout O Gessain A, Bolgert F, Saal F, Tournier-Lasserve E, Lasneret J, Caudie C, Brunet P, DeThé G, Lhermitte F, Lyon-Caen O - Chronic myelopathies associated with human T-lymphotropic virus type I: a clinical, serologic, and immunovirologic study of ten patients in France. Arch Neurol 46:255, 1989.
11. Haaheim LR, Gronning M, Nyland H - Antibodies in sera from norwegian multiple sclerosis patients and the general population reacting with HTLV-1. APMIS 97:767, 1989.
12. Iwasaki Y - Pathology of chronic myelopathy associated with HTLV-1 infection (HAM-TSP). J Neurol Sci 96:103, 1990.
13. Jacobson S, Gupta A, Mattson D, Mingioli E, McFarlin DE - Immunological studies in tropical spastic paraparesis. Ann Neurol 27:149, 1990.
14. Johnson RT, McArthur JC - Myelopathies and retroviral infections. Ann Neurol 21:113, 1987.
15. Kayembe K Goubau P, Desmyter J, Vlietinck R, Carton H - A cluster of HTLV-1 associated tropical spastic paraparesis in Equateur (Zaire): ethnic and familial distribution. J Neurol Neurosurg Psychiat 53:4, 1990.
16. Murphy EL, Figueroa JP, Gibbs WN, Brathwaite A, Holding-Cobham M, Waters D, Cranston B, Hanchard B, Blattner WA - Sexual transmission of human T-lymphotropic virus type 1 (HTLV-1). Ann Intern Med 111:555, 1989.
17. Nakauchi CM, Linhares AC, Maruyama K, Kanazaki LI, Macedo JE, Azevedo VN, Casseb JSR - Prevalence of human T cell leukemia virus I (HTLV-1) antibody among populations living in the Amazon region of Brazil: preliminary report. Mem Inst Osw Cruz, (Rio) 85:29 1990.
18. Rodgers-Johnson P, Morgan O StC, Mora C, Sarin P, Ceroni P, Piccardo P, Garruto RM, Gibbs CJ Jr, Gajdusek DC - The role of HTLV-1 in tropical spastic paraparesis in Jamaica. Ann Neurol 23 (suppl) :121, 1988.
19. Roman GC - Mielopatias y mieloneuropatias tropicales. Bol Of Sanit Panam 101:452, 1986.
20. Roman GC - The neuroepidemiology of tropical spastic paraparesis. Ann Neurol 23(suppl) :113, 1988.
21. Roman GC, Roman LN - Tropical spastic paraparesis: a clinical study of 50 patients from Tumaco (Colombia) and review of the worldwide features of the syndrome. J Neurol Sci 87:121, 1988.
22. Roman GC, Spencer PS, Schoenberg BS - Tropical myeloneuropathies: the hidden endemias. Neurology 35:1158, 1985.
23. Spina-França A Salum PNB, Limongi JCP, Berger A, Losso ER - Mielopatias: aspectos diagnósticos. Arq Neuro-Psiquiat (São Paulo) 38:360, 1980.

HTLV-1 antibodies in serum and cerebrospinal fluid in tropical spastic paraparesis in Brazil

HTLV-1 anticorpos no soro e no liquido cefalorraqueano na paraparesis espástica tropical no Brasil

Publication Dates

Publication in this collection
19 May 2011
Date of issue
Dec 1990

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. Aboulafia DM, Saxton EM, Koga H, Diagne A, Rosenblatt JD - A patient with progressive myelopathy and antibodies to human T-cell leukemia virus type 1 and human immunodeficiency virus type 1 in serum and cerebrospinal fluid. Arch Neurol 47:477, 1990.

[2] 2. Bhagavati S, Ehrlich G, Kula RW Kwork S, Sninsky J, Udani V, Poiesz B - Detection of human T-cell lymphoma/leukemia type I DNA and antigen in spinal fluid and blood of patients with chronic progressive myelopathy. N Engl J Med 318:1141, 1988.

[3] 3. Castro LHM, Chaves CJ, Callegaro D, Nobrega JPS, Scaff M - HTL.V-1 associated myelopathy in Brazil: a preliminary report. Arq NeuroPsiquiat (São Paulo) 47:501, 1989.

[4] 4. Cortes E, Detels R, Aboulafia D, Li XL, Moudgil T, Alam M, Bonecker C, Gonzaga A, Oyafuso L, Tondo M Boite C, Hammaershlak N, Capitani C, Slamon DJ, Ho DD - HIV-1, HIV-2 and HTLV-l infection in high-risk groups in Brazil. N Engl J Med 320:953, 1989.

[5] 5. Costa CMC, Salgueiro MR, Carton H, Vale OC, Arruda AM - Tropical spactic paraparesis in northeastern Brazil. Arq Neuro-Psiquiat (São Paulo) 47:134, 1989.

[6] 6. Cruickshank JK, Richardson JH, Morgan O StC, Porter J, Klenerman P, Knight J, Newell AL, Rudge P, Dalgleish AG - Screening for prolonged incubation of HTLV-l infection in british and Jamaican relatives of british patients with tropical spactic paraparesis. Br Med J 300:300, 1990.

[7] 7. Cruickshank JK Rudge P, Dalgleish AG, Newton M, McLean BN, Barnard RO, Kendall BE, Miller DH - Tropical spastic paraparesis and human T cell lymphotropic virus type 1 in the United Kingdom. Brain 112:1057, 1989.

[8] 8. DeRossi A, Gallo P, Tavolato B, Callegaro D, Chieco-Bianchi L - Search for HTLV-1 and LAV/HTLV-III antibodies in serum and CSF of multiple sclerosis patients. Acta Neurol Scand 74:161, 1986.

[9] 9. Gout O, Baulac M, Gessain A, Semah F, Saal F, Péries J, Cabrol C, Foucault-Fretz C, Laplane D, Sigaux F, DeThé G - Rapid development after HTLV-1 infection acquired by transfusion during cardiac transplantation. N Engl J Med 322:383, 1990.

[10] 10. Gout O Gessain A, Bolgert F, Saal F, Tournier-Lasserve E, Lasneret J, Caudie C, Brunet P, DeThé G, Lhermitte F, Lyon-Caen O - Chronic myelopathies associated with human T-lymphotropic virus type I: a clinical, serologic, and immunovirologic study of ten patients in France. Arch Neurol 46:255, 1989.

[11] 11. Haaheim LR, Gronning M, Nyland H - Antibodies in sera from norwegian multiple sclerosis patients and the general population reacting with HTLV-1. APMIS 97:767, 1989.

[12] 12. Iwasaki Y - Pathology of chronic myelopathy associated with HTLV-1 infection (HAM-TSP). J Neurol Sci 96:103, 1990.

[13] 13. Jacobson S, Gupta A, Mattson D, Mingioli E, McFarlin DE - Immunological studies in tropical spastic paraparesis. Ann Neurol 27:149, 1990.

[14] 14. Johnson RT, McArthur JC - Myelopathies and retroviral infections. Ann Neurol 21:113, 1987.

[15] 15. Kayembe K Goubau P, Desmyter J, Vlietinck R, Carton H - A cluster of HTLV-1 associated tropical spastic paraparesis in Equateur (Zaire): ethnic and familial distribution. J Neurol Neurosurg Psychiat 53:4, 1990.

[16] 16. Murphy EL, Figueroa JP, Gibbs WN, Brathwaite A, Holding-Cobham M, Waters D, Cranston B, Hanchard B, Blattner WA - Sexual transmission of human T-lymphotropic virus type 1 (HTLV-1). Ann Intern Med 111:555, 1989.

[17] 17. Nakauchi CM, Linhares AC, Maruyama K, Kanazaki LI, Macedo JE, Azevedo VN, Casseb JSR - Prevalence of human T cell leukemia virus I (HTLV-1) antibody among populations living in the Amazon region of Brazil: preliminary report. Mem Inst Osw Cruz, (Rio) 85:29 1990.

[18] 18. Rodgers-Johnson P, Morgan O StC, Mora C, Sarin P, Ceroni P, Piccardo P, Garruto RM, Gibbs CJ Jr, Gajdusek DC - The role of HTLV-1 in tropical spastic paraparesis in Jamaica. Ann Neurol 23 (suppl) :121, 1988.

[19] 19. Roman GC - Mielopatias y mieloneuropatias tropicales. Bol Of Sanit Panam 101:452, 1986.

[20] 20. Roman GC - The neuroepidemiology of tropical spastic paraparesis. Ann Neurol 23(suppl) :113, 1988.

[21] 21. Roman GC, Roman LN - Tropical spastic paraparesis: a clinical study of 50 patients from Tumaco (Colombia) and review of the worldwide features of the syndrome. J Neurol Sci 87:121, 1988.

[22] 22. Roman GC, Spencer PS, Schoenberg BS - Tropical myeloneuropathies: the hidden endemias. Neurology 35:1158, 1985.

[23] 23. Spina-França A Salum PNB, Limongi JCP, Berger A, Losso ER - Mielopatias: aspectos diagnósticos. Arq Neuro-Psiquiat (São Paulo) 38:360, 1980.