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Dias ÁRN, Falcão LFM, Quaresma JAS. An Overview of Human T-Lymphotropic Virus Type 1 Lung Injury. Front Immunol 2022; 13:914498. [PMID: 35844492 PMCID: PMC9285117 DOI: 10.3389/fimmu.2022.914498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 06/07/2022] [Indexed: 11/13/2022] Open
Abstract
Previous studies have demonstrated the development of pulmonary impairment in individuals infected with human T-lymphotropic virus type 1 (HTLV-1). Complications, such as alveolitis and bronchiectasis, were found in individuals who developed tropical spastic paraparesis/HTLV-1-associated myelopathy (TSP-HAM) due to chronic inflammation. These patients exhibited increased levels of lymphocytes (CD4+ and CD25+), cytokines (IL-2, IL-12, and IFN-γ), inflammatory chemokines (MIP-1α and IP-10), and cell adhesion molecules (ICAM-1) in the bronchoalveolar lavage fluid, with the result of chronic inflammation and lung injury. The main lesions observed at Chest high-resolution computed tomography were centrilobular nodules, parenchymal bands, lung cysts, bronchiectasis, ground-glass opacity, mosaic attenuation, and pleural thickening. It can lead to progressive changes in pulmonary function with the development of restrictive and obstructive diseases. Recent studies suggest a causal relationship between HTLV-1 and pulmonary diseases, with intensification of lesions and progressive decrease in pulmonary function. This summary updates a previous publication and addresses the general lack of knowledge regarding the relationship between TSP-HAM and pulmonary disease, providing direction for future work and the management of these individuals.
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Affiliation(s)
- Ápio Ricardo Nazareth Dias
- Health and Biologic Center, State University of Pará, Belém, Brazil
- Tropical Medicine Centre, Federal University of Pará, Belém, Brazil
| | - Luiz Fábio Magno Falcão
- Health and Biologic Center, State University of Pará, Belém, Brazil
- University of São Paulo, São Paulo, Brazil
| | - Juarez Antônio Simões Quaresma
- Health and Biologic Center, State University of Pará, Belém, Brazil
- Tropical Medicine Centre, Federal University of Pará, Belém, Brazil
- *Correspondence: Juarez Antônio Simões Quaresma,
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Einsiedel L, Chiong F, Jersmann H, Taylor GP. Human T-cell leukaemia virus type 1 associated pulmonary disease: clinical and pathological features of an under-recognised complication of HTLV-1 infection. Retrovirology 2021; 18:1. [PMID: 33407607 PMCID: PMC7789585 DOI: 10.1186/s12977-020-00543-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 10/13/2020] [Accepted: 10/28/2020] [Indexed: 12/14/2022] Open
Abstract
The lung is one of several organs that can be affected by HTLV-1 mediated inflammation. Pulmonary inflammation associated with HTLV-1 infection involves the interstitium, airways and alveoli, resulting in several clinical entities including interstitial pneumonias, bronchiolitis and alveolitis, depending on which structures are most affected. Augmentation of the inflammatory effects of HTLV-1 infected lymphocytes by recruitment of other inflammatory cells in a positive feedback loop is likely to underlie the pathogenesis of HTLV-1 associated pulmonary disease, as has been proposed for HTLV-1 associated myelopathy. In contrast to the conclusions of early case series, HTLV-1 associated pulmonary disease can be associated with significant parenchymal damage, which may progress to bronchiectasis where this involves the airways. Based on our current understanding of HTLV-1 associated pulmonary disease, diagnostic criteria are proposed.
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Affiliation(s)
- Lloyd Einsiedel
- Department of Medicine, Alice Springs Hospital, Alice Springs, Northern Territory, 0870, Australia.
| | - Fabian Chiong
- Department of Medicine, Alice Springs Hospital, Alice Springs, Northern Territory, 0870, Australia
| | - Hubertus Jersmann
- Department of Respiratory Medicine, Faculty of Medicine, Royal Adelaide Hospital, Adelaide, Australia
| | - Graham P Taylor
- Department of Infectious Diseases, Faculty of Medicine, Imperial College London, London, UK
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Dias ARN, Falcão LFM, Falcão ASC, Normando VMF, Quaresma JAS. Human T Lymphotropic Virus and Pulmonary Diseases. Front Microbiol 2018; 9:1879. [PMID: 30154781 PMCID: PMC6103007 DOI: 10.3389/fmicb.2018.01879] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 07/26/2018] [Indexed: 12/14/2022] Open
Abstract
Human T lymphotropic virus type 1 (HTLV-1) is the etiological agent of HTLV-1-associated myelopathy, and adult T cell lymphoma/leukemia (ATL/L). Pulmonary complications such as alveolitis and bronchiectasis were found in individuals who develop TSP/HAM due to chronic inflammation. These individuals showed image anomalies in CT scans and changes in pulmonary function parameters distinctive of pulmonary disease. Furthermore, infected individuals have a greater susceptibility to pulmonary tuberculosis either due to changes in the innate immune response, in asymptomatic carriers, or to an opportunistic disease linked to immunodepression, in individuals who develop ATL/L. This summary addresses the general lack of knowledge regarding the relationship between HTLV-1 and pulmonary diseases and provides direction for future work.
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Affiliation(s)
- Apio R N Dias
- Tropical Medicine Center, Federal University of Pará, Belém, Brazil.,Center of Health and Biological Sciences, State University of Pará, Belém, Brazil
| | - Luiz F M Falcão
- Center of Health and Biological Sciences, State University of Pará, Belém, Brazil.,Graduate Program of Virology, Evandro Chagas Institute, Ministry of Health, Ananindeua, Brazil
| | - Aline S C Falcão
- Graduate Program of Virology, Evandro Chagas Institute, Ministry of Health, Ananindeua, Brazil
| | - Valéria M F Normando
- Tropical Medicine Center, Federal University of Pará, Belém, Brazil.,Center of Health and Biological Sciences, State University of Pará, Belém, Brazil
| | - Juarez A S Quaresma
- Tropical Medicine Center, Federal University of Pará, Belém, Brazil.,Center of Health and Biological Sciences, State University of Pará, Belém, Brazil.,Graduate Program of Virology, Evandro Chagas Institute, Ministry of Health, Ananindeua, Brazil
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Einsiedel L, Cassar O, Goeman E, Spelman T, Au V, Hatami S, Joseph S, Gessain A. Higher human T-lymphotropic virus type 1 subtype C proviral loads are associated with bronchiectasis in indigenous australians: results of a case-control study. Open Forum Infect Dis 2014; 1:ofu023. [PMID: 25734096 PMCID: PMC4324180 DOI: 10.1093/ofid/ofu023] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Accepted: 04/15/2014] [Indexed: 11/12/2022] Open
Abstract
In this case-control study, HTLV-1 infection increased risk of bronchiectasis 1.84 times. HTLV-1 proviral loads for bronchiectasis patients were significantly higher than those of controls. HTLV-1 proviral loads correlated with the extent of radiologically determined pulmonary injury. Background. We previously suggested that infection with the human T-lymphotropic virus type 1 (HTLV-1) subtype C is associated with bronchiectasis among Indigenous Australians. Bronchiectasis might therefore result from an HTLV-1-mediated inflammatory process that is typically associated with a high HTLV-1 proviral load (PVL). Human T-lymphotropic virus type 1 PVL have not been reported for Indigenous Australians. Methods. Thirty-six Indigenous adults admitted with bronchiectasis from June 1, 2008, to December 31, 2009 were prospectively recruited and matched by age, sex, and ethno-geographic origin to 36 controls. Case notes and chest high-resolution computed tomographs were reviewed, and pulmonary injury scores were calculated. A PVL assay for the HTLV-1c subtype that infects Indigenous Australians was developed and applied to this study. Clinical, radiological, and virological parameters were compared between groups and according to HTLV-1 serostatus. Results. Human T-lymphotropic virus type 1 infection was the main predictor of bronchiectasis in a multivariable model (adjusted risk ratio [aRR], 1.84; 95% confidence interval [CI], 1.19–2.84; P = .006). Moreover, the median HTLV-1c PVL (interquartile range) for cases was >100-fold that of controls (cases, 0.319 [0.007, 0.749]; controls, 0.003 [0.000, 0.051] per 100 peripheral blood lymphocytes; P = .007), and HTLV-1c PVL were closely correlated with radiologically determined pulmonary injury scores (Spearman's rho = 0.7457; P = .0000). Other predictors of bronchiectasis were positive Strongyloides serology (aRR, 1.69; 95% CI, 1.13–2.53) and childhood skin infections (aRR, 1.62; 95% CI, 1.07–2.44). Bronchiectasis was the major predictor of death (aRR, 2.71; 95% CI, 1.36–5.39; P = .004). Conclusions. These data strongly support an etiological association between HTLV-1 infection and bronchiectasis in a socially disadvantaged population at risk of recurrent lower respiratory tract infections.
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Affiliation(s)
- Lloyd Einsiedel
- Northern Territory Rural Clinical School/Flinders University , Northern Territory of Australia , Australia ; SA Pathology, Adelaide , South Australia , Australia
| | - Olivier Cassar
- Institut Pasteur, Unité EPVO, Département de Virologie , F-75015 Paris , France ; CNRS, UMR 3569 , F-75015 Paris , France
| | - Emma Goeman
- Department of Paediatrics , Alice Springs Hospital, Northern Territory of Australia , Australia
| | - Tim Spelman
- Northern Territory Rural Clinical School/Flinders University , Northern Territory of Australia , Australia
| | - Virginia Au
- Department of Radiology , Flinders Medical Centre , Adelaide, South Australia , Australia
| | - Saba Hatami
- Department of Radiology , Flinders Medical Centre , Adelaide, South Australia , Australia
| | - Sheela Joseph
- Northern Territory Rural Clinical School/Flinders University , Northern Territory of Australia , Australia
| | - Antoine Gessain
- Institut Pasteur, Unité EPVO, Département de Virologie , F-75015 Paris , France ; CNRS, UMR 3569 , F-75015 Paris , France
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Einsiedel L, Fernandes L, Spelman T, Steinfort D, Gotuzzo E. Bronchiectasis is associated with human T-lymphotropic virus 1 infection in an Indigenous Australian population. Clin Infect Dis 2011; 54:43-50. [PMID: 22095566 DOI: 10.1093/cid/cir766] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Recent studies suggest that infection with human T-lymphotropic virus 1 (HTLV-1) might be associated with bronchiectasis among Indigenous Australians. The present study compared the clinical characteristics and outcomes of bronchiectasis in this population, according to HTLV-1 serologic status. METHODS We performed a retrospective cohort study of Indigenous adults with bronchiectasis and known HTLV-1 serologic status admitted to Alice Springs Hospital, central Australia, from January 2000 through December 2006. RESULTS Among 89 Indigenous adults whose HTLV-1 serologic status was confirmed, 52 (58.4%) were HTLV-1 seropositive. Differences between HTLV-1-seropositive and HTLV-1-seronegative groups were apparent in childhood presentations and adult outcomes. Among adults, an increasing number of bronchiectatic lobes (univariable odds ratio [OR], 1.51; 95% confidence interval [CI]; 1.03-2.20; P = .033) and the presence of ground-glass opacities at chest high-resolution computed tomography (univariable OR, 8.54; 95% CI, 1.04-70.03; P = .046) predicted HTLV-1 infection. Cor pumonale (HTLV-1-positive group, 10/52; HTLV-1-negative group, 1/37; P = .023) was more frequent among HTLV-1-seropositive adults, who also experienced a higher disease-specific mortality (univariable OR, 5.78; 95% CI, 1.17-26.75; P = .028). Only HTLV-1-seropositive patients were admitted specifically for the treatment of infected skin lesions, and this finding predicted death (multivariable OR, 6.77; 95% CI, 1.46-31.34; P = .014). Overall mortality was high; 34.2% of the cohort died at a median age of 42.5 years. CONCLUSIONS HTLV-1 infection contributes to the risk of developing bronchiectasis and worsens outcomes among Indigenous Australians.
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Affiliation(s)
- Lloyd Einsiedel
- Department of Medicine, Alice Springs Hospital, Alice Springs, Australia.
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Mori S, Mizoguchi A, Kawabata M, Fukunaga H, Usuku K, Maruyama I, Osame M. Bronchoalveolar lymphocytosis correlates with human T lymphotropic virus type I (HTLV-I) proviral DNA load in HTLV-I carriers. Thorax 2005; 60:138-43. [PMID: 15681503 PMCID: PMC1747290 DOI: 10.1136/thx.2004.021667] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND A study was undertaken to investigate the pathogenesis of pulmonary involvement in human T lymphotropic virus type I (HTLV-I) carriers. METHODS The bronchoalveolar lavage (BAL) cell profile of 30 HTLV-I carriers (15 asymptomatic HTLV-I carriers (AHCs) and 15 symptomatic HTLV-I carriers (SHCs)) with chronic inflammatory diseases of respiratory tract and eight patients with HTLV-I associated myelopathy/tropical spastic paraparesis (HAM/TSP) was investigated. The HTLV-I proviral deoxyribonucleic acid (DNA) load in peripheral blood mononuclear cells (PBMCs) and BAL fluid from HTLV-I carriers was estimated using the quantitative polymerase chain reaction method and the correlation between the lymphocyte number in BAL fluid and the HTLV-I proviral DNA load in PBMCs and BAL fluid was examined. RESULTS The percentage of lymphocytes in BAL fluid was increased (>18%) in 11 of 30 HTLV-I carriers although there was no significant difference compared with control subjects. In HTLV-I carriers the lymphocyte number in BAL fluid correlated well with the copy number of HTLV-I proviral DNA in PBMCs. In addition, the copy number of HTLV-I proviral DNA in BAL fluid correlated well with the number of lymphocytes (both CD4+ and CD8+ cells) in BAL fluid. CONCLUSIONS These findings suggest that pulmonary lymphocytosis can occur in a subset of HTLV-I carriers without HAM/TSP and that the increased HTLV-I proviral DNA load may be implicated in the pathogenesis of pulmonary involvement in HTLV-I carriers.
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Affiliation(s)
- S Mori
- Third Department of Internal Medicine, Kagoshima University School of Medicine, Kagoshima 890-8520, Japan.
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Ijichi S, Nakagawa M, Umehara F, Higuchi I, Arimura K, Izumo S, Osame M. HAM/TSP: recent perspectives in Japan. JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES AND HUMAN RETROVIROLOGY : OFFICIAL PUBLICATION OF THE INTERNATIONAL RETROVIROLOGY ASSOCIATION 1996; 13 Suppl 1:S26-32. [PMID: 8797700 DOI: 10.1097/00042560-199600001-00006] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Neurologic diseases associated with human T-cell lymphotropic virus type I (HTLV-I) infection have a clinical spectrum that includes myelopathy (HTLV-I-associated myelopathy/tropical spastic paraparesis, HAM/TSP) as the central manifestation. Many clinical signs of involvement outside the central nervous system (CNS) have been described in some patients with HAM/TSP and have triggered and advanced the discovery of some HTLV-I-associated concepts in HTLV-I-infected individuals without signs of CNS involvement. Most of these HTLV-I-associated diseases exhibit common viroimmunologic characteristics that include a distributional bias of HTLV-I activation between the blood flow and the affected lesions and accumulated cellular immune responses in the lesions. These facts suggest that the vulnerable tissue(s) in some HTLV-I-infected individuals may not be defined by an exclusive tissue specificity, but that common steps of HTLV-I-versus-host interactions may have an important role in the pathologic process(es) in these diseases. This review summarizes the recent perspectives of the clinical spectrum and the pathogenesis of HAM/TSP in Japan. Furthermore, the feasible pathogenic involvement of cellular interactions between infected cells and responding immunocompetent cells in the affected tissues is emphasized.
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Affiliation(s)
- S Ijichi
- Third Department of Internal Medicine, Faculty of Medicine, Kagoshima University, Japan
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Mansueto S, Miceli MD, Di Blasi P, Alleto G, Amico A, Mancuso S, Gentile G. Antibodies anti HTLV-I/II in Sicilian residents, in drug addicts, and in African immigrants. Eur J Epidemiol 1995; 11:359-60. [PMID: 7493673 DOI: 10.1007/bf01719445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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Eguchi K, Matsuoka N, Ida H, Nakashima M, Sakai M, Sakito S, Kawakami A, Terada K, Shimada H, Kawabe Y. Primary Sjögren's syndrome with antibodies to HTLV-I: clinical and laboratory features. Ann Rheum Dis 1992; 51:769-76. [PMID: 1352097 PMCID: PMC1004744 DOI: 10.1136/ard.51.6.769] [Citation(s) in RCA: 117] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
The prevalence of antibodies to human T lymphotropic virus type I (HTLV-I) was studied in patients with primary Sjögren's syndrome. Thirteen of 36 serum samples were positive by enzyme linked immunosorbent assay (ELISA) and particle agglutination assay for antibodies to HTLV-I and were confirmed by western blotting. The presence of antibodies to HTLV-I may signify an HTLV-I carrier state. These patients had a high occurrence of extraglandular manifestations such as uveitis, myopathy, and recurrent high fever compared with patients who did not have antibodies to HTLV-I. Patients with antibodies to HTLV-I had an increased spontaneous proliferation of peripheral blood mononuclear cells compared with those without the antibodies. The proportions of activated and memory T cells (HLA-DR+ CD3+, CD25+ CD3+, and CD29+ CD4+ cells) were higher in HTLV-I carriers than in non-carriers. The presence of antibodies to HTLV-I in some patients with primary Sjögren's syndrome suggests that HTLV-I may cause primary Sjögren's syndrome or its extraglandular manifestations, or both.
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Affiliation(s)
- K Eguchi
- First Department of Internal Medicine, Nagasaki University School of Medicine, Japan
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Vernant JC, Bellance R, Buisson G. [Neurologic manifestations related to HTLV-1 viruses]. Rev Med Interne 1991; 12:441-6. [PMID: 1792435 DOI: 10.1016/s0248-8663(05)83192-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The human T-cell leukaemia virus type 1 was the first human retrovirus to be isolated in 1980 by R. Gallo and coworkers. As its name indicates, this virus is responsible for adult T-cell leukaemia. In 1985, the neurological manifestations associated with this disease were isolated from the tropical spastic paraplegia group in Martinique. Since that time, such manifestations have been reported in non-tropical countries in other foci of viral endemia and sporadically outside these regions. These neurological manifestations are totally independent of the haematological manifestations with which they are virtually never associated. Frequent in areas of viral endemia, they may be encountered in other countries open to human migrations, where they are too often overlooked.
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Affiliation(s)
- J C Vernant
- Service de Neurologie, Hôpital P. Zobda Quitman, Fort-de-France, Martinique
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Sandler SG, Fang CT, Williams AE. Human T-cell lymphotropic virus type I and II in transfusion medicine. Transfus Med Rev 1991; 5:93-107. [PMID: 1687974 DOI: 10.1016/s0887-7963(91)70197-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
As a consequence of migrating populations, IV drug use and, to a lesser extent, blood transfusions, endemic HTLV-I and HTLV-II infections have spread to nonendemic geographic regions. Although the risk that a person infected with HTLV-I will develop significant disease--even over a lifetime--is estimated to be relatively low, our awareness of the serious diseases associated with other retroviruses requires a cautious approach to blood transfusion. Reports from Japan and the United States indicate that programs testing donated blood and excluding units with HTLV-I antibodies have been highly successful in interrupting the spread of HTLV-I by transfusions. One unanticipated outcome of testing large numbers of people in the United States for HTLV-I antibodies has been recognition of the relatively high prevalence of HTLV-II infection, particularly among IV drug users. The long-term effects of HTLV-II infection are also unknown. Until the natural history and clinical consequences of HTLV-II infection are clearly understood, it is only prudent that blood donated by persons identified to be HTLV-II carriers also be excluded.
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Affiliation(s)
- S G Sandler
- Blood Services, American Red Cross National Headquarters, Washington, DC 20006
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Oksenberg JR, Mantegazza R, Sakai K, Bernard CC, Steinman L. HTLV-I sequences are not detected in peripheral blood genomic DNA or in brain cDNA of multiple sclerosis patients. Ann Neurol 1990; 28:574-7. [PMID: 2252368 DOI: 10.1002/ana.410280416] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Human T-cell lymphotropic virus (HTLV-I) was recently reported to be etiologically associated with multiple sclerosis (MS). Genomic DNA from peripheral blood lymphocytes and brain plaques of patients with MS was analyzed for the presence of sequences homologous to the HTLV-I pol gene using the polymerase chain reaction and dot blot techniques. Comparison of DNA amplification patterns between patients with MS, and with control subjects who have other autoimmune conditions, with those in healthy control subjects and with an HTLV-I-infected cell line indicates that HTLV-I pol sequence is not present in the peripheral blood of patients with MS, and that the virus is not active in MS brain plaques.
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Affiliation(s)
- J R Oksenberg
- Department of Neurology, Stanford University School of Medicine, CA
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