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Mashkani B, Jalili Nik M, Rezaee SA, Boostani R. Advances in the treatment of human T-cell lymphotropic virus type-I associated myelopathy. Expert Rev Neurother 2023; 23:1233-1248. [PMID: 37933802 DOI: 10.1080/14737175.2023.2272639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 10/16/2023] [Indexed: 11/08/2023]
Abstract
INTRODUCTION Nearly 2-3% of those 10 to 20 million individuals infected with the Human T-cell lymphotropic virus type-1 (HTLV-1); are predisposed to developing HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP). It is a neuro-inflammatory disease; differentiated from multiple sclerosis based on the presence of typical neurologic symptoms, confirmation of HTLV-1 infection, and other molecular biomarkers. AREAS COVERED A brief review of the epidemiology, host immune responses, and molecular pathogenesis of HAM/TSP is followed by detailed discussions about the host-related risk factors for developing HAM/TSP and success/failure stories of the attempted management strategies. EXPERT OPINION Currently, there is no effective treatment for HAM/TSP. Anti-retroviral therapy, peculiar cytokines (IFN-α), some anti-oxidants, and allograft bone marrow transplantation have been used for treating these patients with limited success. Under current conditions, asymptomatic carriers should be examined periodically by a neurologist for early signs of spinal cord injury. Then it is crucial to determine the progress rate to adapt the best management plan for each patient. Corticosteroid therapy is most beneficial in those with acute myelitis. However, slow-progressing patients are best managed using a combination of symptomatic and physical therapy. Additionally, preventive measures should be taken to decrease further spread of HTLV-1 infection.
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Affiliation(s)
- Baratali Mashkani
- Department of clinical Biochemistry, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Jalili Nik
- Department of clinical Biochemistry, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyed Abdolrahim Rezaee
- Inflammation and Inflammatory Diseases division, Immunology Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Reza Boostani
- Department of Neurology, Mashhad University of Medical Sciences, Mashhad, Iran
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Plaza JA, Gru AA, Sangueza OP, Lourenco SV, Puccio FB, Sanches JA, Miyashiro D, Toussaint S, Sangueza MJ. An update on viral-induced cutaneous lymphoproliferative disorders. CME Part I. J Am Acad Dermatol 2023; 88:965-980. [PMID: 36041557 DOI: 10.1016/j.jaad.2021.11.068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 10/19/2021] [Accepted: 11/03/2021] [Indexed: 11/21/2022]
Abstract
Viral-induced cutaneous T-cell lymphomas are an uncommon group of lymphoproliferative disorders characterized by a viral infection of T and natural killer (NK) cells. This group of cutaneous T-cell lymphomas is more commonly encountered in Asians and Native Americans from Central and South America compared with Western populations. Viral-associated lymphoproliferative disorders include a spectrum of entities that range from nonneoplastic lesions, such as chronic active Epstein-Barr virus infection and infective dermatitis to malignant diseases, such as extranodal NK/T-cell lymphoma, hydroa vacciniforme-like T-cell lymphoma, and adult T-cell leukemia/lymphoma. This review article will focus on hydroa vacciniforme-like lymphoproliferative disorder, extranodal NK/T-cell lymphoma, adult T-cell leukemia/lymphoma, lymphomatoid granulomatosis, and Epstein-Barr virus-positive mucocutaneous ulcers. We will review the pathogenesis of these conditions and the challenges of making a timely diagnosis in early-stage disease and discuss the common clinicopathologic manifestations, mutational landscape, and approaches to treat these highly aggressive and frequently lethal types of lymphoma.
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MESH Headings
- Education, Medical, Continuing
- Lymphoproliferative Disorders/pathology
- Lymphoproliferative Disorders/therapy
- Lymphoproliferative Disorders/virology
- Skin Diseases/pathology
- Skin Diseases/therapy
- Skin Diseases/virology
- Epstein-Barr Virus Infections
- Lymphoma, T-Cell, Cutaneous/pathology
- Lymphoma, T-Cell, Cutaneous/therapy
- Lymphoma, T-Cell, Cutaneous/virology
- Skin Neoplasms/pathology
- Skin Neoplasms/therapy
- Skin Neoplasms/virology
- Hydroa Vacciniforme/pathology
- Hydroa Vacciniforme/therapy
- Leukemia-Lymphoma, Adult T-Cell/pathology
- Leukemia-Lymphoma, Adult T-Cell/therapy
- Lymphomatoid Granulomatosis/pathology
- Lymphomatoid Granulomatosis/therapy
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Affiliation(s)
- Jose A Plaza
- Division of Dermatopathology, Department of Pathology and Dermatology, The Ohio State University Wexner Medical Center (OSUWMC), Columbus, Ohio.
| | - Alejandro A Gru
- Division of Dermatopathology, Department of Pathology, University of Virginia, Charlottesville, Virginia
| | - Omar P Sangueza
- Division of Dermatopathology, Department of Pathology, Wake Forest Baptist Health, Winston-Salem, North Carolina
| | - Silvia V Lourenco
- Department of Stomatology, Dental School, University of Sao Paolo, São Paulo, Brazil
| | - Francisco B Puccio
- Department of Dermatology, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Jose A Sanches
- Department of Dermatology, University of São Paulo, São Paulo, Brazil
| | - Denis Miyashiro
- Department of Dermatology, University of São Paulo, São Paulo, Brazil
| | - Sonia Toussaint
- Department of Dermatology, National Autonomous University, Mexico City, Mexico
| | - Martin J Sangueza
- Department of Pathology and Dermatology, Hospital Obrero, La Paz, Bolivia
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Aggressive Cutaneous Lymphomas and Their Mimics. Surg Pathol Clin 2023; 16:361-383. [PMID: 37149363 DOI: 10.1016/j.path.2023.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2023]
Abstract
Cutaneous lymphomas encompass a heterogeneous group of neoplasms with a wide spectrum of clinical presentations, histopathologic features, and prognosis. Because there are overlapping pathologic features among indolent and aggressive forms and with systemic lymphomas that involve the skin, clinicopathologic correlation is essential. Herein, the clinical and histopathologic features of aggressive cutaneous B- and T-cell lymphomas are reviewed. Indolent cutaneous lymphomas/lymphoproliferative disorders, systemic lymphomas, and reactive processes that may mimic these entities are also discussed. This article highlights distinctive clinical and histopathologic features, increases awareness of rare entities, and presents new and evolving developments in the field.
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da Silva Malta MCF, Silva SMN, de Oliveira MB, Ribeiro MA, Martins ML. Decline in human T-cell lymphotropic virus seroprevalence in blood donors from Minas Gerais, Brazil over a 12-year period (2006-2017). J Med Virol 2022; 94:5535-5542. [PMID: 35855523 DOI: 10.1002/jmv.28010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 05/30/2022] [Accepted: 07/16/2022] [Indexed: 12/15/2022]
Abstract
To investigate a 12-year historical series (2006-2017) of human T-cell lymphotropic virus (HTLV)-positive blood donations from Fundação Hemominas, Minas Gerais, Brazil, an observational retrospective study was performed to evaluate data of blood donor candidates who were screened for HTLV-1/2 by enzyme-linked immunosorbent assay or chemiluminescence assays and confirmed by Western blot. We analyzed 3 309 716 blood donations covering 2006-2017 that were extracted from the institutional database. In a total of 3 308 738 donations that have complete algorithm tests, the global frequency of HTLV-positive donations was 0.012%. The seroprevalence in first-time blood donors was 28.82/100 000 donors; 0.95/100 000 donations were HTLV-positive in repeat blood donors. The frequency of HTLV-seropositive females was significantly higher than males (odds ratio = 1.85, p < 0.001) in first-time donors. The median age of HTLV-positive first-time and repeat donors was similar (36 and 32 years, respectively). First-time donors ≥41 years had higher odds to be infected. There was a clear tendency of decline in the HTLV-positive donations in the period analyzed, going from 19.26/100 000 donations to 8.50/100 000 donations. The increase in the proportion of repeat donors over the period analyzed (from 23% in 2006 to 67% in 2017) must be the principal factor that contributed to this drop. Our results showed a continuous decline in the frequency of HTLV-positive donations from Minas Gerais, Brazil throughout 12 years and emphasize the importance of having a high rate of repeat donors in blood centers to reduce the residual risk of transfusion-transmitted infections.
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Quintero-Muñoz E, Arsanios DM, Beltrán MFE, Vera JD, Giraldo CP, Velandia O, Calderon CM. Palmo-plantar hyperkeratosis associated with HTLV-1 infection: a case report. BMC Infect Dis 2021; 21:652. [PMID: 34229603 PMCID: PMC8258954 DOI: 10.1186/s12879-021-06334-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 06/17/2021] [Indexed: 11/10/2022] Open
Abstract
Background Palmoplantar hyperkeratosis is a cutaneous manifestation that had not been clearly associated with infection by the human T-cell lymphotropic virus, which is a retrovirus that in most cases does not develop clinical pathologies and its symptoms may be undetected. The skin is one of the most affected organs, however until now only seborrheic dermatitis, xerosis/ichthyosis and infective dermatitis associated with HTLV-1 have been described as cutaneous clinical manifestations of this disease. Case presentation We present the case of a 36-year-old male patient with serologically documented HTLV-1 infection, who presented symptoms of diarrhea, malabsorption due to Strongyloides stercoralis, and in whom a physical examination revealed an association with generalized xerosis and palmoplantar keratoderma confirmed by skin biopsy. Other infectious etiologies and malignancy were ruled out. This clinical manifestation was managed with dermal hydration, and skin care which improved the thickened skin and make it less noticeable. Conclusions According to our experience, this is the first reported case of palmoplantar keratoderma associated with a human lymphotropic virus infection. This is a skin manifestation that has not been confirmed in conjunction with HTLV-I before. This implies that palmoplantar keratoderma is a new clinical manifestation of this infection, that should be considered in the initial approach of patients in endemic areas with these dermatological characteristics.
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Affiliation(s)
| | | | | | | | | | - Omar Velandia
- Internal Medicine, La Samaritana Hospital, Bogotá, Colombia
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Nishikawa Y, Kanemaru S, Mori A, Nagano M, Mochida K, Amano M. Adult T-cell leukemia/lymphoma with pagetoid reticulosis-like skin lesions. Int J Dermatol 2021; 60:e342-e344. [PMID: 33559154 DOI: 10.1111/ijd.15446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Accepted: 01/12/2021] [Indexed: 11/27/2022]
Affiliation(s)
- Yotaro Nishikawa
- Department of Dermatology, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Shiho Kanemaru
- Department of Dermatology, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Aina Mori
- Department of Dermatology, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Manami Nagano
- Department of Dermatology, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Kosuke Mochida
- Department of Dermatology, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Masahiro Amano
- Department of Dermatology, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
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Taheri F, Ebrahimi SO, Shareef S, Reiisi S. Regulatory and immunomodulatory role of miR-34a in T cell immunity. Life Sci 2020; 262:118209. [PMID: 32763292 DOI: 10.1016/j.lfs.2020.118209] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 07/25/2020] [Accepted: 08/02/2020] [Indexed: 12/12/2022]
Abstract
miRNAs are a class of non-coding RNAs and very conserve molecules that negatively regulate the expression of many genes by targeting the 3' UTR of mRNAs. miRNAs are involved in the modulation of T-cell biology during the earliest and last stages and key controllers of T-cell differentiation and function. The miR-34a, as a major hub of the regulatory network of T cells, plays an important role in T cell activation. miR-34a is widely expressed in immune cells (dendritic cells, macrophages, mast cells, B cells, and T cells) and regulates their development, function, and survival. This miRNA, by targeting over 30 genes across different cellular pathways controls immune response. miR-34a expression is controlled by p53 in transcription level. As well as, miR-34a by activating dendritic cells mediates innate immune response and increases tumor-infiltrating CD8 expression T lymphocytes. In various types of cancers and autoimmune diseases, miR-34a can regulate T cell function and become a possible significant target of microRNA-based therapy. Therefore, in this review, we focus on miR-34a-related regulatory mechanisms in T cell function and understanding mechanisms and molecules involved in this network.
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Affiliation(s)
- Forough Taheri
- Department of Genetics, Sharekord Branch, Islamic Azad University, Shahrekord, Iran
| | - Seyed Omar Ebrahimi
- Department of Genetics, Faculty of Basic Sciences, Shahrekord University, Shahrekord, Iran
| | - Salar Shareef
- Department of medical laboratory science, College of Sciences, University of Raparin, Ranya, Kurdistan Region, Iraq
| | - Somayeh Reiisi
- Department of Genetics, Faculty of Basic Sciences, Shahrekord University, Shahrekord, Iran.
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Early-Onset HTLV-1-Associated Myelopathy/Tropical Spastic Paraparesis. Pathogens 2020; 9:pathogens9060450. [PMID: 32517313 PMCID: PMC7350296 DOI: 10.3390/pathogens9060450] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 06/01/2020] [Accepted: 06/05/2020] [Indexed: 12/14/2022] Open
Abstract
Background: Vertical transmission of HTLV-1 could lead to the early development of HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP). This significantly affects quality of life and increases morbimortality. Objective: To describe the epidemiological and clinical characteristics of patients with early-onset HAM/TSP, defined as disease onset before 20 years of age. Methods: This is a retrospective study from an HTLV-1 clinical cohort between 1989 and 2019. We searched for medical records of patients with (1) diagnosis of HTLV-1 infection using two ELISA and/or one Western blot, (2) clinical diagnosis of HAM/TSP by neurological assessment, and (3) HAM/TSP symptom-onset before 20 years of age. Results: A total of 38 cases were identified in the cohort; 25 were female (66%). The median age of onset was 14 years old. 31 (82%) cases had HTLV-1 testing done among family members; 22 out of 25 tested mothers (88%) were HTLV-1 positive. Most patients (27/34) were breastfed for more than one year. Disease progression measured through EDSS and IPEC-1 showed an upward trend towards worsening spasticity with 18 patients (47%) eventually requiring mobility aids. Conclusions: Cases of early-onset HAM/TSP are not of rare occurrence, which translates into many more years of dependency, the use of mobility aids, and increased overall morbidity.
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9
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Adkins BD, Ramos JC, Bliss-Moreau M, Gru AA. Updates in lymph node and skin pathology of adult T-cell leukemia/lymphoma, biomarkers, and beyond. Semin Diagn Pathol 2020; 37:1-10. [PMID: 31889601 PMCID: PMC7668393 DOI: 10.1053/j.semdp.2019.12.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Adult T-cell leukemia/lymphoma (ATLL) is a mature T-cell lymphoproliferative disorder associated with the human T lymphotropic virus (HTLV-1) infection. ATLL predominantly affects individuals within HTLV-1 endemic areas such as Japan, areas of Africa, South America, and the Caribbean. HTLV-1 preferentially infects CD4+ T-cells, and several genetic hits must occur before ATLL develops. ATLL is classically divided into four clinical variants based on manifestations of disease: acute, chronic, lymphomatous, and smouldering. As of 2019, a new subtype has been described: lymphoma type of ATL, extranodal primary cutaneous. In this review, emphasis will be taken to describe the common clinicopathologic manifestations of the disease, advances in biomarker discovery, mutational landscape and targeted therapeutic approaches to treat this highly aggressive and frequently lethal type of T-cell lymphoma.
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Affiliation(s)
- Brian D Adkins
- Department of Pathology, University of Virginia, Charlottesville, VA, United States
| | - Juan C Ramos
- Division of Hematology, University of Miami Miller School of Medicine, Sylvester Comprehensive Cancer Center, Miami, FL, United States
| | - Meghan Bliss-Moreau
- Department of Pathology, University of Virginia, Charlottesville, VA, United States
| | - Alejandro A Gru
- Pathology & Dermatology, Hematopathology and Dermatopathology Sections, University of Virginia, Charlottesville, VA, United States.
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Abstract
Adult T-cell leukemia/lymphoma (ATLL) is an aggressive peripheral T-cell lymphoma caused by the human T-lymphotropic virus type-1 (HTLV-1). The skin is affected in approximately half of ATLL patients, and it may be the first manifestation of the disease. The skin lesions of ATLL are polymorphous, and depending on the type of skin eruption, it is possible to predict the prognosis of the disease. Besides specific skin lesions, other non-specific lesions and increased risk of cutaneous and systemic infections are observed. In this article, we describe the different skin lesions of ATLL patients (specific, non-specific, and infectious lesions), the different histopathological patterns, and the association of clinicopathological characteristics with prognosis. Recognition of ATLL skin lesions is essential for the correct management and the search for the virus, even in non-endemic regions, where global migration may bring HTLV-1 infected individuals.
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Affiliation(s)
- Denis Miyashiro
- Department of Dermatology, Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil.
| | - Jose Antonio Sanches
- Department of Dermatology, Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil.
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Nishikawa Y, Mochida K, Kubo T, Horikawa N, Nemoto R, Amano M. Smoldering type adult T-cell leukemia/lymphoma effectively treated with mogamulizumab (anti-CC chemokine receptor 4 monoclonal antibody)-A case report. Clin Case Rep 2019; 7:1057-1061. [PMID: 31110745 PMCID: PMC6509667 DOI: 10.1002/ccr3.2155] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 03/27/2019] [Accepted: 03/31/2019] [Indexed: 11/20/2022] Open
Abstract
The use of mogamulizumab needs careful consideration because of severe adverse reactions such as graft-vs-host disease. However, refractory specific skin lesions of smoldering type adult T-cell leukemia/lymphoma can be effectively treated with mogamulizumab when patients have no opportunity to receive hematopoietic stem cell transplantation like our case.
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Affiliation(s)
- Yotaro Nishikawa
- Department of Dermatology, Faculty of MedicineUniversity of MiyazakiMiyazakiJapan
| | - Kosuke Mochida
- Department of Dermatology, Faculty of MedicineUniversity of MiyazakiMiyazakiJapan
| | - Tamaki Kubo
- Department of Dermatology, Faculty of MedicineUniversity of MiyazakiMiyazakiJapan
| | - Nagako Horikawa
- Department of Dermatology, Faculty of MedicineUniversity of MiyazakiMiyazakiJapan
| | - Rieko Nemoto
- Department of Dermatology, Faculty of MedicineUniversity of MiyazakiMiyazakiJapan
| | - Masahiro Amano
- Department of Dermatology, Faculty of MedicineUniversity of MiyazakiMiyazakiJapan
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12
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Kamath P, Abrahams J, Cho-Vega JH. Bullous CD4+ CD8+ adult T-cell leukemia/lymphoma, a rare diagnostically challenging cutaneous variant. J Cutan Pathol 2018; 45:964-965. [DOI: 10.1111/cup.13337] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2018] [Revised: 07/08/2018] [Accepted: 08/06/2018] [Indexed: 01/20/2023]
Affiliation(s)
| | - Jennifer Abrahams
- Department of Dermatology and Cutaneous Surgery, Miller School of Medicine; University of Miami; Florida
| | - Jeong Hee Cho-Vega
- Department of Pathology, Dermatopathology; Sylvester Comprehensive Cancer Center and Miller School of Medicine, University of Miami; Florida
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Mendes MST, Costa MC, Costa IMC. Human T-cell lymphotropic virus-1 infection: three infected generations in the same family. Rev Soc Bras Med Trop 2016; 49:660-662. [PMID: 27812668 DOI: 10.1590/0037-8682-0437-2015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2015] [Accepted: 04/20/2016] [Indexed: 11/22/2022] Open
Abstract
The human T-cell lymphotropic virus-1 (HTLV-1) affects worldwide population; the estimated number of currently infected individuals is 10-20 million. In this report, we describe the clinical findings of three family members with vertical transmission of HTLV-1. This case report highlights the importance of healthcare providers who have optimal knowledge about HTLV-1 including its transmission and pertinent attributes, and who are able to provide affected individuals with adequate information regarding their condition.
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Affiliation(s)
- Marcela Sena Teixeira Mendes
- Programa de Pós Graduação Senso Stricto em Ciências da Saúde, Universidade de Brasília, Brasília, Disrito Federal, Brazil
| | - Mariana Carvalho Costa
- Departamento de Dermatologia, Hospital Universitário de Brasília, Brasília, Distrito Federal, Brazil
| | - Izelda Maria Carvalho Costa
- Programa de Pós Graduação Senso Stricto em Ciências da Saúde, Universidade de Brasília, Brasília, Disrito Federal, Brazil
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García-Romero MT, Lara-Corrales I, Kovarik CL, Pope E, Arenas R. Tropical Skin Diseases in Children: A Review-Part II. Pediatr Dermatol 2016; 33:264-74. [PMID: 27039881 DOI: 10.1111/pde.12778] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Tropical skin diseases are infectious conditions influenced by factors such as nutrition, housing, and the environment. Migration patterns have caused these conditions to be seen all around the world, not only in developing countries. Many of these diseases have a different presentation in childhood, which changes the diagnostic approach and management options. In this article, we review some of the most common tropical mycobacterial, protozoan, parasitic, and viral dermatologic conditions in children, including their epidemiologic, clinical, diagnostic, and therapeutic aspects.
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Affiliation(s)
| | - Irene Lara-Corrales
- Dermatology Section, Department of Pediatric Medicine, Hospital for Sick Children University of Toronto, Toronto, Ontario, Canada
| | - Carrie L Kovarik
- Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Elena Pope
- Dermatology Section, Department of Pediatric Medicine, Hospital for Sick Children University of Toronto, Toronto, Ontario, Canada
| | - Roberto Arenas
- Micology Section, Hospital General Dr. Manuel Gea González, Mexico City, Mexico
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Human T-Cell Lymphotropic Virus Types 1 and 2 Seropositivity among Blood Donors at Mbarara Regional Blood Bank, South Western Uganda. LEUKEMIA RESEARCH AND TREATMENT 2016; 2016:1675326. [PMID: 27034840 PMCID: PMC4789507 DOI: 10.1155/2016/1675326] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Revised: 01/05/2016] [Accepted: 01/13/2016] [Indexed: 12/30/2022]
Abstract
Background. The human T-cell lymphotropic virus types 1 and 2 (HTLV 1/2) are retroviruses associated with different pathologies. HTLV-1 causes adult T-cell leukemia/lymphoma (ATL) and HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP); HTLV-2 is not clearly associated with a known clinical disease. Both viruses may be transmitted by whole blood transfusion, from mother to child predominantly through breastfeeding, and by sexual contact. Presently, none of the regional blood banks in Uganda perform routine pretransfusion screening for HTLV. The aim of this study was to determine the prevalence of anti-human T-cell lymphotropic virus types 1/2 (HTLV-1/2) antibodies among blood donors at Mbarara Regional Blood Bank in South Western Uganda. A cross-sectional study was conducted between June 2014 and September 2014. Methodology. Consecutive blood samples of 368 blood donors were screened for anti-HTLV-1/2 antibodies using an enzyme linked immunosorbent assay (ELISA). Samples reactive on a first HTLV-1/2 ELISA were further retested in duplicate using the same ELISA. Of the three hundred and sixty-eight blood donors (229 (62.2%) males and 139 (37.8%) females), only two male donors aged 20 and 21 years were HTLV-1/2 seropositive, representing a prevalence of 0.54%. Conclusion. HTLV-1/2 prevalence is low among blood donors at Mbarara Regional Blood Bank. Studies among other categories of people at risk for HTLV 1/2 infection should be carried out.
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Troy SB. Are 'asymptomatic' chronic infections truly asymptomatic? J Trop Pediatr 2015; 61:79-80. [PMID: 25833658 DOI: 10.1093/tropej/fmv025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Stephanie B Troy
- Division of Infectious Diseases, Department of Internal Medicine, Eastern Virginia Medical School, Norfolk, VA, USADepartment of Microbiology and Molecular Cell Biology, Eastern Virginia Medical School,Norfolk, VA, USAE-mail:
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Expansion of natural killer cells in peripheral blood in a Japanese elderly with human T-cell lymphotropic virus type 1-related skin lesions. Case Rep Dermatol Med 2014; 2014:937513. [PMID: 25431695 PMCID: PMC4241692 DOI: 10.1155/2014/937513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Revised: 10/16/2014] [Accepted: 10/20/2014] [Indexed: 12/04/2022] Open
Abstract
Natural killer (NK) cells were proposed to play an important role in the pathogenesis of human T-cell lymphotropic virus type 1- (HTLV-1-) associated neurologic disease. Our patient was a 77-year-old Japanese man, who had been treated for infective dermatitis associated with HTLV-1 for nearly 10 years. When referred to us, he had facial eczema/edema as well as extensive dermatitis at the neck/upper chest and nuchal area/upper back regions. Dermal lesions had CD3+CD4+ cells, but no NK cells. Flow cytometry of his peripheral blood showed a phenotype of CD2+ (97%), CD3+ (17%), CD4+ (12%), CD7+ (94%), CD8+ (6%), CD11c+ (70%), CD16+ (82%), CD19+ (0%), CD20+ (0%), CD56+ (67%), HLA-DR+ (68%), and NKp46+ (36%). Absolute numbers of CD56+NK cells in the peripheral blood were in a range of 986/μL–1,270/μL. The expanded NK cells in the peripheral blood are considered to be reactive, to maintain the confinement of the HTLV-1-positive CD4+ cells in the skin, and to prevent the progression of the disease.
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Sagar D, Masih S, Schell T, Jacobson S, Comber JD, Philip R, Wigdahl B, Jain P, Khan ZK. In vivo immunogenicity of Tax(11-19) epitope in HLA-A2/DTR transgenic mice: implication for dendritic cell-based anti-HTLV-1 vaccine. Vaccine 2014; 32:3274-84. [PMID: 24739247 DOI: 10.1016/j.vaccine.2014.03.087] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2013] [Revised: 03/20/2014] [Accepted: 03/26/2014] [Indexed: 01/10/2023]
Abstract
Viral oncoprotein Tax plays key roles in transformation of human T-cell leukemia virus (HTLV-1)-infected T cells leading to adult T-cell leukemia (ATL), and is the key antigen recognized during HTLV-associated myelopathy (HAM). In HLA-A2+ asymptomatic carriers as well as ATL and HAM patients, Tax(11-19) epitope exhibits immunodominance. Here, we evaluate CD8 T-cell immune response against this epitope in the presence and absence of dendritic cells (DCs) given the recent encouraging observations made with Phase 1 DC-based vaccine trial for ATL. To facilitate these studies, we first generated an HLA-A2/DTR hybrid mouse strain carrying the HLA-A2.1 and CD11c-DTR genes. We then studied CD8 T-cell immune response against Tax(11-19) epitope delivered in the absence or presence of Freund's adjuvant and/or DCs. Overall results demonstrate that naturally presented Tax epitope could initiate an antigen-specific CD8T cell response in vivo but failed to do so upon DC depletion. Presence of adjuvant potentiated Tax(11-19)-specific response. Elevated serum IL-6 levels coincided with depletion of DCs whereas decreased TGF-β was associated with adjuvant use. Thus, Tax(11-19) epitope is a potential candidate for the DC-based anti-HTLV-1 vaccine and the newly hybrid mouse strain could be used for investigating DC involvement in human class-I-restricted immune responses.
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Affiliation(s)
- Divya Sagar
- Department of Microbiology and Immunology, Drexel Institute for Biotechnology & Virology Research, Drexel University College of Medicine, Philadelphia, PA, USA
| | - Shet Masih
- Department of Microbiology and Immunology, Drexel Institute for Biotechnology & Virology Research, Drexel University College of Medicine, Philadelphia, PA, USA
| | - Todd Schell
- Department of Microbiology and Immunology, The Pennsylvania State University College of Medicine, Hershey, PA, USA
| | - Steven Jacobson
- Viral Immunology Section, Neuroimmunology Branch, National Institutes of Health, Bethesda, MD, USA
| | | | | | - Brian Wigdahl
- Department of Microbiology and Immunology, and the Center for Molecular Virology and Translational Neuroscience, Institute for Molecular Medicine and Infectious Disease, Drexel University College of Medicine, Philadelphia, PA, USA
| | - Pooja Jain
- Department of Microbiology and Immunology, Drexel Institute for Biotechnology & Virology Research, Drexel University College of Medicine, Philadelphia, PA, USA.
| | - Zafar K Khan
- Department of Microbiology and Immunology, Drexel Institute for Biotechnology & Virology Research, Drexel University College of Medicine, Philadelphia, PA, USA.
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Abstract
Adult T-cell leukemia/lymphoma is a rare mature CD4+ T-cell neoplasm caused by the retrovirus human T-lymphotrophic virus type 1. At present there are approximately 20 million people infected globally with this virus, and most of these individuals belong to the endemic areas in southern Japan, Africa, the Caribbean basin, and Latin America. In the United States, it is usually seen in immigrants from these endemic regions. Adult T-cell leukemia/lymphoma predominantly affects the adult population and is rare in children. Adult T-cell leukemia/lymphoma has 4 subtypes: acute, lymphomatous, chronic, and smoldering. Clinically, the first 2 variants are classified as aggressive, and the latter two are classified as indolent. Given the rare occurrence and diagnostic challenges associated with adult T-cell leukemia/lymphoma, this review will highlight its salient features to aid in recognition of this entity and perform a comprehensive diagnostic workup.
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Affiliation(s)
- Sohail Qayyum
- From the Department of Pathology, University of Tennessee Health Science Center, Memphis (Dr Qayyum); and the Department of Hematopathology, St Jude Children's Research Hospital, Memphis, Tennessee (Dr Choi)
| | - John K. Choi
- From the Department of Pathology, University of Tennessee Health Science Center, Memphis (Dr Qayyum); and the Department of Hematopathology, St Jude Children's Research Hospital, Memphis, Tennessee (Dr Choi)
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Blas MM, Alva IE, García PJ, Cárcamo C, Montano SM, Mori N, Muñante R, Zunt JR. High prevalence of human T-lymphotropic virus infection in indigenous women from the peruvian Amazon. PLoS One 2013; 8:e73978. [PMID: 24040133 PMCID: PMC3763997 DOI: 10.1371/journal.pone.0073978] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2012] [Accepted: 08/01/2013] [Indexed: 01/05/2023] Open
Abstract
Background In an earlier study, we detected an association between human T-cell lymphotropic virus (HTLV) infection and cervical human papillomavirus (HPV) in indigenous Amazonian Peruvian women of the Shipibo-Konibo ethnic group. As both HTLV and HPV can be transmitted sexually, we now report a population-based study examining the prevalence and risk factors for HTLV-1 and HTLV-2 infection in this population. Methods Between July and December 2010, we conducted a comprehensive screening for HTLV among Shipibo-Konibo women 15 to 39 years of age living in two communities located in Lima and in 17 communities located within four hours by car or boat from the Amazonian city of Pucallpa in Peru. Results We screened 1,253 Shipibo-Konibo women for HTLV infection 74 (5.9%) tested positive for HTLV-1, 47 (3.8%) for HTLV-2 infection, and 4 (0.3%) had indeterminate results. In the multivariate analysis, factors associated with HTLV-1 infection included: older age (Prevalence Ratio (PR): 1.04, 95% CI 1.00–1.08), primary education or less (PR: 2.01, 95% CI: 1.25–3.24), younger or same age most recent sex partner (PR: 1.66, 95% CI: 1.00–2.74), and having a most recent sex partner who worked at a logging camp (PR: 1.73, 95% CI: 1.09–2.75). The only factor associated with HTLV-2 infection was older age (PR: 1.08, 95% CI: 1.03–1.12). Conclusion HTLV infection is endemic among Shipibo-Konibo women. Two characteristics of the sexual partner (younger age and labor history) were associated with infection in women. These results suggest the need for implementation of both HTLV screening during the antenatal healthcare visits of Shipibo-Konibo women, and counseling about the risk of HTLV transmission through prolonged breastfeeding in infected women. We also recommend the implementation of prevention programs to reduce sexual transmission of these viruses.
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Affiliation(s)
- Magaly M. Blas
- Epidemiology, STD and HIV Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
- * E-mail:
| | - Isaac E. Alva
- Epidemiology, STD and HIV Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Patricia J. García
- Epidemiology, STD and HIV Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Cesar Cárcamo
- Epidemiology, STD and HIV Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Silvia M. Montano
- United States Naval Medical Research Unit No. 6 (NAMRU-6), Callao, Peru
| | - Nicanor Mori
- United States Naval Medical Research Unit No. 6 (NAMRU-6), Callao, Peru
| | - Ricardo Muñante
- Ucayali Regional Health Directorate, Ministry of Health, Ucayali, Peru
| | - Joseph R. Zunt
- School of Public Health and Community Medicine, Departments of Neurology, Global Health and Medicine, University of Washington, Seattle, Washington, United States of America
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Coelho-dos-Reis JGA, Passos L, Duarte MC, Araújo MG, Campi-Azevedo AC, Teixeira-Carvalho A, Peruhype-Magalhães V, Trindade BC, dos Santos Dias R, Martins ML, Carneiro-Proietti ABDF, Guedes AC, Gonçalves DU, Martins-Filho OA. Immunological profile of HTLV-1-infected patients associated with infectious or autoimmune dermatological disorders. PLoS Negl Trop Dis 2013; 7:e2328. [PMID: 23936564 PMCID: PMC3723575 DOI: 10.1371/journal.pntd.0002328] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2012] [Accepted: 06/14/2013] [Indexed: 11/19/2022] Open
Abstract
In the present study, the frequency, the activation and the cytokine and chemokine profile of HTLV-1 carriers with or without dermatological lesions were thoroughly described and compared. The results indicated that HTLV-1-infected patients with dermatological lesions have distinct frequency and activation status when compared to asymptomatic carriers. Alterations in the CD4(+)HLA-DR(+), CD8(+) T cell, macrophage-like and NKT subsets as well as in the serum chemokines CCL5, CXCL8, CXCL9 and CXCL10 were observed in the HTLV-1-infected group with skin lesions. Additionally, HTLV-1 carriers with dermatological skin lesions showed more frequently high proviral load as compared to asymptomatic carriers. The elevated proviral load in HTLV-1 patients with infectious skin lesions correlated significantly with TNF-α/IL-10 ratio, while the same significant correlation was found for the IL-12/IL-10 ratio and the high proviral load in HTLV-1-infected patients with autoimmune skin lesions. All in all, these results suggest a distinct and unique immunological profile in the peripheral blood of HTLV-1-infected patients with skin disorders, and the different nature of skin lesion observed in these patients may be an outcome of a distinct unbalance of the systemic inflammatory response upon HTLV-1 infection.
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Affiliation(s)
- Jordana Grazziela Alves Coelho-dos-Reis
- Laboratório de Biomarcadores de Diagnóstico e Monitoração, Instituto René Rachou, FIOCRUZ, Belo Horizonte, Minas Gerais, Brazil
- Aaron Diamond AIDS Research Center, Rockefeller University, New York, New York, United States of America
- Interdisciplinary HTLV Research Group – GIPH – HEMOMINAS, Belo Horizonte, Minas Gerais, Brazil
| | - Livia Passos
- Laboratório de Biomarcadores de Diagnóstico e Monitoração, Instituto René Rachou, FIOCRUZ, Belo Horizonte, Minas Gerais, Brazil
- Interdisciplinary HTLV Research Group – GIPH – HEMOMINAS, Belo Horizonte, Minas Gerais, Brazil
| | - Mariana Costa Duarte
- Laboratório de Biomarcadores de Diagnóstico e Monitoração, Instituto René Rachou, FIOCRUZ, Belo Horizonte, Minas Gerais, Brazil
| | - Marcelo Grossi Araújo
- Interdisciplinary HTLV Research Group – GIPH – HEMOMINAS, Belo Horizonte, Minas Gerais, Brazil
- Faculty of Medicine, Federal University of Minas Gerais, UFMG, Belo Horizonte, Minas Gerais, Brazil
| | - Ana Carolina Campi-Azevedo
- Laboratório de Biomarcadores de Diagnóstico e Monitoração, Instituto René Rachou, FIOCRUZ, Belo Horizonte, Minas Gerais, Brazil
| | - Andréa Teixeira-Carvalho
- Laboratório de Biomarcadores de Diagnóstico e Monitoração, Instituto René Rachou, FIOCRUZ, Belo Horizonte, Minas Gerais, Brazil
| | - Vanessa Peruhype-Magalhães
- Laboratório de Biomarcadores de Diagnóstico e Monitoração, Instituto René Rachou, FIOCRUZ, Belo Horizonte, Minas Gerais, Brazil
| | - Bruno Caetano Trindade
- Laboratório de Biomarcadores de Diagnóstico e Monitoração, Instituto René Rachou, FIOCRUZ, Belo Horizonte, Minas Gerais, Brazil
| | - Raquel dos Santos Dias
- Interdisciplinary HTLV Research Group – GIPH – HEMOMINAS, Belo Horizonte, Minas Gerais, Brazil
- Faculty of Medicine, Federal University of Minas Gerais, UFMG, Belo Horizonte, Minas Gerais, Brazil
| | - Marina Lobato Martins
- Interdisciplinary HTLV Research Group – GIPH – HEMOMINAS, Belo Horizonte, Minas Gerais, Brazil
| | | | - Antônio Carlos Guedes
- Interdisciplinary HTLV Research Group – GIPH – HEMOMINAS, Belo Horizonte, Minas Gerais, Brazil
- Faculty of Medicine, Federal University of Minas Gerais, UFMG, Belo Horizonte, Minas Gerais, Brazil
| | - Denise Utsch Gonçalves
- Interdisciplinary HTLV Research Group – GIPH – HEMOMINAS, Belo Horizonte, Minas Gerais, Brazil
- Faculty of Medicine, Federal University of Minas Gerais, UFMG, Belo Horizonte, Minas Gerais, Brazil
| | - Olindo Assis Martins-Filho
- Laboratório de Biomarcadores de Diagnóstico e Monitoração, Instituto René Rachou, FIOCRUZ, Belo Horizonte, Minas Gerais, Brazil
- Interdisciplinary HTLV Research Group – GIPH – HEMOMINAS, Belo Horizonte, Minas Gerais, Brazil
- * E-mail:
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22
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Wang J, Wang X, Gao C, Song X, Niu Z, Gao Z, Qin Z, Chang J, Wang H. The pyrimidine analog FNC inhibits cell proliferation and viral protein synthesis in HTLV‑1‑infected cells. Mol Med Rep 2013; 7:1656-60. [PMID: 23467991 DOI: 10.3892/mmr.2013.1358] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2012] [Accepted: 02/21/2013] [Indexed: 11/06/2022] Open
Abstract
Human T‑cell leukemia virus type 1 (HTLV‑1), the first retrovirus to be identified, is the etiological agent of an aggressive clonal malignancy of mature CD4+ T lymphocytes known as adult T‑cell leukemia (ATL). The prognosis of ATL patients remains poor despite the availability of a number of clinical chemotherapy drugs. In addition, HTLV‑1‑infected and ATL cells possess an intrinsic resistance to anticancer drugs. 2'‑Deoxy‑2'‑β‑fluoro‑4'‑azidocytidine (FNC) is a novel pyrimidine analog that is efficiently phosphorylated by cellular kinases and is a substrate for RNA and DNA polymerases. In the present study, the antiviral potential of FNC was investigated in HTLV‑1‑infected cell lines. Following FNC treatment, the HTLV‑1‑infected cells underwent G1 or S phase cell cycle arrest. FNC was also observed to reduce cell growth of the HTLV‑1‑infected cell lines in a dose‑dependent manner. Notably, FNC was found to efficiently inhibit the expression of the viral proteins, Tax and p19Gag, in a dose‑ and time‑dependent manner. Treatment with FNC and the protein biosynthesis inhibitor, cycloheximide (CHX), accelerated the inhibition of viral protein synthesis in the HTLV‑1‑infected cells. Collectively, these results demonstrated the efficient antiretroviral effect of FNC in HTLV‑1‑infected cells and indicate that FNC may be utilized as a valuable therapy in HTLV‑1‑infected patients and those with ATL.
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Affiliation(s)
- Jinheng Wang
- Research Center for Immunology, Xinxiang Medical University, Xinxiang, Henan 453003, PR China
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Mounsey KE, McCarthy JS, Walton SF. Scratching the itch: new tools to advance understanding of scabies. Trends Parasitol 2012; 29:35-42. [PMID: 23088958 DOI: 10.1016/j.pt.2012.09.006] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2012] [Revised: 09/20/2012] [Accepted: 09/21/2012] [Indexed: 12/31/2022]
Abstract
Scabies remains a significant public health problem worldwide. Research into aspects of Sarcoptes scabiei biology and host-parasite interactions has been impeded by an inability to maintain mites in vitro and by limited access to parasite material and infected subjects. The generation of comprehensive expressed sequence tag libraries has enabled the initial characterisation of molecules of interest to diagnostics, vaccines, and drug resistance. The recent development and utilisation of animal models, combined with next-generation technologies, is anticipated to lead to new strategies to prevent, diagnose, and treat scabies, ultimately improving skin health in both human and veterinary settings. This article will summarise recent molecular and immunologic advances on scabies, and will address priorities for the exciting 'next chapter' of scabies research.
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Affiliation(s)
- Kate E Mounsey
- School of Health and Sport Sciences, Faculty of Science, Health, Education and Engineering, University of the Sunshine Coast, Locked Bag 4, Maroochydore DC, QLD 4558, Australia.
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