RESUMO
Patients with sickle cell anemia (SCA) had an abnormal susceptibility to infections. In Martinique (French West Indies), a human T-cell leukemia/lymphoma virus type I (HTLV-I) endemic area, we found that 17 (10%) of 173 SCA patients had antibodies to HTLV-I. The possible relationship between HTLV-I seropositivity and altered immunity was studied in 13 SCA patients with HTLV-I antibodies compared with 13 matched SCA patients without HTLV-I antibodies. The immunological results, as evaluated by the T-cell subsets analysis, the lymphocyte proliferation responses analyzed after activation with concanavalin A, phytohemagglutinin, or pokeweed mitogen, and the natural killer activity were not statistically different in these two groups of patients (SCA HTLV-I positive vs SCA HTLV-I negative). These data suggest that HTLV-I infection did not result in a major alteration of cellular immunity in this population.
Assuntos
Anemia Falciforme/imunologia , Anticorpos Antivirais/análise , Anticorpos Antideltaretrovirus , Humanos , Imunidade Celular , Células Matadoras Naturais/imunologia , Ativação Linfocitária , Linfócitos/classificação , Linfócitos T Reguladores/imunologia , Índias OcidentaisRESUMO
Tropical spastic paraparesis (TSP) is a common myeloneuropathy with primary and predominant involvement of the pyramidal tract and minimal sensory loss. The epidemic form of TSP is related to toxic nutritional factors, but the endemic form occurs in clusters in tropical areas, especially in India, Africa, the Seychelles, Colombia, and areas of the Caribbean. We describe the clinical and epidemiological features of 25 TSP patients from Martinique (French West Indies) with serum antibodies to human T-lymphotropic virus type I (HTLV-I). Furthermore, all 11 patients who were seropositive for HTLV-I had specific HTLV-I antibodies in their CSF. All were women. The age of onset varied from 25 to 60 years (mean, 45 years). The main clinical features are spastic paraparesis or paraplegia with spasticity of the upper limbs, minimal sensory loss, and bladder dysfunction. Minimal estimated incidence and prevalence are 1 per 100,000 inhabitants per year and 8 per 100,000, respectively. Seventeen percent of the relatives of patients with HTLV-I-associated TSP have HTLV-I antibodies (1 husband and 7 children). In Martinique, the prevalence of HTLV-I antibodies in the general population is about 2% and reaches 10% for neurological disorders other than TSP. Since our initial report, the association between spastic paraparesis and HTLV-I has been confirmed in Jamaica, Colombia, and Japan, suggesting the neurotropism of this lymphotropic human retrovirus.
Assuntos
Anticorpos Antivirais/análise , Deltaretrovirus/imunologia , Paralisia/imunologia , Adulto , Feminino , HIV/imunologia , Humanos , Masculino , Martinica , Pessoa de Meia-Idade , Espasticidade Muscular/epidemiologia , Espasticidade Muscular/imunologia , Paralisia/epidemiologia , SorologiaRESUMO
Two HTLV-I associated adult T cell leukemia cases were observed in patient from Martinique (French West Indies). These case are similar to the clinical entity, described by Takatsuki in 1977 in Japan and by Catovsky in Caribbean patients, characterized by a lymphadenopathy, skin lesions and visceral involvement, hypercalcemia, an aggressive course, and poor prognosis. The malignant cells with T4 phenotype and often suppressive function, were pleomorphic, mature, with prominent nuclear irregularities. Systematic research of HTLV-I virus or antibodies in patients with this clinical picture, to measure the influence of this virus in T cell lymphoproliferative diseases in France and in French West Indies is required.