Avaliação de perfil inflamatório e carga proviral em portadores de HTLV-1

Abstract

HTLV-1 (Human T-cell lymphotropic virus) is a retrovirus associated with some clinical conditions, among them HTLV-associated / tropic spastic paraparesis (HAM / TSP) and adult T-cell leukemia. The focus of the present study is HAM / TSP, a paraparesis characterized by an insidious onset and slow and progressive evolution. It usually affects individuals in the fourth and fifth decades of life, presenting with urinary, intestinal and sexual impairment, progressing to weakness in the lower limbs, gait disturbances, loss of muscle strength and muscle spasticity. The clinical picture results from the imbalance of immune system response to the virus, which characterizes the pathogenesis of the disease; Immunopathogenic mechanisms, high levels of pro-inflammatory cytokines and proviral load are variables that together determine the clinical course. Studies suggest that the proviral load may be related to the development of HAM / TSP, and patients with the disease present high levels of the proviral load when compared to the asymptomatic group. The relationship of proinflammatory cytokines and the complication to HAM / TSP form is also described, where the inflammation installed in central nervous system tissue may be one of the causes of the symptoms triggered by the onset of the disease. The present study compared the proviral load and the expression of liquid and plasma cytokines between two groups, carriers of the virus without neurological impairment and carriers of the virus with neurological impairment. Results corroborate with the literature, where the proviral load is higher in CSF samples from patients with neurological impairment compared to the asymptomatic group. About the cytokine dosage, levels of ITAC, IL-5, IL-8, TNF-alpha are high in CSF and only ITAC in plasma of patients with neurological impairment. Thus, it is possible to suggest that proviral loading and proinflammatory cytokines are associated with the development of HAM / TSP and further studies are needed to determine biomarkers to aid in predicting disease progression.