WordNet

of or relating to the tropics, or either tropic; "tropical year"
of weather or climate; hot and humid as in the tropics; "tropical weather" (同)tropic
relating to or situated in or characteristic of the tropics (the region on either side of the equator); "tropical islands"; "tropical fruit" (同)tropic
characterized by or of the nature of a trope or tropes; changed from its literal sense
suffering from spastic paralysis; "a spastic child"
a person suffering from spastic paralysis
relating to or characterized by spasm; "a spastic colon"; "spastic paralysis is a spastic form of cerebral palsy"
either of two parallels of latitude about 23.5 degrees to the north and south of the equator representing the points farthest north and south at which the sun can shine directly overhead and constituting the boundaries of the Torrid Zone or tropics
a slight paralysis or weakness of both legs

PrepTutorEJDIC

『熱帯の』,熱帯性の,熱帯産の / 酷暑の
けいれん性麻痺患者
〈C〉回帰線 / 《the tropics》熱帯地方 / 熱帯[地方]の(tropical)

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2014/11/21 05:09:53」(JST)

wiki en

Tropical spastic paraparesis (TSP), also known as HTLV-associated myelopathy or chronic progressive myelopathy, is an infection of the spinal cord by Human T-lymphotropic virus resulting in paraparesis, weakness of the legs. As the name suggests, it is most common in tropical regions, including the Caribbean and Africa.

History

For several decades, the term tropical spastic paraparesis was used to describe a chronic and progressive clinical syndrome that affected adults living in equatorial areas of the world. This condition was initially thought to be associated with infectious agents (such as Treponema pertenue and Treponema pallidum, which cause inflammation of the central nervous system) and with chronic nutritional deficiencies (such as avitaminosis) or exposure to potentially toxic foods (such as bitter cassava). Neurological and modern neuroepidemiological studies found that in some individuals no single cause could explain the progressive weakness, sensory disturbance, and sphincter dysfunction that affected individuals with TSP. In spite of public health programs created to eradicate the above-mentioned infectious and nutritional conditions in the tropics, large numbers of people continued to be affected.

During the mid-1980s, an important association between the first human retrovirus-human T-cell lymphotrophic virus type 1 (also known as HTLV-1)-and idiopathic TSP (idiopathic means of unknown origin) was established. Since then, this condition has been named HTLV-1-associated myelopathy/tropical spastic paraparesis or HAM/TSP, and scientists now understand that it is a condition caused by a virus that results in immune dysfunction.

Presentation

Patients with HAM/TSP may also exhibit uveitis (inflammation of the uveal tract of the eye), arthritis (inflammation of one or more joints), pulmonary lymphocytic alveolitis (inflammation of the lung tissues), polymyositis (an inflammatory muscle disease), keratoconjunctivitis sicca (persistent dryness of the cornea and conjunctiva), and infectious dermatitis (inflammation of the skin). Co-factors that may play a role in transmitting the disorder include being a recipient of transfusion blood products (especially before 1989), breastmilk feeding from a seropositive mother, intravenous drug use, Not every HTLV-1 seropositive carrier will become a HAM/TSP patient. Fewer than 5% will exhibit neurological dysfunction or, eventually, hematological malignancy such as adult T-cell leukemia/lymphoma, suggesting that other host or viral factors are responsible for disease onset.

Pathogenesis

When infected by HTLV-1 the host mounts an antigen-specific immune response toward the HTLV-1 antigen. Cytotoxic T-lymphocytes of the host’s immune response release cytokines in an effort to fight the infection. These cytokines facilitate the transendothelial migration of lymphocytes across the blood–brain barrier. Once cytokines are within the central nervous system, demyelination is brought as a result of bystander cell injury. The disease is chronic, progressing slowly, usually causing symptoms 20–30 years after infection.

Vaccine Development

Currently, there is no licensed vaccine to protect against HTLV-1 or HTLV-2 in the US. At least 500,000 of the individuals infected with HTLV-1 eventually develop an often rapidly fatal leukemia, while others will develop a debilitative myelopathy, and yet others will experience uveitis, infectious dermatitis, or another inflammatory disorder. HTLV-2 is associated with milder neurologic disorders and chronic pulmonary infections. The novel HTLV-3 and HTLV-4 have been isolated only in a few cases. Human T cell lymphotropic virus types I and II (HTLV-I/II) are endemic in certain areas of the world. They cause two life-threatening diseases, adult T cell leukaemia/lymphoma and tropical spastic paraparesis. A vaccine is needed because in developing countries there are no other feasible preventive interventions against these diseases and in Western countries intravenous drug users at high risk for HTLV-I and HTLV-II infections and the health workers in contact with such populations must be protected. A recombinant adenovirus vector that expresses the HTLV-I envelope glycoprotein env in HeLa cells in the clinical trial stage. A pneumococcalpolysaccharide vaccine has elicited significant increases in concentrations of IgG against all 5 serotypes tested at 1 and 6 months after immunization. While there is no present licensed vaccine, there are many factors which make a vaccine against HTLV-1 feasible. The virus displays relatively low antibody production variability, natural immunity does occur in humans, and experimental vaccination using envelope antigens has been shown to be successful in animal models.

Symptoms

Progressive muscle weakness
Sensory disturbance
Sphincter dysfunction
Urinary incontinence
Uveitis
Arthritis
Pulmonary lymphocyte alveolitis
Polymyositis
Keratoconjunctivitis sicca
Infectious dermatitis

Prevention

Blood transfusion products are screened for HTLV-1 antibodies.

Treatment

There is no established treatment program for HAM/TSP, although some patients may be given steroids. Clinical studies using interferon alpha and plasmapheresis have not shown significant patient improvement. Spasticity may be treated with baclofen or tizanidine. Urinary dysfunction should be treated with self-catheterization or oxybutynin.

Prognosis

HAM/TSP is usually a progressive neurological disorder but it is rarely fatal. Most patients live for several decades after the diagnosis. Their prognosis improves if they take steps to prevent urinary tract infection and skin sore formation, and if they enroll in physical and occupational therapy programs.

Similar disorders

A similar disorder can occur in patients with HIV.^[1]

References

Machigashira N, Yoshida Y, Wang S, Osame M (9 January 2001). "HTLV-1-associated myelopathy/tropical spastic paraparesis with pseudohypoparathyroidism". Neurology 56 (1): 104–6. doi:10.1212/wnl.56.1.104. PMID 11148245.

^ The Merck Manual of Medical Information, Section HIV, Sidebar, Myleopathy

External links

International Retrovirology Association

UpToDate Contents

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1. ヒトTリンパ球好性ウイルスI型：疾患関連、診断、および治療 human t lymphotropic virus type i disease associations diagnosis and treatment
2. ヒトTリンパ球好性ウイルスI型：ウイルス学、病因、および疫学 human t lymphotropic virus type i virology pathogenesis and epidemiology
3. 脊髄に影響を与える疾患 disorders affecting the spinal cord
4. 遺伝性痙性対麻痺 hereditary spastic paraplegia
5. ポリオおよび前角細胞への感染性疾患 polio and infectious diseases of the anterior horn

English Journal

Investigating human T cell lymphotropic retrovirus (HTLV) Tax function with molecular and immunophenotypic techniques.

Forlani G, Accolla RS, Tosi G.Author information Department of Experimental Medicine, School of Medicine and Surgery, University of Insubria, Varese, Italy.AbstractHuman T cell Lymphotropic Viruses 1 and 2 (HTLV-1 and HTLV-2) are the first described human retroviruses. HTLV-1 is the causative agent of an aggressive malignancy of CD4+ T lymphocytes named adult T-cell leukemia/lymphoma (ATLL) and of a chronic neurological disease known as HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP). HTLV-2 shares many similarities with HTLV-1, but displays lower or absent association to diseases. Among the proteins encoded by HTLVs, the viral transactivator Tax exerts an essential role in viral transcription as well as in cell transformation. Different experimental methods to study Tax activity on HTLV-LTR promoter and Tax subcellular distribution are described. Emphasis is given to the functional and physical interaction between Tax-1/Tax-2 and cellular cofactors which may have an impact on the infectivity process of the HTLVs and on the capacity of cell transformation.
Methods in molecular biology (Clifton, N.J.).Methods Mol Biol.2014;1087:299-313. doi: 10.1007/978-1-62703-670-2_24.
Human T cell Lymphotropic Viruses 1 and 2 (HTLV-1 and HTLV-2) are the first described human retroviruses. HTLV-1 is the causative agent of an aggressive malignancy of CD4+ T lymphocytes named adult T-cell leukemia/lymphoma (ATLL) and of a chronic neurological disease known as HTLV-1-associated myelo
PMID 24158832

Tax post-translational modifications and interaction with calreticulin in MT-2 cells and human PBMCs of HAM/TSP patients.

Medina F, Quintremil S, Alberti C, Barriga A, Cartier LM, Puente J, Ramirez E, Ferreira A, Tanaka Y, Valenzuela MA.Author information Universidad de Chile, Facultad de Ciencias Quimicas y Farmaceuticas, Bioquimica y Biologia Molecular, Santiago, Chile ; medinaferrer@gmail.com.AbstractThe human retrovirus HTLV-1 is the etiologic agent of the called HTLV-1 Associated Myelopathy/Tropical Spastic Paraparesis (HAM/TSP). Axonal degeneration in HAM/TSP patients occurs without neuron infection, being the secreted viral Tax protein proposed to be involved. We previously found that Tax secreted into the culture medium of MT-2 cells (HTLV-1 infected cell line) produced neurite retraction in neuroblastoma cells differentiated to neuronal type. To assess the relevance of Tax post-translational modifications on this effect, we addressed the question whether Tax secreted by MT-2 cells and Peripheral Blood Mononuclear Cells (PBMCs) of HTLV-1 infected subjects is modified. Tax interaction with calreticulin (CRT) has been described that modulates intracellular Tax localization and secretion. We studied Tax localization and modifications in MT-2 cells and its interaction with CRT. Intracellular Tax in MT-2 cells was assessed by flow cytometry, corresponding mainly to a 71 kDa protein followed by Western Blot. This protein reported as a chimera with gp21 viral proteinconfirmed by Mass Spectrometryshowed no ubiquitination or SUMOylation. Tax-CRT interaction was determined by confocal microscopy and co-immunoprecipitation. Extracellular Tax from HAM/TSP PBMCs is ubiquitinated according to Western Blot, its interaction with CRT was shown by co-immunoprecipitation. A positive correlation between Tax and CRT secretion was observed in HAM/TSP PBMCs and asymptomatic carriers. Inhibitors and activators of secretion showed for both proteins the secretion through endoplasmic reticulum-Golgi complex. Tax, present in PBMCs culture medium, produced neurite retraction in differentiated neuroblastoma cells. These results suggest that Tax whether ubiquitinated or not is active for neurite retraction.
AIDS research and human retroviruses.AIDS Res Hum Retroviruses.2013 Dec 10. [Epub ahead of print]
The human retrovirus HTLV-1 is the etiologic agent of the called HTLV-1 Associated Myelopathy/Tropical Spastic Paraparesis (HAM/TSP). Axonal degeneration in HAM/TSP patients occurs without neuron infection, being the secreted viral Tax protein proposed to be involved. We previously found that Tax se
PMID 24321043

Clinical features of HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) in northeast Iran.

Shoeibi A, Rafatpanah H, Azarpazhooh A, Mokhber N, Hedayati-Moghaddam MR, Amiri A, Hashemi P, Foroghipour M, Hoseini RF, Bazarbachi A, Azarpazhooh MR.Author information Department of Neurology, Faculty of Medicine, Ghaem Hospital, Mashhad University of Medical Sciences, Ahmadabad Boulevard, Mashhad, Iran.AbstractThis study aimed to introduce clinical manifestations of patients in northeast Iran with HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) and describe the epidemiological features, as well as risk factors for HTLV-1 infection. This is a cross-sectional study of HTLV-1 infected cases and HAM/TSP patients referred by outpatient neurology clinics as well as Mashhad Blood Transfusion Center from 2005 to 2010. The study comprises 513 cases, including 358 healthy carriers (HCs) and 145 HAM/TSP patients. The majority of carriers were male (73.5 %), whereas 67.6 % of HAM/TSP sufferers were female (P < 0.001). The mean age of HAM/TSP patients and HCs was 45.9 ± 13.6 and 39.5 ± 11.58 years, respectively (P < 0.001). The history of transfusion, surgery, hospitalization and cupping was observed in a significant greater number of HAM/TSP patients than the HCs (P < 0.001, P < 0.001, P < 0.001 and P = 0.029, respectively). Gait disturbance was the most common complaint in HAM/TSP patients (72.4 %). This research develops an HTLV-1 data registry in an endemic area such as Mashhad which can serve useful purposes, including evaluation of clinical and laboratory characteristics of HAM/TSP patients and epidemiological data of HTLV-1-infected cases.
Acta neurologica Belgica.Acta Neurol Belg.2013 Dec;113(4):427-33. doi: 10.1007/s13760-013-0194-6. Epub 2013 Apr 9.
This study aimed to introduce clinical manifestations of patients in northeast Iran with HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) and describe the epidemiological features, as well as risk factors for HTLV-1 infection. This is a cross-sectional study of HTLV-1 infected cas
PMID 23568138

Japanese Journal

HTLV-1キャリア外来の実態調査

臨床血液 56(6), 666-672, 2015
NAID 130005093099

Intracellular cyclic adenosine monophosphate regulates the efficiency of intercellular transmission of human T-lymphotropic virus type I

Clinical and Experimental Neuroimmunology 5(2), 209-215, 2014-06
NAID 120005476999

Human T-cell leukemia virus type 1 and Foxp3 expression: viral strategy in vivo.

International immunology 26(8), 419-425, 2014-05-02
NAID 120005623226

Related Pictures

★リンクテーブル★

リンク元	「HTLV-1関連脊髄症」「熱帯性痙性不全対麻痺症」「TSP」「熱帯性痙性対麻痺」
関連記事	「spastic」「tropic」「tropical」「spastic paraparesis」

「HTLV-1関連脊髄症」

Tropical spastic paraparesis
	Classification and external resources
ICD-10	G04.1
DiseasesDB	29487
eMedicine	med/1038
Patient UK	Tropical spastic paraparesis
MeSH	D015493

　　[★]

英: HTLV-1-associated myelopathy HTLV-1 associated myelopaty, HTLV-I-associated myelopathy HTLV-I associated myelopathy、human T-lymphotropic virus type I-associated myelopathy, HAM
同: HTLV-I脊髄症、ヒトTリンパ好性ウイルスI型関連脊髄症、HTLV-I型関連ミエロパシー、ヒトTリンパ球向性ウイルスI型関連脊髄症
関: 熱帯性痙性不全対麻痺症 TSP tropical spastic paraparesis、HAM/TSP、ヒトTリンパ球向性ウイルス

[show details]

HTLV-1型関連ミエロパシー : nothing
HTLV-1型関連ミエロパチー : nothing
HTLV-1脊髄症 : 30 件
HTLV-I型関連ミエロパシー : 9 件
HTLV-I型関連ミエロパチー : nothing
HTLV-I脊髄症 : 70 件
ヒトT細胞白血病ウイルス関連脊髄症 : 4 件
ヒトTリンパ球向性ウイルス脊髄症 : 49 件
ヒトT細胞白血病ウイルスI型関連ミエロパシー : 2 件
ヒトTリンパ好性ウイルスI型関連脊髄症 : 10 件
ヒトTリンパ球関連ウイルス脊髄症 : nothing