HTLV-1 and Inflammation Flashcards
How many HTLV-1 carriers get HAM?
> 3%
What is seen with HTLV-1 assocaited alveolitis?
cough and dyspnoea or asymtpomatic
Waht condition is associated with htlv1-associated alevolitis?
HAM
What is seen on BAL with HTLV1-associated alveolitis?
lymphocytosis of activated lymphocytes- CD25 and HLA DR markers
Which type of joints does HTLV-1 assocaited arthropathy affect?
large joints
Which gender is more affected by HTLV1 associated arthropathy?
femal
What is seen histoogically with HTLV-1 associated arthropathy?
synovial proliferation with lymphocytes; HTLV-1 antibodies and flower clels in synovial fluid
Who gets infective dermatits?
children in the tropics
What does infective dermatitis resemble?
infected eczema eithout atopy
What is infective dermatitis associated with?
high proviral load and increased risk of HAM or ATLL
What organisms cause infective dermaittis?
non-pathogenic strep and staph
Where does infective dermatits affect?
scalp, ears, axillae, groins
What is the treatment for infective dermatitis?
long term antibiotics
What are hte clinical features of HTLV-1 associated myositis?
proximal muscle weakness; wasting; elevated CPK; associated with HAM
Which patients get HTLV-1 assocaited myositis?
very rare- all patients have high proviral load
What is seen histologically with myositis?
looks like an inclusion body myositis, lyphocytic infiltration of muscle
What lung diseases are seen with HTLV1?
alveolitis and bronchiectasis
How much does the 10m timed walk deteriorate by per annum with HAM?
4 seconds
How does HAM prgress
slowly
What is seen on MR imaging in HAM?
very atrophic- loss of volume
What is HTLV1 assocaited bronchiectasis assocaited with?
HTLV1 associated inflammatory disease but not ATLL
Which area of the body is initially spared in HAM?
upper limbs and sensory
What does the leg pain in HAM resemble?
sciatica
What is seen histologically with HAM?
lymphocytic infiltration initially CD4>CD8 than CD8 predominante and then atrophy
What is a biomarker of HAM and its severity?
beta2 microglobulin
What is the difference between the CD4 and CD8 cells seen in HAM compared with otehr neurological disease?
the ratio isn’t different but CD4 DR+ and CD8 DR+ increased- high levels of T cell acitvation
What is a disease assocaited with HTLV1 in the eyes?
uveitis
When do patients with HTLV1 set their proviral load?
around 4 months after infection
What is the general proviral load of most asymptomatic carriers of HTLV1?
within 1%
Where does the proviral load of patients with HAM cluster?
around 10%
Over what proviral load does the irsk of HAM increase?
> 1%
How many asymptomatic carriers have a high PVL?
50%
What is the risk of HAM if PVL>1%?
6%
Why is B2M a useful biomarker?
it can be used to differentiate between HAM and other neuro disease; and differentiates between patients with a high PVL and hAM
What happens to T cell activation as PVL increases?
increases as well
What happens to T cell activation in HAM compared with high PVL?
increased in HAM
What are the markers used to identify patients iwth HAM?
HTLV-1 PVL; CD4/CD25; CD4/HLADR; CD8/HLA-DR; B2 microglobulin
How successful are the markers used for identifying HAM?
idetndies 90% of HAM patients but also 6% of AC that have HAM-like phenotype
What is expressed in macrophages and microglia in neuroinflammation?
translocator protein (TSPO)
What is TSPO used for?
PET imaging to investigate disease invovling microglial activation and/or macrophage recruitment
How did TPSO uptake correlate with HAM disease?
with clinical severity and T cell activation markers
Where is there especially high uptake of TPSO in HAM patients?
brainstem and thalamus
