HTLV-1 and Inflammation

Question 1

How many HTLV-1 carriers get HAM?

Answer 1

> 3%

Question 2

What is seen with HTLV-1 assocaited alveolitis?

Answer 2

cough and dyspnoea or asymtpomatic

Question 3

Waht condition is associated with htlv1-associated alevolitis?

Answer 3

HAM

Question 4

What is seen on BAL with HTLV1-associated alveolitis?

Answer 4

lymphocytosis of activated lymphocytes- CD25 and HLA DR markers

Question 5

Which type of joints does HTLV-1 assocaited arthropathy affect?

Answer 5

large joints

Question 6

Which gender is more affected by HTLV1 associated arthropathy?

Answer 6

femal

Question 7

What is seen histoogically with HTLV-1 associated arthropathy?

Answer 7

synovial proliferation with lymphocytes; HTLV-1 antibodies and flower clels in synovial fluid

Question 8

Who gets infective dermatits?

Answer 8

children in the tropics

Question 9

What does infective dermatitis resemble?

Answer 9

infected eczema eithout atopy

Question 10

What is infective dermatitis associated with?

Answer 10

high proviral load and increased risk of HAM or ATLL

Question 11

What organisms cause infective dermaittis?

Answer 11

non-pathogenic strep and staph

Question 12

Where does infective dermatits affect?

Answer 12

scalp, ears, axillae, groins

Question 13

What is the treatment for infective dermatitis?

Answer 13

long term antibiotics

Question 14

What are hte clinical features of HTLV-1 associated myositis?

Answer 14

proximal muscle weakness; wasting; elevated CPK; associated with HAM

Question 15

Which patients get HTLV-1 assocaited myositis?

Answer 15

very rare- all patients have high proviral load

Question 16

What is seen histologically with myositis?

Answer 16

looks like an inclusion body myositis, lyphocytic infiltration of muscle

Question 17

What lung diseases are seen with HTLV1?

Answer 17

alveolitis and bronchiectasis

Question 18

How much does the 10m timed walk deteriorate by per annum with HAM?

Answer 18

4 seconds

Question 19

How does HAM prgress

Answer 19

slowly

Question 20

What is seen on MR imaging in HAM?

Answer 20

very atrophic- loss of volume

Question 21

What is HTLV1 assocaited bronchiectasis assocaited with?

Answer 21

HTLV1 associated inflammatory disease but not ATLL

Question 22

Which area of the body is initially spared in HAM?

Answer 22

upper limbs and sensory

Question 23

What does the leg pain in HAM resemble?

Answer 23

sciatica

Question 24

What is seen histologically with HAM?

Answer 24

lymphocytic infiltration initially CD4>CD8 than CD8 predominante and then atrophy

Question 25

What is a biomarker of HAM and its severity?

Answer 25

beta2 microglobulin

Question 26

What is the difference between the CD4 and CD8 cells seen in HAM compared with otehr neurological disease?

Answer 26

the ratio isn't different but CD4 DR+ and CD8 DR+ increased- high levels of T cell acitvation

Question 27

What is a disease assocaited with HTLV1 in the eyes?

Answer 27

uveitis

Question 28

When do patients with HTLV1 set their proviral load?

Answer 28

around 4 months after infection

Question 29

What is the general proviral load of most asymptomatic carriers of HTLV1?

Answer 29

within 1%

Question 30

Where does the proviral load of patients with HAM cluster?

Answer 30

around 10%

Question 31

Over what proviral load does the irsk of HAM increase?

Answer 31

>1%

Question 32

How many asymptomatic carriers have a high PVL?

Answer 32

50%

Question 33

What is the risk of HAM if PVL>1%?

Answer 33

6%

Question 34

Why is B2M a useful biomarker?

Answer 34

it can be used to differentiate between HAM and other neuro disease; and differentiates between patients with a high PVL and hAM

Question 35

What happens to T cell activation as PVL increases?

Answer 35

increases as well

Question 36

What happens to T cell activation in HAM compared with high PVL?

Answer 36

increased in HAM

Question 37

What are the markers used to identify patients iwth HAM?

Answer 37

HTLV-1 PVL; CD4/CD25; CD4/HLADR; CD8/HLA-DR; B2 microglobulin

Question 38

How successful are the markers used for identifying HAM?

Answer 38

idetndies 90% of HAM patients but also 6% of AC that have HAM-like phenotype

Question 39

What is expressed in macrophages and microglia in neuroinflammation?

Answer 39

translocator protein (TSPO)

Question 40

What is TSPO used for?

Answer 40

PET imaging to investigate disease invovling microglial activation and/or macrophage recruitment

Question 41

How did TPSO uptake correlate with HAM disease?

Answer 41

with clinical severity and T cell activation markers

Question 42

Where is there especially high uptake of TPSO in HAM patients?

Answer 42

brainstem and thalamus