TY - JOUR
T1 - Long term, high dose interferon-alpha treatment in HTLV-I-associated myelopathy/tropical spastic paraparesis
T2 - A combined clinical, virological and immunological study
AU - Yamasaki, Kenji
AU - Kira, Jun Ichi
AU - Koyanagi, Yoshio
AU - Kawano, Yuji
AU - Miyano-Kurosaki, Naoko
AU - Nakamura, Minoru
AU - Baba, Eishi
AU - Suzuki, Jun
AU - Yamamoto, Akifumi
AU - Yamamoto, Naoki
AU - Kobayashi, Takuro
N1 - Funding Information:
This study was supported in part by a grant from the Ministry of Health and Welfare of Japan and Ministry of Education, Science, Sports and Culture of Japan.
PY - 1997/4/15
Y1 - 1997/4/15
N2 - The efficacy of long-term, high dose interferon-α (IFN-α) therapy was studied in seven patients with HTLV-I-associated myelopathy (HAM)/tropical spastic paraparesis (TSP). IFN-α was administered at a dose of 6 x 106 international units daily for the initial 2 weeks and thereafter 3 times a week for the following 22 weeks. Five patients showed a sustained improvement in motor performance during and up to 6 months after the completion of IFN-a. The other patient who responded to IFN-α initially dropped out at 3 months because of depression, while another patient first deteriorated and thereafter dropped out. In the six responders,the absolute number of peripheral blood lymphocytes (PBL) harboring the HTLV-I genome as evaluated by the quantitative polymerase chain reaction method decreased significantly during the therapy period (28.6 ± 16.6% reduction, P=0.0083), whereas the one deteriorated patient showed a 2.5-fold increase in HTLV-I-infected cells. The autoproliferation of CD4+ T clone cells from a single cell culture was markedly depressed even after the cessation of IFN-α in the responders who completed long-term IFN-α therapy. In addition, the CD8+DR+ T cells in the peripheral blood and soluble IL-2 receptor levels in the sera increased significantly during the therapy in all patients (P=0.0431 and P=0.0041, respectively). Therefore, the results of our study suggested that both the reduction of HTLV-I proviral DNA load and immunomodulation by long-term IFN-α therapy contributed to its sustained clinical benefits.
AB - The efficacy of long-term, high dose interferon-α (IFN-α) therapy was studied in seven patients with HTLV-I-associated myelopathy (HAM)/tropical spastic paraparesis (TSP). IFN-α was administered at a dose of 6 x 106 international units daily for the initial 2 weeks and thereafter 3 times a week for the following 22 weeks. Five patients showed a sustained improvement in motor performance during and up to 6 months after the completion of IFN-a. The other patient who responded to IFN-α initially dropped out at 3 months because of depression, while another patient first deteriorated and thereafter dropped out. In the six responders,the absolute number of peripheral blood lymphocytes (PBL) harboring the HTLV-I genome as evaluated by the quantitative polymerase chain reaction method decreased significantly during the therapy period (28.6 ± 16.6% reduction, P=0.0083), whereas the one deteriorated patient showed a 2.5-fold increase in HTLV-I-infected cells. The autoproliferation of CD4+ T clone cells from a single cell culture was markedly depressed even after the cessation of IFN-α in the responders who completed long-term IFN-α therapy. In addition, the CD8+DR+ T cells in the peripheral blood and soluble IL-2 receptor levels in the sera increased significantly during the therapy in all patients (P=0.0431 and P=0.0041, respectively). Therefore, the results of our study suggested that both the reduction of HTLV-I proviral DNA load and immunomodulation by long-term IFN-α therapy contributed to its sustained clinical benefits.
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U2 - 10.1016/S0022-510X(96)05319-1
DO - 10.1016/S0022-510X(96)05319-1
M3 - Article
C2 - 9106118
AN - SCOPUS:0031569835
VL - 147
SP - 135
EP - 144
JO - Journal of the Neurological Sciences
JF - Journal of the Neurological Sciences
SN - 0022-510X
IS - 2
ER -