Human T cell lymphotropic virus 1 (HTLV-1) is a human retrovirus and infects approximately 10–20 million people worldwide. While the majority of infected people are asymptomatic carriers of HTLV-1, only 4% of infected people develop HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP). HAM/TSP is a chronic, progressive, neurological disease which usually progresses slowly without remission, and is characterized by perivascular inflammatory infiltrates in chronic inflammatory lesions of the central nervous system (CNS), primarily affecting the spinal cord. A high HTLV-1 proviral load, high levels of antibodies against HTLV-1 antigens, and elevated concentration of proteins are detected in cerebrospinal fluid (CSF) of HAM/TSP patients. These chronically activated immune responses against HTLV-1 and infiltration of inflammatory cells including HTLV-1 infected cells into the CNS contribute to clinical disability and underlie the pathogenesis of HAM/TSP. Since the disease development of HAM/TSP mainly occurs in adults, with a mean age at onset of 40–50 years, it is important for HTLV-1-infected carriers and HAM/TSP patients to be monitored throughout the disease process. Recent advances in technologies and findings provide new insights to virological and immunological aspects in both the CNS as well as in peripheral blood. In this review, we focus on understanding the inflammatory milieu in the CNS and discuss the immunopathogenic process in HTLV-1-associated neurologic diseases.

中文翻译：

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HTLV-1 相关脊髓病/热带痉挛性下肢轻瘫 (HAM/TSP) 中的免疫病毒学标志物

人类 T 细胞嗜淋巴细胞病毒 1 (HTLV-1) 是一种人类逆转录病毒，全世界约有 10-2000 万人感染。虽然大多数感染者是 HTLV-1 的无症状携带者，但只有 4% 的感染者会发展为 HTLV-1 相关脊髓病/热带痉挛性下肢轻瘫 (HAM/TSP)。HAM/TSP 是一种慢性、进行性、神经系统疾病，通常进展缓慢而无缓解，其特征是中枢神经系统 (CNS) 慢性炎症病变中的血管周围炎症浸润，主要影响脊髓。在 HAM/TSP 患者的脑脊液 (CSF) 中检测到高 HTLV-1 前病毒载量、高水平的抗 HTLV-1 抗原抗体和升高的蛋白质浓度。这些针对 HTLV-1 的慢性激活免疫反应和炎症细胞（包括 HTLV-1 感染细胞）向 CNS 的浸润导致临床残疾，并成为 HAM/TSP 发病机制的基础。由于 HAM/TSP 的疾病发展主要发生在成年人中，平均发病年龄为 40-50 岁，因此在整个疾病过程中对 HTLV-1 感染者和 HAM/TSP 患者进行监测很重要。技术和发现的最新进展为中枢神经系统和外周血的病毒学和免疫学方面提供了新的见解。在这篇综述中，我们重点了解 CNS 中的炎症环境并讨论 HTLV-1 相关神经系统疾病的免疫致病过程。