Progressive spastic myelopathy in a patient co-infected with HIV-1 and HTLV II autoantibodies to the human homologue of rig in blood and cerebrospinal fluid

J. D. Rosenblatt, P. Tomkins, M. Rosenthal, A. Kacena, G. Chan, R. Valderama, W. Harrington, E. Saxton, A. Diagne, J. Q. Zhao, R. T. Mitsuyasu, R. H. Weisbart

Research output: Contribution to journalArticlepeer-review

28 Scopus citations

Abstract

Objective: Human T-cell leukemia virus types I (HTLV-I) and II (HTLV-II) are closely related human retroviruses. HTLV-I has been implicated in a chronic progressive myelopathy, known as tropical spastic paraparesis (TSP) or HTLV-I-associated myelopathy (HAM). We sought to determine whether autoantibodies to brain antigens were present in the cerebrospinal fluid (CSF) of a patient with chronic progressive spastic myelopathy with evidence of both HIV-1 infection and HTLV-I/II seropositivity. Design: A 54-year-old bisexual man with clinical features of HAM/TSP of over 20 years' duration was followed. Methods: We applied discriminatory DNA amplification (polymerase chain reaction) to distinguish HTLV-I from HTLV-II and to verify co-infection with HIV-1. The patient's CSF was used to screen a human brain cDNA expression library to identify antibodies directed against brain antigens. Autoreactive bacteriophage clones were isolated and sequenced. Results: The patient was found to be co-infected with both HIV-1 and HTLV-II, but not with HTLV-I. HTLV-II proviral levels in the peripheral blood remained relatively constant, despite therapy with zidovudine. Prominent oligoclonal banding of immunoglobulins was present in the patient's CSF. A single repeatedly reactive cDNA clone was identified, by screening with CSF antibody, sequenced, and found to be the human homologue of the rat insulinoma gene, rig. Conclusions: HTLV-II infection may predispose to development of a HAM/TSP-like illness. Autoimmune mechanisms, such as autoantibody formation, may play a role in pathogenesis.

Original languageEnglish (US)
Pages (from-to)1151-1158
Number of pages8
JournalAIDS
Volume6
Issue number10
DOIs
StatePublished - Jan 1 1992
Externally publishedYes

Keywords

  • Autoantibodies
  • HTLV-I
  • HTLV-II
  • Myelopathy
  • Rig

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology

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