Title:HTLV-1 Associated Neurological Disorders
Volume: 17
Issue: 12
Author(s): Muhammad Yasir Khan, Ishaq Nasib Khan, Muhammad Farman, Saleh Al Karim, Ishtiaq Qadri, Muhammad Amjad Kamal, Khalid Al Ghamdi and Steve Harakeh
Affiliation:
Keywords:
HTLV-1, Reteroviradae, Antiviral drugs, Neurological disorders, Blood brain barrier, Pathogenesis, New drugs
discovery.
Abstract: Human T-cell lymphotropic virus type 1 (HTLV-1) is a retrovirus which is endemic to certain
regions of the world and infects around 10-20 million people. HTLV-1 is the etiologic agent of
Adult T cell leukemia/lymphoma and HTLV-1 associated neurological disorders including mainly
HTLV-1 associated myelopathy/Tropical spastic paraparesis. The involvement of the central nervous
diseases occurs among: HTLV-1 infected patients from endemic areas, HIV positive individuals and
drug users. The ability of HTLV-1 to cause associated neuropathies starts with the virus crossing the
blood brain barrier (BBB), then entering and infecting the cells of the central nervous system. As a
consequence, to the viral attack, HTLV-1 infected lymphocytes produce pro-inflammatory cytokines
like tumor necrosis factor alpha, Interleukin 1 beta and interleukin 6 which further disrupts the BBB.
Different serological tests have been used in the diagnosis of HTLV-1. These include: ELISA, Western
Blotting (WB), Immunofluorescence, Particle Agglutination and Polymerase Chain Reaction
which is used as a confirmatory test. Danazol, pentoxifylline, azathioprine and vitamin C have been
used in the treatment of the HTLV-1 associated neurological disorders. Other antiviral drugs (lamivudine,
zidovudine), monoclonal antibodies (Daclizumab) and therapeutic agents (valporic acid, interferons)
have also been evaluated. No known drug, so far, has been shown to be efficacious. The
aim of this review is to present the complexities of HTLV-1 associated neurological disorders and
their current ongoing treatment. In addition to discussing future possible therapeutic strategies, by
targeting HTVL-1 viral components and gene/s products, for the treatment of those neurological conditions.
