Immunogenetics and the Pathological Mechanisms of Human T-Cell Leukemia Virus Type 1- (HTLV-1-)Associated Myelopathy/Tropical Spastic Paraparesis (HAM/TSP)

Figure 1

Hypothesis for the pathogenesis of Human T-cell leukemia virus type 1- (HTLV-1-)associated myelopathy/tropical spastic paraparesis (HAM/TSP). In patients with HAM/TSP, genetically determined less efficient CTL response against HTLV-1 may cause higher proviral load and antigen expression, leading in turn to activation and expansion of antigen-specific T cell responses, subsequent induction of large amounts of proinflammatory cytokines and chemokines, and progression of HAM/TSP development. It is also possible that the immunoglobulin G specific to HTLV-1-Tax, which cross-reacts with heterogeneous nuclear ribonuclear protein-A1 (hnRNP-A1), is associated with subsequent inflammation following initial tissue damage.