Treatment of patients with HTLV-1-associated myelopathy with methotrexate

Ahmed, Sibtain; Adonis, Adine; Hilburn, Silva; Demontis, MA; Fedina, Alexandra; Haddow, Jana; Gabriel, Carolyn; Fidler, Sarah; Taylor, G. P.

doi:10.1186/1742-4690-11-s1-p33

Cited by 6 publications

(3 citation statements)

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“…However, the drug was ineffective in improving motor and other disabilities, and the reduction in proviral load was not sustained. Other reagents such as IFN-α 146,147 , cyclosporin A 148 , methotrexate 149 Tables 1 and 2 summarize the main treatments and their specific purpose (reversing or delaying the progression of the disease or relieving symptoms; for a more detailed discussion of different drug options refer to references 154,155 . Figure 7 shows a current management algorithm.…”

Section: [H2] Screening and Prevention Of Ham/tspmentioning

confidence: 99%

HTLV-1-associated myelopathy/tropical spastic paraparesis

Bangham

Araújo

Yamano

et al. 2015

Nat Rev Dis Primers

201

225

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Human T-lymphotropic virus 1 (HTLV-1)-associated myelopathy/tropical spastic paraparesis (HAM/TSP) is a progressive disease of the CNS that causes weakness or paralysis of the legs, lower back pain and urinary symptoms. HAM/TSP was first described in Jamaica in the nineteenth century, but the aetiology of the condition, infection with the retrovirus HTLV-1, was only identified in the 1980s. HAM/TSP causes chronic disability and, accordingly, imposes a substantial health burden in areas where HTLV-1 infection is endemic. Since the discovery of the cause of HAM/TSP, considerable advances have been made in the understanding of the virology, immunology, cell biology and pathology of HTLV-1 infection and its associated diseases. However, progress has been limited by the lack of accurate animal models of the disease. Moreover, the treatment of HAM/TSP remains highly unsatisfactory: antiretroviral drugs have little impact on the infection and, although potential disease-modifying therapies are widely used, their value is unproved. At present, clinical management is focused on symptomatic treatment and counselling. Here, we summarize current knowledge on the epidemiology, pathogenesis and treatment of HAM/TSP and identify areas in which further research is needed. For an illustrated summary of this Primer, visit: http://go.nature.com/tjZCFM.

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Section: [H2] Screening and Prevention Of Ham/tspmentioning

confidence: 99%

HTLV-1-associated myelopathy/tropical spastic paraparesis

Bangham

Araújo

Yamano

et al. 2015

Nat Rev Dis Primers

201

225

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“…To date, therapeutics in HAM/TSP include: antiretrovirals [109], corticosteroids [110,111], steroid-sparing immunosuppressive drugs such as azathioprine [110], methotrexate [112], ciclosporin-A [113], monoclonal antibodies [114], interferons [110,115] and histone de-acetylase inhibitors [116,117]. Currently, three proof-of-concept studies are being conducted: testing monoclonal antibodies against IL-15 (humanized Mikb-1, in the USA), anti-CCR4 antibodies (mogamulizumab, in Japan) and the integrase inhibitor raltegravir in patients with HAM/TSP (in the USA).…”

Section: Treatmentmentioning

confidence: 99%

Inflammatory manifestations of HTLV-1 and their therapeutic options

Martin

Taylor

Jacobson

2014

Expert Review of Clinical Immunology

105

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Human T lymphotropic virus type 1 (HTLV-1) is one of the most intriguing retroviruses infecting humans. Most commonly, infection remains undetected, since it does not cause obvious harm, yet in 4-9% of patients, this infection can be devastating, causing adult T-cell leukemia/lymphoma and/or HTLV-1 associated myelopathy/tropical spastic paraparesis (HAM/TSP). This review concentrates on all inflammatory aspects of HTLV-1 infection: HAM/TSP, HTLV-1 associated uveitis, HTLV-1 associated conjunctivitis, sicca syndrome and interstitial keratitis, HTLV-1 associated Sjö gren's syndrome, Hashimoto's thyroiditis and Graves' disease, HTLV-1 associated pulmonary disease, infective dermatitis associated with HTLV-1, HTLV-1 associated inflammatory myositis and HTLV-1 associated arthritis. With the exception of HAM/TSP treatment, studies of these conditions are sparse and even for HAM/TSP, the level of evidence is limited. While control or elimination of infection remains a goal, most therapy beyond symptomatic management is directed at the immune response to HTLV-1.

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“…[ 36 ], efficacy of Methotrexate (Ahmed et al .) [ 37 ] and efficacy of Fampridine (a selective neuronal potassium channel blocker) (Menna-Barreto) [ 38 ]. One of the problems in these reports is the lack of standard criteria for treatment efficacy, which makes it difficult to compare the results from the different clinical research teams.…”

Section: Introductionmentioning

confidence: 99%

Conference Highlights of the 16th International Conference on Human Retrovirology: HTLV and Related Retroviruses, 26–30 June 2013, Montreal, Canada

et al. 2014

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The 16th International Conference on Human Retrovirology: HTLV and Related Retroviruses was held in Montreal, Québec from June 26th to June 30th, 2013 and was therefore hosted by a Canadian city for the first time. The major topic of the meeting was human T-lymphotropic viruses (HTLVs) and was covered through distinct oral and poster presentation sessions: clinical research, animal models, immunology, molecular and cellular biology, human endogenous and emerging exogenous retroviruses and virology. In this review, highlights of the meeting are provided by different experts for each of these research areas.

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Treatment of patients with HTLV-1-associated myelopathy with methotrexate

Cited by 6 publications

References 0 publications

HTLV-1-associated myelopathy/tropical spastic paraparesis

HTLV-1-associated myelopathy/tropical spastic paraparesis

Inflammatory manifestations of HTLV-1 and their therapeutic options

Conference Highlights of the 16th International Conference on Human Retrovirology: HTLV and Related Retroviruses, 26–30 June 2013, Montreal, Canada

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