Standardisation of Western blotting to detect HTLV-1 antibodies synthesised in the central nervous system of HAM/TSP patients

• Main Authors: Luiz Claudio Pereira Ribeiro, Cassia Cristina Alves Goncalves, Carla Maria Sena Andrade Slater, Silvia Maia Farias de Carvalho, Marzia Puccioni-Sohler
• Format: Article
• Language: English
• Published: Instituto Oswaldo Cruz, Ministério da Saúde 2013-09-01
• Series: Memórias do Instituto Oswaldo Cruz.
• Subjects: intrathecal synthesis; human T-lymphotropic virus type 1; HTLV-1 associated myelopathy; cerebrospinal fluid; Western blot
• Online Access: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0074-02762013000600730&lng=en&tlng=en

Intrathecal synthesis of human T-lymphotropic virus type 1 (HTLV-1) antibodies (Abs) represents conclusive evidence of a specific immune response in the central nervous system of HTLV-1 associated myelopathy/tropical spastic paraparesis (HAM/TSP) patients. Western blotting (WB) for HTLV Abs in serum is a confirmatory test for HTLV-1 infection. The aim of this study was to standardise the Western blot to demonstrate the intrathecal pattern of Abs against HTLV-1 proteins in HAM/TSP patients. Paired cerebrospinal fluid (CSF) and serum samples were selected from 20 patients with definite HAM/TSP, 19 HTLV-1 seronegative patients and two HTLV-1 patients without definite HAM/TSP. The presence of reactive bands of greater intensity in the CSF compared to serum (or bands in only the CSF) indicated the intrathecal synthesis of anti-HTLV-1 Abs. All definite HAM/TSP patients presented with an intrathecal synthesis of anti-HTLV-1 Abs; these Abs were not detected in the control patients. The most frequent intrathecal targets of anti-HTLV-1 Abs were GD21, rgp46-I and p24 and, to a lesser extent, p19, p26, p28, p32, p36, p53 gp21 and gp46. The intrathecal immune response against env (GD21 and rgp46-I) and gag (p24) proteins represents the most important humoral pattern in HAM/TSP. This response may be used as a diagnostic marker, considering the frequent association of intrathecal anti-HTLV-1 Ab synthesis with HAM/TSP and the pathogenesis of this neurological disease.