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Tropical Spastic Paraparesis (Tropical Spastic Paraplegia)

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A subacute paralytic myeloneuropathy occurring endemically in tropical areas such as the Caribbean, Colombia, India, and Africa, as well as in the southwestern region of Japan; associated with infection by HUMAN T-CELL LEUKEMIA VIRUS I. Clinical manifestations include a slowly progressive spastic weakness of the legs, increased reflexes, Babinski signs, incontinence, and loss of vibratory and position sensation. On pathologic examination inflammatory, demyelination, and necrotic lesions may be found in the spinal cord. (Adams et al., Principles of Neurology, 6th ed, p1239)

Also Known As:

Tropical Spastic Paraplegia; Paraparesis, Tropical Spastic; HTLV I Associated Myelopathies; HTLV-I-Associated Myelopathy-Tropical Spastic Paraparesis; Human T-Lymphotropic Virus Type 1 Associated Myelopathy; Myelopathies, HTLV I Associated; Myelopathy, Human T-Lymphotropic Virus Type 1 Associated; Paraplegia, Tropical Spastic; HTLV I Associated Myelopathy; HTLV I Associated Myelopathy Tropical Spastic Paraparesis; HTLV-I-Associated Myelopathies; Human T Lymphotropic Virus Type 1 Associated Myelopathy; Myelopathies, HTLV-I-Associated; Myelopathy, HTLV-I-Associated; Myelopathy, Human T Lymphotropic Virus Type 1 Associated; Parapareses, Tropical Spastic; Paraplegias, Tropical Spastic; Spastic Parapareses, Tropical; Spastic Paraparesis, Tropical; Spastic Paraplegia, Tropical; Spastic Paraplegias, Tropical; Tropical Spastic Parapareses; Tropical Spastic Paraplegias; HTLV-I-Associated Myelopathy

Networked: 353 relevant articles (14 outcomes, 25 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Spinal Cord Diseases
2.	Tropical Spastic Paraparesis (Tropical Spastic Paraplegia)
3.	T-Cell Leukemia (Leukemia, T Cell)
4.	Lymphoma (Lymphomas)
5.	Cerebral Infarction

Experts

1.	Izumo, Shuji: 15 articles (01/2013 - 01/2002)
2.	Osame, Mitsuhiro: 14 articles (04/2008 - 01/2002)
3.	Saito, Mineki: 13 articles (01/2013 - 01/2004)
4.	Usuku, Koichiro: 10 articles (03/2008 - 01/2004)
5.	Bangham, Charles R M: 9 articles (12/2013 - 05/2002)
6.	Arimura, Kimiyoshi: 9 articles (01/2009 - 04/2004)
7.	Nakamura, Tatsufumi: 8 articles (06/2014 - 04/2002)
8.	Nishiura, Yoshihiro: 8 articles (06/2014 - 04/2002)
9.	Tanaka, Yuetsu: 7 articles (04/2014 - 05/2002)
10.	Casseb, Jorge: 6 articles (01/2013 - 07/2006)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Tropical Spastic Paraparesis:

1.	Interferon-alpha (Interferon Alfa)FDA Link 04/01/1996 - "Interferon-alpha is effective in HTLV-I-associated myelopathy: a multicenter, randomized, double-blind, controlled trial." 07/01/1990 - "We investigated the efficacy of interferon-alpha (IFN-alpha) treatment in 5 patients with human T-lymphotropic virus type I (HTLV-I)-associated myelopathy (HAM). " 04/15/1997 - "Long-term, high dose interferon-alpha treatment in HTLV-I-associated myelopathy/tropical spastic paraparesis: a combined clinical, virological and immunological study." 04/01/1996 - "A double-blind, multi-center study was performed on patients with HTLV-I-associated myelopathy (HAM) to evaluate the therapeutic effect of treatment with natural interferon-alpha (HLBI). " 12/01/1991 - "We treated 17 patients with HTLV-I-associated myelopathy (HAM) with interferon-alpha (IFN-alpha) in an open, nonrandomized, uncontrolled study. "
2.	InterferonsIBA 01/01/2004 - "To analyze the mechanism by which interferon (IFN)-alpha is effective against human T cell lymphotropic virus type I (HTLV-I)-associated myelopathy/tropical spastic paraparesis (HAM/TSP), we investigated the T cell phenotype and HTLV-I provirus load in peripheral blood mononuclear cells from 25 patients with HAM/TSP that were obtained before and after administration of IFN-alpha. " 01/10/2002 - "[Chronic hepatitis C with HTLV-I associated myelopathy (HAM) treated with interferon]." 06/01/2014 - "The main therapeutic strategy against human T lymphotropic virus type I (HTLV-I)-associated myelopathy/tropical spastic paraparesis (HAM/TSP) characterized by lower extremity motor dysfunction is immunomodulatory treatment, with drugs such as corticosteroid hormone and interferon-α, at present. " 11/01/2011 - "Short communication an interferon-γ ELISPOT assay with two cytotoxic T cell epitopes derived from HTLV-1 tax region 161-233 discriminates HTLV-1-associated myelopathy/tropical spastic paraparesis patients from asymptomatic HTLV-1 carriers in a Peruvian population." 02/01/2005 - "We analyzed the relationship between the expression of interferon (IFN)-gamma and HTLV-I p19 antigen and activation of p38 mitogen-activated protein kinase (p38 MAPK) in two HTLV-I-infected T cell lines derived from two patients (HCT-1 and HCT-4) with HTLV-I-associated myelopathy/tropical spastic paraparesis (HAM/TSP), and three HTLV-I-infected T cell lines derived from three patients with adult T cell leukemia (ATL). "
3.	Prednisolone (Predate)FDA LinkGeneric 05/01/1990 - "[Efficacy of leukocytapheresis and low-dose prednisolone treatment in a patient with HTLV-I-associated myelopathy (HAM)]." 10/22/1997 - "Alteration of cytokine levels by fosfomycin and prednisolone in spontaneous proliferation of cultured lymphocytes from patients with HTLV-I-associated myelopathy (HAM/TSP)." 07/01/1989 - "We studied the modulating effect of prednisolone (PSL) and interferon-alpha (IFN) on APR of PBLs obtained from five patients with HTLV-I-associated myelopathy (HAM). " 07/01/1989 - "In vitro modulation of lymphocyte proliferation by prednisolone and interferon-alpha in patients with HTLV-I-associated myelopathy (HAM)." 10/01/2015 - "Considering that there is no effective treatment for human T-cell leukemia virus type 1 (HTLV-1)-associated myelopathy/tropical spastic paraparesis, this study aimed to assess the impact of triple combination therapy-interferon-α, valproic acid, and prednisolone-on clinical outcomes, main HTLV-1 viral factors, and host anti-HTLV-1 antibody response. "
4.	Messenger RNA (mRNA)IBA 12/01/2004 - "Increased mRNA expression of Th1-cytokine signaling molecules in patients with HTLV-I-associated myelopathy/tropical spastic paraparesis." 03/01/1995 - "To investigate the expression of inflammatory cytokine messenger RNA (mRNA) in peripheral blood mononuclear cells of patients with human T-cell lymphotropic virus type I (HTLV-I)-associated myelopathy (HAM). " 05/01/1994 - "In order to evaluate the expression of HTLV-1 and its effects in the lung, we examined the expression of mRNA for the HTLV-1 tax/rex gene in fresh bronchoalveolar lavage cells (BALC) and peripheral blood mononuclear cells (PBMC) of 23 seropositive individuals, including six patients with HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP), by use of an improved method of reverse transcription-polymerase chain reaction (RT-PCR). " 12/01/2002 - "This review focuses on current approaches to understanding the immunopathogenesis of human T cell lymphotropic virus (HTLV) type I-associated myelopathy/tropical spastic paraparesis (HAM/TSP) based on newly developed molecular and immunologic techniques that have been adapted to studies of HTLV-I proviral load, HTLV-I mRNA, and HTLV-I tax-specific CD8 T cells. " 01/01/2009 - "We quantified the HBZ and tax mRNA expression levels in peripheral blood from 56 HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) patients, 10 ATL patients, 38 healthy asymptomatic carriers (HCs) and 20 normal uninfected controls, as well as human leukemic T-cell lines and HTLV-1-infected T-cell lines, and the data were correlated with clinical parameters. "
5.	Pentoxifylline (Trental)FDA LinkGeneric 09/01/1999 - "Previously, we reported the efficacy of pentoxifylline (PTX) treatment in human T-lymphotropic virus type I (HTLV-I)-associated myelopathy (HAM). " 10/03/1997 - "Successful application of pentoxifylline in the treatment of HTLV-I associated myelopathy." 03/01/1997 - "Pentoxifylline down-regulates adhesion molecule expression and inflammatory cytokine production in cultured peripheral blood mononuclear cells from patients with HTLV-I-associated myelopathy." 05/01/1995 - "Pentoxifylline treatment in HTLV-I-associated myelopathy." 10/03/1997 - "Fifteen patients with human T-cell lymphotropic virus type-I (HTLV-I)-associated myelopathy (HAM) were treated in an uncontrolled preliminary trial by oral administration of pentoxifylline (PTX). "
6.	prosultiamineIBA 01/01/2013 - "Efficacy of prosultiamine treatment in patients with human T lymphotropic virus type I-associated myelopathy/tropical spastic paraparesis: results from an open-label clinical trial." 01/01/2013 - "Based on the finding that prosultiamine induces apoptosis in human T lymphotropic virus type I (HTLV-I)-infected T cells, Nakamura et al. conducted a clinical trial of prosultiamine in patients with HTLV-I-associated myelopathy (HAM)/tropical spastic paraparesis (TSP). " 01/01/2009 - "This study was conducted to construct a basis for a therapeutic strategy against human T-lymphotropic virus type-I (HTLV-I)-associated myelopathy/tropical spastic paraparesis (HAM/TSP) using a compound that contained a disulfide moiety, prosultiamine, which is a homologue of allithiamine originally synthesized by allicin and thiamine-thiol, for the targeting of HTLV-I-infected cells. "
7.	Valproic Acid (Valproate, Semisodium)FDA LinkGeneric 12/08/2011 - "HTLV-associated myelopathy/tropical spastic paraparesis (HAM/TSP) is a neurodegenerative disease of the central nervous system induced by human T-lymphotropic virus type 1. As a potential therapeutic approach, we previously suggested reducing the proviral load by modulating lysine deacetylase activity using valproic acid (VPA) and exposing virus-positive cells to the host immune response. " 10/01/2015 - "Considering that there is no effective treatment for human T-cell leukemia virus type 1 (HTLV-1)-associated myelopathy/tropical spastic paraparesis, this study aimed to assess the impact of triple combination therapy-interferon-α, valproic acid, and prednisolone-on clinical outcomes, main HTLV-1 viral factors, and host anti-HTLV-1 antibody response. " 10/01/2015 - "HTLV-1 proviral load (PVL), and HBZ and Tax mRNA expression levels were measured in peripheral blood mononuclear cells of 13 patients with HTLV-1-associated myelopathy/tropical spastic paraparesis before and after treatment with 180 μg pegylated interferon once a week, 10-20 mg/kg/day sodium valproate, and 5 mg/day prednisolone for 25 weeks using a TaqMan real-time polymerase chain reaction assay. " 10/01/2015 - "Triple Therapy with Prednisolone, Pegylated Interferon and Sodium Valproate Improves Clinical Outcome and Reduces Human T-Cell Leukemia Virus Type 1 (HTLV-1) Proviral Load, Tax and HBZ mRNA Expression in Patients with HTLV-1-Associated Myelopathy/Tropical Spastic Paraparesis."
8.	Ascorbic Acid (Vitamin C)FDA LinkGeneric 11/01/1993 - "The efficacy of intermittent high-dose vitamin C therapy was evaluated in seven patients with HTLV-I-associated myelopathy (HAM). " 03/01/1993 - "The aim of this study was to determine the efficacy and safety of intermittent high-dose vitamin C therapy in patients with HTLV-I associated myelopathy (HAM). " 11/01/1993 - "Intermittent high-dose vitamin C therapy in patients with HTLV-I associated myelopathy." 03/01/1993 - "[Intermittent high-dose vitamin C therapy in patients with HTLV-I-associated myelopathy]."
9.	Danazol (Azol)FDA LinkGeneric 09/01/1992 - "We investigated the efficacy of danazol treatment in eight patients with HTLV-1 associated myelopathy/tropical spastic paraparesis (HAM/TSP). " 03/01/2013 - "Effects of Danazol on Clinical Improvement of Patients with Human T-cell Lymphotropic Virus Type I Associated Myelopathy/Tropical Spastic Paraparesis (HAM/TSP): A Placebo-Controlled Clinical Trial." 02/08/1992 - "Danazol for urinary incontinence in tropical spastic paraparesis." 12/01/1991 - "Tropical spastic paraparesis/HTLV-1-associated myelopathy (TSP/HAM): treatment with an anabolic steroid danazol." 12/01/1991 - "Because danazol is anabolic, useful in prednisone-responsive diseases, and less toxic than prednisone, we gave danazol to 6 patients with TSP and 1 with HIV, HTLV-I-associated myelopathy. "
10.	14-3-3 Proteins (14-3-3 Protein)IBA 08/15/2003 - "The 14-3-3 protein was identified in seven CSF samples, including four patients with SPMS in acute relapse, one with SPMS in remission accompanied by fresh cerebral infarction, one with RRMS in acute relapse, and one with human T-lymphotropic virus type I (HTLV-I)-associated myelopathy. "

Therapies and Procedures

1.	Plasmapheresis 11/12/1988 - "In 11 of 18 patients with human T-lymphotropic virus type-I (HTLV-I) associated myelopathy (HAM) gait, sensory, and/or sphincter disturbance improved with plasmapheresis (4 to 6 sessions in 2 weeks), and the effects were maintained for 2 to 4 weeks. "
2.	Oral Administration 10/15/2005 - "Ten patients with human T-cell lymphotropic virus type-1 (HTLV-1)-associated myelopathy/tropical spastic paraparesis (HAM/TSP) were treated in an uncontrolled preliminary trial by oral administration of viable Lactobacillus casei strain Shirota (LcS) containing fermented milk. " 10/03/1997 - "Fifteen patients with human T-cell lymphotropic virus type-I (HTLV-I)-associated myelopathy (HAM) were treated in an uncontrolled preliminary trial by oral administration of pentoxifylline (PTX). "
3.	Blood Transfusion (Blood Transfusions) 02/01/1991 - "HTLV-I-associated myelopathy associated with blood transfusion in the United States: epidemiologic and molecular evidence linking donor and recipient." 07/01/1990 - "Nationwide survey of HTLV-I-associated myelopathy in Japan: association with blood transfusion." 12/16/1989 - "Blood transfusion and HTLV-I-associated myelopathy." 07/12/1986 - "Blood transfusion and HTLV-I associated myelopathy." 12/01/1993 - "A seroprevalence study for human T lymphotropic virus type-1 (HTLV-1) and HTLV-2 was conducted in Sao Paulo, Brazil among 2,312 individuals that included following groups: 1,148 volunteer blood donors, 37 patients with tropical spastic paraparesis (TSP), 53 with lymphoproliferative disorders, 171 with a history of multiple blood transfusions, 268 human immunodeficiency virus type-1 (HIV-1) seropositive subjects, and 635 Amazonian Indians. "
4.	Transplants (Transplant) 06/01/1992 - "Development of HTLV-I-associated myelopathy after blood transfusion in a patient with aplastic anemia and a recipient of a renal transplant." 12/01/2005 - "We describe the cases of two transplant patients who developed subacute myelopathy, known as Tropical Spastic Paraparesis, secondary to HTLV-1 infection and review their evolution. " 06/01/1992 - "We report the development of rapid progressive HTLV-I-associated myelopathy (HAM) after blood transfusion in two immunosuppressed patients, one of whom had aplastic anemia and the other was the recipient of a renal transplant receiving immunosuppressive chemotherapy. " 01/01/2014 - "A case of post-transplant adult T-cell leukemia/lymphoma presenting myelopathy similar to but distinct from human T-cell leukemia virus type I (HTLV- I)-associated myelopathy."
5.	Kidney Transplantation 08/15/2000 - "HTLV-I-associated myelopathy manifested after renal transplantation." 08/15/2000 - "We report a patient with HTLV-I-associated myelopathy (HAM), who developed symptoms of myelopathy 4 years after cadaveric renal transplantation. " 03/01/2015 - "HTLV-1-associated myelopathy/tropical spastic paraparesis and peripheral neuropathy following live-donor renal transplantation."