Abstract Details

Title Aquaporin-4 Antibodies Are Not Related to HTLV-1 Associated Myelopathy

Topic MS and Related Diseases

Presentation(s) P02 - (-)

Poster/Presentation
Number 140

Objective

Background BACKGROUND: The seroprevalence of human T-cell leukemia virus type 1 (HTLV-1) is very high among Brazilians ([sim]1:200). HTLV-1 associated myelopathy or tropical spastic paraparesis (HAM/TSP) is the most common neurological complication of HTLV-1 infection. HAM/TSP can present with an acute/subacute form of longitudinally extensive myelitis, which can be confused with lesions seen in aquaporin-4 antibody (AQP4-Ab) positive neuromyelitis optica spectrum disorders (NMOSD) on MRI. Moreover, clinical attacks in patients with NMOSD have been shown to be preceded by viral infections in around 30% of cases.

Design/Methods DESIGN/METHODS: 23 Brazilian patients with HAM/TSP, 20 asymptomatic HTLV-1+ serostatus patients, and 34 with NMOSD were tested for AQP4-Ab using a standardized recombinant cell based assay. In addition, all patients were tested for HTLV-1 by ELISA and Western blotting.

Results RESULTS: 20/34 NMOSD patients were positive for AQP4-Ab but none of the HAM/TSP patients and none of the asymptomatic HTLV-1 infected individuals. Conversely, all AQP4-Ab-positive NMOSD patients were negative for HTLV-1 antibodies. One patient with HAM/TSP developed optic neuritis in addition to subacute LETM; this patient was AQP4-Ab negative as well. Patients were found to be predominantly female and of African descent both in the NMOSD and in the HAM/TSP group; Osame scale and expanded disability status scale scores did not differ significantly between the two groups.

Conclusions CONCLUSIONS: Our results argue both against a role of antibodies to AQP4 in the pathogenesis of HAM/TSP and against an association between HTLV-1 infection and the development of AQP4-Ab. Moreover, the absence of HTLV-1 in all patients with NMOSD suggests that HTLV-1 is not a common trigger of acute attacks in patients with AQP4-Ab positive NMOSD in populations with high HTLV-1 seroprevalence.

Authors/Disclosures
Felipe Von Glehn Silva, MD, PhD, MSc, FAAN (University of Brasilia – School of Medicine) PRESENTER	Dr. Von Glehn Silva has nothing to disclose.
Sven O. Jarius, MD (University of Heidelberg)	Dr. Jarius has nothing to disclose.
Ian T. Rossman, MD, PhD (Akron Children's Hospital)	No disclosure on file
	No disclosure on file
Carlos Otavio Brandao, MD, PhD (Neurolife)	No disclosure on file
	No disclosure on file
Alfredo Damasceno, MD	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
Klaus-Peter Wandinger, MD (Charite, Neurology Dept)	No disclosure on file
Benito P. Damasceno, MD, PhD (Neurology Department, Medical School, State University of Campinas (UNICAMP))	No disclosure on file
Brigitte Wildemann, MD (University Hospital Heidelberg, Department of Neurology)	The institution of Dr. Wildemann has received research support from Roche. The institution of Dr. Wildemann has received research support from Novartis. The institution of Dr. Wildemann has received research support from Argenx. Dr. Wildemann has received personal compensation in the range of $500-$4,999 for serving as a Conference participant with Neuraxpharm. Dr. Wildemann has received personal compensation in the range of $0-$499 for serving as a Speaker with Roche. Dr. Wildemann has received personal compensation in the range of $0-$499 for serving as a Soeaker with Instand.
	No disclosure on file

��ɫ��

��ɫ��