DIFFERENTIAL PATTERNS OF SERUM BIOMARKERS OF IMMUNE ACTIVATION IN HUMAN T-CELL LYMPHOTROPIC VIRUS TYPE I-ASSOCIATED MYELOPATHY TROPICAL SPASTIC PARAPARESIS AND ADULT T-CELL LEUKEMIA/LYMPHOMA/

Adult T-cell leukemia/lymphoma (ATL) and human T-cell lymphotropic vir us type I-associated myelopathy/tropical spastic paraparesis (HAM/TSP) are associated with differing patterns of immune dysfunction, Biomark ers of immune activation may correlate with perturbations of immune fu nction associated,vith these diseases. We conducted a pilot cross-sect ional study to assess four candidate biomarkers of immune activation, beta(2)-microglobulin, neopterin, tryptophan, and kynurenine levels we re assayed in stored sera from asymptomatic, human T-cell leukemia vir us type I (HTLV-I)-seronegative (HTLV-I-) and HTLV-I-seropositive (HTL V-I+) individuals, and ATL and HAM/TSP patients previously enrolled in seroepidemiological studies in Jamaica, Mean levels of beta(2)-microg lobulin, neopterin, and kynurenine were significantly elevated among A TL patients compared to the other study groups, Mean tryptophan levels were significantly lower among ATL and HAM/TSP patients than HTLV-I- and HTLV-I+ groups, No significant differences in biomarkers were foun d between the HTLV-I- and HTLV-I+ groups, Among HAM/TSP patients, a si gnificant association was found between elevated neopterin levels and symptoms of less than 4 years duration, In Cox proportional hazards re gression modeling, neopterin and tryptophan were found to be independe nt predictors of survival among ATL patients, This study demonstrates a differential pattern of biomarkers of immune activation among ATL an d HAM/TSP patients compared to HTLV-I- and HTLV-I+ individuals, Neopte rin and tryptophan mag be useful clinical indicators of disease severi ty and prognosis among HAM/TSP and ATL patients.