PULMONARY INVOLVEMENT IN PATIENTS WITH HUMAN T-LYMPHOTROPIC VIRUS TYPE-1-ASSOCIATED MYELOPATHY - THE PRESENCE OF SPECIFIC IGA ANTIBODY IN BRONCHOALVEOLAR LAVAGE FLUID

It has been shown that T lymphocyte alveolitis occurs in patients with human T lymphotropic virus type-1 (HTLV-1)-associated myelopathy/trop ical spastic paraparesis (HAM/TSP). To determine whether HTLV-1-specif ic antibodies were present in bronchoalveolar lavage (BAL) fluid, we i nvestigated 15 patients with HAM/TSP, five HTLV-1 carriers without HAM /TSP, and 10 normal control subjects seronegative for HTLV-1. Studies of BAL showed that 12 of 15 patients with HAM/TSP were associated with bronchoalveolar T lymphocytosis. Such abnormalities of the lung were not found in three other patients with HAM/TSP, non-HAM/TSP carriers, and normal control subjects. Using Western blots, specific IgA antibod ies were detected only in BAL fluid from 12 patients with HAM/TSP and with pulmonary involvement. On the other hand, specific IgG antibodies in BAL fluid were positive not only in 12 patients with HAM/TSP and w ith pulmonary involvement, but also in two of three patients with HAM/ TSP and three of five non-HAM/TSP carriers, both of whom showed normal BAL findings. Specific IgM class antibodies in BAL fluid were not det ected in any subjects in these three groups. Specific IgA antibodies w ere found in the sera of 12 patients with HAM/TSP and with BAL lymphoc ytosis, but not in three patients with HAM/TSP and without BAL lymphoc ytosis, and five non-HAM/TSP carriers. These results suggest that the production of HTLV-1-specific IgA antibodies is closely related to pul monary involvement in patients with HAM/TSP.