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Chronic progressive myelopathy associated with HTLV-I

Oligoclonal IgG and anti-HTLV-I IgG antibodies in cerebrospinal fluid and serum

From the Department of Neurology (Drs. Link, Cruz, and Kam-Hansen), Karolinska Institutet, Huddinge University Hospital, Stockholm, Sweden; CNRS Laboratory of Epidemiology and Immunology of Tumors (Drs. Gessain, and de Thé), Faculté de Medecine Alexis Carrel, Université Claude Bernard, Lyon, France; and Department of Neurology and Neuropsychology Clinic (Dr. Gout), Pitié Salpétrière Hospital, Paris, France.

Among 22 patients with human T-lymphotropic virus type I (HTLV-I)-associated chronic progressive myelopathy, agarose isoelectric focusing (AIF) revealed oligoclonal IgG bands in 21: in 3 in CSF only; in 11 in CSF and to some extent in serum; and in 7, identical patterns in CSF and serum. By immunoblot after AIF of CSF and serum, we observed bands of anti-HTLV-I IgG antibodies in 19 patients: in 5 in CSF only; in 9 in CSF and partly in serum; and in 5, identical in CSF and serum. Oligoclonal anti-HTLV-I IgG antibody bands could only partly be traced to oligoclonal IgG bands. If, prior to AIF, serum and CSF were absorbed with HTLV-I antigen, practically all oligoclonal HTLV-I-specific IgG antibody activity was abolished, while the oligoclonal pattern of total IgG was affected only to a minor extent. Alongside with HTLV-I-specific oligoclonal B cell response, HTLV-I myelopathy is regularly accompanied by production of oligoclonal IgG of unknown antibody specificities.

Address correspondence and reprint requests to Dr. Link, Karolinska Institutet, Department of Neurology, Huddinge University Hospital, S-141 86 Huddinge. Stockholm. Sweden.

Supported in part by grants from the Swedish Medical Research Council (project No. 3381).

Received February 7, 1989. Accepted for publication in final form June 1, 1989.

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