Even though an estimated 10-20 million people worldwide are infected with the oncogenic retrovirus, human T-lymphotropic virus type 1 (HTLV-1), its epidemiology is poorly understood, and little effort has been made to reduce its prevalence. In response to this situation, the Global Virus Network launched a taskforce in 2014 to develop new methods of prevention and treatment of HTLV-1 infection and promote basic research. HTLV-1 is the etiological agent of two life-threatening diseases, adult T-cell leukemia and HTLV-associated myelopathy/tropical spastic paraparesis, for which no effective therapy is currently available. Although the modes of transmission of HTLV-1 resemble those of the more familiar HIV-1, routine diagnostic methods are generally unavailable to support the prevention of new infections. In the present article, the Taskforce proposes a series of actions to expand epidemiological studies; increase research on mechanisms of HTLV-1 persistence, replication and pathogenesis; discover effective treatments; and develop prophylactic and therapeutic vaccines.

Evidence has been accumulated showing that inflammatory and cell death pathways are altered both in brain and periphery during Parkinson disease (PD). Neuronal loss in PD is associated with chronic neuroinflammation characterized by microglia activation through the release of reactive oxygen radicals, cytokines, and Prostaglandin E2. The release of these inflammatory mediators in addition to deprivation in growth factors and increase of calcium and dopamine seem implicated in triggering apoptosis. The interaction of leucine-rich repeat kinase and Fas- Associated protein with Death Domain has been implicated in the switching-on of the extrinsic apoptotic pathway via caspase-8 activation, while deficiency in PTEN induced putative kinase 1 has been shown to cause Ca2+ accumulation in mitochondria, increased generation of reactive oxygen species and intrinsic cell death. Autophagy/mitophagy appears to be impaired in the brain during PD; this impairment could be related to defective degradation of mutant α-synuclein and consequent apoptotic cell death. Regarding the peripheral blood, reduced amounts of dopamine, reduced levels of immunoreactivity for tyrosine hydroxylase and dopamine active transporter, and alterations of dopamine receptor expression have been detected in mononuclear cells from PD patients. In addition, mononuclear cells from PD patients show mitochondrial, ubiquitin–proteasome system dysfunction and up-regulation of α-synuclein gene, associated to high expression of the Fas molecule, activation of caspase-3 and -9 and proneness to apoptosis. These and other observations reported in this mini-review suggest that a better understanding of molecular dysfunctions in inflammatory and cell death/autophagy pathways, both in the brain and peripheral blood, could provide useful targets for future investigation on drug-discovery and biomarker identification in PD.

The effect of 3'-azido-3'-deoxythymidine (AZT) on in vitro infection of peripheral blood mononuclear cells (PBMCs) isolated from normal adult individuals with human T cell leukaemia/lymphoma virus type I (HTLV-I) was evaluated. Different PBMC samples were exposed to HTLV-I by cocultivation with MT-2 (a chronically infected cell line) in the presence of 20 U/ml of human recombinant interleukin 2 (IL-2) and graded concentrations of AZT. Control and drug-treated cultures, of both infected and uninfected PBMCs, were then grown for several weeks and monitored for virological and immunological parameters. The results showed a concentration-dependent anti-proliferative effect of AZT in both infected and non-infected cultures. Production of both proviral DNA and viral RNA was inhibited not only at the higher concentrations of AZT (8 microM and 32 microM) but also at concentrations as low as 0.1-2 microM. These results were confirmed by PCR and by flow cytometry analysis for the viral core protein p19. Moreover, treatment with AZT resulted in a decreased expression of CD25 in cultures exposed to HTLV-I as well as in non-infected PBMCs. On the other hand, HLA-DR was down-regulated to a greater extent in drug-treated, virus-exposed cultures in comparison with those not infected. No evidence of the antiviral activity of AZT was observed in PBMC cultures already infected by HTLV-I or in MT-2 cells. These findings demonstrate that treatment with AZT, when given at the time of infection with HTLV-I, has a marked protective effect on PBMCs.