ABSTRACT
BACKGROUND: The diagnosis of Adult T-cell leukemia/lymphoma ATLL subtypes in human T-lymphotropic virus type I (HTLV-I) carriers based in morphology and immunophenotype of lymphocytes can be challenger. We propose that polymerase chain reaction (PCR) amplification of the rearranged TCR gene in HTLV-I healthy carriers would be a convenient method for establishing the nature of the circulating T lymphocytes in asymptomatic HTLV-I carriers, presenting only mild and inconclusive signals of deviation from normality. METHODS: Using PCR, we analyzed the genetic recombination pattern of the T-cell beta-chain receptor gene (TCR-beta) in order to identify clonal expansion of peripheral blood T lymphocytes in 17 HTLV-I-positive healthy carriers and in nine normal HTLV-I-negative blood donors. To evaluate the performance of PCR in detection of clonality, we also analyzed 18 patients with post-thymic/mature T-cell malignancies presenting circulating abnormal lymphocytes. RESULTS: Seven of the 17 HTLV-I positive individuals presented circulating abnormal lymphocytes; monoclonal or oligoclonal expansion of T-cells was detected in five of the 17 HTLV-I-positive individuals, all of them presenting abnormal lymphocytes. Clonal expansion was not detected in any of the negative controls or in any of the 12 remaining healthy carriers. All patients in the positive control group tested positive by PCR and Southern blots. Southern blots were negative for all 17 healthy carriers. CONCLUSIONS: PCR amplification of segments of rearranged TCR-beta is reliable for allowing early detection of small populations of clonal T cells in blood samples from asymptomatic HTLV-I carriers, providing an additional alert in the follow-up of carriers with abnormal circulating lymphocytes.
Subject(s)
Carrier State/diagnosis , Gene Rearrangement, beta-Chain T-Cell Antigen Receptor/genetics , HTLV-I Infections/diagnosis , HTLV-I Infections/immunology , T-Lymphocytes/pathology , Adult , Blotting, Southern , Carrier State/immunology , Case-Control Studies , Cell Proliferation , Clone Cells , Female , Humans , Leukemia-Lymphoma, Adult T-Cell/immunology , Leukemia-Lymphoma, Adult T-Cell/prevention & control , Male , Middle Aged , Polymerase Chain Reaction , T-Lymphocytes/immunologyABSTRACT
Os anticorpos antifosfolípides têm sido associados a trombose, abortamento e plaquetopenia em portadores de doenças imunológicas com LES. Investigamos a presença de anticorpos contra alguns fosfolípides (PS, PC, PG, PE e cardiolipina) empregando o método de ELISA em 20 portadores de PTI e demonstramos que apenas quatro pacientes (20%) apresentavam pelo menos um desses anticorpos. A baixa freqüência de anticorpos fosfolípides no soro desses pacientes sugere que esses anticorpos näo teriam participaçäo na patogênese da plaquetopenia da PTI e provavelmente o aparecimento de anticorpos antifosfolípides, em alguns casos de PTI, representa um fenômeno secundário à lesäo da membrana plaquetária por anticorpos dirigidos contra antígenos de natureza näo fosfolipídica
