ciclosporin a proof of concept study in patients with active, progressive htlv-1 associated myelopathytropical spastic paraparesisciclosporin概念验证研究患者的积极,进步htlv 1相关myelopathytropical痉挛性下肢轻瘫.pdfVIP

Ciclosporin A Proof of Concept Study in Patients with Active, Progressive HTLV-1 Associated Myelopathy/ Tropical Spastic Paraparesis 1 2 3 4 4 2 Fabiola Martin *, Hannah Castro , Carolyn Gabriel , Adine Adonis , Alexandra Fedina , Linda Harrison , 2 5 2 4,5 5 Liz Brodnicki , Maria A. Demontis , Abdel G. Babiker , Jonathan N. Weber , Charles R. M. Bangham , Graham P. Taylor4,5 1 Centre for Immunology and Infection, Department of Biology, Hull and York Medical School, University of York, York, United Kingdom, 2 Medical Research Council, Clinical Trials Unit, London, United Kingdom, 3 Department of Neurology, St Mary’s Hospital, London, United Kingdom, 4 National Centre for Human Retrovirology, St Mary’s Hospital, London, United Kingdom, 5 Section of Infectious Diseases, Faculty of Medicine, Imperial College, London, United Kingdom Abstract Introduction: Patients with HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) become progressively impaired, with chronic pain, immobility and bladder, bowel and sexual dysfunction. Tested antiretroviral therapies have not been effective and most patients are offered a short course of corticosteroids or interferon-a, physiotherapy and symptomatic management. Pathogenesis studies implicate activated T-lymphocytes and cytokines in tissue damage. We therefore tested the hypothesis that inhibition of T-cell activation with ciclosporin A would be safe and clinically beneficial in patients with early and/or clinically progressing HAM/TSP. Materials and Methods: Open label, proof