Abstract

Patients with HTLV-1-associated myelopathy (HAM) show increased levels of soluble IL-2 receptor in serum and bronchoalveolar lavage (BAL) fluid in association with T-lymphocyte alveolitis. Furthermore, lymphocytes in peripheral blood and BAL fluid proliferated spontaneously when cultured in vitro. These results indicate that lymphocytes are activated in HAM patients.Erythromycin is an antibacterial drug and has also been shown to act as biological response modifier. In this context, we investigated if erythromycin could suppress the lymphocyte function of HAM patients. Erythromycin (600 mg/day) was administered orally for 2 to 12 months without any side effects. Serum levels of soluble IL-2 receptor and spontaneous proliferation of lymphocytes were decreased in all HAM patients after treatment with erythromycin. An interesting finding was the decrease of lymphocytes in BAL fluid after treatment.Thus, erythromycin may inhibit the infiltration and local proliferation of lymphocytes in target organs such as spinal cord or the lung, although neurological manifestations were not improved satisfactorily.

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