Targeted Interventions in HAM/TSP: Emerging Therapies and Future Directions - A Narrative Review

Area of Science:

• Neurology
• Infectious Diseases
• Immunology

Background:

• Human T-Lymphotropic virus type 1 (HTLV-1) infection causes HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP), a progressive neurological disorder.
• Current HAM/TSP management options have limited efficacy, highlighting the need for novel therapeutic strategies.

Purpose of the Study:

• To review current, historical, and emerging treatment approaches for HAM/TSP.
• To assess the efficacy of various therapeutic interventions for managing HAM/TSP.

Main Methods:

• A comprehensive narrative review of existing literature on HAM/TSP treatments.
• Inclusion of pharmacological, immunological, targeted, and non-pharmacological strategies.

Main Results:

• Current disease-modifying therapies include immunomodulatory agents like corticosteroids and interferon-alpha, with limited efficacy of antiretrovirals.
• Emerging targeted therapies, such as mogamulizumab, show potential in reducing HTLV-1-infected cells and spinal cord inflammation.
• Integrated care involves targeting cellular pathways and non-pharmacological support like physical rehabilitation.

Conclusions:

• Effective HAM/TSP management requires a holistic, multidisciplinary approach.
• Novel interventions and disease-modifying therapies offer promising avenues for treatment.
• High-quality randomized clinical trials are crucial for establishing standard regimens and ensuring long-term efficacy and safety.