鹿児島県における造血器腫ようおよび自己免疫疾患の抗Ａｄｕｌｔ　Ｔ‐ｃｅｌｌ　ｌｅｕｋｅｍｉａ‐ａｓｓｏｃｉａｔｅｄ　ａｎｔｉｇｅｎ（ＡＴＬＡ）抗体の検索 Detection of antibodies to adult T-cell leukemia-associated antigen(anti-ATLA) in the patients with hematologic malignancies and autoimmune disease in Kagoshima district.

HTLV-1 endemic areaである鹿児島地方における造血器腫瘍および自己免疫疾患の抗ATLA抗体陽性頻度を間接螢光抗体法または酵素抗体法を用いて検索した. ATLL (98.3%), Mycosis fungoides (87.5%), Hodgkin's disease (53.3%), RA (22.7%), SLE (25.7%)の抗ATLA抗体陽性頻度は健常者(17.2%)よりも高かった.他疾患は健常者との間に有意差を認めなかった.したがってATLL発症におけるHTLV-1の関与を確認したがmycosis fungoidesおよびHodgkin's diseaseに関しては臨床診断上の問題が残りさらに検討する必要を認めた. SLEおよびRAの抗ATLA抗体陽性頻度を輸血歴の有無により2群にわけて検討すると輸血群ではSLE 60.0%, RA 44.4%,非輸血群ではSLE 12.0%, RA 7.7%であり,輸血によるHTLV-1感染の可能性が示唆された.今回の検索結果からはATLL, mycosis fungoides, Hodgkin's diseaseをのぞく造血器腫瘍,自己免疫疾患においては輸血歴のあるものをのぞき,その抗ATLA抗体陽性頻度は健常者との間に有意差はなかった.

We examined the antibodies to adult T-cell leukemia-associated antigen (anti-ATLA) in the sera from 858 cases of healthy residents, 302 cases with hematologic malignancies and 63 cases of autoimmune disease. Anti-ATLA was detected by the indirect immunofluorescence assay or enzyme linked immunosorbent assay.<br>The positive rate of anti-ATLA was 17.2% (148/858)in healthy residents, 98.3% (174/177) in the patients with adult T-cell leukemia-lymphoma (ATLL), 87.5% (7/8) mycosis fungoides, 53.3% (8/15) Hodgkin's disease, 15.0% (9/60) other lymphoproliferative disorders, 11.9% (5/42) myeloproliferative disorders and 22.2% (14/63) autoimmune disease. The positive rate of anti-ATLA in the patients with ATLL, mycosis fungoides and Hodgkin's disease were significantly differed from that of human T-cell leukemia virus (HTLV-1) healthy carriers in Kagoshima district. However, clinical and pathological diagnosis of mycosis fungoides and Hodgkin's disease was difficult in the ATLL endemic area such as Kagoshima district, so further investigation was needed. While the incidence of anti-ATLA in the patients with other lymphoproliferative disorders and myeloproliferative disorders were not differed from that of HTLV-1 healthy carriers.<br>In autoimmune disease, the positive rate of anti-ATLA in the patients with rheumatoid arthritis (RA) was 22.7% (5/22) and that of systemic lupus erythematosus (SLE) was 25.7% (9/35). Four out of 9 patients with RA and six out of 10 patients with SLE who were found to have had blood transfusion, were positive for anti-ATLA. Then, in these disease, the positive rate of anti-ATLA in the patients without blood transfusion were 7.7% (1/13) and 12.0% (3/25), respectively. From these deta, a possible role of HTLV-1 in the etiology of autoimmune disease was not established.