OVER EXPRESSION OF MMP9 AND TIMP3 CORRELATED WITH NEOPTERIN LEVEL IN THE CSF OF TSP/HAM PATIENTS AND NOT ASYMPTOMATIC CARRIERS.

P155 Pathomechanism of TSP/HAM is not yet clearly understood. Infected/activated T-cells infiltrating lesions are thought to be implicated in physiopathology. Using a model of interaction of glial cells with HTLV-I T-lymphocytes we previously observed an altered expression of matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs) in astrocytes objectived by induction of MMP9 expression. This one was further detected in some cerebrospinal fluids from TSP/HAM patients. Objectives: The aim of the present study was to compare the expression of MMP9, TIMP1, TIMP3 and Neopterin level in the CSF from 32 TSP/HAM patients and 29 HTLV-I asymptomatic carriers (AC). Results: Using zymography, MMP9 was detected in 84% TSP/HAM versus 24% AC. Using Western-Blotting TIMP3 was detected in 75% TSP/HAM versus 15% AC. The more frequent detection of MMP9 (×3.5) and TIMP3 (×5) in the CSF from TSP/HAM patients presumably reflects intense cell remodelling and inflammation within CNS. As expected, neopterin level, a marker of cell-immune mediated inflammation, was higher in TSP/HAM (63% patients >10 nmol/L) than in AC (0% patients >10nmol/L). In TSP/HAM, inflammation revealed by high neopterin level (>10nmol/L) correlated the presence of MMP9 (94%) and TIMP3 (100%). Moreover, global examination of the HTLV-I positive group suggested that MMP9 in CSF may be a more discriminative marker than neopterin for TSP/HAM diagnosis since MMP9 positivity was found in 81% TSP/HAM while neopterin pathological level (>3 nmol/L) was found in 71% TSP/HAM. Conclusion: Since detection of MMP9 by zymography is less challenging than neopterin detection by HPLC and results conclusive, we propose MMP9 as a possible alternative marker helping in TSP/HAM diagnosis.