Cannabinoid receptors as new targets for HTLV-1 associated myelopathy (HAM/TSP) treatment

Background/Aim: The roles of endocannabinoids are described in immune modulation and neuroprotection. HTLV-1-associated myelopathy (HAM/TSP) is an inflammatory neurodegenerative disease. Therefore, in this study, the interactions of HTLV-1 regulatory factors and host cannabinoid receptors (CBRs) were evaluated in HAM/TSP. Methods: Nineteen HAM/TSPs, 22 asymptomatic carriers (ACs), and 18 healthy controls (HCs) were enrolled. RNA was extracted from PBMCs and then reverse-transcribed to cDNA. The gene expression of CB1R and CB2R, as well as HTLV-1 proviral load (PVL), Tax and HTLV-1 basic leucine zipper factor (HBZ) were assessed by RTqPCR. Results: The mean expression of CB1R in ACs (8.51 +/- 2.76) was significantly higher than HAMTSPs (1.593 +/- 0.74, p = 0.05) and also HCs (0.10 +/- 0.039, p = 0.001). The CB2R gene expression level in ACs (2.62 +/- 0.44) was significantly higher than HAM/TSPs (0.59 +/- 0.15, p = 0.001) and HCs (1.00 +/- 0.2, p = 0.006). Meanwhile there was a strong correlation between CB1R and CB2R gene expression levels in the HCs and HAM/TSPs (p = 0.001). HTLV-1-Tax expression in HAM/TSPs (386 +/- 104) was higher than ACs (75 +/- 32) and statistically significant (p = 0.003). While HTLV-1-HBZ was only expressed in three AC subjects and five HAM/TSPs, thus it cannot be analyzed. Conclusion: The up-regulation of CB2R has immunomodulatory effects in inflammatory reactions. While CB1R as a neuroprotective agent may suppress inflammatory reactions in ACs, preventing HAM/TSP. It seems that, like multiple sclerosis (MS), cannabinoid medications are beneficial in HAM/TSP.