| A. Introduction  Since type-C retroviruses are known to be involved in naturally 
              occurring leukemias of many animal species [26], a similar viral 
              etiology has been sought in human leukemias. Some of the animal 
              models provide important insight for consideration of human leukemias. 
              For example, while most virus-induced animal leukemias and lymphomas 
              are associated with abundant virus production in the tumor cells, 
              bovine leukemia virus (EL V), the causative agent of bovine leukemias, 
              was not detected until the leukemic cells were cultured in vitro 
              (see review by Miller and Van Der Maaten [13]). This brings out 
              the importance of long-term culture of the appropriate target cells 
              for virus detection and isolation. In 1976, our laboratory reported 
              the discovery of a factor termed T-cell growth factor (TCGF) [ 15]. 
              Following interaction with an antigen, different subsets of mature 
              T cells respond by making and releasing TCG F or making a receptor 
              to TCG F. The TCG F binds to the receptor-bearing T cells and induces 
              cell growth. Addition of exogenous TCGF can maintain growth of activated 
              mature T cells for long periods [6, 26]. When TCGF was added to 
              T cells obtained from patients with mature T -cell leukemias and 
              lymphomas, some cells directly responded without prior activation 
              in vitro [18]. Some of those samples released a retrovirus which 
              we call human T -cell leukemia-Iymphoma virus (HTL V) ([19, 20]; 
              Popovic et al., in preparation). The morphology of HTL V is typically 
              type c. Figure 1 shows an electron micrograph of some HTL V particles. 
              Like all retroviruses, HTL V contains reverse transcriptase, has 
              a high molecular weight RNA genome, and buds from cell membranes. 
              It is distinct from all other known animal retroviruses [9, 16, 
              22, 23] and to date is the only unequivocal human retrovirus. (The 
              retrovirus later isolated independently in Japan [14, 31] and called 
              ATLV is, in fact, HTL V.) Furthermore, it is specifically associated 
              with certain forms of human leukemia and lymphoma [4]. Here we wish 
              to describe some of the new isolates of HTL V and report on some 
              recent findings on the nature and distribution of HTL V and its 
              transmission to and biological effects on normal T -lymphocytes 
              in vitro. 
 
 
 B. Identification of New HTL V Isolates in Established Cell Lines
 Derived from Patients with T -Cell Leukemias/Lymphomas
 Cell lines derived from patients with leukemia/lymphomas 
              of mature T cells from geographically different parts of the world 
              have been established in culture in the presence of TCGF as described 
              previously for normal mature human T cells [ 15, 26] and neoplastic 
              mature T cells [ 18 ]. These cell lines were analyzed for HTL V 
              by (a) competition radioimmunoprecipitation assay (RIPA) for the 
              major core protein p24 [9], (b) indirect immune fluorescence assay 
              (IF A) using highly specific monoclonal antibody for another HTLV 
              antigen, pl9 [24], (c) reverse transcriptase activity in the culture 
              fluids, and (d) electron microscopy. In addition to the positive 
              cell lines CR [19] and MB [20] published earlier, seven of eight 
              recently established T -cell lines fully expressed HTL V (Table 
              I) and one showed partial expression, These patients include four 
              individuals from the United States, one from Israel, and three from 
              a single Japanese family from the northwest part of the Honshu Island 
              in Japan. In this family, the patient SK with acute T -cell lymphoma 
              (A TL) and both his parents are virus positive. The father (MK) 
              is clinically healthy and the mother has persistent lymphocytosis, 
              which is considered to be a preleukemic state. All cell lines have 
              karyotype and HLA patterns that match those of the donors, and the 
              HLA profiles are different for all eight cell lines. In addition, 
              a T -cell line established by Golde and colleagues from a patient 
              (MO) with hairy cell leukemia [27] was positive vor HTL V p 19 and 
              p24 [II]. We propose to designate each virus isolate with a subscript 
              of the patient's initials, e.g., HTL V CR, HTL V MB, etc. All isolates 
              except HTL V MO are highly related to each other as assayed by competitive 
              radioimmunoassay with p24 (Fig. 2) and hybridization of viral cDNA 
              to mRNA of the producer cell lines (Fig. 3). By these assays, the 
              virus of Japanese A TL is indistinguishable from the prototype HTL 
              V as exemplified by the earlier isolates HTL V CR and HTL V MB. 
              On the other hand, HTL V MO competes poorly in the p24 assay (Fig.2), 
              and nucleic acid sequence homology with HTL V CR was detected only 
              under very nonstringent hybridization conditions ( our unpublished 
              data). Therefore, this virus may form a distinct subgroup in the 
              HTLV family. We propose to group them as HTLV-IcR, etc. versus HTLV-IIMo. 
              
 
 
   
 Fig. I. Electron microscopic examination of
 the cellline MB, showing extracellular and
 budding HTL V particles. Bar represents 90 µ
 
 
 
 
 Table I. Expression of new HTL V isolates in T -cell lines
 derived from patients with adult T -cellleukemia/lymphomas
 
 
  
 a. Detected by competitive radioimmunoprecipitation 
              assay (RIPA) in cell extract
 
 b. Indirect immunofluorescence assay (IFA)
 
 c. Reverse transcriptase activity (RTA) in culture
 fluids was measured with (dT)15(rA)n
 
 
 d. Celllines were derived from peripheral blood (PE) or bone marrow 
              (EM) of different patients as follows. (a) MJ from PB of a 50-yearold 
              white male with mycosis fungoides, from Boston, Massachusetts; (b) 
              UK from PB of a 45-year-old white male with diffuse histiocytic 
              lymphoma, from Jerusalem, Israel; (c) MI from PB of a 32-year-old 
              black female with T -cell lymphosarcoma cell leukemia, from Granada, 
              West Indies; (d) WA from BM ofa 24-year-old black male with diffuse 
              mixed lymphoma, from Augusta, Georgia; (e) PL from PB of a 27-year-old 
              black female with T -cell diffuse mixed lymphoma, from Ovita, Florida; 
              (I) SK from PE ofa 21-year-old male with adult T -cell leukemia, 
              from Akita perlecture, Japan; (g) TK from PB of a 45-yearold female 
              (mother of patient SK) who has 7% abnormal cells in her blood, from 
              Akita perfecture, Japan; and (h) HK from PE of a 49year-old male 
              (father of patient SK) who is normal, from Akita perfecture, Japan.
 
 
 
   
 Fig.2A-C. Homologous and heterologous competition radioimmunoassays 
            of HTL v p24. Assays were carried out as described [9] using l25I-labeled 
            HTL V CR p24 and a limiting dilution of hyperimmune rabbit antibody 
            to HTLV CR or sera from patients MO and MJ. A Competition RIA using 
            rabbit anti-HTL V CR. B Competition RIA using MO serum. C Competition 
            RIA using MJ serum. virus extracts used for competition were: black 
            circle - black circle, HTLV CR; white circle- white circle , HTLV 
            MO; x-x, Mason Pfizer monkey virus; white triangle- white triangle, 
            bovine leukemia virus; white square - white square , Rauscher murine 
            leukemia: black triangle - black triangle, simian sarcoma virus
 
 
 
 
 
   
 Fig.3A-F. Relationship of different HTL V isolates by RNA 
            hybridization. ³H-HTL V (R cDNA was synthesized by calf thymus 
            DNA primer [22] and hybridized to cellular RNA from different HTLVpositive 
            cell lines. Results with the controls with poly(A) + RNA from CR- 
            T (HUT 102) and CR-B cells are superimposed on each panel for comparison 
            with the others
 
 
 
 
 
   
 Fig.4. HTL V proviral DNA in T- but not B-celllines of patient 
            CR, ³H-HTL V cDNA was annealed to cellular DNA from CR-T lymphocytes 
            (black circle), CR-B lymphocytes (black triangle), and PHA-stimulated 
            normal human peripheral blood T -lymphocytes (black square)
 
 
 
 
 C. HTLV Provirus in Neoplastic T Cells: Evidence for Exogenous 
              Infection We had reported earlier that HTL V sequences are present in the 
              infected cells and not in normal uninfected human cells [22], suggesting 
              that HTL V is not an endogenous human virus. In the case of the 
              patient CR, we also had the opportunity to find out whether he was 
              infected pre- or post-zygotically [5]. Several T -cell lines, some 
              clonal derivatives of these lines and a B-cellline have been established 
              from CR. These cells were shown to have originated from the same 
              individual by HLA typing. HTL V proviral DNA was detected in some 
              but not all of the independently established T -cell lines of CR 
              and not in the B cells. An example of the DNA hybridization kinetics 
              is shown in Fig. 4. Furthermore, the surface phenotype OKT3-, OKT4+, 
              and OKT8appears to correlate with the presence of HTL V. These results 
              indicate that HTL V was acquired by CR by horizontal transmission 
              and suggest that only a subtype of T cells is the target for HTL 
              V infection.Recently, molecularly cloned sequences representing the 5' and 3' 
              ends of HTL V have been obtained in our laboratory [12 a]. These 
              clones have been used as probes for Southern hybridization of fresh 
              leukemic DNA from patients with HTL V -positive diseases [30]. These 
              revealed one or few copies of HTL V integrated at a site which is 
              unique for a given patient but varies from patient to patient. DNA 
              from normal people did not contain hybridizing sequences. A similar 
              observation has been made by others [31 ]. These results suggest 
              that the infected cells are of clonal origin, so infection must 
              have occurred prior to disease development. This feature is also 
              found in animal leukemia-Iymphomas induced by chronic leukemia retroviruses.
 
 
 D. Clinical Features of HTL V -Positive Diseases Seroepidemiological studies have identified HTL V -positive patients 
              from many regions of the world with at least three major areas that 
              appear to be endemic: Southwestern Japan [4, 8, 9,25], the Caribbean 
              [I], centraI South America (see also Blattner et al., this volume), 
              but only sporadically in the United States [21 ]. Similar clinical 
              features are found in the diseases associated with these areas, 
              i.e., Japanese adult T -cellleukemia (ATL) and T-cell lymphosarcoma 
              cell leukemia (T- LCL ) in the West Indian Blacks from the Caribbean. 
              Both are represented by an aggressive course an frequent association 
              with lymphadenopathy, hypercalcemia, hepatosplenomegaly, and cutaneous 
              manifestations [2, 28]. The tumor cells are all mature, lack terminal 
              deoxynucleotidyl transferase and express differentiated functions. 
              Typing with monoclonal antibodies as well as functional studies 
              showed that the cells may be either of the helper-inducer or suppressor-cytotoxic 
              phenotype. Histologically, the cells are pleomorphic, often with 
              highly convoluted nuclei. Almost all patients with A TL and T-LCL 
              are HTLV positive. These observations led to the hypothesis that 
              HTL V is associated with a subtype of adult T -cell malignancy which 
              may include an aggressive form of cutaneous T -cell lymphoma (CTCL) 
              found in patients CR and MB. In fact, the presence of HTL V may 
              be of practical importance in disease classification. However, at 
              least two HTL V -positive patients have relatively benign diseases: 
              MJ with Sezary syndrome and MO with T -cell hairy cell leukemia. 
              It should be noted, however, that at least the virus in MO is significantly 
              different from the prototype HTL V.
 
 E. Infection and Transformation of Human Cord Blood T Cells 
              by HTL V In Vitro Seven of the HTL V isolates described above have been successfully 
              transmitted into fresh human cord blood T cells by cocultivation 
              (Popovic et al., in preparation). The virus-positive neoplasic cells 
              used as donors were first treated with mitomycin-C or X-irradiation 
              before cocultivation with recipient cord blood cells. After 4 weeks, 
              assays for T -cell markers, HTL V, karyotype, and HLA-typing were 
              performed. As shown in Table 2, all recipient cord blood are mature 
              T cells, positive for HTL V provirus, and express various levels 
              of HTL V antigens (pI9, p24, and RT). Karyotype and HLA typing consistently 
              matched the recipient cells. Since cord blood T cells from the same 
              donors were consistently negative for HTL V markers and the plasma 
              from their cord blood were also negative for HTL V antibodies, we 
              conclude that the virus was transmitted from HTL V -producing neoplastic 
              T -cell lines into cord blood recipient T cells.To characterize further whether a target for HTL V could represent 
              a certain subset of mature T cells, phenotypes of HTL Vproducing 
              cells were analyzed by a series of monoclonal antibodies specific 
              for helper/ inducer and suppressor/cytotoxic T cells. We found that 
              a majority of HTL V -producing T -cell lines consistently exhibited 
              only helper-inducer phenotype. Two established T -cell lines, SK 
              and TK, both from Japanese patients and two HTL V -infected cord 
              blood T cells (C 1 and C5) revealed "double" phenotype. 
              However, none of the T -cell lines exhibited pure suppressor/cytotoxic 
              phenotype. Unlike HTL V-infected cord blood T cells, PHAstimulated 
              cells (control) consist of 70% helper/inducer and 30% of T cells 
              with suppressor/cytotoxic phenotype. Thus, these data from T -cell 
              phenotype characterization of HTL V -infected T cells again suggest 
              that a certain subset of mature T -cells is the target for HTL V. 
              HTL V infection studies with cord blood cells deprived ofT-cell 
              population with helper/ind ucer of suppressor / cytotoxic phenotype 
              are currently being carried out.
 HTL V -infected cord blood T cells differ from mitogen-stimulated 
              cord blood T cells in several growth properties and cell surface 
              characteristics, the infected cells resembling more the neoplastic 
              cells transformed in vivo by HTL V (see Sarin et al., this volume 
              for details). The most striking feature of HTL V -infected cord 
              blood T cells is their potential for indefinite growth as shown 
              in Fig.5. In contrast, mitogenstimulated cord blood T cells from 
              the same patients consistently exhibited growth "crises" 
              after 1 month in culture, even in the continued presence ofTCGF. 
              Furthermore, the infected cells, like the neoplastic cells, had 
              the tendency to form clumps in culture. When analyzed by electron 
              microscopy, the cells were seen to have convoluted nuclei (not shown) 
              while the mitogen-stimulated cells did not. Another important and 
              reproducible difference is the decrease in requirement for TCGF 
              by the infected cells. In fact, some of the infected cells are completely 
              independent of exogenous TCGF (see Sarin et al., this volume). Other 
              changes of the infected cells include alteration in their HLA profile 
              and expression of receptors for transferrin, TCGF, and HAA (human-activated 
              lymphocyte antigen detected by monoclonal antibodies) in a high 
              percentage of cells. The data indicate that HTL V is also capable 
              of causing morphological transformation of cord blood T cells in 
              vitro (see Sarin et al., this volume).
 
 Table 2. Transmission of HTLV into human cord blood T cells
 
 
   
 
 
 
 
   
 Fig.5. Growth curves of uninfected and HTL V -infected 
              human cord blood T cells in vitro. Left panel, mitogen-stimulated 
              cord blood T cells. Right panel, HTL V -infected cord blood T cells. 
              C6/W A and C7/TK cell lines are primary cocultures (for details 
              see Table 2). C5/MJ cells were obtained in three successive transmissions 
              of HTL V MJ isolate into cord blood cells
 
 
 F. Possible Molecular Mechanism of Transformation by HTL V As mentioned earlier, analysis of HTL V positive leukemic T cells 
              showed that the cells are of clonal origin with respect to the provirus 
              integration sites. In animal systems monoclonality has also been 
              shown to be a common feature of leukemias induced by retroviruses 
              which are chronic leukemia viruses but not those induced by retroviruses 
              which are acute leukemia viruses. Consequently, in spite of its 
              high efficiency to transform T cells in vitro, HTL V probably does 
              not carryon onc gene. Several chronic leukemia viruses are known 
              to induce leukemia by activating cellular onc genes (myc in B-cell 
              lymphomas and erb in erythroleukemias) ([7]; Kung, personal communication) 
              by integrating in the proximity of these genes. Activation of thcse 
              genes is brought about by providing either a viral promotor or viral 
              nucleotide sequences dubbed ""enhancer" [12, 17], 
              the real function of which is still unknown. Since HTL V specifically 
              transforms mature T cells, it is likely to affect expression of 
              genes that are important in T -cell proliferation. A model has been 
              proposed for the mechanism of leukemogenesis by HTL V [4]. Briefly, 
              the HTL V envelope protein interacts with the population ofT cells 
              normally designed to make TCGF receptors, mimicking an antigen stimulation 
              of blastogenesis. These cells then synthesize receptors for TCGF. 
              Simultaneously, the HTLV provirus integrates in the vicinity of 
              the TCGF gene or a gene that exerts a pleiotropic effect on TCGF 
              expression and activates this gene either hy direct promotion or 
              enhancement. The production ofTCGF by a cell bearing a TCGF receptor 
              may result in autostimulation and increased cell proliferation. 
              As an approach to study the gene(s) activated by HTL V infection, 
              we have recently identified and isolated a gene that is expressed 
              at high levels in all HTL V -positive neoplastic T cells and in 
              normal cord blood T cells after infection with HTLV hut not the 
              uninfected counterparts [12 b]. Study of the expression pattern 
              of this gene in uninfcctcd human hematopoietic cells suggests that 
              its expression may be linked to TCGF production. Experiments are 
              in progress to determine if HTL V integrates at a preferred locus 
              in the human chromosome and affects transcription of specific cellular 
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	    "RNA Tumor Viruses and Leukemia: Evaluation of Present Results Supporting their Presence in Human Leukemias", 1976  "Cellular and Virological Studies Directed to the Pathogenesis of the Human Myelogenous Leukemias", 1979Personal Reflections on the Origin of Human Leukemia 1987Human Retroviruses: Linkage to Leukemia and AIDS 1992    |