We have surveyed the incidence of adult T-cell leukemia/lymphoma (ATLL) in an endemic area of 290,464 inhabitants for 7 years. We now revise our previous results on the basis of additional findings and estimate the age- and sex-specific cumulative rate for HTLV-I carriers, the adoption of which is recommended by current cancer epidemiology as a new age-standardized incidence rate. An unequivocal age-dependent increase in seroprevalence was observed for both sexes with a characteristic predominance in females. The age-dependent seroconversion in females may be partly explained by additional infection from infected husbands to their wives but the reason for men remains obscure. The mean annual number of incident cases of ATLL was 11.4, giving 3.9 ATLL patients annually per 10(5) inhabitants, 6.1 per 10(5) inhabitants aged over 30, and 85.0 per 10(5) seropositives aged over 30. Crude annual incidence rate of ATLL among 10(5) male seropositives aged over 30 was 145.3 and that for females was 55.2 and 95% confidence intervals of ATLL incidence rates were 34.8 to 255.7 for males and 6.4 to 104.1 for females, respectively. Although the sex ratio of 80 ATLL patients was 1.35, males are more prone to the disease (46 male patients among 4,522 male seropositives aged over 30 vs 34 female patients among 8,801 female seropositives aged over 30; p less than 0.001) for unknown reason(s). Morbidity in male seropositives aged over 30 is 2.6 times as high as that of females. Decennial incidence rates in males in their fifties and sixties were significantly higher than those in females. The remarkable male preponderance in oncogenicity of HTLV-I may be due to the fact that men are more prone to the disease and the number of female carriers in the denominator used to calculate the incidence rate is larger than that of males. The whole life span (0-79) cumulative risk for males was 6.9% and significantly higher than that of females (2.95%).

In order to clarify the cellular tropism of human T-cell leukemia virus type I (HTLV-I) and the effects of HTLV-I infection on T-cell functions, we investigated the infectiousness of HTLV-I on T cells bearing T-cell receptor (TCR) gamma delta and functional alterations of the HTLV-I-infected TCR-gamma delta + T cells. CD3+ CD4-CD8-TCR-gamma delta + T-cell clones which possessed cytotoxicity were co-cultured with a HTLV-I-producing T-cell line. After several weeks, integration of HTLV-I proviral DNA in TCR-gamma delta + T cells was detected by Southern blot analysis. During the continuous culture of HTLV-I-infected TCR-gamma delta + T-cell clones, 2 distinct phases were observed in terms of cytotoxic activity and expression of the CD3-TCR-gamma delta complex. Early after HTLV-I infection, TCR-gamma delta + T cells lost their spontaneous cytotoxicity, but this was restored by the addition of lectin. At this time, no differences were observed in the expression of various surface molecules between HTLV-I-infected and uninfected parent cells, except for increased expression of CD25 on HTLV-I-infected cells. At about 30 weeks after HTLV-I infection, the cytotoxicity of HTLV-I-infected cells was almost completely lost, even in the presence of lectin, and expression of the CD3-TCR-gamma delta complex on the cell surface was markedly decreased. Concomitant with the decreased expression of CD3-TCR-gamma delta complexes, a decrease in the elevation of cytoplasmic Ca2+ concentration induced by anti-CD3 and anti-TCR monoclonal antibodies (MAbs) was also observed. Our present findings thus show that HTLV-I can infect TCR-gamma delta + T cells, and that consequently their functions are profoundly affected through 2 distinct phases.

In an effort to clarify the effect of human T cell leukaemia virus type I (HTLV-I) infection on virus-specific CD8+ cytotoxic T cells, a herpes simplex virus-specific CD8+ cytotoxic T cell clone was infected with HTLV-I in vitro. The cytotoxic activity of the clone was found to have declined early after HTLV-I infection when the expression of T cell receptor-CD3 complex on the cell surface still showed no difference in comparison with that of uninfected parent cells. After 16 weeks of HTLV-I infection, expression of T cell receptor-CD3 complex on HTLV-I-infected clone cells became decreased. This phenomenon is similar to the effect of HTLV-I infection on CD4+ cytotoxic T cells as we previously reported, and suggests that there are common mechanisms of declined cytotoxic activity mediated by both CD4+ and CD8+ cytotoxic T cells following infection with HTLV-I. Such functional alterations of cytotoxic effector cells might be one of the mechanisms underlying immunodeficiency caused by HTLV-I infection.

The ability of B-cell chronic lymphocytic leukemia (B-CLL) cells to present antigen to antigen-specific T cells was investigated. B-CLL cells present herpes simplex virus (HSV) antigen and purified protein derivative (PPD) to HSV- and PPD-specific, interleukin-2-dependent T- cell lines in an antigen-specific manner. Treatment of B-CLL cells with the phorbol ester 12-O-tetradecanoylphorbol-13-acetate (TPA) induced markedly increased levels of HLA-DR expression. TPA-treated B-CLL cells showed substantially more effective presentation, especially at low antigen concentrations, than did untreated B-CLL cells. By coculturing different allogeneic combinations of B-CLL cells and T cells and by adding anti-HLA-DR monoclonal antibody to cultures, it was found that antigen presentation by B-CLL cells was restricted by HLA-DR in the same way as for macrophages. We concluded from these experiments that B- CLL cells have a capacity to serve as antigen-presenting cells in an HLA class II-restricted fashion and that increasing the amount of HLA class II antigen and activation of B-CLL cells resulted in effective antigen presentation.

SUMMARYExpression of CD4 or CD8 on the cell surface is an important guide for discriminating tbe immunoiogical functions of T cells. However, a minor T cell subset, which lacks both CD4 and CD8 molecules but bears the usual form of T cell receptor (TCR) afi (CD4-CD8-TCRa^+ T cells), has recently been found not only in mice but also in humans, and its role in immune response is now of considerable interest. In order to clarify tbe cbaracteristies of this newly defined T eell subpopulation, we established five IL-2-dependent CD4~CD8"TCRa/S+ T cell clones from the peripheral blood of a healthy individual, and examined their various biological functions. It was found that all clones not only helped B cells in immunoglobulin production, but also exerted major histocompatibility complex-unrestricted eytotoxicity. Although their CD3/TCR complexes were functionally competent, the cytotoxicity seemed to be mediated via unknown molecules other than the CD3/TCR complex, as evidenced by the failure of CD3 MoAb to inhibit the cytotoxic activity. Our present findings showed that CD4"CD8'"TCRa^+ T eells possess potential bifunction, i.e. helper and cytotoxic activities. Their roles in the pathogenesis of immunodeficiency are discussed.