{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T18:56:28Z","timestamp":1778180188881,"version":"3.51.4"},"reference-count":54,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T00:00:00Z","timestamp":1767916800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T00:00:00Z","timestamp":1767916800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Smart Medicine"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Human T\u2010lymphotropic virus type 1 (HTLV\u20101)\u2010associated myelopathy\/tropical spastic paraparesis (HAM\/TSP) is a chronic neuroinflammatory disease. Given the established role of the gut\u2010brain axis in other neurological diseases such as multiple sclerosis, the role of the gut microbiome in the pathogenesis of HAM\/TSP remains a critical unexplored area. The aim of this study was to characterize alterations in the gut microbiome associated with HTLV\u20101 infection and its clinical stages. We performed a cross\u2010sectional analysis of the gut microbiome from 112 Brazilian individuals, including 24 healthy controls and 88 HTLV\u20101\u2010infected individuals at different disease stages: 38 HAM patients, 17 patients with intermediate syndromes, and 33 asymptomatic carriers. Fecal samples were collected and analyzed using Illumina MiSeq sequencing to assess bacterial composition and diversity. Functional analysis was performed to identify differentially enriched gene categories and Kyoto Encyclopedia of Genes and Genomes (KEGG) modules. Significant dysbiosis was observed in HTLV\u20101\u2010infected individuals, characterized by reduced bacterial diversity, an inverted Firmicutes\/Bacteroidetes ratio, and specific changes in bacterial genera. Notably, HAM patients exhibited decreased\n                    <jats:italic>Faecalibacterium<\/jats:italic>\n                    and increased\n                    <jats:italic>Ruminococcus_g2<\/jats:italic>\n                    abundance. These associations should be interpreted with caution, as patient cohorts were significantly older and differed in sex distribution from healthy controls. Functional analysis revealed 13 differentially enriched gene categories and five KEGG modules that were more abundant in HAM patients, indicating alterations in metabolic processes. These findings provide the first comprehensive insight into gut microbiome changes associated with HTLV\u20101 infection and disease progression. This study provides the first comprehensive insight into gut microbiome changes associated with HTLV\u20101 infection and disease progression. The identified microbial signatures and functional alterations highlight potential diagnostic and therapeutic targets for HTLV\u20101\u2010associated diseases, particularly HAM. These findings open new avenues for further research and clinical applications.\n                  <\/jats:p>","DOI":"10.1002\/smmd.70024","type":"journal-article","created":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T13:12:16Z","timestamp":1767964336000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Gut Microbiome Dysbiosis is Associated With Human T\u2010Lymphotropic Virus Type 1 (HTLV\u20101) Infection and Disease Progression to HTLV\u20101\u2010Associated Myelopathy\/Tropical Spastic Paraparesis: A Cross\u2010Sectional Study"],"prefix":"10.1002","volume":"5","author":[{"given":"Lorena Abreu","family":"Fernandes","sequence":"first","affiliation":[{"name":"Postgraduate Program in Translational Medicine, Department of Medicine Federal University of S\u00e3o Paulo (UNIFESP)  S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana Olivia","family":"de Souza","sequence":"additional","affiliation":[{"name":"Development and Innovation Laboratory Butantan Institute  S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Youko","family":"Nukui","sequence":"additional","affiliation":[{"name":"Department of Hematology, Faculty of Medicine University of S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rosa Maria","family":"Marcusso","sequence":"additional","affiliation":[{"name":"Department of Neurology Emilio Ribas Institute of Infectious Diseases  S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Augusto C\u00e9sar Penalva","family":"de Oliveira","sequence":"additional","affiliation":[{"name":"Department of Neurology Emilio Ribas Institute of Infectious Diseases  S\u00e3o Paulo 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