These results demonstrate that expression and subcellular distribution of CD244 and perforin on cytotoxic lymphocytes from HAM/TSP patients was translocated to the contact area (immunological synapse) with CD48+ target cells, suggesting that CD244 on cytotoxic lymphocytes is involved in recognition of target cells or activation of cytotoxic lymphocytes in HTLV-I-infected patients. This evidence concerns the gene CD244 and tropical spastic paraparesis.