In HAM/TSP, the expression of proinflammatory cytokines such as IL-1β, TNF-α and IFN-γ is detected in peripheral blood mononuclear cells (PBMCs) as well as in perivascular infiltrating macrophages and microglia in the spinal cords of patients with HAM/TSP [26,27]. Here, TNF is linked to tropical spastic paraparesis.