Second International Congress Drug Therapy in HIV Infection 18-22 November 1994 Glasgow, UK

PATHOGENESIS AND AETIOLOGY OF KAPOSI SARCOMA

Robin A. Weiss
Institute of Cancer Research, Chester Beatty Laboratories, 237 Fulham Road, London SW3 6JB, U.K.

Int Cong Drug Therapy HIV 1994 Nov 18-22;2:Abstract No. 13.1
AIDS 1994, Vol. 8 (Suppl. 4);S10

Kaposi sarcoma (KS) has attracted attention owing to its association with acquired immune deficiency syndrome (AIDS). Before AIDS, KS was endemic in East Africa and occurred sporadically among people of Eastern and Southern European origin, especially in transplant patients. Thus immunosuppression is likely to be a common factor in the pathogenesis of KS. The high frequency of KS in homosexuals with AIDS but its virtual absence in haemophiliacs with AIDS indicates that an aetiological agent other than human immunodeficiency virus (HIV) may be the underlying cause of KS. HIV-induced immunosuppression may then allow the development of KS in individuals already infected with a KS agent. An alternative view is that KS is not in itself transmissible, but that HIV proteins, especially tat, trigger a cytokine cascade inducing the lesion. However, the two mechanisms are not mutually exclusive.

Kaposi sarcoma is a proliferative lesion of endothelial cells and spindle cells. The origin of the spindle cells is not clear; they may develop from the capillary endothelium or from the smooth muscle cells surrounding it. KS does not appear to be a clonal malignancy, except possibly in some late stage, highly aggressive forms. Rather, it resembles a hyperplastic state in which cellular proliferation is driven by local autocrine and paracrine signals. Endocrine influences may also be manifest, as individual KS lesions often appear in crops on the skin. Moreover, in non-AIDS KS there is a 10:1 ratio of incidence in men to women.

Presenting author: Robin A. Weiss

1994-11-18
13.1

Originally published in AIDS Volume 8, Supplement 4 and hosted with permission of the publisher Lippincott Williams & Wilkins, 250 Waterloo Road, London, SE1 8RD, UK. Tel: +44 (0)20 7981 0700 Fax: +44 (0) 7981 0701

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