Multifactorial Etiology Of Kaposi's Sarcoma: A Hypothesis

摘要

Kaposi's sarcoma (KS) is the most common cancer among AIDS patients in North America and Europe, and also occurs among elderly Mediterranean men, sub-Saharan African adults and children, and organ transplant recipients. In 1994 Chang et al identified a new herpes virus, HHV-8, as the cause of KS. However, the abrupt onset followed by a steep decline in AIDS-associated KS in the USA suggests HHV-8 is insufficient to induce KS and that additional factors are required. Immunosuppression via HIV, malnutrition, and chemotherapy appears to play a role. In addition, vasoactive agents have been linked to KS in epidemiologic studies and anecdotal reports. Ziegler et al suggest that aluminosilicates from African volcanic soils activate HHV-8 to induce KS. Dermatologists have reported a few patients developing KS after initiating captopril or lisinopril therapy and regression of lesions when therapy discontinued. Several epidemiologic studies, but not all, have demonstrated significant associations between development of AIDS-related KS and use of large quantities on nitrite inhalants; furthermore, nitrites are mutagenic. It may be that KS results from a complex interaction between HHV-8, immunosuppression, and vasoactive agents. More research is needed to evaluate these hypotheses to elucidate the cause(s) of KS.