Frequency and distribution of herpesvirus-like DNA sequences (KSHV) in different stages of classic Kaposi's sarcoma and in normal tissues from an Italian population
✍ Scribed by Mario Luppi; Patrizia Barozzi; Antonio Maiorana; Guido Collina; M. Grazia Ferrari; Roberto Marasca; Monica Morselli; Elena Rossi; Luca Ceccherini-Nelli; Giuseppe Torelli
- Publisher
- John Wiley and Sons
- Year
- 1996
- Tongue
- French
- Weight
- 739 KB
- Volume
- 66
- Category
- Article
- ISSN
- 0020-7136
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✦ Synopsis
The frequency and distribution of herpesvirus-like DNA sequences (KSHV) were investigated by PCR in the pathologic skin lesions of a series of 22 HIV-negative elderly patients with classic Kaposi's sarcoma (KS) from Italy, one of the few regions of the world where classic KS is prevalent. Viral sequences were clearly identifiable in I 5 cases, in particular in 2 of 5 patch, in 3 of 6 plaque and in 10 of I I nodular lesions. Our findings confirm the association of these herpesvirus-like DNA sequences with KS in unrelated populations, providing evidence of the putative KS-associated agent in all different histologic lesions of the disease, mainly in the nodular stage. The search for other herpesviruses by PCR showed that Epstein-Barr virus (EBV) sequences were present in 7 of 22 pathologic skin lesions. In 4 cases, both EBV and KSHV were present. On the contrary, all 22 classic KS specimens were negative for human herpesvirus-6 sequences. Two of 3 patch and the I nodular lesions from AIDS-related KS patients examined were positive for KSHV but negative for both EBV and HHV-6 sequences. Furthermore, we evaluated the prevalence of KSHV sequences in the normal population of the same geographical area. Thirteen peripheral blood mononuclear cell samples, 9 salivary gland tissues and 6 saliva samples from healthy subjects were invariably found negative for KSHV, using the same PCR technique. Of interest, 2 of I I hyperplastic tonsils harboured these herpesvirus-like sequences, suggesting that, like other herpesviruses, the KSassociated agent may be harboured in a proportion of normal individuals and tonsils may represent at least one of the possible reservoirs of this putative lymphotropic y-herpesvirus in vivo. o 1996 Wiley-Liss, Inc.
Kaposi's sarcoma (KS) is considered an acquired immunodeficiency syndrome (AIDS)-defining condition, associated with the epidemic from the onset in 1981 . In non-AIDS patients, the incidence of KS is 400-to 500-fold increased in the clinical setting of iatrogenic immunosuppression, e.g., in transplant recipients . Furthermore, KS also occurs in an endemic form in central and eastern Africa, while the "classic" form of KS, the first to be described over 100 years ago, is prevalent in certain parts of the world, including Poland, Russia and Italy . In fact, in the period 1976-1984 elevated incidence rates of KS were documented in 9 Italian cancer registries, 2to 3-fold higher than in the United States and Sweden and more than 10-fold higher than in England, Wales and Australia during the same period (Geddes et al., 1995). The epidemiology and clinical behaviour of this disease may vary, but there is no significant difference in the spectrum of typical histologic lesions, evolving from patch to plaque to nodular stages in all of the different clinical forms of KS, suggesting a common pathogenesis.
Epidemiologic information points to the involvement of an infectious agent, preferentially transmitted by sexual contact, in the pathogenesis of KS . KS is common in HIV-positive homosexual men and apparently associated with specific sexual practices among homosexual men with AIDS, while it is virtually absent in haemophiliacs with AIDS . Furthermore, KS is also frequent in HIV-positive women who are sexual partners of bisexual men but uncommon in i.v. drug users with AIDS . The high frequency of KS in HIV-negative homosexual men also sup-