Bobroski L, Bagasra A U, Patel D, Saikumari P, Memoli M, Abbey M V, Wood C, Sosa C, Bagasra O
Department of Medicine, Thomas Jefferson University, Jefferson Medical College, Philadelphia, PA 19107, USA.
J Reprod Immunol. 1998 Dec;41(1-2):149-60. doi: 10.1016/s0165-0378(98)00055-2.
Kaposi's sarcoma (KS) is a form of skin cancer, most commonly found in individuals suffering from acquired immunodeficiency syndrome, or AIDS. However, before the worldwide infection of human immunodeficiency virus (HIV), the rare occurrence of KS was confined to two distinct groups of individuals. In the Western world, the classical form of KS was often found in older men (60-70 years of age) from the Mediterranean area. Another form called endemic KS, was found in Equatorial Africa. Currently, the most common cases of KS are found in individuals suffering from AIDS. This is called AIDS-associated KS. Between 30 and 40% of male, homosexual AIDS patients suffer from AIDS-associated KS. KS is also occasionally diagnosed in transplant patients receiving immunosuppressive drugs (to keep their body from rejecting the foreign organ). As opposed to cases of classic and endemic KS, the KS in AIDS patients progresses very quickly, often with a fatal outcome. Human herpesvirus type 8 (HHV-8) has been implicated as the cause of Kaposi's sarcoma (KS), but the exact connection of the virus to the neoplasm is not known. The virus has been detected within the sarcoma skin lesions, but has additionally been seen in peripheral blood cells, semen samples, prostate tissue, and other types of soft tissue tumors. In this study, we evaluated HHV-8 within the skin lesion of KS as well as in semen specimens obtained from HIV-1 infected and uninfected specimens from HIV-1-seronegative individuals. Twenty-eight tissue samples representing AIDS-associated, endemic KS, and six non-KS patients were collected for observation from different centers throughout the world. The tissues were examined utilizing in situ polymerase chain reaction (ISPCR) and hybridization to identify and localize the herpesvirus within the KS lesions. With the use of the sensitive ISPCR technique, HHV-8 DNA was detected in the spindle cells within the nodular skin lesions, as well as in the microvascular endothelial cells which line small vessels within the lesions in all forms of KS. In addition, we analysed semen specimens from HIV-1 infected and uninfected men, our analyses revealed that HHV-8 was present in the significant proportions of the HIV-1-infected-individuals' sperm, as well as in the mononuclear cells of the semen specimens. HHV-8 DNA was demonstrated, by ISPCR, in KS lesions as well as in seminal mononuclear cells and sperm of significantly high proportion of HIV-1-infected men. What role the presence of HHV-8 in the sperm cells plays in the sexual transmission of this herpesvirus will require further study. However, the reports which demonstrate that KS lesions can develop in infants of only a few weeks of age, increases the possibility that this agent may be vertically transmitted. It can be suggested that HHV-8 is relatively ubiquitous and its frequency increases with the increasing immunosuppression.
卡波西肉瘤(KS)是一种皮肤癌,最常见于患有获得性免疫缺陷综合征(AIDS,艾滋病)的个体。然而,在人类免疫缺陷病毒(HIV)全球感染之前,KS的罕见病例局限于两个不同的人群。在西方世界,经典型KS常见于来自地中海地区的老年男性(60 - 70岁)。另一种称为地方性KS的类型,见于赤道非洲。目前,KS最常见的病例见于患有艾滋病的个体。这被称为艾滋病相关KS。30%至40%的男性同性恋艾滋病患者患有艾滋病相关KS。KS偶尔也在接受免疫抑制药物(以防止身体排斥异体器官)的移植患者中被诊断出来。与经典型和地方性KS病例不同,艾滋病患者中的KS进展非常迅速,往往导致致命后果。人类疱疹病毒8型(HHV - 8)被认为是卡波西肉瘤(KS)的病因,但该病毒与肿瘤的确切联系尚不清楚。该病毒已在肉瘤皮肤病变中被检测到,但也在周围血细胞、精液样本、前列腺组织和其他类型的软组织肿瘤中被发现。在本研究中,我们评估了KS皮肤病变以及从HIV - 1感染和未感染的HIV - 1血清阴性个体的精液标本中的HHV - 8。从世界各地不同中心收集了28份代表艾滋病相关、地方性KS的组织样本以及6份非KS患者的组织样本用于观察。利用原位聚合酶链反应(ISPCR)和杂交技术对组织进行检查,以识别和定位KS病变内的疱疹病毒。使用敏感的ISPCR技术,在所有类型KS的结节性皮肤病变中的梭形细胞以及病变内小血管内衬的微血管内皮细胞中检测到了HHV - 8 DNA。此外,我们分析了HIV - 1感染和未感染男性的精液标本,我们的分析显示,HHV - 8存在于相当比例的HIV - 1感染个体的精子以及精液标本的单核细胞中。通过ISPCR在KS病变以及相当比例的HIV - 1感染男性的精液单核细胞和精子中证实了HHV - 8 DNA。HHV - 8在精子细胞中的存在在这种疱疹病毒的性传播中起什么作用尚需进一步研究。然而,有报告表明仅几周大的婴儿也会发生KS病变,这增加了这种病原体可能垂直传播的可能性。可以认为HHV - 8相对普遍存在,并且其频率随着免疫抑制的增加而升高。