Sullivan Ryan, Dezube Bruce J, Koon Henry B
Division of Hematology/Oncology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts 02215, USA.
Curr Opin Oncol. 2006 Sep;18(5):456-62. doi: 10.1097/01.cco.0000239884.05914.13.
AIDS-related Kaposi's sarcoma results from co-infection with HIV and Kaposi's sarcoma herpesvirus/human herpesvirus-8, which leads to the development of an angiogenic-inflammatory state that is critical in the pathogenesis of the condition. Recent discoveries regarding Kaposi's sarcoma herpesvirus/human herpesvirus-8 infection and its activation of signal transduction have led to a greater understanding into Kaposi's sarcoma pathogenesis and have identified potential targets for therapy.
Kaposi's sarcoma is driven by Kaposi's sarcoma herpesvirus/human herpesvirus-8-specific pathways, which include viral G protein-coupled receptor, viral IL-6, and viral chemokine homologues. In addition, cellular growth/angiogenic pathways such as vascular endothelial growth factor, insulin growth factor, platelet-derived growth factor, angiopoietin and matrix metalloproteinases are 'pirated' by Kaposi's sarcoma herpesvirus/human herpesvirus-8. Recent findings show Kaposi's sarcoma herpesvirus/human herpesvirus-8 specific signaling pathways and pirated pathways to be important therapeutic targets.
Numerous advances have been made recently that expand the understanding of Kaposi's sarcoma pathogenesis. These findings and recent clinical trials of targeted therapy for treatment are a prelude to a shift in the paradigm of how AIDS-related Kaposi's sarcoma is managed.
艾滋病相关的卡波西肉瘤是由人类免疫缺陷病毒(HIV)与卡波西肉瘤疱疹病毒/人类疱疹病毒8型(KSHV/HHV-8)共同感染所致,这会导致血管生成性炎症状态的发展,而这种状态在该疾病的发病机制中至关重要。近期关于卡波西肉瘤疱疹病毒/人类疱疹病毒8型感染及其信号转导激活的发现,使人们对卡波西肉瘤的发病机制有了更深入的了解,并确定了潜在的治疗靶点。
卡波西肉瘤由卡波西肉瘤疱疹病毒/人类疱疹病毒8型特异性途径驱动,这些途径包括病毒G蛋白偶联受体、病毒白细胞介素-6和病毒趋化因子同源物。此外,细胞生长/血管生成途径,如血管内皮生长因子、胰岛素生长因子、血小板衍生生长因子、血管生成素和基质金属蛋白酶,也被卡波西肉瘤疱疹病毒/人类疱疹病毒8型“盗用”。近期发现表明,卡波西肉瘤疱疹病毒/人类疱疹病毒8型特异性信号通路和盗用途径是重要的治疗靶点。
最近取得了许多进展,扩展了对卡波西肉瘤发病机制的认识。这些发现以及近期针对该疾病的靶向治疗临床试验,是艾滋病相关卡波西肉瘤治疗模式转变的前奏。