Szajerka Tobiasz, Jablecki Jerzy
Wroclaw Medical University, Wroclaw, Poland.
AIDS Rev. 2007 Oct-Dec;9(4):230-6.
Kaposi's sarcoma is a puzzling condition of unclear, possibly endothelial origin. It is divided into four distinct types regarding the affected population: classic in elder men of Ashkenazi Jewish and Mediterranean origin; endemic in African infants and young males; iatrogenic in patients under immunosuppressive regimens; epidemic in men having sex with men affected by AIDS. The exact etiopathogenesis of Kaposi's sarcoma continues to elude its researchers. Nonetheless, it has been discovered that human herpesvirus 8 is essential but not sufficient for sarcoma development. Also, iron exposure of populations inhabiting regions with volcanic soils has been suggested to play a pivotal role in the classic and endemic Kaposi's sarcoma etiology. The epidemic Kaposi's sarcoma is strongly associated with HIV's detrimental effect on immune system and HIV's Tat protein proangiogenic properties. Because Kaposi's sarcoma is found also in men having sex with men without AIDS, it has been proposed that certain lifestyle features (e.g. massive semen exposure and inhalant nitrites) may promote transformation of endothelial cells of both lymphatic and vascular origin. Despite numerous studies on Kaposi's sarcoma, it continues to be an incurable disease. The therapeutic approach includes local treatment and systemic administration of cytotoxic, immunomodulator and antiviral drugs. Because of the increasing prevalence of Kaposi's sarcoma, especially in certain parts of Africa, a better understanding of this condition is necessary.
卡波西肉瘤是一种病因不明、可能起源于内皮细胞的疑难病症。根据受影响人群，它可分为四种不同类型：经典型见于阿什肯纳兹犹太人和地中海裔老年男性；地方性见于非洲婴幼儿和年轻男性；医源性见于接受免疫抑制治疗的患者；流行型见于感染艾滋病的男同性恋者。卡波西肉瘤的确切发病机制仍然让研究人员捉摸不透。尽管如此，人们已经发现人类疱疹病毒8对肉瘤的发展至关重要，但并不充分。此外，居住在火山土壤地区人群的铁暴露被认为在经典型和地方性卡波西肉瘤的病因中起关键作用。流行型卡波西肉瘤与HIV对免疫系统的有害影响以及HIV的Tat蛋白的促血管生成特性密切相关。由于在未感染艾滋病的男同性恋者中也发现了卡波西肉瘤，有人提出某些生活方式特征（如大量接触精液和吸入亚硝酸盐）可能促进淋巴和血管来源的内皮细胞转化。尽管对卡波西肉瘤进行了大量研究，但它仍然是一种无法治愈的疾病。治疗方法包括局部治疗以及细胞毒性、免疫调节剂和抗病毒药物的全身给药。由于卡波西肉瘤的患病率不断上升，尤其是在非洲的某些地区，有必要更好地了解这种疾病。
