ETIOLOGY OF KAPOSI'S SARCOMA: ANGIOGENESIS

Important note: Information in this article was accurate in 1989. The state of the art may have changed since the publication date.

ETIOLOGY OF KAPOSI'S SARCOMA: ANGIOGENESIS

Kaposi's Sarcoma: Pathophysiology and Clinical Management. Ziegler JL, Dorfman RF, eds. New York, Marcel Dekker, p. 151-68, 1988.. Unique Identifier : AIDSLINE ICDB/89650414
Ziegler JL; Veterans Administration Medical Center, San Francisco, CA

Abstract: Evidence supporting a link between angiogenesis and the development of Kaposi's sarcoma (KS) is presented under the following headings: oncogenes, the endothelial cell, angiogenic factors (eg, tumor angiogenesis factor, leukemia growth factor, macrophage growth factor, glial growth factor, and endothelial cell growth factor), and endothelial cells and the immune system. Perturbation of the regulatory machinery that governs cell growth and differentiation leads to the stepwise progression to neoplasia. Angiogenic factors are likely to participate in the earliest stages of KS and are perhaps involved in an autocrine manner as the neoplasm progresses. The dynamics of this hypothesis in patients with AIDS are as follows. The earliest event following infection with HIV is pronounced lymphoproliferation. Angiogenic lymphokines provoke local capillary and lymphatic endothelial cell hyperplasia. This propensity may have genetic determinants. In some proliferating endothelial cells, additional cofactors, such as activation of c-sis or another transforming oncogene, confer further growth autonomy. Growing endothelial cells are also subject to normal regulatory restraints exerted in the microenvironment; some proliferating lesions may differentiate, remain stable, or regress. The exact nature and sequence of the transforming events (eg, cytomegalovirus infection, circulating carcinogens, or evasion of immunologic surveillance) are speculative. If angiogenic growth factors play a primary role in the pathogenesis of KS, then measures to counter this process have potential therapeutic value. (58 Refs)

Keywords: Acquired Immunodeficiency Syndrome/COMPLICATIONS Angiogenesis Factor/*PHYSIOLOGY Endothelium, Vascular/PHYSIOPATHOLOGY Gene Expression Regulation Human Lymph Nodes/IMMUNOLOGY Proto-Oncogenes Sarcoma, Kaposi's/GENETICS/IMMUNOLOGY/*PHYSIOPATHOLOGY Skin Neoplasms/GENETICS/IMMUNOLOGY/*PHYSIOPATHOLOGY MONOGRAPH REVIEW REVIEW, TUTORIAL

890430
M8940676

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