ETIOLOGY OF KAPOSI'S SARCOMA: ROLE OF CYTOMEGALOVIRUS

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: ROLE OF CYTOMEGALOVIRUS

Kaposi's Sarcoma: Pathophysiology and Clinical Management. Ziegler JL, Dorfman RF, eds. New York, Marcel Dekker, p. 113-28, 1988.. Unique Identifier : AIDSLINE ICDB/89650412
Drew WL; Huang ES; Clinical Microbiology and Infectious Diseases, Mount Zion Hosp.; and Medical Center, San Francisco, CA

Abstract: Evidence linking cytomegalovirus (CMV) to the etiology of Kaposi's sarcoma (KS) is reviewed, including the oncogenic potential of human CMV in vitro, epidemiologic evidence (CMV in renal transplant patients, homosexual men, and iv drug users), and the recent decline in incidence of AIDS-associated KS accompanied by a similar decline in CMV infection among seronegative homosexual men. An etiologic role for CMV in the pathogenesis of KS has yet to be established. Possibilities for a CMV role in KS include the following: (1) the transforming sequences in CMV may immortalize its endothelial target cell in a manner analogous to the transforming effects of Epstein-Barr virus on B lymphocytes; (2) CMV may induce a state of 'insertional mutagenesis' by integrating powerful regulatory genes into the target cell; or (3) CMV may interact with an additional cofactor (eg, angiogenesis factor) to induce its proliferative effects. The failure to detect CMV genome or antigen in all cases of KS has two possible explanations: the virus produces its effects by a 'hit-and-run' mechanism, or the virus has no etiologic relationship in some cases of KS. Other cofactors (eg, genetic predisposition, nitrite abuse, or another virus) must be postulated to interact with CMV-infected endothelial cells to induce a malignant phenotype. (36 Refs)

Keywords: Acquired Immunodeficiency Syndrome/COMPLICATIONS/GENETICS Cell Line, Transformed Cytomegalovirus/GENETICS Cytomegalovirus Infections/*COMPLICATIONS/GENETICS DNA, Viral/GENETICS Gene Expression Regulation Genes, Viral Human HIV/GENETICS RNA, Viral/GENETICS Sarcoma, Kaposi's/*ETIOLOGY/GENETICS Skin Neoplasms/*ETIOLOGY/GENETICS MONOGRAPH REVIEW REVIEW, TUTORIAL

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