African Kaposi Research Articles

Antibody epitope profiling of the KSHV LANA protein using VirScan.

The humoral antibody response against Kaposi sarcoma-associated herpesvirus (KSHV) in infected individuals has been characterized demonstrating the latency-associated nuclear antigen (LANA) as the most antigenic KSHV protein. Despite the antigenicity of the protein, specific LANA epitopes have not been systematically characterized. Here, we utilized a bacteriophage T7 library, which displays 56-amino acid KSHV LANA peptides with 28-amino acid overlap (VirScan), to define those epitopes in LANA targeted by antibodies from a cohort of 62 sub-Saharan African Kaposi sarcoma (KS) patients and 22 KSHV-infected asymptomatic controls. Intra- and inter-patient breadth and magnitude of the anti-LANA responses were quantified at the peptide and amino acid levels. From these data, we derived a detailed epitope annotation of the entire LANA protein, with a high-resolution focus on the N- and C-termini. Overall, the central repeat region was highly antigenic, but the responses to this region could not be confidently mapped due to its high variability. The highly conserved N-terminus was targeted with low breadth and magnitude. In a minority of individuals, antibodies specific to the nuclear localization sequence and a portion of the proline-rich regions of the N-terminus were evident. In contrast, the first half of the conserved C-terminal domain was consistently targeted with high magnitude. Unfortunately, this region was not included in LANA partial C-terminal crystal structures, however, it was predicted to adopt predominantly random-coil structure. Coupled with functional and secondary structure domain predictions, VirScan revealed fine resolution epitope mapping of the N- and C-terminal domains of LANA that is consistent with previous antigenicity studies and may prove useful to correlate KSHV humoral immunity with pathogenesis.

Une présentation cutanée inhabituelle de la maladie de Kaposi: un nodule plantaire solitaire

Kaposi's disease is a polyclonal tumor originating by chronic proliferations of Human Herpesvirus-8 (HHV-8) infected fusiform and endothelial cells. Endemic or african Kaposi's disease manifests in adults as angiomatous or pigmented nodules, macules or patches associated with bilateral lymphoedema of the legs and feet. We here report a case of epidemic Kaposi’s disease in an adult patient who presented with an unusual clinical manifestation of the disease: a solitary fleshy plantar nodule. The study involved a 68-year-old woman come to consultation in the department of dermatology with a painless plantar nodule, sometimes bleeding after trauma, which had evolved over the previous year. Physical examination showed a single rounded, angiomatous plantar nodule, measuring 3 cm along its longer axis, surrounded by a desquamative crown. The remainder of the physical examination was normal. Diagnostic hypotheses included eccrine poroma, botryomycoma and achromic melanoma. Complete excisional biopsy of the nodule was performed. Histological examination of the specimen showed tumor proliferation of fusiform cells associated with neocapillaries. This suggested Kaposi's disease. Immunostaining could not be performed as it was not available in our working environment. Our case is original because of an unusual clinical manifestation of epidemic Kaposi's disease, a solitary plantar nodule, that can be confused with botryomyoma and eccrine poroma.

Malignant Cutaneous Tumors

This chapter reviews the most common malignant cutaneous tumors. The section on malignant tumors of the epidermis discusses nonmelanoma skin cancer (i.e., basal cell carcinoma and squamous cell carcinoma) and malignant melanoma. The section on malignant tumors of the dermis covers metastatic tumors, primary tumors (Merkel cell carcinoma, Paget disease, extramammary Paget disease, angiosarcoma, and dermatofibrosarcoma protuberans), and Kaposi sarcoma (i.e., classic Kaposi sarcoma, African Kaposi sarcoma, organ-transplant Kaposi sarcoma, and HIV-associated Kaposi sarcoma). The final section covers cutaneous lymphomas. The coverage of each disease includes a discussion of epidemiology, etiology, diagnosis, differential diagnosis, treatment, and prognosis. Tables provide the adjusted estimated relative risks of melanoma by nevus type and number, the American Joint Committee on Cancer (AJCC) TNM classification and staging system, the estimated probability of 10-year survival in patients with primary cutaneous melanoma, and an overview of overview of therapy for cutaneous T cell lymphoma. Figures illustrate the presentation of many malignant cutaneous tumors. This review contains 10 highly rendered figures, 5 tables, and 105 references.

Malignant Cutaneous Tumors

This chapter reviews the most common malignant cutaneous tumors. The section on malignant tumors of the epidermis discusses nonmelanoma skin cancer (i.e., basal cell carcinoma and squamous cell carcinoma) and malignant melanoma. The section on malignant tumors of the dermis covers metastatic tumors, primary tumors (Merkel cell carcinoma, Paget disease, extramammary Paget disease, angiosarcoma, and dermatofibrosarcoma protuberans), and Kaposi sarcoma (i.e., classic Kaposi sarcoma, African Kaposi sarcoma, organ-transplant Kaposi sarcoma, and HIV-associated Kaposi sarcoma). The final section covers cutaneous lymphomas. The coverage of each disease includes a discussion of epidemiology, etiology, diagnosis, differential diagnosis, treatment, and prognosis. Tables provide the adjusted estimated relative risks of melanoma by nevus type and number, the American Joint Committee on Cancer (AJCC) TNM classification and staging system, the estimated probability of 10-year survival in patients with primary cutaneous melanoma, and an overview of overview of therapy for cutaneous T cell lymphoma. Figures illustrate the presentation of many malignant cutaneous tumors. This review contains 10 highly rendered figures, 5 tables, and 105 references.

Malignant Cutaneous Tumors

This chapter reviews the most common malignant cutaneous tumors. The section on malignant tumors of the epidermis discusses nonmelanoma skin cancer (i.e., basal cell carcinoma and squamous cell carcinoma) and malignant melanoma. The section on malignant tumors of the dermis covers metastatic tumors, primary tumors (Merkel cell carcinoma, Paget disease, extramammary Paget disease, angiosarcoma, and dermatofibrosarcoma protuberans), and Kaposi sarcoma (i.e., classic Kaposi sarcoma, African Kaposi sarcoma, organ-transplant Kaposi sarcoma, and HIV-associated Kaposi sarcoma). The final section covers cutaneous lymphomas. The coverage of each disease includes a discussion of epidemiology, etiology, diagnosis, differential diagnosis, treatment, and prognosis. Tables provide the adjusted estimated relative risks of melanoma by nevus type and number, the American Joint Committee on Cancer (AJCC) TNM classification and staging system, the estimated probability of 10-year survival in patients with primary cutaneous melanoma, and an overview of overview of therapy for cutaneous T cell lymphoma. Figures illustrate the presentation of many malignant cutaneous tumors. This review contains 10 highly rendered figures, 5 tables, and 105 references.

Sarcoma de Kaposi lingual. Rara variante en paciente VIH positivo. A propósito de un caso.

Kaposi's sarcoma is a vascular lesion of intermediate-grade malignant potential affecting skin, mucosa, lymph nodes, and viscera. Four clinical variants have been recognized: classic, African Kaposi sarcoma, immunosuppression-associated Kaposi sarcoma and AIDS-associated Kaposi sarcoma. Human herpes virus type 8 is implicated as the etiological agent in all of them. We present a 39-year-old man with a history of pulmonary tuberculosis under treatment, and two months of evolution HIV / AIDS, with a lympangiomatous Kaposi sarcoma in an atypical location. Keywords: Kaposi's sarcoma; HIV; HHV-8; vascular neoplasia; lymphangioma-like Kaposi sarcoma.

Sarcoma de Kaposi y angiosarcoma cutáneo: directrices para el diagnóstico y tratamiento

Kaposi sarcoma is a vascular sarcoma with 4 clinical variants: classic Kaposi sarcoma, which mainly affect the extremities of elderly patients and follows a chronic, generally indolent course; African Kaposi sarcoma; immunosuppression-associated Kaposi sarcoma; and AIDS-associated Kaposi sarcoma. Type8 human herpesvirus is the etiologic agent in all 4variants. Cutaneous angiosarcoma is a cutaneous neoplasm with a very poor prognosis. It carries a high probability of local relapse and has a 10% to 15% survival rate at 5years. There are 3 main variants of cutaneous angiosarcoma: idiopathic angiosarcoma of the face and scalp; Stewart-Treves syndrome; and postradiation angiosarcoma. The only potentially curative treatment is surgery with or without radiotherapy. However, its indistinct borders and multicentric nature mean that treatment is often palliative with chemotherapy, radiotherapy, or both.

Therapeutic efficacy of topical timolol for treatment of African endemic Kaposi sarcoma of the penis

Therapeutic efficacy of topical timolol for treatment of African endemic Kaposi sarcoma of the penis

African Kaposi's sarcoma in the light of global AIDS: antiblackness and viral visibility.

Drawing on the theoretical frameworks of antiblackness and intersectionality and the concept of viral visibility, this essay attends to the considerable archive of research about endemic Kaposi's sarcoma (KS) in sub-Saharan Africa accrued during the mid-20th century. This body of data was inexplicably overlooked in Western research into KS during the first decade of the AIDS epidemic, during which period European and Mediterranean KS cases were most often cited as precedents despite the volume of African data available. This paper returns to the research on KS conducted in Africa during the colonial and postcolonial period to consider visibility, racial erasure, and discourses of global epidemiology, suggesting that the dynamics of medical research on HIV/AIDS have proceeded according to a tacit paradigm of antiblackness manifest in multiple exclusions of Africa from global health agendas--most recently the exclusion of the region from antiretroviral (ARV) drug therapy during the first decades of the treatment's availability. During that decade KS all but disappeared among people with access to ARV therapy while KS became even more prevalent in sub-Saharan Africa, escalating along with HIV.

Endemic (African) Kaposi sarcoma: Presenting as pathological fracture of left tibia and fibula

Kaposi sarcoma is a malignant vascular tumour of multifocal origin from undifferentiated vasoformative spindle cell. It presents frequently as cutaneous lesions, and musculoskeletal involvement is rare. Presented is a 52-year-old male farmer with inability to walk and pain of two months duration with cutaneous lesion noticed 3 years prior to presentation. Clinical, radiological and histopathological evaluation revealed cutaneous Kaposi sarcoma with a rare complication of pathological fracture of the left tibia and fibula with dystrophic calcification of the adjoining soft tissue. He had cytotoxic chemotherapy with poor outcome in cutaneous and skeletal lesions. Kaposi sarcoma if neglected presents with significant morbidity. Health promotion on early presentation and diagnosis are recommended for improved outcome.

African Kaposi Sarcoma – Florid Lesions in a Nigerian Male in South Eastern Equatorial Rain Forest: A Case Report.

Endemic African Kaposi sarcoma is a clinically and epidemiologically distinct human immunodeficiency virus negative form of Kaposi sarcoma (KS) occurring in Africa. This condition runs a variable clinical course ranging from minimal-florid cutaneous disease to extensive organ involvement. We present this seronegetive patient with peculiar and striking florid chemo-sensitive cutaneous lesions with good response in patient performance post chemotherapy. Kaposi sarcoma is chemo-sensitive and should be offered to patients as cutaneous KS lesions may be disfiguring and often generate significant psychological distress. Nigerian Medical Practitioner Vol. 50 (3&4) 2006: pp. 72-76

Kaposi's sarcoma in a hospital setting in Lomé (Togo): a study of 93 cases

To define the epidemiologic and clinical profile and course of the disease in African Kaposi's sarcoma (KS) and acquired immunodeficiency syndrome (AIDS)-associated KS in Togo. This was a retrospective study performed on the medical records of patients seen at the Department of Dermatology, University Hospital of Lomé, Togo from January 1994 to December 2004. The medical records of all patients with KS, who had undergone human immunodeficiency virus (HIV) serology, were included in the study. Ninety-three files on 98 patients with KS, who had undergone HIV serology, were included in the study. The annual incidence during the study period was 8.5. HIV serology was positive in 73 patients (78.5%) and negative in 20 patients (21.5%). The mean age of the patients with AIDS-associated KS was 33.8 +/- 8.2 years, and 49.5 +/- 15.8 years for African KS. The male to female ratio for AIDS-associated KS was 1.4, and 9 for African KS. The mortality rate at 2 years for African KS was 5%, and 45% for AIDS-associated KS. The low level of access to antiretroviral drugs in HIV-infected patients explains the morbidity and mortality from AIDS-associated KS in Togo.

C-Kit (CD117) Expression in AIDS-Related, Classic, and African Endemic Kaposi Sarcoma

Kaposi sarcoma (KS) is a multicentric vascular neoplasm characterized histologically by the progressive proliferation of spindle-shaped tumor cells in all epidemiologic (AIDS-related, classic, endemic, and iatrogenic) forms. Human herpesvirus 8 (HHV8) is associated with all epidemiologic forms of KS and has been shown in vitro to induce the tyrosine receptor kinase c-kit in HHV8-infected cells. To date, c-kit immunoreactivity has not been systematically studied in KS lesions. Therefore, the aim of this study was to evaluate c-kit expression by immunohistochemistry in different proliferative stages and epidemiologic forms of KS. Archival cases of formalin-fixed, paraffin-embedded KS lesions, including 9 classic, 11 AIDS-related, and 15 African (endemic) forms at various histologic stages (5 patch, 8 plaque, 22 nodular), biopsied from different sites, were stained using immunohistochemistry with antibodies to HHV8 (LNA-1) and c-kit (CD117). C-kit immunoreactivity of lesional cells was demonstrated in 15 (43%) cases overall. A total of five (56%) classic, five (45%) AIDS-related, and five (33%) endemic KS cases were positive for c-kit. There was no difference in the intensity of c-kit staining between the different epidemiologic groups and histologic stages of KS. HHV8 (LNA-1) immunoreactivity was present in all (100%) classic, 10 (91%) AIDS-related, and 9 (60%) endemic cases. LNA-1 staining was demonstrated in 13 (93%) of the c-kit-positive and 15 (75%) of the c-kit-negative KS lesions. These findings indicate that c-kit expression in lesional cells can be detected by immunohistochemistry in different epidemiologic forms and histologic stages of KS. Furthermore, the expression of c-kit does not correspond with the presence of HHV8 (LNA-1) immunoreactivity in KS lesions.

The clonality of tumor-infiltrating lymphocytes in African Kaposi's sarcoma.

African Kaposi's sarcoma (KS) lesions contain human herpesvirus-8 (HHV-8) and Epstein-Barr virus (EBV), both of which are associated with various types of non-Hodgkin's lymphomas and are known to produce several factors suspected of lymphomagenic potential. The aim of this study was to evaluate tumor-infiltrating lymphocytes for the evidence of clonal expansion in African KS. We used polymerase chain reaction (PCR)-based assays to determine the clonality of tumor-infiltrating lymphocytes in African KS lesions and compared the results to similar studies of patient-matched uninvolved skin and peripheral blood. T cells were polyclonal in all samples tested. Peripheral blood B cells were also polyclonal; however, a minority of lesional and uninvolved skin samples exhibited evidence of restricted B-cell clonality. Correlation with immunohistological analysis revealed that this clonal B-cell restriction was secondary to the sparse nature of lesional B cells rather than their clonal overgrowth. We conclude that, despite the putative lymphomagenic potential of HHV-8 and EBV and their co-existence in African KS lesions, tumor-infiltrating lymphocytes in these cases do not show evidence of clonal expansion that might be an early manifestation of lymphoma. Nevertheless, these studies are a case in point that sparse lymphoid subpopulations in lesional and uninvolved extranodal tissues can give rise to restricted clonal patterns that must be interpreted carefully to avoid the misdiagnosis of occult lymphoma.

Expression of HHV-8 latency-associated T0.7 RNA in spindle cells and endothelial cells of AIDS-associated, classical and African Kaposi's sarcoma.

Analysis by polymerase chain reaction (PCR) and serological studies have demonstrated a close association between the novel human herpes virus, Kaposi's sarcoma-associated herpes virus (KSHV) or human herpes virus-8 (HHV-8) and the development of Kaposi's sarcoma (KS). To clarify the role of HHV-8 in KS pathogenesis, we investigated at the cellular level by in situ hybridization the expression of a recently described 0.7-kb HHV-8-encoded mRNA (T0.7 mRNA) in KS tissues of different epidemiological origin (AIDS-KS, African endemic KS and classical KS). The T0.7 mRNA likely encodes a small membrane protein, supposedly expressed in latently HHV-8-infected cells. Indeed, we detected T0.7 mRNA in virtually all cells of the cell line BCBL-1 established from a body cavity-based lymphoma (BCBL) and latently infected with HHV-8. In all KS biopsies examined, independent of their epidemiological type, the late-stage (nodular) KS tissues showed a high level of T0.7 mRNA expression in typical KS spindle cells but also in endothelial cells lining blood vessels, indicating latent HHV-8 infection of these cells. The presence of T0.7-expressing cells was restricted to KS tumor tissue and therefore appears to indicate an important role of latent HHV-8 infection in KS pathogenesis.

Expression of HHV‐8 latency‐associated T0.7 RNA in spindle cells and endothelial cells of AIDS‐associated, classical and African Kaposi's sarcoma

Analysis by polymerase chain reaction (PCR) and serological studies have demonstrated a close association between the novel human herpes virus, Kaposi's sarcoma-associated herpes virus (KSHV) or human herpes virus-8 (HHV-8) and the development of Kaposi's sarcoma (KS). To clarify the role of HHV-8 in KS pathogenesis, we investigated at the cellular level by in situ hybridization the expression of a recently described 0.7-kb HHV-8-encoded mRNA (T0.7 mRNA) in KS tissues of different epidemiological origin (AIDS-KS, African endemic KS and classical KS). The T0.7 mRNA likely encodes a small membrane protein, supposedly expressed in latently HHV-8-infected cells. Indeed, we detected T0.7 mRNA in virtually all cells of the cell line BCBL-1 established from a body cavity-based lymphoma (BCBL) and latently infected with HHV-8. In all KS biopsies examined, independent of their epidemiological type, the late-stage (nodular) KS tissues showed a high level of T0.7 mRNA expression in typical KS spindle cells but also in endothelial cells lining blood vessels, indicating latent HHV-8 infection of these cells. The presence of T0.7-expressing cells was restricted to KS tumor tissue and therefore appears to indicate an important role of latent HHV-8 infection in KS pathogenesis. Int. J. Cancer 72:68–71, 1997. © 1997 Wiley-Liss Inc.

The spectrum of African Kaposi's sarcoma: is it consequential upon diverse immunological responses?

Kaposi's sarcoma (KS) is a complex, multicellular growth, the pathogenesis of which remains unclear. Endemic African Kaposi's Sarcoma (KS) is characterized by its epidemiological peculiarities, protean clinical manifestations and an unpredictable natural history. A wide spectrum of clinical manifestations occurs, although the reasons for the heterogeneity remain unclear. Clinical observations in the presentation of human immunodeficiency virus (HIV)-associated epidemic African KS show a considerable overlap with endemic African KS obscuring the conventional binomial concept of African KS which was developed in light of the HIV epidemic. It is probable that once the KS lesions are expressed clinically, the subsequent spectrum and behaviour of all forms of African KS are consequential upon a complex interplay between the nature of the host cell-mediated immune responses and the putative aetiological factor(s).

Chemotherapy for AIDS-related and endemic African Kaposi's sarcoma in southern Africa.

Kaposi's sarcoma (KS), either in its endemic (African) form or its AIDS-related variant, is a common neoplastic disorder seen in Southern Africa. Chemotherapy has been proven to be very effective in advanced or relapsed African Kaposi's sarcoma, but much less so in AIDS-related, endemic KS. The study consists of a retrospective analysis of the results of chemotherapy alone in 17 patients with African KS (AKS) and in 32 patients with epidemic AIDS-related KS (EKS), treated at the Johannesburg General Hospital between 1982 and 1992. Single agents included vinblastine, actinomycin D, bleomycin, and vincristine; combined regimens were largely doxorubicin/vincristine/bleomycin or etoposide/methotrexate. Outcome classifications were: complete remission (CR), partial remission (PR), and treatment failure (TF). Four of the 17 patients with AKS had CR, 10 a PR, and three were TF and died rapidly from their disease. The combined chemotherapeutic regimens produced marked symptomatic relief and even long-term remission in AKS. In patients with EKS, the response rate to chemotherapy was very low and of brief duration. No patient had a CR and debilitating side effects were common. The African type of AKS is a chemo-sensitive tumor, whereas the endemic type EKS, like its Western counterpart, has a dismal prognosis.

CLINICAL CLASSIFICATION OF AFRICAN KAPOSI'S SARCOMA: TIME FOR REAPPRAISAL

International Journal of DermatologyVolume 34, Issue 3 p. 166-167 CLINICAL CLASSIFICATION OF AFRICAN KAPOSI'S SARCOMA: TIME FOR REAPPRAISAL PATRICK MATONDO M.B., Ch.B., Corresponding Author PATRICK MATONDO M.B., Ch.B. From the University Teaching Hospital, Lusaka, Zambia.Address for correspondence: Patrick Matondo, M.B., Ch.B., Northwick Park Hospital, Genitourinary Medicine, Harrow, Middlesex, HA1 3UJ, England.Search for more papers by this author PATRICK MATONDO M.B., Ch.B., Corresponding Author PATRICK MATONDO M.B., Ch.B. From the University Teaching Hospital, Lusaka, Zambia.Address for correspondence: Patrick Matondo, M.B., Ch.B., Northwick Park Hospital, Genitourinary Medicine, Harrow, Middlesex, HA1 3UJ, England.Search for more papers by this author First published: March 1995 https://doi.org/10.1111/j.1365-4362.1995.tb01558.xCitations: 3AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article.Citing Literature Volume34, Issue3March 1995Pages 166-167 RelatedInformation

Radiation therapy in endemic (african) Kaposi's sarcoma (EKS) — a retrospective study

Radiation therapy in endemic (african) Kaposi's sarcoma (EKS) — a retrospective study