[Demonstration of complex dysregulation of anti-cytomegalovirus T-cellular immunity in Kaposi's sarcoma following renal transplantation].
An increased incidence of Kaposi's sarcoma is well known in renal transplant recipients in whom it may represent up to 3 p. 100 of all de novo tumours. This sarcoma has a close relationship with the potential oncogenicity of the cytomegalovirus (CMV) and with chronic immunological deficiency. Anti-CMV immunity is based on the integrity of cytotoxic cellular functions such as those of cytotoxic T lymphocytes (CTL), "natural killers" cells, and K cells which function in the antibody-dependent cell cytotoxicity (ADCC) system. Two cases of Kaposi's sarcoma were observed out of a total of 700 renal transplant recipients; they underwent the following investigations: lymphocyte sub-group counts by murine monoclonal antibodies, lymphocyte proliferation to lectins and allogenic cells, NK activity and generation of specific auxiliary and cytotoxic anti-CMV cells. Both cases of Kaposi's sarcoma were seropositive for CMV and seronegative for LAV. In one case, an abnormal number of peripheral OKT9 + lymphocytes (normally a thymocytic marker) was observed with small numbers of OKT4/OKT8, a reduced proliferative response to mitogens and allogenic cells. All these in vitro changes persisted despite reduction of immunosuppressive therapy and clinical improvement. A clinical and biological cure was only obtained after withdrawal of immunosuppressive therapy and return to haemodialysis. In the second case of Kaposi's sarcoma, the initial biochemical changes were minimal and a clinical cure was obtained by decreasing the immunosuppressive therapy. These two cases illustrate the complex dysregulation of the immune system in Kaposi's sarcoma.
Charpentier
B
B
Laboratoire de Transplantation d'Organes, Hôpital de Bicêtre, Kremlin-Bicêtre.
Lang
P
P
Hiesse
C
C
Fixy
P
P
Lantz
O
O
Bellamy
J
J
Benoit
G
G
Fries
D
D
D000328:Adult; D000914:Antibodies, Viral / Q000276:immunology*; D003587:Cytomegalovirus / Q000276:immunology*; D006801:Humans; D007111:Immunity, Cellular; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012514:Sarcoma, Kaposi / Q000209:etiology / Q000276:immunology*; D013601:T-Lymphocytes / Q000276:immunology*
D000914:Antibodies, Viral
Mise en évidence d'une dysrégulation complexe de l'immunité cellulaire T anti-cytomégalovirus dans le sarcome de Kaposi post-transplantation rénale.