Delayed-type hypersensitivity in classic Kaposi sarcoma patients and controls.
BACKGROUND
Immune perturbation likely affects the development of Kaposi sarcoma (KS) among people infected with the KS-associated herpesvirus (KSHV). We tested whether KSHV-seropositive individuals or cases of classic KS (cKS), which typically originates in the leg, had differing delayed-type hypersensitivity (DTH) in the forearm or leg.


METHODS
Mantoux DTH with three antigens (Candida, tetanus, PPD) was performed on the forearm and leg of 15 cKS cases, 14 KSHV-positives without KS, and 15 KSHV-negative controls. The diameters of induration responses were compared by group and body site.


RESULTS
Leg DTH was greater than forearm DTH among controls (mean difference 5.6 mm, P=0.0004), whereas this was not observed in cKS cases (-2.2 mm, P=0.32) or KSHV-positives (0.5 mm, P=0.56). Leg-minus-forearm DTH difference was greater in controls compared with cKS cases (P=0.004) and KSHV-positives (P=0.002). Leg-plus-forearm DTH was similar in controls (mean 28.2 mm) and cKS cases (24.5 mm, P=0.60), but it was reduced in KSHV-positives (11.8 mm, P=0.02), particularly in the leg (P=0.004) and marginally in the forearm (P=0.07).


CONCLUSIONS
KS cases had weaker DTH only in the leg, whereas both body sites appeared weaker in KSHV-positives without KS. Both systemic and regional immune alterations may influence the development of this malignancy.
Section of Hygiene, Department of Sciences for Health Promotion 'G D'Alessandro', Università degli Studi di Palermo, Palermo 90127, Italy.
R M
RM
Valenti
E
E
Amodio
J-M
JM
Nam
L
L
Preiss
B I
BI
Graubard
N
N
Romano
J J
JJ
Goedert
D000368:Aged; D005260:Female; D005542:Forearm; D019288:Herpesvirus 8, Human / Q000276:immunology*; D006801:Humans; D006968:Hypersensitivity, Delayed / Q000276:immunology*; D007866:Leg; D008297:Male; D012514:Sarcoma, Kaposi / Q000276:immunology*
AIDS. 2003 Aug 15;17(12):1847-51
12891072
Lancet. 1995 Sep 23;346(8978):799-802
7674745
Br Med J. 1970 Mar 7;1(5696):600-2
4909367
J Acquir Immune Defic Syndr (1988). 1990;3 Suppl 1:S38-43
2395084
N Engl J Med. 1975 Sep 4;293(10):501-2
1152865
Int J Dermatol. 1986 Nov;25(9):594-6
3793361
Int J Dermatol. 1984 Jan-Feb;23(1):56-60
6724769
Trans R Soc Trop Med Hyg. 1996 Mar-Apr;90(2):173-4
8761581
Br J Cancer. 2000 Feb;82(3):702-4
10682685
Int J Cancer. 2006 Dec 1;119(11):2685-91
16929513
AIDS. 2010 Sep 10;24(14):2279-81
20616696
Int J Cancer. 1999 Sep 9;82(6):817-21
10446447
Cancer Epidemiol Biomarkers Prev. 2008 Dec;17(12):3435-43
19064559
J Med Virol. 2009 Nov;81(11):1938-44
19777527
Int J Cancer. 2001 Feb 15;91(4):588-91
11251987
Cancer. 2006 Nov 1;107(9):2282-90
16998933
Am J Epidemiol. 1992 Jul 1;136(1):71-80
1384311
J Acquir Immune Defic Syndr (1988). 1993 Nov;6(11):1248-57
7901383