title: Differences in Kaposi sarcoma-associated herpesvirus-specific and herpesvirus-non-specific immune responses in classic Kaposi sarcoma cases and matched controls in Sicily.
abstract: Kaposi sarcoma (KS) might develop because of incompetent immune responses, both non-specifically and specifically against the KS-associated herpesvirus (KSHV). Peripheral blood mononuclear cells from 15 classic (non-AIDS) KS cases, 13 KSHV seropositives (without KS) and 15 KSHV-seronegative controls were tested for interferon-γ T-cell (enzyme-linked immunospot [Elispot]) responses to KSHV-latency-associated nuclear antigen (LANA), KSHV-K8.1 and CMV/Epstein-Barr virus (EBV) peptide pools. The forearm and thigh of each participant was also tested for delayed-type hypersensitivity (DTH) against common recall antigens. Groups were compared with Fisher exact test and multinomial logistic regression to calculate odds ratios (OR) and 95% confidence intervals (CI). A KSHV Elispot response was detected in 10 (67%) classic KS cases, 11 (85%) KSHV seropositives (without KS) and two (13%) seronegative controls. All four cases with KSHV-LANA responses had current KS lesions, whereas five of six cases with KSHV-K8.1 responses had no lesions (P = 0.048). No case responded to both LANA and K8.1. Compared with the seronegative controls, the risk for classic KS was inversely related to DTH in the thigh (OR 0.71, 95% CI 0.55-0.94, P = 0.01), directly associated with DTH in the forearm (OR 1.35, 95% CI 1.02-1.80, P = 0.04) and tended to be increased fivefold per KSHV Elispot response (OR 5.13, 95% CI 0.86-30.77, P = 0.07). Compared with KSHV seropositives (without KS), the risk for classic KS was reduced fivefold (OR 0.20, CI 0.03-0.77, P = 0.04) per KSHV response. The CMV/EBV Elispot responses were irrelevant. Deficiency of both KSHV-specific and KSHV-non-specific immunity is associated with classic KS. This might clarify why Kaposi sarcoma responds to immune reconstitution.
authors: Department of Sciences for Health Promotion G. D'Alessandro, Section of Hygiene, University of Palermo, Palermo, Italy.
authors: Emanuele
authors: E
authors: Amodio
authors: James J
authors: JJ
authors: Goedert
authors: Patrizia
authors: P
authors: Barozzi
authors: Giovanni
authors: G
authors: Riva
authors: Alberto
authors: A
authors: Firenze
authors: Filippa
authors: F
authors: Bonura
authors: Enza
authors: E
authors: Viviano
authors: Nino
authors: N
authors: Romano
authors: Mario
authors: M
authors: Luppi
mesh_terms: D000914:Antibodies, Viral / Q000097:blood / Q000276:immunology; D034961:Antigens, Nuclear / Q000276:immunology; D000956:Antigens, Viral / Q000276:immunology*; D016022:Case-Control Studies; D004797:Enzyme-Linked Immunosorbent Assay; D006023:Glycoproteins / Q000276:immunology*; D019288:Herpesvirus 8, Human / Q000276:immunology*; D006801:Humans; D006968:Hypersensitivity, Delayed; D007113:Immunity, Innate; D007371:Interferon-gamma / Q000096:biosynthesis* / Q000097:blood; D007963:Leukocytes, Mononuclear / Q000276:immunology; D009687:Nuclear Proteins / Q000276:immunology*; D012514:Sarcoma, Kaposi / Q000276:immunology* / Q000821:virology*; D012802:Sicily; D013601:T-Lymphocytes / Q000276:immunology; D014764:Viral Proteins / Q000276:immunology*
chemical_list: D000914:Antibodies, Viral; D034961:Antigens, Nuclear; D000956:Antigens, Viral; D006023:Glycoproteins; C113454:K8.1 protein, Human herpesvirus 8; D009687:Nuclear Proteins; D014764:Viral Proteins; C109540:latency-associated nuclear antigen; D007371:Interferon-gamma