Document Detail


Changes in T-cell responses against human herpesvirus-8 correlate with the disease course of iatrogenic Kaposi's sarcoma in a patient with undifferentiated arthritis.
MedLine Citation:
PMID:  18639317     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To describe the first in-depth analysis of both the T-cell responses against human herpesvirus-8 (HHV-8) and the HHV-8 viral load in 1 patient who developed iatrogenic HHV-8-associated-Kaposi's sarcoma (KS) following immunosuppressive treatment for undifferentiated arthritis and to review the literature on iatrogenic KS (IKS). METHODS: T-cell responses against HHV-8 lytic and latent antigens were analyzed by ex vivo enzyme-linked immunospot (Elispot) and HHV-8 viral load was assessed by quantitative polymerase chain reaction, in sequential peripheral blood samples from a 55-year-old woman who developed skin/mucosal and visceral KS, while receiving treatment with cyclosporine, methotrexate, and methylprednisolone for undifferentiated arthritis. RESULTS: KS may result from HHV-8 infection in patients undergoing immunosuppressive treatment for rheumatic diseases and this is the first case of IKS occurring in undifferentiated arthritis. A role for immune surveillance in the pathogenesis of IKS is supported by the observation of disease regression following discontinuation of immunosuppressive therapy. In a 4-year follow-up, we showed that variations of the virus-specific immune responses but not of the viral load correlated well with the disease course, characterized by 2 remission and subsequent relapse phases, following changes of immunosuppressive therapy. CONCLUSIONS: We have provided evidence of a clear-cut correlation between changes in immunologic markers of HHV-8 infection and the disease course of this viral associated tumor, concomitant with variations of immunosuppressive treatment. Thus, ex vivo enzyme-linked immunospot for HHV-8-specific T-cell responses represents a new tool for the clinical management of rheumatic patients with IKS.
Authors:
Patrizia Barozzi; Leonardo Potenza; Giovanni Riva; Daniela Vallerini; Chiara Quadrelli; Raffaella Bosco; Monica Morselli; Fabio Forghieri; Francesco Volzone; Giulio Rossi; Clodoveo Ferri; Chiara Bonini; Fabio Ciceri; Claudio Bordignon; Denise Whitby; Thomas F Schulz; Giuseppe Torelli; Mario Luppi
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Publication Detail:
Type:  Case Reports; Journal Article; Research Support, Non-U.S. Gov't     Date:  2008-07-17
Journal Detail:
Title:  Seminars in arthritis and rheumatism     Volume:  39     ISSN:  1532-866X     ISO Abbreviation:  Semin. Arthritis Rheum.     Publication Date:  2009 Dec 
Date Detail:
Created Date:  2009-11-25     Completed Date:  2010-02-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  1306053     Medline TA:  Semin Arthritis Rheum     Country:  United States    
Other Details:
Languages:  eng     Pagination:  170-5     Citation Subset:  IM    
Affiliation:
Department of Oncology and Hematology, University of Modena and Reggio Emilia, Azienda Ospedaliera Policlinico, Modena, Italy.
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MeSH Terms
Descriptor/Qualifier:
Antibodies, Viral / blood*
Arthritis / complications*,  drug therapy
Disease Progression*
Female
Follow-Up Studies
Herpesvirus 8, Human / immunology*
Humans
Iatrogenic Disease
Immunosuppressive Agents / adverse effects,  therapeutic use
Middle Aged
Opportunistic Infections / etiology,  immunology
Sarcoma, Kaposi / etiology,  immunology*
T-Lymphocytes / immunology*
Viral Load
Chemical
Reg. No./Substance:
0/Antibodies, Viral; 0/Immunosuppressive Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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