西罗莫司治疗肾移植患者的卡波济肉瘤  

Sirolimus for Kaposi's sarcoma in renal-transplant recipients

作　　者：Stallone G. Schena A. Infante B. G. Grandaliano 刘燕 

机构地区：[1]Division of Nephrology, Dept. of Emergency and Transplant., University of Bari, Piazza Giulio Cesare 11, 70124 Bari, Italy Dr.

出　　处：《世界核心医学期刊文摘（皮肤病学分册）》2005年第7期2-3,共2页Digest of the World Core Medical JOurnals:Dermatology

摘　　要：BACKGROUND: Recipients of organ transplants are susceptible to Kaposi’ s sarcoma as a result of treatment with immunosuppressive drugs. Sirolimus (rapamycin), an immunosuppressive drug, may also have antitumor effects. METHODS: We stopped cyclosporine therapy in 15 kidney- transplant recipients who had biopsy-proven Kaposi’ s sarcoma and began sirolimus therapy. All patients underwent an excisional biopsy of the lesion and one biopsy of normal skin at the time of diagnosis. A second biopsy was performed at the site of a previous Kaposi’ s sarcoma lesion six months after sirolimus the rapy was begun. We examined biopsy specimens for vascular endothelial growth factor (VEGF), Flk-1/KDR protein, and phosphorylated Akt and p70S6 kinase, two enzymes in the signaling pathway targeted by sirolimus. RESULTS: Three months after sirolimus therapy was begun, all cutaneous Kaposi’ s sarcoma lesions had disappeared in all patients. Remission was confirmed histologically in all patients six months after sirolimus therapy was begun. There were no acute episodes of rejection or changes in kidney- graft function. Levels of Flk- 1/KDR and phosphorylated Akt and p70S6 kinase were increased in Kaposi’ s sarcoma cells. The expression of VEGF was increased in Kaposi’ s sarcoma cells and even more so in normal skin cells around the Kaposi’ s sarcoma lesions. CONCLUSIONS: Sirolimus inhibits the progression of dermal Kaposi’ s sarcoma in kidney- transplant recipients while providing effective immunosuppression. Copyright.BACKGROUND: Recipients of organ transplants are susceptible to Kaposi' s sarcoma as a result of treatment with immunosuppressive drugs. Sirolimus (rapamycin), an immunosuppressive drug, may also have antitumor effects. METHODS: We stopped cyclosporine therapy in 15 kidney- transplant recipients who had biopsy-proven Kaposi' s sarcoma and began sirolimus therapy. All patients underwent an excisional biopsy of the lesion and one biopsy of normal skin at the time of diagnosis. A second biopsy was performed at the site of a previous Kaposi' s sarcoma lesion six months after sirolimus the rapy was begun. We examined biopsy specimens for vascular endothelial growth factor (VEGF), Flk-1/KDR protein, and phosphorylated Akt and p70S6 kinase, two enzymes in the signaling pathway targeted by sirolimus. RESULTS: Three months after sirolimus therapy was begun, all cutaneous Kaposi' s sarcoma lesions had disappeared in all patients. Remission was confirmed histologically in all patients six months after sirolimus therapy was begun. There were no acute episodes of rejection or changes in kidney- graft function. Levels of Flk- 1/KDR and phosphorylated Akt and p70S6 kinase were increased in Kaposi' s sarcoma cells. The expression of VEGF was increased in Kaposi' s sarcoma cells and even more so in normal skin cells around the Kaposi' s sarcoma lesions. CONCLUSIONS: Sirolimus inhibits the progression of dermal Kaposi' s sarcoma in kidney- transplant recipients while providing effective immunosuppression. Copyright.

关 键 词：卡波 西罗莫司 移植肾脏 免疫抑制药物 急性排斥反应 皮肤活检 病理活检 组织学检查 器官移植患者 环孢菌素 

分 类 号：R730.5[医药卫生—肿瘤]