ABSTRACT
Objective To investigate the difference of expression and distribution of Toll-like receptor 4 (TLR4)between acquired immunodeficiency syndrome (AIDS)-related Kaposi sarcoma (AIDS-KS)and classic Kaposi sarcoma (KS).Methods The subjects were collected from The First Teaching Hospital of Xinjiang Medical University from January 2010 to January 2012,including 11 patients with AIDS-KS,7 patients with classic KS,7 human immunodeficiency virus (HIV)infective patients without KS and 7 healthy volunteers.Clinical data and biopsy specimens were collected.The expression of TLR4 was detected by immunohistochemical method.Statistical analysis of mean between two groups was conducted by using t test.Statistical analysis of ranked data was conducted by using U test.Comparison between groups was analyzed with one-way ANOVA.Results The expressions of TLR4 were both strongly positive in patients with AIDS-KS and classic KS,and mainly in alien vascular endothelial cells (VEC)and tumor cells.TLR4 was located on cell membrane and cytoplasm,and also in the nucleus. TLR4 was rarely expressed in the skin tissue in HIV infective patients without KS and healthy volunteers. The expressions of TLR4 in AIDS-KS,classic KS,HIV infective patients and healthy volunteers were 0.242±0.443,0.208±0.059,0.072±0.042 and 0.065 ±0.031 ,respectively (F =33.70,P <0.01 ). The expressions of TLR4 were lower in HIV infective (AIDS ) patients without KS and healthy volunteers.The expression level of TLR4 was significantly higher in KS patients compared with non-KS patients (t=4.097,P =0.003).However,TLR4 expression had no significant difference between AIDS-KS and classic KS patients (t =0.480,P =0.638).The expression of TLR4 was significantly higher in AIDS-KS patients compared with HIV infective patients (t=2.900,P =0.010).Conclusions The study identifies that TLR4 is highly expressed in patients with AIDS-KS or classic KS.It is suggested that TLR4 may play an important role in occurrence and development of KS.
ABSTRACT
Objective To analyze the clinical features of AIDS-related Kaposi's sarcoma (AIDSKS) patients in Xinjiang uygur autonomous region,and to evaluate the efficacy of highly active antiretroviral therapy (HAART) and systemic chemotherapy.Methods Clinical data on 70 AIDS-KS patients admitted in Sixth People' s Hospital of Xinjiang Uygur Autonomous Region from January 2008 to June 2013 were reviewed.The demographic characteristics,progress of KS,extent of lesions,treatment and prognosis of these patients were retrospectively studied.The efficacy of different therapies and the prognosis were compared using t or x2 test.Results The average age of 70 AIDS-KS patients was (40 ± 10) years,and the ratio of male and female was 2.5 ∶ 1.Sixty-six out of 70 (94.29％) patients were Uyghur ethnic.Among 70 patients,23 cases (32.9％) were rapidly progressed.Lesions often progress to plaques and nodules affecting head,neck,trunk,limbs and internal organs.Among 64 evaluable cases,the fatality rate in treatment group was 7.7 (4/52),which was significantly lower than that in patients who did not receive treatment (4/12,x2 =5.861,P ＜ 0.05).After 6-month of HAART or HAART sequenced by chemotherapy,CD4+ T lymphocyte counts were significantly increased (t =35.258 and 42.528,P ＜0.01),while it was decreased or remained in low level in patients received other treatments or untreated.HAART sequenced by chemotherapy,chemotherapy sequenced by HAART,and chemotherapy alone were effective for all AIDS-KS patients,while the effective rate in patients received HAART alone was 86.4％ (19/22),and immune reconstitution inflammatory syndrome (IRIS) was appeared in 45.5％ (10/22)patients.Conclusions AIDS-KS more frequently occurs in young Uighur males.The lesion may affect various organs,and some progress rapidly.HAART plus chemotherapy may reduce the incidence of IRIS and improve the prognosis.