Kaposi肉瘤疱疹病毒相关疾病的临床管理:疾病表现和治疗策略的最新进展。
Clinical management of Kaposi sarcoma herpesvirus-associated diseases: an update on disease manifestations and treatment strategies.
发表日期:2023 Aug 14
作者:
Roshani Patel, Kathryn Lurain, Robert Yarchoan, Ramya Ramaswami
来源:
CYTOKINE & GROWTH FACTOR REVIEWS
摘要:
Kaposi肉瘤疱疹病毒(KSHV)与几种疾病相关,包括Kaposi肉瘤、多中心Castleman病、原发性渗出性淋巴瘤和炎性细胞因子综合征。这些与KSHV相关的疾病(KAD)可呈现多样化的体征和症状,经常与细胞因子失调相关,可能导致多器官功能障碍。未能及时诊断和治疗这些疾病可能导致长期并发症和死亡。我们描述了现有的KSHV相关疾病,特别是Kaposi肉瘤的流行病学亚型以及多种KSHV相关疾病的发病率。我们回顾了与KSHV相关疾病相关的KSHV潜伏期和溶解期。鉴于其复杂的表现,我们讨论了临床表现、当前诊断标准、个别KAD的现有治疗算法以及它们的并发情况。根据对病毒和宿主相互作用的新证据,我们评估了治疗KAD的新方法。我们进行了广泛的文献搜索以支持这些发现。KSHV导致复杂且并发的疾病过程,在美国和全球范围内通常被低估。目前存在的针对许多这些病症的新疗法侧重于无需化疗的选择,旨在攻击潜在的病毒发病机制或免疫疗法策略。
Kaposi sarcoma herpes virus (KSHV) is associated with several diseases including Kaposi sarcoma, a form of multicentric Castleman's disease, primary effusion lymphoma, and an inflammatory cytokine syndrome. These KSHV-associated diseases (KAD) can present with heterogenous signs and symptoms that are often associated with cytokine dysregulation that may result in multiorgan dysfunction. Inability to promptly diagnose and treat these conditions can result in long term complications and mortality.Existing epidemiological subtypes of existing KSHV-associated diseases, specifically Kaposi sarcoma as well as the incidence of several KSHV-associated disorders are described. We review the KSHV latent and lytic phases as they correlate with KSHV-associated diseases. Given the complicated presentations, we discuss the clinical manifestations, current diagnostic criteria, existing treatment algorithms for individual KAD, and when they occur concurrently. With emerging evidence on the virus and host interactions, we evaluate novel approaches for treatment of KAD. An extensive literature search was conducted to support these findings.KSHV leads to complex and concurrent disease processes that are often underdiagnosed both in the United States and worldwide. New therapies that exist for many of these conditions focus on chemotherapy-sparing options that seek to target the underlying viral pathogenesis or immunotherapy strategies.