What is the role of cofactors in the pathophysiology of Kaposi sarcoma (KS)?

Updated: Apr 11, 2019
  • Author: Jessica Katz, MD, PhD, FACP; Chief Editor: Edwin Choy, MD, PhD  more...
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The fact that Kaposi sarcoma develops in only a small percentage of HHV-8–seropositive individuals points to the importance of other factors. Some of these may be genetic: For example, individuals with certain polymorphisms in the MDM2 gene, which is involved in the function of the tumor suppressor protein p53, may be at increased risk for Kaposi sarcoma. [39]

It is possible that some agents may either stimulate or inhibit the development of Kaposi sarcoma, depending on the presence of influences such as genetic predisposition, environmental factors, drug intake, or lymphatic system disorders. The high prevalence of Kaposi sarcoma in areas where quinine and its derivatives are widely used for treatment of malaria may be partly attributable to the immunosuppressant effect of those drugs; however, quinolones also have several effects that could inhibit Kaposi sarcoma development. Likewise, angiotensin-converting enzyme (ACE) inhibitors have been described as inducing Kaposi sarcoma, in some reports, and inhibiting it, in others. [39]  

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