Journal of Cancer Research and Therapeutics

LETTER TO THE EDITOR
Year
: 2012  |  Volume : 8  |  Issue : 1  |  Page : 163--164

Arabs and kaposi sarcoma


Hamdi Shelleh, Hamad A Fahhad, Mohammad N Qasabah 
 KSA, Najran, P.O. Box 8931, Saudi Arabia

Correspondence Address:
Hamdi Shelleh
KSA, Najran, P.O. Box 8931
Saudi Arabia




How to cite this article:
Shelleh H, Fahhad HA, Qasabah MN. Arabs and kaposi sarcoma.J Can Res Ther 2012;8:163-164


How to cite this URL:
Shelleh H, Fahhad HA, Qasabah MN. Arabs and kaposi sarcoma. J Can Res Ther [serial online] 2012 [cited 2020 Aug 13 ];8:163-164
Available from: http://www.cancerjournal.net/text.asp?2012/8/1/163/95208


Full Text

Sir,

We read with interest the report by Kumar about classical Kaposi sarcoma (CKS ). [1] Principally, claiming the existence of a disease in a nation is not a credit; it usually comes within the scientific facts, which serve in epidemiological studies and prophylaxis, and also in preparing the clinician to the possibility of encountering a disease in definite people. Kumar documented the existence of CKS in Oman, [1] but is it really the first such documentation in Arab descents that widens the ethnic involvement?

Reviewing literature refutes this claim; CKS has been reported twice in Iraq; in a 21 cases and another-but more aggressive- 20 cases separately, before his report. [2],[3] At least these two reports document CKS in Arabs - as part of the Mediterranean peoples, and confirm the well widening of the ethnic map. CKS is there in Arabs, as all the large textbooks, which are the skeletal core of literature, state. Yes, CKS involves Arabs, Jews, and East Europe; a geographical extension of the Mediterranean basin upwards and endemic with Kaposi. Now, is it genetics or geography which plays the fundamental role in CKS pathogenesis? Mediterranean peoples form a rather inconsistent mosaic mixture of different ethnic groups, yet, more than one ancestry; at least Arabs, Jews, and Turks display CKS. This indicates that CKS is intra-racial, and the genetic predisposition is not sufficient alone to explain the restriction of CKS to Mediterraneans as a major focus of it. Fortunately, another epidemiological-infectious factor-; HHV 8 by Chang 1994, which does not respect ethnic boundaries but surpass it filled the gap. HHV 8 seems to be global but more endemic ecologically in the Mediterranean basin, it was later called Kaposi sarcoma-associated herpes virus (KSHV). [4] Probably, the well reported high incidence of CKS in Arabs, Turkish, and Jews populations suggests Mediterranean inhabitance rather than genetic inheritance, and support geography on descent predilection and phenotype on genotype. [2],[3] The report-by Iscovich which the author quoted- documenting high CKS in Arabs living with Jews in Palestine favors this view. Also, the report which recorded CKS incidence in Jews of West Europe and USA origin similar to the nations they came from supports this view! The report about CKS from Turkey by Gul, the author quoted, potentiates the non-ethnic theory of the disease, as Turkey is an ethnic mixture with different racial mosaicism. In southern Italy, [5] CKS incidence was two-to-three-folds higher than that of USA and Sweden and many folds higher than England. CKS is quite common in Peru specially the coastal region with similar presentation to the Mediterranean CKS. Probably, the ecological conditions which allow a convenient vital media for the HHSV 8 to survive are alike between the Mediterranean and the Caribbean basin. We think that it is geographical infection rather than racial affliction, without complete exclusion of this factor. HHV 8 was found in all KS subtypes, and was assumed as a requisite, which is efficient but not sufficient alone to cause CKS. Yet further investigations for these co-factors are needed to be well defined.

References

1Kumar P. Classic Kaposi's sarcoma in Arabs, Widening ethnic involvement. J Cancer Res Ther 2011;7:92-4.
2Al-Saleem T, Sharquie K, Alash N, Naimi A, Sha'arbaf H, editors. Kaposi's sarcoma in Iraqi patients. Proceedings of the first scientific conference of Medical College, Baghdad, Iraq: University of Baghdad; 1984.
3Al-Waiz M, Sharquie KE, Al-Hamdani GA. An upsurge of new cases of Kaposi's sarcoma in Iraqi patients. Saudi Med J 2003;24:224-5.
4Chang Y, Cesarman E, Pessin MS, Lee F, Culpepper J, Knowles DM, et al. Identification of herpesvirus-like DNA sequences in AIDS-associated Kaposi's sarcoma. Science 1994;266:1865-9.
5Atzori L, Fadda D, Ferreli C, Pastrelli C, Iannelli P, Rais M, et al. Classic Kaposi's sarcoma in southern Sardinia, Italy. Br J Cancer 2004;91:1261-2.