Kaposi's Sarcoma, Genistein, and Soybeans

A paper published a year ago, in the Proceedings of the National
Academy of Sciences, USA, suggested that substances found in a
plant-based diet, especially one high in soy products, such as the
traditional Japanese diet, may help control abnormal angiogenesis
(growth of blood vessels).(1) Angiogenesis is centrally important in
Kaposi's sarcoma, and is important in solid tumors (which cannot
grow beyond a small size unless they can force the growth of new
blood vessels to nourish the tumor), and in a number of other
diseases.

The authors, at universities in Heidelberg, Geneva, and Helsinki,
chemically fractionated the urine of volunteers who were eating a
soy-rich vegetarian diet. They found one substance, genistein, which
had a strong anti-angiogenesis effect in laboratory tests, and which is
30 times more concentrated in the urine of those eating traditional
Japanese diets vs. those eating typical Western diets. (Soy contains
genistein precursors.) The higher urine concentrations were enough
to affect angiogenesis in laboratory tests.

This paper did not mention KS, or anything AIDS related. Therefore it
is not included on AIDS computer databases, and is largely unknown
to the AIDS community. However, abnormal angiogenesis is central to
KS. (Two reference on the AIDSLINE database do mention genistein;
one of them noted that it suppressed KS cell growth.(2))

The urine of the volunteers was chemically fractionated into six
fractions. Four of them had anti-angiogenesis activity. The two most
active fractions were NOT analyzed in this study, however; genistein
came from one of the less active fractions. (This suggests that plant-
based diets may supply other substances which may be better than
genistein in anti-angiogenesis activity.)

The paper cited other published studies which suggested that the
traditional Japanese diet may inhibit breast and prostate cancer.
Incidentally -- though not cited in the paper -- there are popular
"alternative" cancer treatments (for example, the Gerson diet) which
emphasize large quantities of juices, etc.

Comment: The Next Step

"Macrobiotic" and other plant-based diets have long had advocates in
the AIDS community. Unfortunately, these diets have often ignored
the known nutritional needs of people with AIDS, as well as food-
safety requirements for avoiding infection. Diets not properly
designed for persons with HIV disease can do much more harm than
good.

We see little hope that enough money can be found for clinical trials
to scientifically test diets, or nutritional products, for KS or other
AIDS-related conditions. Mainstream research is unlikely to develop
this area for years. Instead of waiting for trials that may never come,
let's take what knowledge does exist and see if something useful can
be done with it.

What is needed now is for a team, including an HIV-experienced
dietitian, to prepare recommendations which meet the nutritional
and food-safety needs of persons with AIDS, but also are formulated
to have anti-angiogenesis effects, based on what is known at this
time. Persons with KS might want to try such a diet to see if it
seemed to help.

References

1. Fotsis T, Pepper M, Adlercreutz H, and others. Genistein, a dietary-
derived inhibitor of in vitro angiogenesis. PROCEEDINGS OF THE
NATIONAL ACADEMY OF SCIENCES, USA. April 1993; volume 90,
pages 2690-2694.

2. Amaral MC, Miles S, Kumar G, and Nel AE. Oncostatin-M stimulates
tyrosine protein phosphorylation in parallel with the activation of
p42MAPK/ERK-2 in Kaposi's cells. Evidence that this pathway is
important in Kaposi cell growth. JOURNAL OF CLINICAL
INVESTIGATION. August 1993; volume 92 (2), pages 848-857.