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Saikia PJ, Pathak L, Mitra S, Das B. The emerging role of oral microbiota in oral cancer initiation, progression and stemness. Front Immunol 2023; 14:1198269. [PMID: 37954619 PMCID: PMC10639169 DOI: 10.3389/fimmu.2023.1198269] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 08/23/2023] [Indexed: 11/14/2023] Open
Abstract
Oral squamous cell carcinoma (OSCC) is the most prevalent malignancy among the Head and Neck cancer. OSCCs are highly inflammatory, immune-suppressive, and aggressive tumors. Recent sequencing based studies demonstrated the involvement of different oral microbiota in oral cavity diseases leading OSCC carcinogenesis, initiation and progression. Researches showed that oral microbiota can activate different inflammatory pathways and cancer stem cells (CSCs) associated stemness pathways for tumor progression. We speculate that CSCs and their niche cells may interact with the microbiotas to promote tumor progression and stemness. Certain oral microbiotas are reported to be involved in dysbiosis, pre-cancerous lesions, and OSCC development. Identification of these specific microbiota including Human papillomavirus (HPV), Porphyromonas gingivalis (PG), and Fusobacterium nucleatum (FN) provides us with a new opportunity to study the bacteria/stem cell, as well as bacteria/OSCC cells interaction that promote OSCC initiation, progression and stemness. Importantly, these evidences enabled us to develop in-vitro and in-vivo models to study microbiota interaction with stem cell niche defense as well as CSC niche defense. Thus in this review, the role of oral microbiota in OSCC has been explored with a special focus on how oral microbiota induces OSCC initiation and stemness by modulating the oral mucosal stem cell and CSC niche defense.
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Affiliation(s)
- Partha Jyoti Saikia
- Department of Cancer and Stem Cell Biology, KaviKrishna Laboratory, Research Park, Indian Institute of Technology, Guwahati, India
- Department of Stem Cell and Infectious Diseases, KaviKrishna Laboratory, Research Park, Indian Institute of Technology, Guwahati, India
| | - Lekhika Pathak
- Department of Cancer and Stem Cell Biology, KaviKrishna Laboratory, Research Park, Indian Institute of Technology, Guwahati, India
- Department of Stem Cell and Infectious Diseases, KaviKrishna Laboratory, Research Park, Indian Institute of Technology, Guwahati, India
| | - Shirsajit Mitra
- Department of Cancer and Stem Cell Biology, KaviKrishna Laboratory, Research Park, Indian Institute of Technology, Guwahati, India
- Department of Stem Cell and Infectious Diseases, KaviKrishna Laboratory, Research Park, Indian Institute of Technology, Guwahati, India
| | - Bikul Das
- Department of Cancer and Stem Cell Biology, KaviKrishna Laboratory, Research Park, Indian Institute of Technology, Guwahati, India
- Department of Stem Cell and Infectious Diseases, KaviKrishna Laboratory, Research Park, Indian Institute of Technology, Guwahati, India
- Department of Experimental Therapeutics, Thoreau Laboratory for Global Health, M2D2, University of Massachusetts, Lowell, MA, United States
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Rosseto JHF, Tenório JR, Mamana AC, Tozetto-Mendoza TR, Andrade NS, Braz-Silva PH, Ortega KL. Epstein-Barr virus oral shedding and viremia and their association with oral hairy leukoplakia in HIV+ individuals. Oral Dis 2023; 29:796-802. [PMID: 34379873 DOI: 10.1111/odi.14001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 07/23/2021] [Accepted: 08/03/2021] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To assess the oral shedding and viremia of Epstein-Barr virus (EBV) in HIV-positive patients and their relationship with oral hairy leukoplakia (OHL). METHODOLOGY A total of 94 HIV-positive patients were included in the study, in which blood and saliva samples were collected for EBV quantification. Data on gender, age, time of HIV seropositivity, combined antiretroviral therapy (cART), CD4+ T-cell counts, and HIV viral load were collected. OHL diagnosis was based on histopathological examination and EBV in situ hybridization. RESULTS The EBV load in the 94 HIV-positive patients was higher in saliva than in blood (2.4 and 1.6, respectively), and there was a positive correlation between EBV oral shedding and viremia (p = 0.001). Twenty (21.27%) patients had OHL and also a higher EBV load in saliva (mean log10 = 3.11) compared to those who had no OHL (p = 0.045). Presence of OHL was only associated with age (p = 0.030). CONCLUSION In HIV-positive patients, the presence of OHL was associated with EBV oral shedding but not with viremia, regardless of the amount of circulating CD4+ T cells.
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Affiliation(s)
| | - Jefferson Rocha Tenório
- Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil.,Department of Pathology and Oral Diagnosis, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Ana Carolina Mamana
- Laboratory of Virology, School of Medicine, Institute of Tropical Medicine of São Paulo, University of São Paulo, São Paulo, Brazil
| | - Tânia Regina Tozetto-Mendoza
- Laboratory of Virology, School of Medicine, Institute of Tropical Medicine of São Paulo, University of São Paulo, São Paulo, Brazil
| | - Natália Silva Andrade
- Department of Dentistry, School of Dentistry, Federal University of Sergipe, Lagarto, Brazil
| | - Paulo Henrique Braz-Silva
- Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil.,Laboratory of Virology, School of Medicine, Institute of Tropical Medicine of São Paulo, University of São Paulo, São Paulo, Brazil
| | - Karem L Ortega
- Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil
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Erira AT, Navarro AFR, Robayo DAG. Human papillomavirus, Epstein-Barr virus, and Candida albicans co-infection in oral leukoplakia with different degrees of dysplasia. Clin Exp Dent Res 2021; 7:914-923. [PMID: 34101999 PMCID: PMC8543472 DOI: 10.1002/cre2.435] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 03/30/2021] [Accepted: 04/05/2021] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVES To identify human papillomavirus (HPV), Epstein-Barr virus (EBV), and Candida albicans in oral leukoplakia with different degrees of dysplasia. MATERIALS AND METHODS An observational, cross-sectional, descriptive study was performed using 30 formalin-fixed and paraffin-embedded tissues from patients with clinical suspicion of leukoplakia and confirmed diagnosis of oral dysplasia. Histological analyses were performed by two pathologists (interobserver) and dysplasias were classified as mild, moderate, or severe. Conventional PCR was used to detect HPV and EBV viruses and C. albicans. To determine the association between each microorganism with different degrees of dysplasia a Chi-square test was employed. RESULTS The tongue was the most common site for leukoplakias (71.4%) in females with a mean age of 50 years (ranging between 30 to 50 years old; 57.1%). EBV was the most frequently detected (73.3%), followed by HPV (43.3%), mainly of type 16 (40%), and C. albicans (23.3%). Significant differences were observed between degrees of dysplasia and HPV presence (p = 0.005). In lesions positive for HPV, EBV, and C. albicans the most frequent histological changes were hyperkeratosis, irregular interpapillary ridges, and loss of basal stratum cell polarity. CONCLUSION Co-infection with human papillomavirus, Epstein Barr virus, and Candida albicans in oral leukoplakia could be associated with dysplastic changes.
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Affiliation(s)
- Alveiro T Erira
- Facultad de Odontología, Universidad Cooperativa de Colombia, Bogotá, Colombia
| | | | - Dabeiba Adriana García Robayo
- Centro de Investigaciones Odontológicas - Facultad de Odontología, Pontificia Universidad Javeriana, Bogotá, Colombia
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Alramadhan SA, Bhattacharyya I, Cohen DM, Islam MN. Oral Hairy Leukoplakia in Immunocompetent Patients Revisited with Literature Review. Head Neck Pathol 2021; 15:989-993. [PMID: 33428065 PMCID: PMC8384929 DOI: 10.1007/s12105-021-01287-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Accepted: 01/02/2021] [Indexed: 10/22/2022]
Abstract
Oral hairy leukoplakia (OHL) is an Epstein-Barr virus (EBV) related lesion seen in severely immunocompromised patients especially, those with concomitant human immunodeficiency virus (HIV) infection. It has been rarely reported in immunocompetent patients. OHL most often presents on the lateral border of the tongue as an asymptomatic, white, and corrugated plaque that does not rub off. With Institutional Review Board (IRB) approval, the University of Florida Oral & Maxillofacial Pathology Biopsy Service archives spanning 1994-2020 were queried. All cases of OHL affecting immunocompetent patients were identified. Data related to age, gender, clinical presentation, results of Epstein-Barr virus in situ hybridization (EBER-ISH), and periodic acid-Schiff (PAS)-fungus stains were recorded. Medical history and histology of all cases were reviewed for confirmation of diagnosis. A total of 11 cases were identified, the majority of which were males (63.6%) with a mean age of 62 years. All patients were Caucasian. Lesions entirely were located on the lateral borders of the tongue. OHL should not be considered pathognomonic for HIV infection and should be included in the differential diagnoses of keratotic lesions affecting the lateral border of tongue even in immunocompetent elderly patients. The etiology of OHL in this group of patients is not clearly understood.
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Affiliation(s)
- Saja A. Alramadhan
- grid.15276.370000 0004 1936 8091Department of Oral and Maxillofacial Diagnostic Sciences, University of Florida College of Dentistry, 1395 Center Drive, Gainesville, FL 32610 USA
| | - Indraneel Bhattacharyya
- grid.15276.370000 0004 1936 8091Department of Oral and Maxillofacial Diagnostic Sciences, University of Florida College of Dentistry, 1395 Center Drive, Gainesville, FL 32610 USA
| | - Donald M. Cohen
- grid.15276.370000 0004 1936 8091Department of Oral and Maxillofacial Diagnostic Sciences, University of Florida College of Dentistry, 1395 Center Drive, Gainesville, FL 32610 USA
| | - Mohammed N. Islam
- grid.15276.370000 0004 1936 8091Department of Oral and Maxillofacial Diagnostic Sciences, University of Florida College of Dentistry, 1395 Center Drive, Gainesville, FL 32610 USA
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Shanahan D, Cowie R, Rogers H, Staines K. Oral hairy leukoplakia in healthy immunocompetent patients: a small case series. Oral Maxillofac Surg 2018; 22:335-339. [PMID: 30079439 DOI: 10.1007/s10006-018-0709-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 08/02/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND Oral hairy leukoplakia (OHL) is caused by the Epstein-Barr virus (EBV) and usually presents in patients with human immunodeficiency virus (HIV) infection and systemic immunosuppression. It is rarely seen in patients who are immunocompetent. It is clinically characterised as an asymptomatic, soft, white and corrugated lesion that cannot be scraped from the surface it adheres to. METHODS Immunocompetent patients with OHL attending Bristol Dental Hospital within the last 6 months were identified. EBV infection was demonstrated using EBV in situ hybridization. Clinical features and medical history were determined by reviewing medical records. CASE REPORT Four cases of OHL in immunocompetent individuals were identified. All lesions were located on the lateral borders of the tongue. DISCUSSION OHL should be considered as a differential diagnosis for white patches on the lateral borders of the tongue in apparently healthy immunocompetent patients, even when they do not have a typical corrugated appearance. OHL should no longer be regarded as pathognomonic for HIV infection or systemic immunosuppression.
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Affiliation(s)
- Daire Shanahan
- Department of Oral Medicine, The University of Bristol Dental Hospital, Lower Maudlin Street, Bristol, BS1 2LY, England.
| | - Rachel Cowie
- Department of Oral Medicine, The University of Bristol Dental Hospital, Lower Maudlin Street, Bristol, BS1 2LY, England
| | - Helen Rogers
- Department of Oral Medicine, The University of Bristol Dental Hospital, Lower Maudlin Street, Bristol, BS1 2LY, England
| | - Konrad Staines
- Department of Oral Medicine, The University of Bristol Dental Hospital, Lower Maudlin Street, Bristol, BS1 2LY, England
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Guidry JT, Birdwell CE, Scott RS. Epstein-Barr virus in the pathogenesis of oral cancers. Oral Dis 2018; 24:497-508. [PMID: 28190296 PMCID: PMC5554094 DOI: 10.1111/odi.12656] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Revised: 01/30/2017] [Accepted: 01/31/2017] [Indexed: 12/28/2022]
Abstract
Epstein-Barr virus (EBV) is a ubiquitous gamma-herpesvirus that establishes a lifelong persistent infection in the oral cavity and is intermittently shed in the saliva. EBV exhibits a biphasic life cycle, supported by its dual tropism for B lymphocytes and epithelial cells, which allows the virus to be transmitted within oral lymphoid tissues. While infection is often benign, EBV is associated with a number of lymphomas and carcinomas that arise in the oral cavity and at other anatomical sites. Incomplete association of EBV in cancer has questioned if EBV is merely a passenger or a driver of the tumorigenic process. However, the ability of EBV to immortalize B cells and its prevalence in a subset of cancers has implicated EBV as a carcinogenic cofactor in cellular contexts where the viral life cycle is altered. In many cases, EBV likely acts as an agent of tumor progression rather than tumor initiation, conferring malignant phenotypes observed in EBV-positive cancers. Given that the oral cavity serves as the main site of EBV residence and transmission, here we review the prevalence of EBV in oral malignancies and the mechanisms by which EBV acts as an agent of tumor progression.
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Affiliation(s)
- Joseph T. Guidry
- Department of Microbiology and Immunology, Center for Tumor and Molecular Virology, and Feist-Weiller Cancer Center. Louisiana State University Health Sciences Center-Shreveport. Shreveport, LA 71103
| | - Christine E. Birdwell
- Department of Microbiology and Immunology, Center for Tumor and Molecular Virology, and Feist-Weiller Cancer Center. Louisiana State University Health Sciences Center-Shreveport. Shreveport, LA 71103
| | - Rona S. Scott
- Department of Microbiology and Immunology, Center for Tumor and Molecular Virology, and Feist-Weiller Cancer Center. Louisiana State University Health Sciences Center-Shreveport. Shreveport, LA 71103
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Kim Y, Kim HS, Park JS, Kim CJ, Kim WH. Identification of Epstein-Barr Virus in the Human Placenta and Its Pathologic Characteristics. J Korean Med Sci 2017; 32:1959-1966. [PMID: 29115077 PMCID: PMC5680494 DOI: 10.3346/jkms.2017.32.12.1959] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Accepted: 09/03/2017] [Indexed: 12/27/2022] Open
Abstract
Epstein-Barr virus (EBV), a common pathogen in humans, is suspected as the cause of multiple pregnancy-related pathologies including depression, preeclampsia, and stillbirth. Moreover, transmission of EBV through the placenta has been reported. However, the focus of EBV infection within the placenta has remained unknown to date. In this study, we proved the expression of latent EBV genes in the endometrial glandular epithelial cells of the placenta and investigated the cytological characteristics of these cells. Sixty-eight placentas were obtained from pregnant women. Tissue microarray was constructed. EBV latent genes including EBV-encoding RNA-1 (EBER1), Epstein-Barr virus nuclear antigen 1 (EBNA1), late membrane antigen (LMP1), and RPMS1 were detected with silver in situ hybridization and/or mRNA in situ hybridization. Nuclear features of EBV-positive cells in EBV-infected placenta were compared with those of EBV-negative cells via image analysis. Sixteen placentas (23.5%) showed positive expression of all 4 EBV latent genes; only the glandular epithelial cells of the decidua showed EBV gene expression. EBV infection status was not significantly correlated with maternal, fetal, or placental factors. The nuclei of EBV-positive cells were significantly larger, longer, and round-shaped than those of EBV-negative cells regardless of EBV-infection status of the placenta. For the first time, evidence of EBV gene expression has been shown in placental tissues. Furthermore, we have characterized its cytological features, allowing screening of EBV infection through microscopic examination.
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Affiliation(s)
- Younghoon Kim
- Department of Pathology, Seoul National University College of Medicine, Seoul, Korea
- Laboratory of Epigenetics, Cancer Research Institute, Seoul National University, Seoul, Korea
| | - Hye Sung Kim
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea
| | - Joong Shin Park
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea
| | - Chong Jai Kim
- Department of Pathology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Woo Ho Kim
- Department of Pathology, Seoul National University College of Medicine, Seoul, Korea.
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Diagnosis of Oral Hairy Leukoplakia: The Importance of EBV In Situ Hybridization. Int J Dent 2017; 2017:3457479. [PMID: 28798771 PMCID: PMC5536144 DOI: 10.1155/2017/3457479] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Revised: 05/29/2017] [Accepted: 06/19/2017] [Indexed: 11/18/2022] Open
Abstract
Oral hairy leukoplakia (OHL) is caused by the Epstein-Barr virus (EBV), which has been related to HIV infection. In situ hybridization (ISH) is the gold-standard diagnosis of OHL, but some authors believe in the possibility of performing the diagnosis based on clinical basis. The aim of this study is diagnose incipient lesions of OHL by EBV ISH of HIV-infected patients and the possible correlations with clinical characteristics of the patients. Ninety-four patients were examined and those presenting with clinical lesions compatible to OHL were submitted to biopsy prior to EBV ISH. Twenty-eight patients had lesions clinically compatible to the diagnosis of OHL, but only 20 lesions were confirmed by EBV ISH. The patients with OHL had a mean age of 41.9 years and were HIV-infected for 11.2 years, on average, including CD4 count of 504.7 cells/mm3 and log10 viral load = 1.1. Among the quantitative variables, there was a statistically significant correlation with age only (P = 0.030). In conclusion, the presence of OHL in patients with HIV/AIDS results in changes in the epidemiological characteristics of the disease, and this fact allied with subtle clinical-morphological features makes clinical diagnosis very difficult. Therefore, EBV ISH is important for a definitive diagnosis of OHL.
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Davis G, Perks A, Liyanage P, Staines K. Oral hairy leukoplakia arising in a patient with hairy cell leukaemia: the first reported case. BMJ Case Rep 2017; 2017:bcr-2016-218663. [PMID: 28385698 DOI: 10.1136/bcr-2016-218663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Oral hairy leukoplakia (OHL) is an oral mucosal lesion that is associated with Epstein-Barr virus infection. It commonly presents as an asymptomatic, non-removable white patch on the lateral borders of the tongue in individuals who are immunocompromised. Historically, OHL was thought to be pathognomonic of HIV infection; however, it is now an established phenomenon in a range of conditions affecting immune competence. Hairy cell leukaemia (HCL) is a rare chronic B cell lymphoproliferative disease named after the distinctive cytology of the atypical cells. We report the first case of OHL arising in an individual with HCL that resolved following remission of the haematological malignancy.
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Affiliation(s)
- Gemma Davis
- Oral Medicine, University of Bristol Dental Hospital, Bristol, UK
| | - Alexandra Perks
- Oral Medicine, University of Bristol Dental Hospital, Bristol, UK
| | - Pemith Liyanage
- Oral and Maxillofacial Pathology, University of Bristol Dental Hospital, Bristol, UK
| | - Konrad Staines
- Oral Medicine, University of Bristol Dental Hospital, Bristol, UK
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Vale DAD, Martins FME, Silva PHBD, Ortega KL. Retrospective analysis of the clinical behavior of oral hairy leukoplakia in 215 HIV-seropositive patients. Braz Oral Res 2016; 30:e118. [PMID: 27901200 DOI: 10.1590/1807-3107bor-2016.vol30.0118] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Accepted: 08/25/2016] [Indexed: 11/21/2022] Open
Abstract
Oral manifestations are common findings in human immunodeficiency virus (HIV) infected patients and frequently influence the overall health. Oral hairy leukoplakia (OHL) is strongly associated with HIV infection demonstrating its relationship with the individual's immune status and progression of immunosuppression. This study aims to retrospectively evaluate OHL in HIV patients, analyzing its incidence, demographic aspects and possible changes in clinical and epidemiological profile of the disease over 17 years. The records of 1600 HIV-infected patients were reviewed. The data were correlated and analyzed, considering HIV exposure category, age, gender, harmful habits, CD4 level, use and type of antiretroviral. OHL was observed in 215 (13.4%) patients. Most were men in the fourth decade of life, 171 (79.5%) and 112 (52,1%) respectively, but an increase in the incidence of OHL among female patients and those in the fifth decade of life was observed. Tobacco smoking was the most frequent harmful habit reported by 114 (68%) patients. OHL occurred mostly in patients with CD4 counts between 200 and 500 cells/mm3 35 (55.5%). The lower incidence of OHL was found among patients using at least one non-nucleoside reverse transcriptase inhibitor (NNRTI). OHL is related to CD4 count, use of ARVT and tobacco smoking and is also more prevalent in men in the fourth decade of life. These characteristics were recognized in absolute values, but when verifying the behavior over the years we noticed that the incidence of OHL is decreasing and its epidemiological characteristics changing.
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Affiliation(s)
- Daniela Assis do Vale
- Universidade de São Paulo - USP, Special Care Dentistry Center, Department of Oral Pathology, São Paulo, SP, Brazil
| | - Fabiana Martins E Martins
- Universidade de São Paulo - USP, Special Care Dentistry Center, Department of Oral Pathology, São Paulo, SP, Brazil
| | | | - Karem López Ortega
- Universidade de São Paulo - USP, Special Care Dentistry Center, Department of Oral Pathology, São Paulo, SP, Brazil
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11
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Epstein-Barr Virus and Its Association with Oral Hairy Leukoplakia: A Short Review. Int J Dent 2016; 2016:4941783. [PMID: 27047546 PMCID: PMC4800082 DOI: 10.1155/2016/4941783] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Revised: 02/12/2016] [Accepted: 02/15/2016] [Indexed: 12/27/2022] Open
Abstract
In immunocompromised subjects, Epstein-Barr virus (EBV) infection of terminally differentiated oral keratinocytes may result in subclinical productive infection of the virus in the stratum spinosum and in the stratum granulosum with shedding of infectious virions into the oral fluid in the desquamating cells. In a minority of cases this productive infection with dysregulation of the cell cycle of terminally differentiated epithelial cells may manifest as oral hairy leukoplakia. This is a white, hyperkeratotic, benign lesion of low morbidity, affecting primarily the lateral border of the tongue. Factors that determine whether productive EBV replication within the oral epithelium will cause oral hairy leukoplakia include the fitness of local immune responses, the profile of EBV gene expression, and local environmental factors.
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12
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Chambers AE, Conn B, Pemberton M, Robinson M, Banks R, Sloan P. Twenty-first-century oral hairy leukoplakia--a non-HIV-associated entity. Oral Surg Oral Med Oral Pathol Oral Radiol 2015; 119:326-32. [PMID: 25600979 DOI: 10.1016/j.oooo.2014.11.012] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2014] [Revised: 11/10/2014] [Accepted: 11/19/2014] [Indexed: 12/15/2022]
Abstract
OBJECTIVE This study presents the clinicopathologic features of a series (N = 35) of patients with non-human immunodeficiency virus (HIV)-associated oral hairy leukoplakia (OHL). METHODS Patients with non-HIV-associated OHL were identified from three centers. Epstein-Barr virus infection was demonstrated by using EBV early ribonucleic acid in situ hybridization. The presence of Candida co-infection was evaluated by diastase periodic acid-Schiff staining. The clinical features were determined by review of the medical records. RESULTS Twenty-eight patients had intercurrent respiratory problems requiring long-term steroid inhaler use, four suffered from autoimmune diseases requiring immunosuppressant therapy, and four had diabetes. The majority of lesions were located on the tongue, and 24 showed evidence of Candida co-infection. CONCLUSIONS In the twenty-first century, the presence of OHL should not be regarded as pathognomic for HIV infection or significant systemic immunosuppression. Local and systemic immunosuppression, in the form of steroid inhaler use, is a risk factor for the development of OHL.
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Affiliation(s)
- Anne Elizabeth Chambers
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Department of Cellular Pathology, Royal Victoria Infirmary, Queen Victoria Road, Newcastle upon Tyne, UK.
| | - Brenden Conn
- Royal Infirmary of Edinburgh, Department of Pathology, Royal Infirmary Edinburgh, Scotland
| | - Michael Pemberton
- University Dental Hospital of Manchester, Department of Oral Medicine, University Dental Hospital of Manchester, Higher Cambridge Street, Manchester, UK
| | - Max Robinson
- Newcastle University, Centre for Oral Health Research, Newcastle University, Framlington Place, Newcastle upon Tyne, UK
| | - Rob Banks
- Sunderland Royal Hospital, Department of Oral and Maxillofacial Surgery, Sunderland Royal Hospital, Kayll Road, Sunderland, Tyne and Wear, UK
| | - Philip Sloan
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Department of Cellular Pathology, Royal Victoria Infirmary, Queen Victoria Road, Newcastle upon Tyne, UK
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Prasad JL, Bilodeau EA. Oral hairy leukoplakia in patients without HIV: presentation of 2 new cases. Oral Surg Oral Med Oral Pathol Oral Radiol 2014; 118:e151-60. [PMID: 25096885 DOI: 10.1016/j.oooo.2014.05.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2014] [Revised: 04/10/2014] [Accepted: 05/04/2014] [Indexed: 11/18/2022]
Abstract
OBJECTIVE We report 2 cases of oral hairy leukoplakia (OHL) in patients without HIV and present a comprehensive review of OHL in HIV-negative individuals. STUDY DESIGN Two cases of non-HIV-associated OHL are described. A PubMed search identified previously reported cases. The attributes of those cases were ascertained. RESULTS OHL was confirmed in both of our cases. Both patients used inhaled steroids for pulmonary disorders, and were found to have depressed levels of immunoglobulin M. Additionally, 76 cases were identified in the literature. The condition occurred in association with various medical conditions, with the majority of patients on immunosuppressant medications (67 of 76). Systemic drugs were implicated most frequently. The condition has also been reported in healthy individuals (6 of 76). CONCLUSIONS Although thought of as an HIV/AIDS-associated condition, OHL can develop in patients without HIV, including healthy individuals. There is a strong correlation between the use of immunosuppressants and development of OHL in these patients.
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Affiliation(s)
- Joanne Leger Prasad
- Clinical Assistant Professor, Department of Diagnostic Sciences, University of Pittsburgh School of Dental Medicine, Pittsburgh, PA, USA.
| | - Elizabeth Ann Bilodeau
- Assistant Professor, Department of Diagnostic Sciences, University of Pittsburgh School of Dental Medicine, Pittsburgh, PA, USA
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Sand L, Jalouli J. Viruses and oral cancer. Is there a link? Microbes Infect 2014; 16:371-8. [PMID: 24613199 DOI: 10.1016/j.micinf.2014.02.009] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2013] [Revised: 02/24/2014] [Accepted: 02/24/2014] [Indexed: 12/28/2022]
Abstract
Oral squamous cell carcinoma (OSCC) is the most common malignant tumour of the oral cavity. The aetiology of epithelial cancer of the head and neck is considered to be a multifactorial, sequential process. DNA viruses are found in many different cancers and are also capable of transforming cells to a malignant phenotype. Human Papilloma Virus (HPV) has been proposed as risk factors in OSCC development and HPV type 16 is the most important subtype. Other oncogenic virus species i.e., Epstein-Barr Virus and Herpes Simplex Virus Type 1 have been proposed to be involved in oral carcinogenesis. However, no convincing evidence exist that they are an established risk factor in OSCC. Therefore more studies are needed in order to clarify the different aspects of virus involvement. Here, we review the existing literature on viral involvement in oral cancer.
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Affiliation(s)
- Lars Sand
- Department of Surgical Sciences, Oral and Maxillofacial Surgery, Medical Faculty, Uppsala University, Akademiska sjukhuset, 751 85 Uppsala, Sweden.
| | - Jamshid Jalouli
- Department of Surgical Sciences, Oral and Maxillofacial Surgery, Medical Faculty, Uppsala University, Akademiska sjukhuset, 751 85 Uppsala, Sweden
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15
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Braz-Silva PH, Santos RTM, Schussel JL, Gallottini M. Oral hairy leukoplakia diagnosis by Epstein-Barr virusin situhybridization in liquid-based cytology. Cytopathology 2013; 25:21-6. [DOI: 10.1111/cyt.12053] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/17/2013] [Indexed: 11/28/2022]
Affiliation(s)
- P. H. Braz-Silva
- Laboratory of Virology; Institute of Tropical Medicine; University of São Paulo; São Paulo Brazil
- Department of Oral Pathology; School of Dentistry; University of São Paulo; São Paulo Brazil
| | - R. T. M. Santos
- Division of Pathology; Adolfo Lutz Institute; São Paulo Brazil
| | - J. L. Schussel
- Department of Oral and Maxillofacial Surgery; Erasto Gaertner Hospital; Curitiba Brazil
| | - M. Gallottini
- Department of Oral Pathology; School of Dentistry; University of São Paulo; São Paulo Brazil
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16
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Petti S, Polimeni A, Berloco PB, Scully C. Orofacial diseases in solid organ and hematopoietic stem cell transplant recipients. Oral Dis 2012; 19:18-36. [PMID: 22458357 DOI: 10.1111/j.1601-0825.2012.01925.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Solid organ transplant (SOT) and hematopoietic stem cell transplant (HSCT) recipients are at risk of several diseases, principally attributable to immunosuppression. This global overview of SOT/HSCT-associated orofacial diseases is aimed at providing a practical instrument for the oral healthcare management of SOT/HSCT recipients. METHODS Literature search was made through MEDLINE. The associations between orofacial diseases and SOT/HSCT were assessed using observational studies and case series and were classified into 'association', 'no association', and 'unclear association'. RESULTS Lip/oral cancers, drug-induced gingival overgrowth (DIGO), infections, including hairy leukoplakia and, less frequently, post-transplantation lymphoproliferative disorders (PTLDs) and oral lichenoid lesions of graft-versus-host disease (GVHD), were associated with SOT. Lip/oral cancers, GVHD, mucositis, DIGO, infections and, less frequently, PTLDs were associated with HSCT. Associations of orofacial granulomatosis-like lesions and oral mucosa-associated lymphoid tissue-type lymphoma with SOT, and of pyogenic granuloma and hairy leukoplakia with HSCT were unclear. Periodontal disease and dental caries were not associated with SOT/HSCT. For none of the local treatments was there a strong evidence of effectiveness. CONCLUSIONS Solid organ transplant/HSCT recipients are at risk of orofacial diseases. Adequate management of these patients alleviates local symptoms responsible for impaired eating, helps prevent systemic and lethal complications, and helps where dental healthcare has been neglected.
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Affiliation(s)
- S Petti
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy.
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17
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Braz-Silva PH, Magalhães MHCG, Hofman V, Ortega KL, Ilie MI, Odin G, Vielh P, Hofman P. Usefulness of oral cytopathology in the diagnosis of infectious diseases. Cytopathology 2010; 21:285-99. [PMID: 20629682 DOI: 10.1111/j.1365-2303.2010.00779.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
In recent years, the incidence of oral opportunistic infections has increased, partly due to the widespread implementation of organ and bone marrow transplantation and the increase in the prevalence of human immunodeficiency virus (HIV) infection. Cytology can be used as a rapid, inexpensive and simple routine procedure in diagnosing infectious diseases of the mouth. Moreover, ancillary methods can be applied to cytological samples, increasing the specificity and sensitivity for the diagnosis of infectious diseases. This review describes the cytopathological features of the main viral, fungal, bacterial and parasitic infections of the mouth. Cytological techniques of specimen collection, identification of infectious agents by cytomorphological approaches and ancillary methods, and diagnostic pitfalls will be discussed.
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Affiliation(s)
- P H Braz-Silva
- Laboratory of Clinical and Experimental Pathology, Pasteur Hospital, University of Nice Sophia Antipolis, Nice, France
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18
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Bilodeau E, Alawi F, Costello BJ, Prasad JL. Molecular diagnostics for head and neck pathology. Oral Maxillofac Surg Clin North Am 2010; 22:183-94. [PMID: 20159486 DOI: 10.1016/j.coms.2009.10.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Molecular diagnostic techniques are quickly finding a role in the detection and diagnosis of tumors, and in predicting their behavior. They may also prove useful in developing new therapeutic approaches to head and neck cancer. The surgeon working in the craniomaxillofacial region should have an understanding of these technologies, their availability in various settings, and how they affect various aspects of treatment, particularly in the detection and treatment of malignancies. This article offers an overview of recent advances in molecular diagnostic techniques, with their implications for diagnosis and management of head and neck tumors.
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Affiliation(s)
- Elizabeth Bilodeau
- Department of Oral and Maxillofacial Surgery, University of Pittsburgh School of Dental Medicine, 3501 Terrace Street, Pittsburgh, PA 15261, USA
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