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Béziat V, Casanova JL, Jouanguy E. Human genetic and immunological dissection of papillomavirus-driven diseases: new insights into their pathogenesis. Curr Opin Virol 2021; 51:9-15. [PMID: 34555675 DOI: 10.1016/j.coviro.2021.09.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 08/26/2021] [Accepted: 09/03/2021] [Indexed: 12/23/2022]
Abstract
Human papillomaviruses (HPVs) are responsible for cutaneous and mucosal lesions. Persistent HPV infection remains a leading cause of uterine cancer in women, but also of cutaneous squamous cell carcinoma in patients with epidermodysplasia verruciformis (EV), and of rare and devastating benign tumors, such as 'tree-man' syndrome. HPV infections are usually asymptomatic or benign in the general population. Severe manifestations in otherwise healthy subjects can attest to inherited immunodeficiencies. The human genetic dissection of these cases has identified critical components of the immune response to HPVs, including the non-redundant roles of keratinocyte-intrinsic immunity in controlling β-HPVs, and of T cell-dependent adaptive immunity for controlling all HPV types. A key role of the CD28 T-cell costimulation pathway in controlling common warts due to HPVs was recently discovered. This review summarizes the state of the art in the human genetics of HPV infection, focusing on two key affected cell types: keratinocytes and T cells.
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Affiliation(s)
- Vivien Béziat
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Institut National de la Santé et de la Recherche Médicale (INSERM) UMR-1163, Necker Hospital for Sick Children, Paris, France; University of Paris, Imagine Institute, Paris, France; St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, Rockefeller University, New York, USA.
| | - Jean-Laurent Casanova
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Institut National de la Santé et de la Recherche Médicale (INSERM) UMR-1163, Necker Hospital for Sick Children, Paris, France; University of Paris, Imagine Institute, Paris, France; St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, Rockefeller University, New York, USA; Howard Hughes Medical Institute, New York, USA
| | - Emmanuelle Jouanguy
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Institut National de la Santé et de la Recherche Médicale (INSERM) UMR-1163, Necker Hospital for Sick Children, Paris, France; University of Paris, Imagine Institute, Paris, France; St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, Rockefeller University, New York, USA
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Abstract
Human papillomaviruses (HPVs) infect squamous epithelia and can induce hyperproliferative lesions. More than 220 different HPV types have been characterized and classified into five different genera. While mucosal high-risk HPVs have a well-established causal role in anogenital carcinogenesis, the biology of cutaneous HPVs is less well understood.From patients with the rare genetic disorder epidermodysplasia verruciformis (EV) and animal models, evidence is accumulating that cutaneous PV of genus β synergize with ultraviolet (UV) radiation in the development of cutaneous squamous cell carcinoma (cSCC). In 2009, the International Agency for Research on Cancer (IARC) classified the genus β-HPV types 5 and 8 as "possible carcinogenic" biological agents (group 2B) in EV disease. Epidemiological and biological studies indicate that genus β-PV infection may also play a role in UV-mediated skin carcinogenesis in non-EV patients. However, they rather act at early stages of carcinogenesis and become dispensable for the maintenance of the malignant phenotype, compatible with a "hit-and-run" mechanism.This chapter will give an overview on genus β-PV infections and discuss similarities and differences of cutaneous and genus α mucosal high-risk HPV in epithelial carcinogenesis.
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Gheit T. Mucosal and Cutaneous Human Papillomavirus Infections and Cancer Biology. Front Oncol 2019; 9:355. [PMID: 31134154 PMCID: PMC6517478 DOI: 10.3389/fonc.2019.00355] [Citation(s) in RCA: 144] [Impact Index Per Article: 28.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 04/17/2019] [Indexed: 12/13/2022] Open
Abstract
Papillomaviridae is a family of small non-enveloped icosahedral viruses with double-stranded circular DNA. More than 200 different human papillomaviruses (HPVs) have been listed so far. Based on epidemiological data, a subgroup of alphapapillomaviruses (alpha HPVs) was referred to as high-risk (HR) HPV types. HR HPVs are the etiological agents of anogenital cancer and a subset of head and neck cancers. The cutaneous HPV types, mainly from beta and gamma genera, are widely present on the surface of the skin in the general population. However, there is growing evidence of an etiological role of betapapillomaviruses (beta HPVs) in non-melanoma skin cancer (NMSC), together with ultraviolet (UV) radiation. Studies performed on mucosal HR HPV types, such as 16 and 18, showed that both oncoproteins E6 and E7 play a key role in cervical cancer by altering pathways involved in the host immune response to establish a persistent infection and by promoting cellular transformation. Continuous expression of E6 and E7 of mucosal HR HPV types is essential to initiate and to maintain the cellular transformation process, whereas expression of E6 and E7 of cutaneous HPV types is not required for the maintenance of the skin cancer phenotype. Beta HPV types appear to play a role in the initiation of skin carcinogenesis, by exacerbating the accumulation of UV radiation-induced DNA breaks and somatic mutations (the hit-and-run mechanism), and they would therefore act as facilitators rather than direct actors in NMSC. In this review, the natural history of HPV infection and the transforming properties of various HPV genera will be described, with a particular focus on describing the state of knowledge about the role of cutaneous HPV types in NMSC.
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Affiliation(s)
- Tarik Gheit
- Infections and Cancer Biology Group, International Agency for Research on Cancer (IARC), Lyon, France
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Nunes EM, Talpe-Nunes V, Sichero L. Epidemiology and biology of cutaneous human papillomavirus. Clinics (Sao Paulo) 2018; 73:e489s. [PMID: 30133564 PMCID: PMC6097087 DOI: 10.6061/clinics/2018/e489s] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Accepted: 02/06/2018] [Indexed: 01/16/2023] Open
Abstract
Cutaneous human papillomaviruses (HPVs) include β- and γ-HPVs, in addition to a small fraction of α-HPVs. β-HPVs were first isolated from patients with the rare genetic disorder Epidermodysplasia verruciformis, and they are associated with the development of nonmelanoma skin cancer at sun-exposed skin sites in these individuals. Organ transplant recipients also have greater susceptibility to β-HPV infection of the skin and an increased risk of developing nonmelanoma skin cancer. In both immunosuppressed and immunocompromised individuals, cutaneous HPVs are ubiquitously disseminated throughout healthy skin and may be an intrinsic part of the commensal flora. Functional analysis of E6 and E7 proteins of specific cutaneous HPVs has provided a mechanistic comprehension of how these viruses may induce carcinogenesis. Nevertheless, additional research is crucial to better understand the pathological implications of the broad distribution of these HPVs.
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Affiliation(s)
- Emily M Nunes
- Centro de Investigação Translacional em Oncologia, Instituto do Cancer do Estado de Sao Paulo (ICESP), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
- *Corresponding author. E-mail:
| | - Valéria Talpe-Nunes
- Centro de Investigação Translacional em Oncologia, Instituto do Cancer do Estado de Sao Paulo (ICESP), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Laura Sichero
- Centro de Investigação Translacional em Oncologia, Instituto do Cancer do Estado de Sao Paulo (ICESP), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
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de Jong SJ, Imahorn E, Itin P, Uitto J, Orth G, Jouanguy E, Casanova JL, Burger B. Epidermodysplasia Verruciformis: Inborn Errors of Immunity to Human Beta-Papillomaviruses. Front Microbiol 2018; 9:1222. [PMID: 29946305 PMCID: PMC6005841 DOI: 10.3389/fmicb.2018.01222] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 05/22/2018] [Indexed: 12/24/2022] Open
Abstract
Epidermodysplasia verruciformis (EV) is an autosomal recessive skin disorder with a phenotype conditional on human beta-papillomavirus (beta-HPV) infection. Such infections are common and asymptomatic in the general population, but in individuals with EV, they lead to the development of plane wart-like and red or brownish papules or pityriasis versicolor-like skin lesions, from childhood onwards. Most patients develop non-melanoma skin cancer (NMSC), mostly on areas of UV-exposed skin, from the twenties or thirties onwards. At least half of the cases of typical EV are caused by biallelic loss-of-function mutations of TMC6/EVER1 or TMC8/EVER2. The cellular and molecular basis of disease in TMC/EVER-deficient patients is unknown, but a defect of keratinocyte-intrinsic immunity to beta-HPV is suspected. Indeed, these patients are not susceptible to other infectious diseases and have apparently normal leukocyte development. In contrast, patients with an atypical form of EV due to inborn errors of T-cell immunity invariably develop clinical symptoms of EV in the context of other infectious diseases. The features of the typical and atypical forms of EV thus suggest that the control of beta-HPV infections requires both EVER1/EVER2-dependent keratinocyte-intrinsic immunity and T cell-dependent adaptive immunity.
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Affiliation(s)
- Sarah J de Jong
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York NY, United States
| | - Elias Imahorn
- Department of Biomedicine, University Hospital of Basel, University of Basel, Basel, Switzerland
| | - Peter Itin
- Department of Biomedicine, University Hospital of Basel, University of Basel, Basel, Switzerland.,Department of Dermatology, University Hospital of Basel, Basel, Switzerland
| | - Jouni Uitto
- Department of Dermatology and Cutaneous Biology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, United States.,Jefferson Institute of Molecular Medicine, Thomas Jefferson University, Philadelphia PA, United States
| | | | - Emmanuelle Jouanguy
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York NY, United States.,INSERM UMR 1163, Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Necker Hospital for Sick Children, Paris, France.,Imagine Institute, Paris Descartes University, Paris, France
| | - Jean-Laurent Casanova
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York NY, United States.,INSERM UMR 1163, Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Necker Hospital for Sick Children, Paris, France.,Imagine Institute, Paris Descartes University, Paris, France.,Pediatric Hematology and Immunology Unit, Necker Hospital for Sick Children, Paris, France.,Howard Hughes Medical Institute, New York NY, United States
| | - Bettina Burger
- Department of Biomedicine, University Hospital of Basel, University of Basel, Basel, Switzerland
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Prevalence and Associated Risk Factors of Human Papillomavirus in Healthy Skin Specimens Collected from Rural Anyang, China, 2006-2008. J Invest Dermatol 2016; 136:1191-1198. [PMID: 26916390 DOI: 10.1016/j.jid.2016.02.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2015] [Revised: 02/02/2016] [Accepted: 02/05/2016] [Indexed: 12/20/2022]
Abstract
Skin infections with cutaneous human papillomavirus (HPV) have been linked to the development of non-melanoma skin cancer, in which mucosal HPV may also play a crucial role. However, systematic investigations of the distribution and associated factors of HPV infection in healthy skin of the general population are scarce. HPV DNA from palmar exfoliated cells of 2,087 individuals was detected by FAP6085/64 and SPF1/GP6+ primers followed by sequencing. A total of 338 papillomavirus types were detected, with HPV-3, HPV-57, and HPV-49 being the most dominant types. The overall prevalence for HPV DNA on skin was 79.92% and for alpha-, beta-, and gamma-HPV were 27.07%, 38.76%, and 29.56%, respectively. Having multiple lifetime sexual partners (adjusted odds ratio 1.60), being a migrant worker (adjusted odds ratio 2.05, reference: farmers), and frequent bathing (Ptrend = 0.001) were associated with alpha-HPV DNA presence. Advancing age increased the detection risk of beta-HPV (Ptrend = 0.001). Higher education (Ptrend = 0.017) and frequent bathing (Ptrend = 0.001) were positively related to gamma-HPV positivity. This study demonstrates that alpha-HPV commonly exists on healthy skin of the general population in rural China, and alpha- and gamma-HPV infections are related to certain behaviors, different from beta-HPV infection. These findings are crucial to better understanding the biology of HPV infection and may be suggestive of the potential transmission of these viruses.
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Human papillomaviruses: shared and distinct pathways for pathogenesis. Curr Opin Virol 2015; 14:87-92. [PMID: 26398222 DOI: 10.1016/j.coviro.2015.09.001] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Revised: 08/31/2015] [Accepted: 09/01/2015] [Indexed: 12/17/2022]
Abstract
Over 200 types of human papillomaviruses (HPV) have been identified that infect epithelial cells at different anatomic locations. HPVs are grouped into five genera with the alpha and beta viruses being the most commonly studied. Members of the alpha HPV genus infect genital epithelia and are the causative agents of many anogenital cancers. Beta HPVs infect cutaneous epithelia and have been suggested as co-factors in the development of non-melanoma skin cancers. Recent studies have shown that activation of DNA damage pathways is important for the productive life cycle of the alpha HPVs while the beta viruses suppress their activation. These differences likely contribute to the varying types of lesions and malignancies that are associated with these viruses.
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Batrani M, Mahalingam M. Human papillomavirus and cutaneous squamous cell carcinoma: the dilemma continues. ACTA ACUST UNITED AC 2014. [DOI: 10.1586/edm.12.6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Comparison of different assays to assess human papillomavirus (HPV) type 16- and 18-specific antibodies after HPV infection and vaccination. CLINICAL AND VACCINE IMMUNOLOGY : CVI 2013; 20:1329-32. [PMID: 23740920 DOI: 10.1128/cvi.00153-13] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
We compared the measurement of human papillomavirus (HPV)-specific serum antibody levels with the virus-like-particle multiplex immunoassay (VLP-MIA), competitive Luminex immunoassay (cLIA), and glutathione S-transferase (GST) L1-based MIA. Using a large panel of serum samples, these assays showed mutually good correlations for both naturally induced and vaccine-derived HPV-specific antibody levels. However, an adaptation of the GST L1-based MIA resulted in an improved correlation with both cLIA and VLP-MIA.
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Abstract
Human papillomaviruses (HPVs) are small double-stranded DNA viruses that infect the epithelia of skin or mucosa. Cutaneous HPV is ubiquitous and many children have skin warts at some stage during childhood and a high proportion of the adult population have asymptomatic skin HPV infections. While a subset of mucosal HPV types are involved in cervical cancer, the role for cutaneous HPV types in skin cancer is still under debate. There is some evidence that the skin HPV types have mechanisms to induce skin cancer, but the role of HPV infection has never been proved in larger epidemiological studies and is not well understood. Cutaneous HPV serology has been employed more commonly during the last decade to help find a link between cutaneous HPV and skin cancer. This review covers the findings from cutaneous HPV serology studies published during the last decade and discusses differences in seroprevalence and risk factors.
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Affiliation(s)
- Annika Antonsson
- Queensland Institute of Medical Research, Cancer Control Group, Population Health Department, Herston, Brisbane, Australia.
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Namujju PB, Waterboer T, Banura C, Muwonge R, Mbidde EK, Byaruhanga R, Muwanga M, Surcel HM, Pawlita M, Lehtinen M. Risk of seropositivity to multiple oncogenic human papillomavirus types among human immunodeficiency virus-positive and -negative Ugandan women. J Gen Virol 2011; 92:2776-2783. [DOI: 10.1099/vir.0.035923-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
To understand the prospects for human papillomavirus (HPV) mass vaccination in the setting of a developing country, we studied the co-occurrence of seropositivity to multiple high-risk (hr) HPV types among HIV-positive and HIV-negative Ugandan women. Our seroepidemiological study was conducted among 2053 women attending antenatal clinics. Sera were analysed for antibodies to eight hrHPV types of the α-7 (18/45) and α-9 (16/31/33/35/52/58) species of HPV by using a multiplex serology assay. Our results show that seropositivity for greater than one hrHPV type was as common (18 %) as for a single type (18 %). HIV-positive women had higher HPV16, HPV18 and HPV45 seroprevalences than HIV-negative women. In multivariate logistic regression analysis, age (>30 years) and level of education (secondary school and above) reduced the risk, whereas parity (>5) and HIV-positivity increased the risk for multiple hrHPV seropositivity. However, in stepwise logistic regression analyses, HIV-status remained the only independent, stand-alone risk factor [odds ratio (OR) 1.7, 95 % confidence interval (CI) 1.0–2.8). On the other hand, the risk of HPV16 or HPV18 seropositive women, as compared to HPV16 or HPV18 seronegative women, for being seropositive to other hrHPV types was not significantly different when they were grouped by HIV-status (ORHPV16/HIV+ 12, 95 % CI 4.5–32 versus ORHPV16/HIV− 22, 95 % CI 15–31 and ORHPV18/HIV+ 58, 95 % CI 14–242 versus ORHPV18/HIV− 45, 95 % CI 31–65). In conclusion, seropositivity to HPV16, HPV18 and to non-vaccine hrHPV types is common in Ugandan women, suggesting that there is little natural cross-protective immunity between the types. HIV-positivity was an independent, stand-alone, albeit moderate risk factor for multiple hrHPV seropositivity. HPV mass vaccination may be the most appropriate method in the fight against cervical cancer in the Ugandan population.
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Affiliation(s)
- P. B. Namujju
- School of Health Sciences, University of Tampere, Tampere, Finland
- Uganda Virus Research Institute, Entebbe, Uganda
- National Institute for Health and Welfare, Oulu, Finland
| | - T. Waterboer
- German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - C. Banura
- College of Health Sciences, Makerere University, Kampala, Uganda
| | - R. Muwonge
- International Agency for Research on Cancer, Lyon, France
| | - E. K. Mbidde
- Uganda Virus Research Institute, Entebbe, Uganda
| | - R. Byaruhanga
- Department of Obstetrics and Gynaecology, San Raphael of St Francis Hospital Nsambya, Kampala, Uganda
| | | | - H.-M. Surcel
- National Institute for Health and Welfare, Oulu, Finland
| | - M. Pawlita
- German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - M. Lehtinen
- School of Health Sciences, University of Tampere, Tampere, Finland
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Heratizadeh A, Völker B, Kupsch E, Wichmann K, Kapp A, Werfel T. [Successful symptomatic treatment of epidermodysplasia verruciformis with imiquimod 5% cream]. Hautarzt 2011; 61:1052-5. [PMID: 20824263 DOI: 10.1007/s00105-010-1998-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
A 19-year-old patient presented with epidermodysplasia verruciformis (EV). In this genodermatosis, pathogenetic factors such as infection by human papilloma viruses as well as sun exposure are considered responsible for the malignant transformation of EV lesions to skin cancer within decades. So far, several therapeutic strategies have been unsatisfactory. In our case HPV 5b was detected and the associated skin lesions were successfully treated with imiquimod 5% cream.
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Affiliation(s)
- A Heratizadeh
- Klinik für Dermatologie, Allergologie und Venerologie, Medizinische Hochschule Hannover, Ricklinger Str. 5, 30449, Hannover.
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Orth G. Génétique et sensibilité aux papillomavirus: le modèle de l’épidermodysplasie verruciforme. BULLETIN DE L'ACADÉMIE NATIONALE DE MÉDECINE 2010. [DOI: 10.1016/s0001-4079(19)32253-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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