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Zambrano TBS, Ramos SDP, Mendoza NB, Vivas XSG, Dias BG, Maddela NR. Prevalence of HPV16 L1 protein in oral biopsies: A diagnostic study from Ecuador. Diagn Microbiol Infect Dis 2024; 110:116440. [PMID: 39018933 DOI: 10.1016/j.diagmicrobio.2024.116440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Revised: 06/23/2024] [Accepted: 07/10/2024] [Indexed: 07/19/2024]
Abstract
This study was designed to investigate the expression of HPV16 L1-protein in biopsies of oral mucosa samples. The expression of HPV16 L1 protein was investigated in biopsies taken from oral mucosa from patients who required pathological diagnosis of oral lesions. Seventy-two samples were incubated with anti-L1 protein monoclonal antibodies and protein detection was revealed with diaminobenzidine. Expression of L1 protein was performed by a pathologist blinded for tissue diagnosis under light microscopy. Most of the lesions of oral mucosa were present in lining mucosa (75 %) and the most frequent lesion were mucocele (n = 17, 23.6 %), epithelial hyperplasia (n = 6, 8.33 %), fibroma (n = 5, 6.9 %) and inflammatory hyperplasia (n = 5, 6.9 %). L1 protein expression was observed only in five (6.9 %) samples (two squamous cell carcinomas, two epithelial hyperplasia, and one gingival hyperplasia). We concluded that L1 expression in oral biopsies presented a low frequency in oral mucosal biopsies samples.
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Affiliation(s)
| | | | | | | | | | - Naga Raju Maddela
- Departamento de Ciencias Biológicas, Facultad de Ciencias de la Salud, Universidad Técnica de Manabí, Portoviejo 130105, Manabí, Ecuador.
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2
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Lycke KD, Kahlert J, Petersen LK, Damgaard RK, Cheung LC, Gravitt PE, Hammer A. Untreated cervical intraepithelial neoplasia grade 2 and subsequent risk of cervical cancer: population based cohort study. BMJ 2023; 383:e075925. [PMID: 38030154 PMCID: PMC10685285 DOI: 10.1136/bmj-2023-075925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/24/2023] [Indexed: 12/01/2023]
Abstract
OBJECTIVE To describe the long term risk of cervical cancer in women with untreated (that is, undergoing active surveillance) or immediately treated cervical intraepithelial neoplasia grade 2 (CIN2). DESIGN Nationwide population based historical cohort study. SETTING Danish healthcare registries. PARTICIPANTS Women with CIN2 diagnosed in 1998-2020 and aged 18-40 years at diagnosis, who had either active surveillance or immediate treatment with large loop excision of the transformation zone (LLETZ). Women with a previous record of CIN2 or worse or LLETZ were excluded. MAIN OUTCOME MEASURE A Weibull survival model for interval censored time-to-event data was used to estimate the cumulative risk of cervical cancer. Inverse probability treatment weighting was used to adjust estimates for age, index cytology, calendar year, and region of residence. RESULTS The cohort included 27 524 women with CIN2, of whom 12 483 (45%) had active surveillance and 15 041 (55%) had immediate LLETZ. During follow-up, 104 cases of cervical cancer were identified-56 (54%) in the active surveillance group and 48 (46%) in the LLETZ group. The cumulative risk of cervical cancer was comparable across the two groups during the active surveillance period of two years. Thereafter, the risk increased in the active surveillance group, reaching 2.65% (95% confidence interval 2.07% to 3.23%) after 20 years, whereas it remained stable in the LLETZ group at 0.76% (0.58% to 0.95%). CONCLUSIONS Undergoing active surveillance for CIN2, thereby leaving the lesion untreated, was associated with increased long term risk of cervical cancer compared with immediate LLETZ. These findings show the importance of continued follow-up of women having active surveillance.
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Affiliation(s)
- Kathrine Dyhr Lycke
- Department of Obstetrics and Gynaecology, Gødstrup Hospital, Herning, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Johnny Kahlert
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | - Lone Kjeld Petersen
- Department of Obstetrics and Gynaecology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Rikke Kamp Damgaard
- Department of Obstetrics and Gynaecology, Gødstrup Hospital, Herning, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Li C Cheung
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Patti E Gravitt
- Centre for Global Health, National Cancer Institute, Rockville, MD, USA
| | - Anne Hammer
- Department of Obstetrics and Gynaecology, Gødstrup Hospital, Herning, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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Varghese CS, Parish JL, Ferguson J. Lying low-chromatin insulation in persistent DNA virus infection. Curr Opin Virol 2022; 55:101257. [PMID: 35998396 DOI: 10.1016/j.coviro.2022.101257] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 07/08/2022] [Accepted: 07/28/2022] [Indexed: 11/03/2022]
Abstract
Persistent virus infections are achieved when the intricate balance of virus replication, host-cell division and successful immune evasion is met. The genomes of persistent DNA viruses are either maintained as extrachromosomal episomes or can integrate into the host genome. Common to both these strategies of persistence is the chromatinisation of viral DNA by cellular histones which, like host DNA, are subject to epigenetic modification. Epigenetic repression of viral genes required for lytic replication occurs, while genes required for latent or persistent infection are maintained in an active chromatin state. Viruses utilise host-cell chromatin insulators, which function to maintain epigenetic boundaries and enforce this strict transcriptional programme. Here, we review insulator protein function in virus transcription control, focussing on CCCTC-binding factor (CTCF) and cofactors. We describe CTCF-dependent activities in virus transcription regulation through epigenetic and promoter-enhancer insulation, three-dimensional chromatin looping and manipulation of transcript splicing.
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Affiliation(s)
- Christy S Varghese
- Institute of Cancer and Genomic Sciences, College of Medical and Dental Sciences, University of Birmingham, B15 2TT, UK
| | - Joanna L Parish
- Institute of Cancer and Genomic Sciences, College of Medical and Dental Sciences, University of Birmingham, B15 2TT, UK.
| | - Jack Ferguson
- Institute of Cancer and Genomic Sciences, College of Medical and Dental Sciences, University of Birmingham, B15 2TT, UK
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Hammer A, Blaakaer J, de Koning MNC, Steiniche T, Mejlgaard E, Svanholm H, Roensbo MT, Fuglsang K, Doorbar J, Andersen RH, Quint WGV, Gravitt PE. Evidence of latent HPV infection in older Danish women with a previous history of cervical dysplasia. Acta Obstet Gynecol Scand 2022; 101:608-615. [PMID: 35481603 DOI: 10.1111/aogs.14362] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 03/27/2022] [Accepted: 03/28/2022] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Understanding whether human papillomavirus (HPV) may establish latency in the uterine cervix is important. A better understanding of HPV natural history is useful for clinical counseling of women attending screening and to accurately inform health prevention strategies such as screening and HPV vaccination. We evaluated the extent of latent HPV infections in older women with a history of abnormal cytology. MATERIAL AND METHODS We conducted a cross-sectional study in Aarhus, Denmark, from March 2013 through April 2015. Women were enrolled if they underwent cervical amputation or total hysterectomy because of benign disease. Prior to surgery, women completed a questionnaire and a cervical smear was collected for HPV testing and morphological assessment. For evaluation of latency (i.e., no evidence of active HPV infection, but HPV detected in the tissue), we selected women with a history of abnormal cervical cytology or histology, as these women were considered at increased risk of harboring a latent infection. Cervical tissue underwent extensive HPV testing using the SPF10-DEIA-LipA25 assay. RESULTS Of 103 women enrolled, 26 were included in this analysis. Median age was 55 years (interquartile range [IQR] 52-65), and most women were postmenopausal and parous. The median number of sexual partners over the lifetime was six (IQR 3-10), and 85% reported no recent new sexual partner. Five women (19.2%) had evidence of active infection at the time of surgery, and 19 underwent latency evaluation. Of these, a latent infection was detected in 11 (57.9%), with HPV16 being the most prevalent type (50%). Nearly 80% (n = 14) of the 18 women with a history of previous low-grade or high-grade cytology with no treatment had an active or latent HPV infection, with latent infections predominating. HPV was detected in two of the six women with a history of high-grade cytology and subsequent excisional treatment, both as latent infections. CONCLUSIONS HPV can be detected in cervical tissue specimens without any evidence of an active HPV infection, indicative of a latent, immunologically controlled infection. Modeling studies should consider including a latent state in their model when estimating the appropriate age to stop screening and when evaluating the impact of HPV vaccination.
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Affiliation(s)
- Anne Hammer
- Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.,Department of Obstetrics and Gynecology, Gødstrup Hospital, Gødstrup, Denmark
| | - Jan Blaakaer
- Department of Obstetrics and Gynecology, Odense University Hospital, Odense, Denmark.,Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | | | - Torben Steiniche
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.,Department of Pathology, Aarhus University Hospital, Aarhus, Denmark
| | - Else Mejlgaard
- Department of Pathology, Aarhus University Hospital, Aarhus, Denmark
| | - Hans Svanholm
- Department of Pathology, Randers Regional Hospital, Randers, Denmark
| | - Mette T Roensbo
- Department of Renal Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Katrine Fuglsang
- Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark
| | - John Doorbar
- Department of Pathology, University of Cambridge, Cambridge, UK
| | - Rikke H Andersen
- Department of Pathology, Randers Regional Hospital, Randers, Denmark
| | - Wim G V Quint
- DDL Diagnostic Laboratory, Viroclinics-DDL, Rijswijk, the Netherlands
| | - Patti E Gravitt
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland, USA
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Known Benefits and Unknown Risks of Active Surveillance of Cervical Intraepithelial Neoplasia Grade 2. Obstet Gynecol 2022; 139:680-686. [PMID: 35271554 DOI: 10.1097/aog.0000000000004705] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 12/30/2021] [Indexed: 01/18/2023]
Abstract
Cervical intraepithelial neoplasia grade 2 (CIN 2) is an equivocal diagnosis with high interobserver variation. Owing to high regression rates of 50%, many countries recommend active surveillance of CIN 2, especially in women younger than age 25-30 years, where regression rates are even higher (ie, 60%). Additionally, excisional treatment is associated with increased risk of reproductive harm, particularly preterm birth. Active surveillance typically consists of semi-annual follow-up visits for up to 2 years, including colposcopy and either cytology, testing for human papillomavirus, or both. Excisional treatment is recommended for progression or persistent disease after 2 years. Because active surveillance in younger women is relatively new, knowledge on subsequent risk of cervical cancer is limited. Considering human papillomavirus latency, women undergoing active surveillance might be at higher risk of cervical cancer than women undergoing excisional treatment. Furthermore, there are limited data describing preferences of women for the management of CIN 2, and it is also unclear how active surveillance may affect planning for future pregnancy. In this context, biomarkers for risk stratification of CIN 2 into either high or low probability of progression would allow for targeted treatment. Currently, immunohistochemical staining for p16 is used to clarify the histologic diagnosis, but whether it or other biomarkers can be used for risk-stratification in clinical management of women with CIN 2 remains unknown. In conclusion, active surveillance of CIN 2 needs further investigation, including understanding the long-term cervical cancer risk and evaluation of markers that may enable risk stratification of CIN 2.
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Værnesbranden MR, Wiik J, Sjøborg K, Staff AC, Carlsen KCL, Haugen G, Hedlin G, Hilde K, Nordlund B, Nystrand CF, Rangberg A, Rehbinder EM, Rudi K, Rueegg CS, Sandberg Y, Sjelmo S, Skjerven HO, Söderhäll C, Vettukattil R, Jonassen CM. Maternal human papillomavirus infections at mid-pregnancy and delivery in a Scandinavian mother-child cohort study. Int J Infect Dis 2021; 108:574-581. [PMID: 34077798 DOI: 10.1016/j.ijid.2021.05.064] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 05/21/2021] [Accepted: 05/26/2021] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES Human papillomavirus (HPV) infections are common, especially during women's reproductive years, with unclear obstetrical impact. This study aimed to identify HPV prevalence at mid-gestation and delivery, type-specific persistence from mid-gestation to delivery, and risk factors for HPV infection and persistence. METHODS In 757 women from a Scandinavian prospective mother-child cohort, HPV was analyzed in first-void urine samples at mid-gestation and delivery. We used Seegene Anyplex II HPV28 PCR assay for genotyping and semi-quantifying 28 genital HPV genotypes, including 12 high-risk HPVs (HR-HPV). Socio-demographic and health data were collected through e-questionnaires. RESULTS Any-HPV genotype (any of 28 assessed) was detected in 38% of the study cohort at mid-gestation and 28% at delivery, and HR-HPVs in 24% and 16%, respectively. The most prevalent genotype was HPV16: 6% at mid-gestation and 4% at delivery. Persistence of Any-HPV genotype was 52%, as was HR-HPV genotype-specific persistence. A short pre-conception relationship with the child's father and alcohol intake during pregnancy increased HPV infection risk at both time points. Low viral load at mid-gestation was associated with clearance of HPV infections at delivery. CONCLUSION HPV prevalence was higher at mid-gestation compared with delivery, and low viral load was associated with clearance of HPV at delivery.
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Affiliation(s)
- Magdalena R Værnesbranden
- Department of Obstetrics and Gynecology, Østfold Hospital Trust, Kalnes, Norway; University of Oslo, Faculty of Medicine, Institute of Clinical Medicine, Oslo, Norway.
| | - Johanna Wiik
- Department of Obstetrics and Gynecology, Østfold Hospital Trust, Kalnes, Norway; Department of Obstetrics and Gynecology, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
| | - Katrine Sjøborg
- Department of Obstetrics and Gynecology, Østfold Hospital Trust, Kalnes, Norway
| | - Anne Cathrine Staff
- University of Oslo, Faculty of Medicine, Institute of Clinical Medicine, Oslo, Norway; Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
| | - Karin C Lødrup Carlsen
- University of Oslo, Faculty of Medicine, Institute of Clinical Medicine, Oslo, Norway; Division of Pediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Guttorm Haugen
- University of Oslo, Faculty of Medicine, Institute of Clinical Medicine, Oslo, Norway; Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
| | - Gunilla Hedlin
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden; Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Katarina Hilde
- University of Oslo, Faculty of Medicine, Institute of Clinical Medicine, Oslo, Norway; Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
| | - Björn Nordlund
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden; Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Camilla F Nystrand
- Genetic Unit, Centre for Laboratory Medicine, Østfold Hospital Trust, Kalnes, Norway
| | - Anbjørg Rangberg
- Genetic Unit, Centre for Laboratory Medicine, Østfold Hospital Trust, Kalnes, Norway
| | - Eva Maria Rehbinder
- University of Oslo, Faculty of Medicine, Institute of Clinical Medicine, Oslo, Norway; Department of Dermatology and Venereology, Oslo University Hospital, Oslo, Norway
| | - Knut Rudi
- Faculty of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences, Ås, Norway
| | - Corina Silvia Rueegg
- Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway
| | - Yvonne Sandberg
- Genetic Unit, Centre for Laboratory Medicine, Østfold Hospital Trust, Kalnes, Norway
| | - Sigrid Sjelmo
- Department of Obstetrics and Gynecology, Østfold Hospital Trust, Kalnes, Norway
| | - Håvard O Skjerven
- University of Oslo, Faculty of Medicine, Institute of Clinical Medicine, Oslo, Norway; Division of Pediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Cilla Söderhäll
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden; Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Riyas Vettukattil
- University of Oslo, Faculty of Medicine, Institute of Clinical Medicine, Oslo, Norway; Division of Pediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Christine M Jonassen
- Faculty of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences, Ås, Norway; Genetic Unit, Centre for Laboratory Medicine, Østfold Hospital Trust, Kalnes, Norway
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Isaguliants M, Krasnyak S, Smirnova O, Colonna V, Apolikhin O, Buonaguro FM. Genetic instability and anti-HPV immune response as drivers of infertility associated with HPV infection. Infect Agent Cancer 2021; 16:29. [PMID: 33971936 PMCID: PMC8111735 DOI: 10.1186/s13027-021-00368-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 04/16/2021] [Indexed: 12/18/2022] Open
Abstract
Human papillomavirus (HPV) is a sexually transmitted infection common among men and women of reproductive age worldwide. HPV viruses are associated with epithelial lesions and cancers. HPV infections have been shown to be significantly associated with many adverse effects in reproductive function. Infection with HPVs, specifically of high-oncogenic risk types (HR HPVs), affects different stages of human reproduction, resulting in a series of adverse outcomes: 1) reduction of male fertility (male infertility), characterized by qualitative and quantitative semen alterations; 2) impairment of couple fertility with increase of blastocyst apoptosis and reduction of endometrial implantation of trophoblastic cells; 3) defects of embryos and fetal development, with increase of spontaneous abortion and spontaneous preterm birth. The actual molecular mechanism(s) by which HPV infection is involved remain unclear. HPV-associated infertility as Janus, has two faces: one reflecting anti-HPV immunity, and the other, direct pathogenic effects of HPVs, specifically, of HR HPVs on the infected/HPV-replicating cells. Adverse effects observed for HR HPVs differ depending on the genotype of infecting virus, reflecting differential response of the host immune system as well as functional differences between HPVs and their individual proteins/antigens, including their ability to induce genetic instability/DNA damage. Review summarizes HPV involvement in all reproductive stages, evaluate the adverse role(s) played by HPVs, and identifies mechanisms of viral pathogenicity, common as well as specific for each stage of the reproduction process.
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Affiliation(s)
- Maria Isaguliants
- N.F. Gamaleya National Research Center for Epidemiology and Microbiology, Moscow, Russia. .,Chumakov Federal Scientific Center for Research and Development of Immune-and-Biological Products of Russian Academy of Sciences, Moscow, Russia. .,Riga Stradiņs University, Riga, Latvia. .,Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden.
| | - Stepan Krasnyak
- Research Institute of Urology and Interventional Radiology named after N.A. Lopatkin, Moscow, Russia
| | - Olga Smirnova
- N.F. Gamaleya National Research Center for Epidemiology and Microbiology, Moscow, Russia.,Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, Moscow, Russia.,Center for Precision Genome Editing and Genetic Technologies for Biomedecine, Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, Moscow, Russia
| | - Vincenza Colonna
- Institute of Genetics and Biophysics "Adriano Buzzati-Traverso", National Research Council, Naples, Italy
| | - Oleg Apolikhin
- Research Institute of Urology and Interventional Radiology named after N.A. Lopatkin, Moscow, Russia
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Oton-Gonzalez L, Rotondo JC, Cerritelli L, Malagutti N, Lanzillotti C, Bononi I, Ciorba A, Bianchini C, Mazziotta C, De Mattei M, Pelucchi S, Tognon M, Martini F. Association between oncogenic human papillomavirus type 16 and Killian polyp. Infect Agent Cancer 2021; 16:3. [PMID: 33413530 PMCID: PMC7792173 DOI: 10.1186/s13027-020-00342-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 12/25/2020] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Killian polyp (KP) is a benign lesion that arises from the maxillary sinus. The etiology of KP is unknown. The aim of this study was to investigate the potential involvement of human papilloma- (HPV) and polyoma-viruses (HPyV) infections in the onset of KP. METHODS DNA from antral (n = 14) and nasal (n = 14) KP fractions were analyzed for HPV and HPyV sequences, genotypes, viral DNA load and physical status along with expression of viral proteins and p16 cellular protein. RESULTS The oncogenic HPV16 was detected in 3/14 (21.4%) antral KPs, whilst nasal KPs tested HPV-negative (0/14). The mean HPV16 DNA load was 4.65 ± 2.64 copy/104 cell. The whole HPV16 episomal genome was detected in one KP sample, whereas HPV16 DNA integration in two KPs. P16 mRNA level was lower in the KP sample carrying HPV16 episome than in KPs carrying integrated HPV16 and HPV- negative KPs (p< 0.001). None of the antral and nasal KP samples tested positive for HPyV DNA (0/28). CONCLUSIONS A fraction of KP tested positive for the oncogenic HPV16. HPV16 detection in the KP antral portion may be consistent with HPV16 infection derived from the maxillary sinus. HPV16 DNA integration represents a novel finding. Altogether, these data improve our knowledge on the association between KP and HPV infection, whereas it indicates that the KP onset is heterogeneous.
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Affiliation(s)
- Lucia Oton-Gonzalez
- Department of Medical Sciences, Laboratories of Cell Biology and Molecular Genetics, School of Medicine, University of Ferrara, 64/B, Fossato di Mortara Street, 44121, Ferrara, Italy
| | - John Charles Rotondo
- Department of Medical Sciences, Laboratories of Cell Biology and Molecular Genetics, School of Medicine, University of Ferrara, 64/B, Fossato di Mortara Street, 44121, Ferrara, Italy
| | - Luca Cerritelli
- Department of Biomedical Sciences and Specialistic Surgeries, ENT Section, University of Ferrara and University Hospital of Ferrara, 8, Aldo Moro Square, 44124, Cona, Italy
| | - Nicola Malagutti
- Department of Biomedical Sciences and Specialistic Surgeries, ENT Section, University of Ferrara and University Hospital of Ferrara, 8, Aldo Moro Square, 44124, Cona, Italy
| | - Carmen Lanzillotti
- Department of Medical Sciences, Laboratories of Cell Biology and Molecular Genetics, School of Medicine, University of Ferrara, 64/B, Fossato di Mortara Street, 44121, Ferrara, Italy
| | - Ilaria Bononi
- Department of Medical Sciences, Laboratories of Cell Biology and Molecular Genetics, School of Medicine, University of Ferrara, 64/B, Fossato di Mortara Street, 44121, Ferrara, Italy
| | - Andrea Ciorba
- Department of Biomedical Sciences and Specialistic Surgeries, ENT Section, University of Ferrara and University Hospital of Ferrara, 8, Aldo Moro Square, 44124, Cona, Italy
| | - Chiara Bianchini
- Department of Biomedical Sciences and Specialistic Surgeries, ENT Section, University of Ferrara and University Hospital of Ferrara, 8, Aldo Moro Square, 44124, Cona, Italy
| | - Chiara Mazziotta
- Department of Medical Sciences, Laboratories of Cell Biology and Molecular Genetics, School of Medicine, University of Ferrara, 64/B, Fossato di Mortara Street, 44121, Ferrara, Italy
| | - Monica De Mattei
- Department of Medical Sciences, Laboratories of Cell Biology and Molecular Genetics, School of Medicine, University of Ferrara, 64/B, Fossato di Mortara Street, 44121, Ferrara, Italy
| | - Stefano Pelucchi
- Department of Biomedical Sciences and Specialistic Surgeries, ENT Section, University of Ferrara and University Hospital of Ferrara, 8, Aldo Moro Square, 44124, Cona, Italy
| | - Mauro Tognon
- Department of Medical Sciences, Laboratories of Cell Biology and Molecular Genetics, School of Medicine, University of Ferrara, 64/B, Fossato di Mortara Street, 44121, Ferrara, Italy.
| | - Fernanda Martini
- Department of Medical Sciences, Laboratories of Cell Biology and Molecular Genetics, School of Medicine, University of Ferrara, 64/B, Fossato di Mortara Street, 44121, Ferrara, Italy.
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9
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Paul P, Hammer A, Rositch AF, Burke AE, Viscidi RP, Silver MI, Campos N, Youk AO, Gravitt PE. Rates of New Human Papillomavirus Detection and Loss of Detection in Middle-aged Women by Recent and Past Sexual Behavior. J Infect Dis 2020; 223:1423-1432. [PMID: 32870982 DOI: 10.1093/infdis/jiaa557] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 08/27/2020] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Understanding the source of newly detected human papillomavirus (HPV) in middle-aged women is important to inform preventive strategies, such as screening and HPV vaccination. METHODS We conducted a prospective cohort study in Baltimore, Maryland. Women aged 35-60 years underwent HPV testing and completed health and sexual behavior questionnaires every 6 months over a 2-year period. New detection/loss of detection rates were calculated and adjusted hazard ratios were used to identify risk factors for new detection. RESULTS The new and loss of detection analyses included 731 women, and 104 positive for high-risk HPV. The rate of new high-risk HPV detection was 5.0 per 1000 woman-months. Reporting a new sex partner was associated with higher detection rates (adjusted hazard ratio, 8.1; 95% confidence interval, 3.5-18.6), but accounted only for 19.4% of all new detections. Among monogamous and sexually abstinent women, new detection was higher in women reporting ≥5 lifetime sexual partners than in those reporting <5 (adjusted hazard ratio, 2.2; 95% confidence interval, 1.2-4.2). CONCLUSION Although women remain at risk of HPV acquisition from new sex partners as they age, our results suggest that most new detections in middle-aged women reflect recurrence of previously acquired HPV.
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Affiliation(s)
- Proma Paul
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.,Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Anne Hammer
- Department of Obstetrics and Gynecology, Regional Hospital West Jutland, Herning, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.,Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark
| | - Anne F Rositch
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Anne E Burke
- Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Raphael P Viscidi
- Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Michelle I Silver
- Division of Public Health Sciences, Washington University School of Medicine, St Louis, Missouri, USA
| | - Nicole Campos
- Center for Health Decision Science, Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Ada O Youk
- Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Patti E Gravitt
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.,Department of Epidemiology and Public Health, University of Maryland School of Medicine Baltimore, Maryland, USA
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10
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Burley M, Roberts S, Parish JL. Epigenetic regulation of human papillomavirus transcription in the productive virus life cycle. Semin Immunopathol 2020; 42:159-171. [PMID: 31919577 PMCID: PMC7174255 DOI: 10.1007/s00281-019-00773-0] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Accepted: 11/08/2019] [Indexed: 12/13/2022]
Abstract
Human papillomaviruses (HPV) are a large family of viruses which contain a circular, double-stranded DNA genome of approximately 8000 base pairs. The viral DNA is chromatinized by the recruitment of cellular histones which are subject to host cell-mediated post-translational epigenetic modification recognized as an important mechanism of virus transcription regulation. The HPV life cycle is dependent on the terminal differentiation of the target cell within epithelia-the keratinocyte. The virus life cycle begins in the undifferentiated basal compartment of epithelia where the viral chromatin is maintained in an epigenetically repressed state, stabilized by distal chromatin interactions between the viral enhancer and early gene region. Migration of the infected keratinocyte towards the surface of the epithelium induces cellular differentiation which disrupts chromatin looping and stimulates epigenetic remodelling of the viral chromatin. These epigenetic changes result in enhanced virus transcription and activation of the virus late promoter facilitating transcription of the viral capsid proteins. In this review article, we discuss the complexity of virus- and host-cell-mediated epigenetic regulation of virus transcription with a specific focus on differentiation-dependent remodelling of viral chromatin during the HPV life cycle.
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Affiliation(s)
- Megan Burley
- College of Medical and Dental Sciences, Institute of Cancer and Genomic Sciences, University of Birmingham, B152TT, Birmingham, UK
| | - Sally Roberts
- College of Medical and Dental Sciences, Institute of Cancer and Genomic Sciences, University of Birmingham, B152TT, Birmingham, UK
| | - Joanna L Parish
- College of Medical and Dental Sciences, Institute of Cancer and Genomic Sciences, University of Birmingham, B152TT, Birmingham, UK.
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11
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Díaz Del Arco C, Jiménez Ayala B, García D, Sanabria C, Fernández Aceñero MJ. Distribution of cervical lesions in young and older women. Diagn Cytopathol 2019; 47:659-664. [PMID: 31184808 DOI: 10.1002/dc.24163] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 02/11/2019] [Accepted: 02/15/2019] [Indexed: 10/27/2023]
Abstract
INTRODUCTION Age range for cervical screening varies widely between countries. In addition, sexual behavior has changed, life expectancy is increasing, and new insights have been gained into the pathogenesis of HPV infection. Our aim is to evaluate the distribution of cervical lesions in young and older patients. METHODS Review of all cervical smears diagnosed in a public institution (2010-2017) and a private institution (2016-2017) in Madrid, Spain. We have included all women aged younger than 30 and older than 65 years with atypical smears (n = 1573). RESULTS Women younger than 30 years were diagnosed with ASCUS, ASC-H, LSIL, and HSIL in 47%, 5.3%, 45.17%, and 2.6% of atypical cases, respectively. Women older than 65 years were diagnosed with ASCUS, ASC-H, LSIL, HSIL, and SCC in 38%, 12.39%, 16.8%, 13.27%, and 19.5% of atypical cases, respectively. Medical records of patients from the public institution were reviewed. Of note, 76.3% of young women showed negative smears at follow-up and 14.1% showed high-grade dysplasia (HGD). Mean ages for low-grade and HGD were 24.7 and 25.7 years, respectively. HGD was found in 37.9% of women with histological examination (33.5%). As for older patients, 25% of them had no Pap smears performed before age 65, and in 60% of the previously screened women, the screening program had not been used adequately. Mean age of first smear was 69.5 years. Carcinoma was subsequently detected in 20.7% of patients. CONCLUSIONS Current guidelines seem to be adequately preventing carcinoma in young women. However, screening adherence should be encouraged to detect important lesions in both age groups, especially among older women.
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Affiliation(s)
- Cristina Díaz Del Arco
- Department of Surgical Pathology, Hospital Clínico San Carlos, Madrid, Spain
- Complutense University of Madrid, Madrid, Spain
| | | | - Dolores García
- Department of Surgical Pathology, Hospital Clínico San Carlos, Madrid, Spain
| | - Carmen Sanabria
- Department of Surgical Pathology, Hospital Clínico San Carlos, Madrid, Spain
| | - Mª Jesús Fernández Aceñero
- Department of Surgical Pathology, Hospital Clínico San Carlos, Madrid, Spain
- Complutense University of Madrid, Madrid, Spain
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12
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Palve V, Bagwan J, Krishnan NM, Pareek M, Chandola U, Suresh A, Siddappa G, James BL, Kekatpure V, Kuriakose MA, Panda B. Detection of High-Risk Human Papillomavirus in Oral Cavity Squamous Cell Carcinoma Using Multiple Analytes and Their Role in Patient Survival. J Glob Oncol 2019; 4:1-33. [PMID: 30398949 PMCID: PMC7010445 DOI: 10.1200/jgo.18.00058] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
PURPOSE Accurate detection of human papillomavirus (HPV) in oral cavity squamous cell carcinoma (OSCC) is essential to understanding the role of HPV in disease prognosis and management of patients. We used different analytes and methods to understand the true prevalence of HPV in a cohort of patients with OSCC with different molecular backgrounds, and we correlated HPV data with patient survival. METHODS We integrated data from multiple analytes (HPV DNA, HPV RNA, and p16), assays (immunohistochemistry, polymerase chain reaction [PCR], quantitative PCR [qPCR], and digital PCR), and molecular changes (somatic mutations and DNA methylation) from 153 patients with OSCC to correlate p16 expression, HPV DNA, and HPV RNA with HPV incidence and patient survival. RESULTS High prevalence (33% to 58%) of HPV16/18 DNA did not correlate with the presence of transcriptionally active viral genomes (15%) in tumors. Eighteen percent of the tumors were p16 positive and only 6% were both HPV DNA and HPV RNA positive. Most tumors with relatively high copy number HPV DNA and/or HPV RNA, but not with HPV DNA alone (irrespective of copy number), were wild-type for TP53 and CASP8 genes. In our study, p16 protein, HPV DNA, and HPV RNA, either alone or in combination, did not correlate with patient survival. Nine HPV-associated genes stratified the virus-positive from the virus-negative tumor group with high confidence ( P < .008) when HPV DNA copy number and/or HPV RNA were considered to define HPV positivity, and not HPV DNA alone, irrespective of copy number ( P < .2). CONCLUSION In OSCC, the presence of both HPV RNA and p16 is rare. HPV DNA alone is not an accurate measure of HPV positivity and therefore may not be informative. HPV DNA, HPV RNA, and p16 do not correlate with patients' outcome.
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Affiliation(s)
- Vinayak Palve
- Vinayak Palve, Jamir Bagwan, Neeraja M. Krishnan, Manisha Pareek, Udita Chandola, and Binay Panda, Ganit Labs, Institute of Bioinformatics and Applied Biotechnology; Amritha Suresh, Gangotri Siddappa, Bonney L. James, and Moni Abraham Kuriakose, Mazumdar Shaw Centre for Translational Cancer Research; and Vikram Kekatpure and Moni Abraham Kuriakose, Mazumdar Shaw Medical Centre, Bangalore; Neeraja M. Krishnan and Binay Panda, Ganit Labs Foundation, Delhi, India
| | - Jamir Bagwan
- Vinayak Palve, Jamir Bagwan, Neeraja M. Krishnan, Manisha Pareek, Udita Chandola, and Binay Panda, Ganit Labs, Institute of Bioinformatics and Applied Biotechnology; Amritha Suresh, Gangotri Siddappa, Bonney L. James, and Moni Abraham Kuriakose, Mazumdar Shaw Centre for Translational Cancer Research; and Vikram Kekatpure and Moni Abraham Kuriakose, Mazumdar Shaw Medical Centre, Bangalore; Neeraja M. Krishnan and Binay Panda, Ganit Labs Foundation, Delhi, India
| | - Neeraja M Krishnan
- Vinayak Palve, Jamir Bagwan, Neeraja M. Krishnan, Manisha Pareek, Udita Chandola, and Binay Panda, Ganit Labs, Institute of Bioinformatics and Applied Biotechnology; Amritha Suresh, Gangotri Siddappa, Bonney L. James, and Moni Abraham Kuriakose, Mazumdar Shaw Centre for Translational Cancer Research; and Vikram Kekatpure and Moni Abraham Kuriakose, Mazumdar Shaw Medical Centre, Bangalore; Neeraja M. Krishnan and Binay Panda, Ganit Labs Foundation, Delhi, India
| | - Manisha Pareek
- Vinayak Palve, Jamir Bagwan, Neeraja M. Krishnan, Manisha Pareek, Udita Chandola, and Binay Panda, Ganit Labs, Institute of Bioinformatics and Applied Biotechnology; Amritha Suresh, Gangotri Siddappa, Bonney L. James, and Moni Abraham Kuriakose, Mazumdar Shaw Centre for Translational Cancer Research; and Vikram Kekatpure and Moni Abraham Kuriakose, Mazumdar Shaw Medical Centre, Bangalore; Neeraja M. Krishnan and Binay Panda, Ganit Labs Foundation, Delhi, India
| | - Udita Chandola
- Vinayak Palve, Jamir Bagwan, Neeraja M. Krishnan, Manisha Pareek, Udita Chandola, and Binay Panda, Ganit Labs, Institute of Bioinformatics and Applied Biotechnology; Amritha Suresh, Gangotri Siddappa, Bonney L. James, and Moni Abraham Kuriakose, Mazumdar Shaw Centre for Translational Cancer Research; and Vikram Kekatpure and Moni Abraham Kuriakose, Mazumdar Shaw Medical Centre, Bangalore; Neeraja M. Krishnan and Binay Panda, Ganit Labs Foundation, Delhi, India
| | - Amritha Suresh
- Vinayak Palve, Jamir Bagwan, Neeraja M. Krishnan, Manisha Pareek, Udita Chandola, and Binay Panda, Ganit Labs, Institute of Bioinformatics and Applied Biotechnology; Amritha Suresh, Gangotri Siddappa, Bonney L. James, and Moni Abraham Kuriakose, Mazumdar Shaw Centre for Translational Cancer Research; and Vikram Kekatpure and Moni Abraham Kuriakose, Mazumdar Shaw Medical Centre, Bangalore; Neeraja M. Krishnan and Binay Panda, Ganit Labs Foundation, Delhi, India
| | - Gangotri Siddappa
- Vinayak Palve, Jamir Bagwan, Neeraja M. Krishnan, Manisha Pareek, Udita Chandola, and Binay Panda, Ganit Labs, Institute of Bioinformatics and Applied Biotechnology; Amritha Suresh, Gangotri Siddappa, Bonney L. James, and Moni Abraham Kuriakose, Mazumdar Shaw Centre for Translational Cancer Research; and Vikram Kekatpure and Moni Abraham Kuriakose, Mazumdar Shaw Medical Centre, Bangalore; Neeraja M. Krishnan and Binay Panda, Ganit Labs Foundation, Delhi, India
| | - Bonney L James
- Vinayak Palve, Jamir Bagwan, Neeraja M. Krishnan, Manisha Pareek, Udita Chandola, and Binay Panda, Ganit Labs, Institute of Bioinformatics and Applied Biotechnology; Amritha Suresh, Gangotri Siddappa, Bonney L. James, and Moni Abraham Kuriakose, Mazumdar Shaw Centre for Translational Cancer Research; and Vikram Kekatpure and Moni Abraham Kuriakose, Mazumdar Shaw Medical Centre, Bangalore; Neeraja M. Krishnan and Binay Panda, Ganit Labs Foundation, Delhi, India
| | - Vikram Kekatpure
- Vinayak Palve, Jamir Bagwan, Neeraja M. Krishnan, Manisha Pareek, Udita Chandola, and Binay Panda, Ganit Labs, Institute of Bioinformatics and Applied Biotechnology; Amritha Suresh, Gangotri Siddappa, Bonney L. James, and Moni Abraham Kuriakose, Mazumdar Shaw Centre for Translational Cancer Research; and Vikram Kekatpure and Moni Abraham Kuriakose, Mazumdar Shaw Medical Centre, Bangalore; Neeraja M. Krishnan and Binay Panda, Ganit Labs Foundation, Delhi, India
| | - Moni Abraham Kuriakose
- Vinayak Palve, Jamir Bagwan, Neeraja M. Krishnan, Manisha Pareek, Udita Chandola, and Binay Panda, Ganit Labs, Institute of Bioinformatics and Applied Biotechnology; Amritha Suresh, Gangotri Siddappa, Bonney L. James, and Moni Abraham Kuriakose, Mazumdar Shaw Centre for Translational Cancer Research; and Vikram Kekatpure and Moni Abraham Kuriakose, Mazumdar Shaw Medical Centre, Bangalore; Neeraja M. Krishnan and Binay Panda, Ganit Labs Foundation, Delhi, India
| | - Binay Panda
- Vinayak Palve, Jamir Bagwan, Neeraja M. Krishnan, Manisha Pareek, Udita Chandola, and Binay Panda, Ganit Labs, Institute of Bioinformatics and Applied Biotechnology; Amritha Suresh, Gangotri Siddappa, Bonney L. James, and Moni Abraham Kuriakose, Mazumdar Shaw Centre for Translational Cancer Research; and Vikram Kekatpure and Moni Abraham Kuriakose, Mazumdar Shaw Medical Centre, Bangalore; Neeraja M. Krishnan and Binay Panda, Ganit Labs Foundation, Delhi, India
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13
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Hammer A, de Koning MN, Blaakaer J, Steiniche T, Doorbar J, Griffin H, Mejlgaard E, Svanholm H, Quint WG, Gravitt PE. Whole tissue cervical mapping of HPV infection: Molecular evidence for focal latent HPV infection in humans. PAPILLOMAVIRUS RESEARCH 2019; 7:82-87. [PMID: 30772498 PMCID: PMC6389775 DOI: 10.1016/j.pvr.2019.02.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Revised: 02/01/2019] [Accepted: 02/13/2019] [Indexed: 12/27/2022]
Abstract
In this study, we aimed to provide molecular evidence of HPV latency in humans and discuss potential challenges of conducting studies on latency. We analyzed the entire cervix of two women who underwent hysterectomy unrelated to cervical abnormality. The cervices were sectioned into 242 and 186 sets respectively, and each set was tested separately for HPV using the SPF10-PCR-DEIA-LiPA25 system. To identify whether there was any evidence of transforming or productive infection, we used the biomarkers E4 and P16INK4a to stain slides immediately adjacent to HPV-positive sections. HPV was detected in both cervices. In patient 1, 1/242 sets was positive for HPV31. In patient 2, 13/186 sets were positive for HPV18 and 1/186 was positive for HPV53. The infection was very focal in both patients, and there was no sign of a transforming or productive infection, as evaluated by the markers E4 and P16INK4a. Had we only analyzed one set from each block, the probability of detecting the infection would have been 32.3% and 2%, respectively.Our findings support the idea that HPV may be able to establish latency in the human cervix; however, the risk associated with a latent HPV infection remains unclear.
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Affiliation(s)
- Anne Hammer
- Department of Obstetrics and Gynecology, Aarhus University Hospital, Denmark; Department of Clinical Medicine, Aarhus University, Denmark.
| | | | - Jan Blaakaer
- Department of Obstetrics and Gynecology, Odense University Hospital, Denmark
| | - Torben Steiniche
- Department of Clinical Medicine, Aarhus University, Denmark; Department of Pathology, Aarhus University Hospital, Denmark
| | - John Doorbar
- Department of Pathology, University of Cambridge, United Kingdom
| | - Heather Griffin
- Department of Pathology, University of Cambridge, United Kingdom
| | - Else Mejlgaard
- Department of Pathology, Aarhus University Hospital, Denmark
| | | | - Wim Gv Quint
- DDL Diagnostic Laboratory, Rijswijk, the Netherlands
| | - Patti E Gravitt
- Department of Global Health, Milken Institute School of Public Health, the George Washington University, USA
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14
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Nuovo GJ, de Andrade CV, Wells SI, Brusadelli M, Nicol AF. New biomarkers of human papillomavirus infection in acute cervical intraepithelial neoplasia. Ann Diagn Pathol 2018; 36:21-27. [PMID: 29966832 DOI: 10.1016/j.anndiagpath.2018.06.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2018] [Accepted: 06/19/2018] [Indexed: 11/28/2022]
Abstract
Acute human papillomavirus (HPV) infection of the cervix (cervical intraepithelial neoplasia, CIN) is marked by high copy episomal viral DNA and L1/L2 capsid protein expression (productive infection) in the cells towards the surface that facilitate sexual viral transmission. Viral DNA is low copy and not associated with viral capsid protein expression in the less differentiated lower part of the CIN (nonproductive infection). The purpose of this study was to examine the host response in these two areas. Serial section and co-localization analyses demonstrated that in 29/33 (88%) of cases the NF-κB pathway was activated and localized to the suprabasal nonproductively infected cells in the CIN lesions. There was a concomitant increased expression of importin-β, exportin-5, Mcl1, p16, Ki67 and cFLIP in 32/33 (96%) of CIN lesions that likewise localized primarily to the nonproductively infected cells. Only Ki67 and exportin-5 were expressed, though much less so, in the adjacent, normal squamous epithelia. The viral proteins E1^E4 and L1 were localized to productively infected cells whereas E6/E7 protein/RNA was rarely present in early CIN. It is concluded that the host viral response to acute cervical HPV infection includes strong increased expression of proteins besides p16 and Ki67. These include importin-β, exportin-5, Mcl1, and cFLIP in cells with low copy and relatively quiescent viral DNA that, in turn, may serve as new biomarkers of this disease.
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Affiliation(s)
- Gerard J Nuovo
- The Ohio State University Comprehensive Cancer Center, Columbus, OH, United States of America; Phylogeny Laboratory, Powell, OH, United States of America.
| | - Cecilia Vianna de Andrade
- National Institute of Health of Women, Children, and Adolescents, Fernandes Figueira - IFF-FIOCRUZ, Rio de Janeiro, Brazil
| | - Susanne I Wells
- Division of Oncology, Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, United States of America; University of Cincinnati, Cincinnati, OH, United States of America
| | - Marion Brusadelli
- Division of Oncology, Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, United States of America; University of Cincinnati, Cincinnati, OH, United States of America
| | - Alcina F Nicol
- National Institute of Infectious Diseases Evandro Chagas - INI-Fiocruz, Rio de Janeiro, Brazil
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15
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Yap JKW, O'Neill D, Nagenthiran S, Dawson CW, Luesley DM. Current insights into the aetiology, pathobiology, and management of local disease recurrence in squamous cell carcinoma of the vulva. BJOG 2017; 124:946-954. [PMID: 28081287 DOI: 10.1111/1471-0528.14560] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/16/2016] [Indexed: 01/04/2023]
Affiliation(s)
- JKW Yap
- Institute of Cancer and Genomic Sciences; College of Dental and Medical School; University of Birmingham; Edgbaston UK
- Department of Obstetrics and Gynaecology; Birmingham City Hospital; Sandwell and West Birmingham Hospitals NHS Trust; Birmingham UK
| | - D O'Neill
- Department of Obstetrics and Gynaecology; Birmingham City Hospital; Sandwell and West Birmingham Hospitals NHS Trust; Birmingham UK
| | - S Nagenthiran
- Department of Obstetrics and Gynaecology; Birmingham City Hospital; Sandwell and West Birmingham Hospitals NHS Trust; Birmingham UK
| | - CW Dawson
- Institute of Cancer and Genomic Sciences; College of Dental and Medical School; University of Birmingham; Edgbaston UK
| | - DM Luesley
- Institute of Cancer and Genomic Sciences; College of Dental and Medical School; University of Birmingham; Edgbaston UK
- Department of Obstetrics and Gynaecology; Birmingham City Hospital; Sandwell and West Birmingham Hospitals NHS Trust; Birmingham UK
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16
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Scagnolari C, Turriziani O, Monteleone K, Pierangeli A, Antonelli G. Consolidation of molecular testing in clinical virology. Expert Rev Anti Infect Ther 2016; 15:387-400. [PMID: 28002969 DOI: 10.1080/14787210.2017.1271711] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
INTRODUCTION The development of quantitative methods for the detection of viral nucleic acids have significantly improved our ability to manage disease progression and to assess the efficacy of antiviral treatment. Moreover, major advances in molecular technologies during the last decade have allowed the identification of new host genetic markers associated with antiviral drug response but have also strongly revolutionized the way we see and perform virus diagnostics in the coming years. Areas covered: In this review, we describe the history and development of virology diagnostic methods, dedicating particular emphasis on the gradual evolution and recent advances toward the introduction of multiparametric platforms for the syndromic diagnosis. In parallel, we outline the consolidation of viral genome quantification practice in different clinical settings. Expert commentary: More rapid, accurate and affordable molecular technology can be predictable with particular emphasis on emerging techniques (next generation sequencing, digital PCR, point of care testing and syndromic diagnosis) to simplify viral diagnosis in the next future.
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Affiliation(s)
- Carolina Scagnolari
- a Laboratory of Virology, Department of Molecular Medicine, and Istituto Pasteur Italia-Cenci Bolognetti Foundation , 'Sapienza' University of Rome , Rome , Italy
| | - Ombretta Turriziani
- a Laboratory of Virology, Department of Molecular Medicine, and Istituto Pasteur Italia-Cenci Bolognetti Foundation , 'Sapienza' University of Rome , Rome , Italy
| | - Katia Monteleone
- a Laboratory of Virology, Department of Molecular Medicine, and Istituto Pasteur Italia-Cenci Bolognetti Foundation , 'Sapienza' University of Rome , Rome , Italy
| | - Alessandra Pierangeli
- a Laboratory of Virology, Department of Molecular Medicine, and Istituto Pasteur Italia-Cenci Bolognetti Foundation , 'Sapienza' University of Rome , Rome , Italy
| | - Guido Antonelli
- a Laboratory of Virology, Department of Molecular Medicine, and Istituto Pasteur Italia-Cenci Bolognetti Foundation , 'Sapienza' University of Rome , Rome , Italy
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17
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Zhao JW, Fang F, Guo Y, Zhu TL, Yu YY, Kong FF, Han LF, Chen DS, Li F. HPV16 integration probably contributes to cervical oncogenesis through interrupting tumor suppressor genes and inducing chromosome instability. JOURNAL OF EXPERIMENTAL & CLINICAL CANCER RESEARCH : CR 2016; 35:180. [PMID: 27884161 PMCID: PMC5123399 DOI: 10.1186/s13046-016-0454-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Accepted: 11/09/2016] [Indexed: 12/11/2022]
Abstract
Background The integration of human papilloma virus (HPV) into host genome is one of the critical steps that lead to the progression of precancerous lesion into cancer. However, the mechanisms and consequences of such integration events are poorly understood. This study aims to explore those questions by studying high risk HPV16 integration in women with cervical intraepithelial neoplasia (CIN) and cervical squamous cell carcinoma (SCC). Methods Specifically, HPV integration status of 13 HPV16-infected patients were investigated by ligation-mediated PCR (DIPS-PCR) followed by DNA sequencing. Results In total, 8 HPV16 integration sites were identified inside or around genes associated with cancer development. In particular, the well-studied tumor suppressor genes SCAI was found to be integrated by HPV16, which would likely disrupt its expression and therefore facilitate the migration of tumor. On top of that, we observed several cases of chromosome translocation events coincide with HPV integration, which suggests the existence of chromosome instability. Additionally, short overlapping sequences were observed between viral derived and host derived fragments in viral-cellular junctions, indicating that integration was mediated by micro homology-mediated DNA repair pathway. Conclusions Overall, our study suggests a model in which HPV16 might contribute to oncogenesis not only by disrupting tumor suppressor genes, but also by inducing chromosome instability. Electronic supplementary material The online version of this article (doi:10.1186/s13046-016-0454-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jun-Wei Zhao
- Department of Gynecology, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, 200040, China
| | - Fang Fang
- Department of Gynecology, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, 200040, China
| | - Yi Guo
- Department of Gynecology, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, 200040, China
| | - Tai-Lin Zhu
- Abbey College Cambridge, Homerton Gardens, Cambridge, CB2 8EB, UK
| | - Yun-Yun Yu
- Department of Gynecology, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, 200040, China
| | - Fan-Fei Kong
- Department of Gynecology, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, 200040, China
| | - Ling-Fei Han
- Department of Gynecology, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, 200040, China
| | - Dong-Sheng Chen
- Department of Genetics, University of Cambridge, Cambridge, CB2 3EH, UK. .,Fitzwilliam College, University of Cambridge, Storey's Way, Cambridge, CB3 0DG, UK.
| | - Fang Li
- Department of Gynecology, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, 200040, China.
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18
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Leonard S, Pereira M, Fox R, Gordon N, Yap J, Kehoe S, Luesley D, Woodman C, Ganesan R. Over-expression of DNMT3A predicts the risk of recurrent vulvar squamous cell carcinomas. Gynecol Oncol 2016; 143:414-420. [PMID: 27623253 DOI: 10.1016/j.ygyno.2016.09.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Revised: 08/25/2016] [Accepted: 09/01/2016] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Cancer initiation and progression has been linked to aberrant expression of the DNA methyltransferases (DNMT), the enzymes which establish and maintain DNA methylation patterns throughout the genome. In this study, we investigated if DNMT expression in vulvar squamous cell carcinomas (VSCC) was related to clinical outcome. METHODS DNMT1, DNMT3A and DNMT3B expression was measured in a subset of cases drawn from a cohort of consecutive women treated for primary VSCC at the Pan Birmingham Gynaecological Cancer Centre between 2001 and 2008. Univariable and multivariable competing risk modelling was performed to identify whether DNMT expression was associated with local disease recurrence or disease morbidity. RESULTS Over-expression of DNMT3A in the invasive component of the tumour was seen in 44% of tumours and was associated with an increased risk of local vulvar recurrence (LVR) (HR=4.51, p=0.012). This risk was found to increase further after adjustment for disease stage (HR=6.00, p=0.003) and groin node metastasis (HR=4.81, p=0.008). Over-expression of DNMT3B was associated with an increased risk of LVR (HR=5.69 p=0.03), however this ceased to be significant after adjustment for groin node metastasis. In a subset analysis, over-expression of DNMT3A was found to be significantly more common in VSCCs that stained negative for CDKN2A. CONCLUSIONS These observations are consistent with the possibility that epigenetic changes contribute to vulvar neoplasia and DNMT3A over-expression may be useful in predicting local disease recurrence.
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Affiliation(s)
- Sarah Leonard
- Institute of Cancer and Genomic Sciences, College of Dental and Medical School, University of Birmingham, Edgbaston B15 2TT, United Kingdom
| | - Merlin Pereira
- Institute of Cancer and Genomic Sciences, College of Dental and Medical School, University of Birmingham, Edgbaston B15 2TT, United Kingdom
| | - Richard Fox
- Cancer Research UK Clinical Trials Unit, University of Birmingham, Edgbaston B15 2TT, United Kingdom
| | - Naheema Gordon
- Institute of Cancer and Genomic Sciences, College of Dental and Medical School, University of Birmingham, Edgbaston B15 2TT, United Kingdom
| | - Jason Yap
- Institute of Cancer and Genomic Sciences, College of Dental and Medical School, University of Birmingham, Edgbaston B15 2TT, United Kingdom
| | - Sean Kehoe
- Institute of Cancer and Genomic Sciences, College of Dental and Medical School, University of Birmingham, Edgbaston B15 2TT, United Kingdom
| | - David Luesley
- Institute of Cancer and Genomic Sciences, College of Dental and Medical School, University of Birmingham, Edgbaston B15 2TT, United Kingdom
| | - Ciaran Woodman
- Institute of Cancer and Genomic Sciences, College of Dental and Medical School, University of Birmingham, Edgbaston B15 2TT, United Kingdom
| | - Raji Ganesan
- Birmingham Women's NHS Foundation Trust, Mindelsohn Way, Edgbaston, Birmingham B15 2TG, United Kingdom.
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19
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Adjacent Lichen Sclerosis predicts local recurrence and second field tumour in women with vulvar squamous cell carcinoma. Gynecol Oncol 2016; 142:420-6. [PMID: 27396942 DOI: 10.1016/j.ygyno.2016.06.019] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2016] [Revised: 06/23/2016] [Accepted: 06/26/2016] [Indexed: 11/22/2022]
Abstract
OBJECTIVE In this study, we investigated if the presence of histologically abnormal epithelium adjacent to the primary tumour influenced the frequency, timing, and topography of local vulvar recurrences (LVR) following treatment for squamous cell carcinoma of the vulva (VSCC). METHODS The study population comprised a cohort of 201 consecutive cases with incident VSCC. LVR were categorised as local relapses (LR) if they occurred <2cm from the tumour margins, and as second field tumours (SFT) when ≥2cm from these margins. Univariable and multivariable competing risk modelling was performed to identify the prognostic factors associated with local disease recurrence. RESULTS The characterization of the epithelium adjacent to the invasive component was possible for 199 (99.0%) patients. Of these, 171 (85.9%) were found to have intraepithelial abnormalities found adjacent to the surgical specimen. Multivariable analyses revealed that, following adjustment, Lichen Sclerosis (LS) was associated with an increase in the incidence of LVR, LR and SFT (SHRs: 3.4, 2.7 and 4.4, respectively). Although the incidence of LR and SFT in women with LS associated VSCC was similar, the peak incidence of SFT occurred more than two years before that of LR. CONCLUSIONS Women with VSCC arising in a field of LS may continue to have an increased risk of developing LR and SFT for many years after resection of their primary tumour. Our study suggests that these women should be followed up more regularly so that LVR can be detected earlier; unless a more robust surveillance programme or chemopreventative treatments become available.
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