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Kandolf L, Peris K, Malvehy J, Mosterd K, Heppt MV, Fargnoli MC, Berking C, Arenberger P, Bylaite-Bučinskiene M, Del Marmol V, Dirschka T, Dreno B, Forsea AM, Harwood CA, Hauschild A, Heerfordt IM, Kauffman R, Kelleners-Smeets N, Lallas A, Lebbe C, Leiter U, Longo C, Mijušković Ž, Pellacani G, Puig S, Saiag P, Šitum M, Stockfleth E, Salavastru C, Stratigos A, Zalaudek I, Garbe C. European consensus-based interdisciplinary guideline for diagnosis, treatment and prevention of actinic keratoses, epithelial UV-induced dysplasia and field cancerization on behalf of European Association of Dermato-Oncology, European Dermatology Forum, European Academy of Dermatology and Venereology and Union of Medical Specialists (Union Européenne des Médecins Spécialistes). J Eur Acad Dermatol Venereol 2024; 38:1024-1047. [PMID: 38451047 DOI: 10.1111/jdv.19897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 01/23/2024] [Indexed: 03/08/2024]
Abstract
A collaboration of multidisciplinary experts from the European Association of Dermato-Oncology, the European Dermatology Forum, the European Academy of Dermatology and Venereology, and the European Union of Medical Specialists was formed to develop European recommendations on AK diagnosis and treatment, based on current literature and expert consensus. This guideline addresses the epidemiology, diagnostics, risk stratification and treatments in immunocompetent as well as immunosuppressed patients. Actinic keratoses (AK) are potential precursors of cutaneous squamous cell carcinoma (cSCC) and display typical histopathologic and immunohistochemical features of this malignancy in an early stage. They can develop into cSSC in situ and become invasive in a low percentage of cases. AK is the most frequent neoplasia in white populations, frequently occurring within a cancerous field induced by ultraviolet radiation. Since it cannot be predicted, which lesion will progress to cSCC and when treatment is usually recommended. The diagnosis of AK and field cancerization is made by clinical examination. Dermatoscopy, confocal microscopy, optical coherence tomography or line-field confocal-OCT can help in the differential diagnosis of AK and other skin neoplasms. A biopsy is indicated in clinically and/or dermatoscopically suspicious and/or treatment-refractory lesions. The choice of treatment depends on patients' and lesion characteristics. For single non-hyperkeratotic lesions, the treatment can be started upon patient's request with destructive treatments or topical treatments. For multiple lesions, field cancerization treatment is advised with topical treatments and photodynamic therapy. Preventive measures such as sun protection, self-examination and repeated field cancerization treatments of previously affected skin areas in high-risk patients are advised.
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Affiliation(s)
- Lidija Kandolf
- Department of Dermatology, Faculty of Medicine, University of Defence, Military Medical Academy, Belgrade, Serbia
| | - Ketty Peris
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche Addominali ed Endrocrino Metaboliche, Fondazione Policlinico Universitario A. Gemelli - IRCCS, Rome, Italy
- Dermatologia, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Josep Malvehy
- Dermatology Department of Hospital Clinic of Barcelona, IDIBAPS, CIBER de Enfermedades Raras, Instituto Carlos III, University of Barcelona, Barcelona, Spain
| | - Klara Mosterd
- Department of Dermatology, Maastricht University Medical Centre+ Comprehensive Cancer Centre, Maastricht, The Netherlands
- GROW-School for Oncology and Reproduction, Maastricht University, Maastricht, The Netherlands
| | - Markus V Heppt
- Department of Dermatology, Uniklinikum Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
- Comprehensive Cancer Center Erlangen-European Metropolitan Area of Nuremberg (CC ER-EMN), Erlangen, Germany
| | - Maria Concetta Fargnoli
- Dermatology, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Carola Berking
- Department of Dermatology, Uniklinikum Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
- Comprehensive Cancer Center Erlangen-European Metropolitan Area of Nuremberg (CC ER-EMN), Erlangen, Germany
| | - Petr Arenberger
- Department of Dermatovenereology, Third Faculty of Medicine, Charles University and University Hospital of Kralovske Vinohrady, Prague, Czech Republic
| | - Matilda Bylaite-Bučinskiene
- Clinic of Infectious Diseases and Dermatovenereology, Centre of Dermatovenereology, Vilnius University, Vilnius, Lithuania
| | - Veronique Del Marmol
- Department of Dermatology, University Hospital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Thomas Dirschka
- Faculty of Health, University Witten-Herdecke, Witten, Germany
- CentroDerm Clinic, Wuppertal, Germany
| | - Brigitte Dreno
- Nantes Université, INSERM, CNRS, Immunology and New Concepts in ImmunoTherapy, INCIT, UMR 1302/EMR6001, Nantes, France
| | - Ana-Maria Forsea
- Department of Oncologic Dermatology, Elias University Hospital Bucharest, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Catherine A Harwood
- Centre for Cell Biology and Cutaneous Research, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Axel Hauschild
- Department of Dermatology, University Hospital (UKSH), Kiel, Germany
| | - Ida Marie Heerfordt
- Department of Dermatology, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Roland Kauffman
- Department of Dermatology, Venereology and Allergology, Frankfurt University Hospital, Frankfurt, Germany
| | - Nicole Kelleners-Smeets
- Department of Dermatology, Maastricht University Medical Centre+ Comprehensive Cancer Centre, Maastricht, The Netherlands
- GROW-School for Oncology and Reproduction, Maastricht University, Maastricht, The Netherlands
| | - Aimilios Lallas
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - Celeste Lebbe
- Université Paris Cite, AP-HP Dermato-oncology, Cancer institute APHP, Nord Paris cité, INSERM U976, Saint Louis Hospital, Paris, France
| | - Ulrike Leiter
- Centre for Dermatooncology, Department of Dermatology, Eberhard Karls University, Tuebingen, Germany
| | - Caterina Longo
- Skin Cancer Center, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Željko Mijušković
- Department of Dermatology, Faculty of Medicine, University of Defence, Military Medical Academy, Belgrade, Serbia
| | - Giovanni Pellacani
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - Susana Puig
- Dermatology Department of Hospital Clinic of Barcelona, IDIBAPS, CIBER de Enfermedades Raras, Instituto Carlos III, University of Barcelona, Barcelona, Spain
| | - Philippe Saiag
- Department of General and Oncologic Dermatology, Ambroise Paré Hospital, APHP, & EA 4340 "Biomarkers in Cancerology and Hemato-Oncology", UVSQ, Université Paris-Saclay, Boulogne-Billancourt, France
| | - Mirna Šitum
- Department of Dermatology and Venereology, Sestre Milosrdnice University Hospital Center, Zagreb, Croatia
| | - Eggert Stockfleth
- Skin Cancer Center, Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - Carmen Salavastru
- Department of Pediatric Dermatology, Colentina Clinical Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Alexander Stratigos
- 1st Department of Dermatology-Venereology, National and Kapodistrian University of Athens, Andreas Sygros Hospital, Athens, Greece
| | - Iris Zalaudek
- Dermatology Clinic, Maggiore Hospital, Department of Medical Sciences, University of Trieste, Trieste, Italy
| | - Claus Garbe
- Centre for Dermatooncology, Department of Dermatology, Eberhard Karls University, Tuebingen, Germany
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Allnutt KJ, Vogrin S, Li J, Goh MS, Brennand S, Davenport R, Chong AH. A long-term cohort study of acitretin for prevention of keratinocyte carcinoma in solid organ transplant recipients. Australas J Dermatol 2022; 63:e121-e126. [PMID: 35333399 PMCID: PMC9311671 DOI: 10.1111/ajd.13821] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Revised: 02/25/2022] [Accepted: 03/05/2022] [Indexed: 12/11/2022]
Abstract
Background Solid organ transplant recipients (SOTR) are at high risk of keratinocyte carcinoma (KC). Long‐term evidence for acitretin as chemoprophylaxis in this population is lacking. Objective To determine the benefit of long‐term acitretin for KC chemoprevention in SOTR. Methods A retrospective cohort study of SOTR treated with acitretin at an Australian transplant dermatology clinic was performed. General estimating equations were used to evaluate change in rates of histologically confirmed KC in the 6–12 months prior to acitretin and following a minimum 6 months of treatment. A control group of patients within the same service was included, comprising SOTR who were not treated with acitretin. Results Twenty‐two patients received acitretin treatment for at least 6 months, eighteen for at least 5 years and four for at least 9 years. The median KC rate pretreatment was 3.31 per year (IQR 1.93, 5.40). There was a significant reduction in the rate of KC in the first year of acitretin treatment (IRR 0.41, 95% CI 0.22, 0.76, P = 0.005), and this effect was observed for 5 years (IRR at 5 years 0.34, 95% CI 0.17, 0.67, P = 0.002). The control group had no statistically significant change in KC rate over time in the study. Conclusions Acitretin appears to be well‐tolerated and effective in reducing KC in SOTR for at least 5 years. Study limitations include its retrospective nature, small sample size and lack of blinding.
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Affiliation(s)
| | - Sara Vogrin
- Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Jane Li
- Skin Health Institute, Carlton, Melbourne, Victoria, Australia.,Department of Medicine (Dermatology), St Vincent's Hospital Melbourne, University of Melbourne, Melbourne, Victoria, Australia
| | - Michelle S Goh
- Skin Health Institute, Carlton, Melbourne, Victoria, Australia.,Department of Medicine (Dermatology), St Vincent's Hospital Melbourne, University of Melbourne, Melbourne, Victoria, Australia
| | - Sarah Brennand
- Skin Health Institute, Carlton, Melbourne, Victoria, Australia
| | | | - Alvin H Chong
- Skin Health Institute, Carlton, Melbourne, Victoria, Australia.,Department of Medicine (Dermatology), St Vincent's Hospital Melbourne, University of Melbourne, Melbourne, Victoria, Australia
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Chandra A, Newman A, Mullens D, Lin CC. Human Papillomavirus (HPV)-Associated Squamous Cell Carcinoma In situ With Positive p16 and Ki-67 Immunohistochemical Stains in a Young Immunocompetent Patient. Cureus 2020; 12:e9673. [PMID: 32923268 PMCID: PMC7485991 DOI: 10.7759/cureus.9673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
There is an oncogenic role of human papillomavirus (HPV) in the development of premalignant and malignant skin cancers, especially squamous cell carcinomas (SCCs). Some of the major risk factors for SCC include older age, fair skin types, immunosuppression, ultraviolet radiation (UVR), history of epidermodysplasia verruciformis (EV), and co-carcinogenesis by the HPV. Our case report exemplifies a unique case of a low-risk, 34-year-old female who developed an HPV-associated squamous cell carcinoma in situ (SCCIS) on her left palmar hand, despite having none of the contributing risk factors. The biopsy also showed full-thickness keratinocyte atypia and increased mitotic activity throughout all the layers of the epidermis. Immunohistochemical stains showed strong and diffuse nuclear staining of p16 and Ki-67 throughout the SCCIS, confirming HPV etiology. We speculate that tumor development in our patient relied on the combined effects of UVR exposure, localized immunosuppression, and the co-carcinogenic effects of HPV infection.
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Affiliation(s)
- Aditi Chandra
- Dermatology, Midwestern University, Arizona College of Osteopathic Medicine, Phoenix, USA
| | - Andrew Newman
- Dermatology, Affiliated Dermatology, Scottsdale, USA
| | - Dustin Mullens
- Dermatology, Honor Health/Affiliated Dermatology, Scottsdale, USA
| | - Christine C Lin
- Dermatology, Honor Health/Affiliated Dermatology, Scottsdale, USA
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Ji YZ, Ma ZM, Chang L, Liu SR. A novel case of cutaneous squamous cell carcinoma at the site of previous sporotrichosis. J Cosmet Dermatol 2019; 19:1487-1489. [PMID: 31556217 DOI: 10.1111/jocd.13158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2019] [Revised: 07/25/2019] [Accepted: 09/04/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Cutaneous squamous cell carcinoma (cSCC) is a malignant tumor of epithelial keratinocytes, with a relatively reduced frequency of lymph node metastasis. Despite the fact that this tumor type is largely preventable, the incidence of cSCC is rising every year. Ultraviolet exposure is a major cause of cSCC and directly contributes to cSCC. Other known environmental risk factors include ionizing radiation, cigarette smoking, and certain chemical exposures. AIMS In this study, we report a clinical case of cSCC with a novel causative factor. PATIENT/METHODS The report describes a 72-year-old male who was seen for a dermatosis condition initially. Later, epidermal hyperplasia and granulomatous inflammation of the dermis was diagnosed based on skin biopsy. Fungal culture revealed the presence of Sporothrix schenckii which led to the diagnosis of fixed-type sporotrichosis. RESULTS Four months of oral terbinafine (250 mg once a day) administration partially resolved the lesions. Patient was subsequently diagnosed with cSCC, and surgical resection with wider margins was performed. CONCLUSION After a careful and rigorous exclusion of known risk factors, we confirmed that this incidence of cSCC was caused by chronic inflammation which followed fixed-type sporotricosis.
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Affiliation(s)
- Yong-Zhi Ji
- Department of Dermatology, Second Hospital of Ji Lin University, Changchun, China
| | - Zhi-Ming Ma
- Department of Gastrointestinal Nutrition and Hernia Surgery, Second Hospital of Jilin University, Changchun, China
| | - Li Chang
- Department of Pathology, Second Hospital of Jilin University, Changchun, China
| | - Shi-Rui Liu
- Department of Dermatology, Second Hospital of Ji Lin University, Changchun, China
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Lozzi F, Lanna C, Mazzeo M, Garofalo V, Palumbo V, Mazzilli S, Diluvio L, Terrinoni A, Bianchi L, Campione E. Investigational drugs currently in phase II clinical trials for actinic keratosis. Expert Opin Investig Drugs 2019; 28:629-642. [PMID: 31232099 DOI: 10.1080/13543784.2019.1636030] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
INTRODUCTION Actinic keratoses (AKs) are limited areas of irregular epidermal growth on a background of excessive solar exposure. The entire sun-damaged skin is considered a field of cancerization with multiple visible and subclinical lesions. AK management requires field-directed therapies to block lesion relapse and prevent squamous cell carcinoma (SCC). AREAS COVERED In this review, we focused on phase II clinical trials for AKs, involving well-known agents and newer molecules such as proapoptotic drugs (VDA-1102, SR-T100, oleogel-S10, ICVT, eflornithine), immunomodulants (isotretinoin, tretinoin) and chemopreventive agents (nicotinamide, perillyl alcohol, liposomal T4N5). We used the website 'ClinicalTrials.Gov' as main reference. We selected and discussed completed and ongoing trials and analysed chemical structure and mechanism of action of the investigated molecules. EXPERT OPINION AK therapy should be tailored on the patient's profile considering first of all the age and site of the AKs, which are relevant parameters for local immune response. The new molecules could be combined to obtain a synergic effect blocking the different steps of skin tumorigenesis. Phase II trials highlight a new therapeutic opportunity to block selectively cell proliferation regulators and work both on the field of cancerization and on the AKs currently present.
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Affiliation(s)
- Flavia Lozzi
- a Department of Systems Medicine , University of Rome "Tor Vergata" , Rome , Italy
| | - Caterina Lanna
- a Department of Systems Medicine , University of Rome "Tor Vergata" , Rome , Italy
| | - Mauro Mazzeo
- a Department of Systems Medicine , University of Rome "Tor Vergata" , Rome , Italy
| | - Virginia Garofalo
- a Department of Systems Medicine , University of Rome "Tor Vergata" , Rome , Italy
| | - Vincenzo Palumbo
- a Department of Systems Medicine , University of Rome "Tor Vergata" , Rome , Italy
| | - Sara Mazzilli
- a Department of Systems Medicine , University of Rome "Tor Vergata" , Rome , Italy
| | - Laura Diluvio
- a Department of Systems Medicine , University of Rome "Tor Vergata" , Rome , Italy
| | - Alessandro Terrinoni
- b Department of Experimental Medicine and Biochemical Sciences , University of Rome "Tor Vergata" , Rome , Italy
| | - Luca Bianchi
- a Department of Systems Medicine , University of Rome "Tor Vergata" , Rome , Italy
| | - Elena Campione
- a Department of Systems Medicine , University of Rome "Tor Vergata" , Rome , Italy
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Nadhan KS, Larijani M, Abbott J, Doyle AM, Linfante AW, Chung CL. Prevalence and Types of Genital Lesions in Organ Transplant Recipients. JAMA Dermatol 2019; 154:323-329. [PMID: 29387873 DOI: 10.1001/jamadermatol.2017.5801] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance Squamous cell carcinoma (SCC) is the most common skin cancer diagnosed in solid organ transplant recipients (OTRs) and confers significant mortality. The development of SCC in the genital region is elevated in nonwhite OTRs. Viral induction, specifically human papillomavirus (HPV), is hypothesized to play a role in the pathophysiology of these lesions. Objective To assess the prevalence and types of genital lesions observed in OTRs. Design, Setting, and Participants This retrospective review included 496 OTRs who underwent full skin examination from November 1, 2011, to April 28, 2017, at an academic referral center. The review was divided into 2 distinct periods before a change in clinical management that took effect on February 1, 2016 (era 1) and after that change (era 2). Patient awareness of genital lesions was assessed. All lesions clinically suggestive of malignant tumors were biopsied and underwent HPV polymerase chain reaction typing. Main Outcomes and Measures Number and types of genital lesions, proportion of malignant tumors positive for HPV, and patients cognizant of genital lesions. Results Of the total 496 OTRs, 376 OTRs were evaluated during era 1 (mean [SD] age, 60 years; age range, 32-94 years; 45 [65.2%] male; 164 [43.6%] white) and 120 OTRs were evaluated during era 2 of the study (mean age, 56 years; age range, 22-79 years; 76 [63.3%] male; 30 [25.0%] white). Overall, 111 of the 120 OTRs (92.5%) denied the presence of genital lesions during the history-taking portion of the medical examination. Genital lesions were found in 53 OTRs (44.2%), cutaneous malignant tumors (basal cell carcinoma and SCC in situ) in 6 (5.0%), genital SCC in situ in 3 (4.2%), and condyloma in 29 (24.2%). Eight of the 12 SCC in situ lesions (66.7%) were positive for high-risk HPV. Seven tested positive for HPV-16 and HPV-18, and 1 tested positive for high-risk HPV DNA but could not be further specified. Conclusions and Relevance Genital lesions in OTRs are common, but awareness is low. All OTRs should undergo thorough inspection of genital skin as a part of routine posttransplant skin examinations. Patients with darker skin types are disproportionately affected by cutaneous genital malignant tumors and should undergo a targeted program of early detection, prevention, and awareness focused on the risk of genital skin cancer after transplant. High-risk HPV subtypes are associated with genital SCC in OTRs. Additional studies are warranted to identify significant risk factors for HPV infection and to assess the utility of pretransplant HPV vaccination in the prevention of cutaneous genital malignant tumors.
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Affiliation(s)
- Kumar S Nadhan
- Department of Dermatology, Drexel University, Philadelphia, Pennsylvania
| | - Mary Larijani
- Department of Dermatology, Drexel University, Philadelphia, Pennsylvania
| | - James Abbott
- Department of Dermatology, Drexel University, Philadelphia, Pennsylvania
| | - Alden M Doyle
- Department of Internal Medicine, University of Virginia, Charlottesville
| | - Anthony W Linfante
- Department of Dermatology, Drexel University, Philadelphia, Pennsylvania
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Angehrn S, Tschernitz S. [CME: Update Actinic Keratoses]. PRAXIS 2019; 108:381-388. [PMID: 31039704 DOI: 10.1024/1661-8157/a003231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
CME: Update Actinic Keratoses Abstract. Actinic keratoses (AKs) present as changes to the skin caused by chronic UVB damage. The warning signs are increased keratinization and dysplasia of epidermal cells. AKs can evolve into squamous cell carcinomas. The prevalence of this disease that affects areas of the skin exposed to sunlight increases with age. Diagnosis often takes the form of visual diagnosis. In cases of recurrence or doubt, histological confirmation should be sought. Various treatment options are available, ranging from the use of ablative to topical drug-based procedures. Prevention is very important. This article provides information on the clinical picture, assistance in identifying this disease, and therapeutic options.
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A Dual-Type L2 11-88 Peptide from HPV Types 16/18 Formulated in Montanide ISA 720 Induced Strong and Balanced Th1/Th2 Immune Responses, Associated with High Titers of Broad Spectrum Cross-Reactive Antibodies in Vaccinated Mice. J Immunol Res 2018; 2018:9464186. [PMID: 29854852 PMCID: PMC5960516 DOI: 10.1155/2018/9464186] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2017] [Accepted: 01/18/2018] [Indexed: 12/22/2022] Open
Abstract
E. coli-derived concatenated, multitype L2-conserved epitopes of human papillomavirus (HPV) L2 protein might represent a less expensive and pan-type vaccine alternative (compared to type-specific HPV L1 virus-like particles), if stable protein expression and strong immunogenicity features could be met. Herein, three dual-type- (DT-) HPV L2 fusion peptides comprising the three head-to-tail tandem repeats (multimers) of either HPV 16 epitope “17-36” or “69-81” or one copy (monomer) of 11-88 fused to the same residues of HPV 18 were constructed and expressed in E. coli. SDS-PAGE and Western blot analyses indicated the proper expression and stability of the E. coli-derived DT peptides. Mice immunized by formulation of the purified DT peptides and Freund's adjuvant (CFA/IFA) raised neutralizing antibodies (NAbs; the highest for DT: 11-88 peptide) which showed proper cross-reactivity to HPV types: 18, 16, 31, and 45 and efficiently neutralized HPV 18/16 pseudoviruses in vitro. Immunization studies in mice by formulation of the DT: 11-88 × 1 peptide with various adjuvants (alum, MF59, and Montanides ISA 720 and 50) indicated that Montanide adjuvants elicited the highest cross-reactive titers of NAbs and similar levels of IgG1 and IgG2a (switching towards balanced Th1/Th2 responses). The results implied development of low-cost E. coli-derived DT: 11-88 peptide formulated in human compatible ISA 720 adjuvant as a HPV vaccine.
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Verkouteren J, Ramdas K, Wakkee M, Nijsten T. Epidemiology of basal cell carcinoma: scholarly review. Br J Dermatol 2017; 177:359-372. [DOI: 10.1111/bjd.15321] [Citation(s) in RCA: 133] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/07/2016] [Indexed: 12/21/2022]
Affiliation(s)
- J.A.C. Verkouteren
- Department of Dermatology; Erasmus MC Cancer Institute; Burgemeester s'Jacobplein 51 3015 CA Rotterdam the Netherlands
| | - K.H.R. Ramdas
- Department of Dermatology; Erasmus MC Cancer Institute; Burgemeester s'Jacobplein 51 3015 CA Rotterdam the Netherlands
| | - M. Wakkee
- Department of Dermatology; Erasmus MC Cancer Institute; Burgemeester s'Jacobplein 51 3015 CA Rotterdam the Netherlands
| | - T. Nijsten
- Department of Dermatology; Erasmus MC Cancer Institute; Burgemeester s'Jacobplein 51 3015 CA Rotterdam the Netherlands
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Ferreira FR, Ogawa MM, Nascimento LFC, Tomimori J. Risk factors for nonmelanoma skin cancer in renal transplant recipients: a case-control study from a reference outpatient clinic in Southeast Brazil. Int J Dermatol 2017; 56:154-160. [DOI: 10.1111/ijd.13508] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Revised: 10/06/2016] [Accepted: 10/18/2016] [Indexed: 10/20/2022]
Affiliation(s)
| | - Marilia M. Ogawa
- Department of Dermatology; Federal University of São Paulo (UNIFESP); São Paulo Brazil
| | | | - Jane Tomimori
- Department of Dermatology; Federal University of São Paulo (UNIFESP); São Paulo Brazil
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Joh J, Ghim SJ, Chilton PM, Sundberg JP, Park J, Wilcher SA, Proctor ML, Bennett Jenson A. MmuPV1 infection and tumor development of T cell-deficient mice is prevented by passively transferred hyperimmune sera from normal congenic mice immunized with MmuPV1 virus-like particles (VLPs). Exp Mol Pathol 2016; 100:212-9. [PMID: 26778691 DOI: 10.1016/j.yexmp.2016.01.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Accepted: 01/08/2016] [Indexed: 12/28/2022]
Abstract
Infection by mouse papillomavirus (PV), MmuPV1, of T cell-deficient, B6.Cg-Foxn1(nu)/J nude mice revealed that four, distinct squamous papilloma phenotypes developed simultaneously after infection of experimental mice. Papillomas appeared on the muzzle, vagina, and tail at or about day 42days post-inoculation. The dorsal skin developed papillomas and hair follicle tumors (trichoblastomas) as early as 26days after infection. Passive transfer of hyperimmune sera from normal congenic mice immunized with MmuPV1 virus-like particles (VLPs) to T cell-deficient strains of mice prevented infection by virions of experimental mice. This study provides further evidence that T cell deficiency is critical for tumor formation by MmuPV1 infection.
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Affiliation(s)
- Joongho Joh
- James Graham Brown Cancer Center, 505 South Hancock Street, Louisville, KY, United States; Department of Medicine, 550 South Jackson Street, Louisville, KY, United States.
| | - Shin-je Ghim
- James Graham Brown Cancer Center, 505 South Hancock Street, Louisville, KY, United States
| | - Paula M Chilton
- Christine M. Kleinert Institute for Hand & Microsurgery, 225 Abraham Flexner Way, Suite 850, Louisville, KY, United States
| | | | - Jino Park
- James Graham Brown Cancer Center, 505 South Hancock Street, Louisville, KY, United States
| | - Sarah A Wilcher
- Research Resources Center, 530 South Jackson Street, Louisville, KY, United States
| | - Mary L Proctor
- Research Resources Center, 530 South Jackson Street, Louisville, KY, United States
| | - A Bennett Jenson
- James Graham Brown Cancer Center, 505 South Hancock Street, Louisville, KY, United States
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Campione E, Paternò EJ, Candi E, Falconi M, Costanza G, Diluvio L, Terrinoni A, Bianchi L, Orlandi A. The relevance of piroxicam for the prevention and treatment of nonmelanoma skin cancer and its precursors. DRUG DESIGN DEVELOPMENT AND THERAPY 2015; 9:5843-50. [PMID: 26604686 PMCID: PMC4630202 DOI: 10.2147/dddt.s84849] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Piroxicam (PXM), a nonsteroidal anti-inflammatory drug, is an enolic benzothiazine and a potent member of the oxicam series. The drug suppresses the synthesis of proinflammatory enzymes, such as cyclo-oxygenases-1 and -2 (COX-1 and 2), downregulates the production of prostaglandins (PGs) and tromboxanes, and inhibits polyamines production by blocking ornithine decarboxylase induction involved in nonmelanoma skin carcinogenesis. In addition, PXM is able to induce tumor cell apoptosis and suppresses metalloproteinase 2 activities. Skin carcinogenesis is a multistep process in which the accumulation of genetic events leads to a gradually dysplastic cellular expression, deregulation of cell growth, and carcinomatous progression. COX-1 upregulation plays a significant role in PG and vascular epidermal growth factor production supporting tumor growth. Increased level of PGs in premalignant and/or malignant cutaneous tumors is also favored by upregulation of COX-2 and downregulation of the tumor suppressor gene 15-hydroxy-prostaglandin dehydrogenase. Chemoprevention can be a hopeful approach to inhibit carcinoma occurrence before an invasive tumor develops. The chemopreventive effect of nonsteroidal anti-inflammatory drugs on nonmelanoma skin cancers has been established. In this study, we highlighted the different modalities of action of PXM on the pathogenesis of nonmelanoma skin cancer, analyzing and evaluating binding modes and energies between COX-1 or COX-2 and PXM by protein–ligand molecular docking. Our clinical experience about the local use of PXM on actinic keratoses and field cancerization is also reported, confirming its efficacy as target therapy.
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Affiliation(s)
- Elena Campione
- Department of Dermatology, University of Rome "Tor Vergata" Rome, Italy
| | | | - Eleonora Candi
- Department of Experimental Medicine and Surgery, University of Rome "Tor Vergata" Rome, Italy ; Biochemistry Laboratory IDI-IRCCS, Faculty of Medicine, University of Rome "Tor Vergata" Rome, Italy
| | - Mattia Falconi
- Department of Biology, University of Rome "Tor Vergata" Rome, Italy
| | - Gaetana Costanza
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata" Rome, Italy
| | - Laura Diluvio
- Department of Dermatology, University of Rome "Tor Vergata" Rome, Italy
| | - Alessandro Terrinoni
- Biochemistry Laboratory IDI-IRCCS, Faculty of Medicine, University of Rome "Tor Vergata" Rome, Italy
| | - Luca Bianchi
- Department of Dermatology, University of Rome "Tor Vergata" Rome, Italy
| | - Augusto Orlandi
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata" Rome, Italy ; Institute of Anatomic Pathology, University of Rome "Tor Vergata" Rome, Italy ; Tor Vergata University-Policlinic of Rome, Rome, Italy
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13
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Werner R, Stockfleth E, Connolly S, Correia O, Erdmann R, Foley P, Gupta A, Jacobs A, Kerl H, Lim H, Martin G, Paquet M, Pariser D, Rosumeck S, Röwert-Huber HJ, Sahota A, Sangueza O, Shumack S, Sporbeck B, Swanson N, Torezan L, Nast A. Evidence- and consensus-based (S3) Guidelines for the Treatment of Actinic Keratosis - International League of Dermatological Societies in cooperation with the European Dermatology Forum - Short version. J Eur Acad Dermatol Venereol 2015; 29:2069-79. [DOI: 10.1111/jdv.13180] [Citation(s) in RCA: 188] [Impact Index Per Article: 20.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Accepted: 04/02/2015] [Indexed: 12/22/2022]
Affiliation(s)
- R.N. Werner
- Division of Evidence Based Medicine (dEBM), Department of Dematology, Venerology and Allergology; Charité - Universitätsmedizin Berlin; Berlin Germany
| | - E. Stockfleth
- Department of Dermatology, Venerology and Allergology; Skin Cancer Center (HTCC); Charité - Universitätsmedizin Berlin; Berlin Germany
| | - S.M. Connolly
- Department of Dermatology; Mayo Clinic; Scottsdale Arizona USA
| | - O. Correia
- Centro Dermatologia Epidermis; Instituto CUF and Faculty of Medicine of University of Porto; Porto Portugal
| | - R. Erdmann
- Division of Evidence Based Medicine (dEBM), Department of Dematology, Venerology and Allergology; Charité - Universitätsmedizin Berlin; Berlin Germany
| | - P. Foley
- Skin and Cancer Foundation Victoria; Carlton Victoria Australia
- St. Vincent's Hospital Melbourne; Fitzroy Victoria Australia
- The University of Melbourne; Melbourne Victoria Australia
| | - A.K. Gupta
- Division of Dermatology; Department of Medicine; University of Toronto; Toronto Ontario Canada
- Mediprobe Research Inc.; London Ontario Canada
| | - A. Jacobs
- Division of Evidence Based Medicine (dEBM), Department of Dematology, Venerology and Allergology; Charité - Universitätsmedizin Berlin; Berlin Germany
| | - H. Kerl
- Department of Dermatology; Medical University of Graz; Graz Austria
| | - H.W. Lim
- Department of Dermatology; Henry Ford Hospital; Detroit Michigan USA
| | - G. Martin
- Dermatology Laser Center of Maui; Kihei Hawaii USA
| | - M. Paquet
- Mediprobe Research Inc.; London Ontario Canada
| | - D.M. Pariser
- Division of Dermatology and Virginia Clinical Research Inc; Eastern Virginia Medical School; Norfolk Virginia USA
| | - S. Rosumeck
- Division of Evidence Based Medicine (dEBM), Department of Dematology, Venerology and Allergology; Charité - Universitätsmedizin Berlin; Berlin Germany
| | - H.-J. Röwert-Huber
- Division of Dermatopathology; Department of Dermatology, Venerology and Allergology; Charité - Universitätsmedizin Berlin; Berlin Germany
| | - A. Sahota
- Department of Dermatology; Whipps Cross University Hospital; London UK
| | - O.P. Sangueza
- Department of Pathology; Wake Forest Baptist Medical Center; Winston-Salem North Carolina USA
- Department of Dermatology; Wake Forest Baptist Medical Center; Winston-Salem North Carolina USA
| | - S. Shumack
- Department of Dermatology; Northern Medical School; University of Sydney; Sydney New South Wales Australia
| | - B. Sporbeck
- Division of Evidence Based Medicine (dEBM), Department of Dematology, Venerology and Allergology; Charité - Universitätsmedizin Berlin; Berlin Germany
| | - N.A. Swanson
- Dermatology, Surgery, and Otolaryngology; Oregon Health and Science University; Portland Oregon USA
- Surgical and Cosmetic Dermatology and Clinical Operations; Oregon Health and Science University Knight Cancer Institute; Portland Oregon USA
| | - L. Torezan
- Faculty of Medicine; Hospital das Clínicas; Universidade de São Paulo; São Paulo Brazil
| | - A. Nast
- Division of Evidence Based Medicine (dEBM), Department of Dematology, Venerology and Allergology; Charité - Universitätsmedizin Berlin; Berlin Germany
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14
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Ferreira FR, Ogawa MM, Nascimento LFC, Tomimori J. Epidemiological profile of nonmelanoma skin cancer in renal transplant recipients: experience of a referral center. An Bras Dermatol 2015; 89:745-50. [PMID: 25184913 PMCID: PMC4155952 DOI: 10.1590/abd1806-4841.20142590] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2013] [Accepted: 05/05/2013] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Nonmelanoma skin cancer is the most common form of cancer in humans and also the
malignant disease that is increasingly common among kidney transplant
recipients. OBJECTIVE To determine the epidemiological characteristics of renal transplant recipients
with nonmelanoma skin cancer seen at a referral transplantation center. METHODS Cross-sectional descriptive study with renal transplant recipients presenting
nonmelanoma skin cancer, treated at a transplantation referral center between
08/01/2004 and 08/31/2009. Analyzed variables were: gender, age, skin phototype,
occupational and recreational sun exposure, use of photoprotection, personal and
family history of non-melanoma skin cancer, clinical type and location, time
between transplantation and the appearance of the first nonmelanoma skin cancer,
occurrence of viral warts, timing of transplantation, type of donor, cause of
kidney failure, previous transplants, comorbidities, pre-transplant dialysis, type
and duration of dialysis. RESULTS 64 subjects were included. Males - 71.9%; low skin phototypes (up to Fitzpatrick
III) - 89%; mean age - 57.0 years - and mean age at transplant - 47.3 years; sun
exposure - 67.2% occupational - and 64.1% recreational; photoprotection - 78.2%
(although only 34.4% in a regular manner); squamous cell carcinoma - 67.2%;
squamous cell carcinoma/basal cell carcinoma ratio - 2:1; personal history of
nonmelanoma skin cancer - 25% - and family history - 10.9%; location at
photoexposed area - 98.4%; average latency time between transplantation and first
nonmelanoma skin cancer appearance - 78.3 months; viral warts (HPV) after
transplant - 53.1%; average timing of transplantation - 115.5 months; living donor
- 64.1%; triple regimen (antirejection) - 73.2%; comorbidities - 92.2%;
pre-transplant dialysis - 98.4%; hemodialysis - 71.7%; average duration of
dialysis - 39.1 months; previous transplants - 3.1%; hypertension as cause of
renal failure - 46.9%. CONCLUSION This study allowed the epidemiological characterization of a population of kidney
transplant recipients with nonmelanoma skin cancer.
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Affiliation(s)
| | | | | | - Jane Tomimori
- Universidade Federal de São Paulo, São Paulo, SP, Brazil
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15
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Abstract
Nearly 200 distinct human papilloma viruses (HPVs) have now been recognized, and each is associated with a specific set of clinical lesions. They are associated with a spectrum of diseases, from benign verrucae vulgares and condylomata acuminata to the malignancies of the cervix, vulva, anus, and penis. Disease associated with HPV can be divided into skin and mucosal lesion of the genital and extragenital regions. The relationship between HPV and nonmelanoma skin cancer (NMSC) is important clinically, because NMSC is the most common form of malignancy among fair-skinned populations. HPVs have also been detected in skin tags, lichen sclerosus, seborrheic keratoses, actinic keratoses, epidermal cysts, psoriatic plaques, and plucked hairs, but cutaneous HPV can be found on healthy skin.
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Affiliation(s)
- Suzana Ljubojevic
- Department of Dermatology and Venereology, University Hospital Center Zagreb, School of Medicine University of Zagreb, Zagreb, Croatia.
| | - Mihael Skerlev
- Department of Dermatology and Venereology, University Hospital Center Zagreb, School of Medicine University of Zagreb, Zagreb, Croatia
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16
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Zalaudek I, Piana S, Moscarella E, Longo C, Zendri E, Castagnetti F, Pellacani G, Lallas A, Argenziano G. Morphologic grading and treatment of facial actinic keratosis. Clin Dermatol 2014; 32:80-7. [PMID: 24314380 DOI: 10.1016/j.clindermatol.2013.05.028] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Actinic keratoses (AKs) represent the earliest stage in the development of squamous cell carcinoma (SCC) and represent important biomarkers for individuals at risk for development of invasive SCC. Based on clinical morphology, AK can be subdivided into three different grades, which correspond to specific dermatoscopic, reflectance confocal microscopic, and histopathologic substrates. Given the risk for potential progression toward invasive SCC, AK should be treated at the earliest stage. A wide range of minimal destructive or topical therapies is available for the treatment of AK. The choice of treatment depends on the number, size, clinical grading, duration, and location of lesions, patient's compliance, general health conditions, and cosmetic outcome. Treatment can be divided into lesion-directed and field-directed therapies. Lesion-directed treatment focuses on the treatment of single lesions, whereas field-directed treatment aims to eliminate both clinically visible and subclinical lesions within the field of actinic damage (concept of field cancerization). Noninvasive techniques such as dermoscopy and reflectance confocal microscopy can be helpful in identifying AK potentially progressing toward SCC, as well as in the selection of the adequate treatment and monitoring of the treatment outcome.
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Affiliation(s)
- Iris Zalaudek
- Skin Cancer Unit, Arcispedale Santa Maria Nuova, Istituto di Ricovero e Cura a Carattere Scientifico, Reggio Emilia, Viale Risorgimento 80, 42100 Reggio Emilia, Italy; Department of Dermatology, Medical University of Graz Auenbruggerplatz 8; 8046 Graz, Austria.
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17
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Drvar DL, Lipozenčić J, Sabol I, Mokos ZB, Ilic I, Grce M. Human papillomavirus status in extragenital nonmelanoma skin cancers. Clin Dermatol 2014; 32:248-52. [PMID: 24559560 DOI: 10.1016/j.clindermatol.2013.08.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
About 5% of all cancers worldwide can be attributed to human papillomaviruses (HPVs); namely, six sites are strongly associated with HPV infections: cervix, penis, vulva, vagina, anus, and oropharynx. Nonmelanoma skin cancers (NMSC), basal cell carcinoma (BCC), and squamous cell carcinoma (SCC) are the most common malignancies in Caucasians. In fact, there is an intense connection between sunlight exposure, fair skin, HPV, and development of NMSC. We have conducted a pilot study that included tissue samples from 26 carcinoma patients, of which there were 13 BCC and 13 SCC. HPV detection and typing was done with DNA amplification and sequencing, respectively. In total, 23.1% of SCC samples (3/13) and 7.7% of BCC samples (1/13) were positive for HPV DNA. The importance of understanding all aspects of NMSC carcinogenesis may be to reveal novel therapeutic options or preventive measures for HPV containing NMSC patients.
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Affiliation(s)
- Daniela Ledic Drvar
- Department of Dermatology and Venereology, University Hospital Center Zagreb, School of Medicine, University of Zagreb, Salata 4, 10000 Zagreb, Croatia.
| | - Jasna Lipozenčić
- Croatian Academy of Medical Sciences, Praška 2, 10000 Zagreb, Croatia
| | - Ivan Sabol
- Department of Molecular Medicine, Rudjer Boskovic Institute, Bijenicka Cesta 54, 10000 Zagreb, Croatia
| | - Zrinka Bukvic Mokos
- Department of Dermatology and Venereology, University Hospital Center Zagreb, School of Medicine, University of Zagreb, Salata 4, 10000 Zagreb, Croatia
| | - Ivana Ilic
- Department of Pathology and Cytology, Zagreb University Hospital Center, and School of Medicine University of Zagreb, Kispaticeva 12, 10 000 Zagreb, Croatia
| | - Magdalena Grce
- Department of Molecular Medicine, Rudjer Boskovic Institute, Bijenicka Cesta 54, 10000 Zagreb, Croatia
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18
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Dayal JHS, Cole CL, Pourreyron C, Watt SA, Lim YZ, Salas-Alanis JC, Murrell DF, McGrath JA, Stieger B, Jahoda C, Leigh IM, South AP. Type VII collagen regulates expression of OATP1B3, promotes front-to-rear polarity and increases structural organisation in 3D spheroid cultures of RDEB tumour keratinocytes. J Cell Sci 2014; 127:740-51. [PMID: 24357722 PMCID: PMC3924202 DOI: 10.1242/jcs.128454] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2013] [Accepted: 11/12/2013] [Indexed: 12/24/2022] Open
Abstract
Type VII collagen is the main component of anchoring fibrils, structures that are integral to basement membrane homeostasis in skin. Mutations in the gene encoding type VII collagen COL7A1 cause recessive dystrophic epidermolysis bullosa (RDEB) an inherited skin blistering condition complicated by frequent aggressive cutaneous squamous cell carcinoma (cSCC). OATP1B3, which is encoded by the gene SLCO1B3, is a member of the OATP (organic anion transporting polypeptide) superfamily responsible for transporting a wide range of endogenous and xenobiotic compounds. OATP1B3 expression is limited to the liver in healthy tissues, but is frequently detected in multiple cancer types and is reported to be associated with differing clinical outcome. The mechanism and functional significance of tumour-specific expression of OATP1B3 has yet to be determined. Here, we identify SLCO1B3 expression in tumour keratinocytes isolated from RDEB and UV-induced cSCC and demonstrate that SLCO1B3 expression and promoter activity are modulated by type VII collagen. We show that reduction of SLCO1B3 expression upon expression of full-length type VII collagen in RDEB cSCC coincides with acquisition of front-to-rear polarity and increased organisation of 3D spheroid cultures. In addition, we show that type VII collagen positively regulates the abundance of markers implicated in cellular polarity, namely ELMO2, PAR3, E-cadherin, B-catenin, ITGA6 and Ln332.
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MESH Headings
- Adaptor Proteins, Signal Transducing/genetics
- Adaptor Proteins, Signal Transducing/metabolism
- Animals
- Antigens, CD
- Biomarkers, Tumor/genetics
- Biomarkers, Tumor/metabolism
- Cadherins/genetics
- Cadherins/metabolism
- Carcinoma, Squamous Cell/genetics
- Carcinoma, Squamous Cell/metabolism
- Carcinoma, Squamous Cell/pathology
- Cell Adhesion Molecules/genetics
- Cell Adhesion Molecules/metabolism
- Cell Cycle Proteins/genetics
- Cell Cycle Proteins/metabolism
- Cell Polarity
- Coculture Techniques
- Collagen Type VII/physiology
- Cytoskeletal Proteins/genetics
- Cytoskeletal Proteins/metabolism
- Epidermolysis Bullosa Dystrophica/genetics
- Epidermolysis Bullosa Dystrophica/metabolism
- Epidermolysis Bullosa Dystrophica/pathology
- Gene Expression Regulation, Neoplastic
- Humans
- Integrin alpha6/genetics
- Integrin alpha6/metabolism
- Keratinocytes
- Membrane Proteins/genetics
- Membrane Proteins/metabolism
- Mice
- Neoplasm Transplantation
- Organic Anion Transporters, Sodium-Independent/genetics
- Organic Anion Transporters, Sodium-Independent/metabolism
- Promoter Regions, Genetic
- Protein Transport
- Skin Neoplasms/genetics
- Skin Neoplasms/metabolism
- Skin Neoplasms/pathology
- Solute Carrier Organic Anion Transporter Family Member 1B3
- Transcription, Genetic
- Tumor Cells, Cultured
- beta Catenin/genetics
- beta Catenin/metabolism
- Kalinin
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Affiliation(s)
- Jasbani H. S. Dayal
- Division of Cancer Research, Medical Research Institute, Ninewells Hospital and Medical School, University of Dundee, Dundee DD1 9SY, UK
| | - Clare L. Cole
- Division of Cancer Research, Medical Research Institute, Ninewells Hospital and Medical School, University of Dundee, Dundee DD1 9SY, UK
| | - Celine Pourreyron
- Division of Cancer Research, Medical Research Institute, Ninewells Hospital and Medical School, University of Dundee, Dundee DD1 9SY, UK
| | - Stephen A. Watt
- Division of Cancer Research, Medical Research Institute, Ninewells Hospital and Medical School, University of Dundee, Dundee DD1 9SY, UK
| | - Yok Zuan Lim
- Division of Cancer Research, Medical Research Institute, Ninewells Hospital and Medical School, University of Dundee, Dundee DD1 9SY, UK
| | | | - Dedee F. Murrell
- St George Hospital, University of New South Wales, Sydney, 2217 NSW, Australia
| | - John A. McGrath
- King's College School of Medicine, St Thomas' Hospital, Guys Campus, London WC2R 2LS, UK
| | - Bruno Stieger
- Swiss Federal Institute of Technology, 8092 Zurich, Switzerland
| | | | - Irene M. Leigh
- Division of Cancer Research, Medical Research Institute, Ninewells Hospital and Medical School, University of Dundee, Dundee DD1 9SY, UK
| | - Andrew P. South
- Division of Cancer Research, Medical Research Institute, Ninewells Hospital and Medical School, University of Dundee, Dundee DD1 9SY, UK
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19
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Gupta V, Dhote V, Paul BN, Trivedi P. Development of novel topical drug delivery system containing cisplatin and imiquimod for dual therapy in cutaneous epithelial malignancy. J Liposome Res 2013; 24:150-62. [PMID: 24328725 DOI: 10.3109/08982104.2013.865216] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
CONTEXT Strategy of dual therapy has been proposed to minimize the amount of each drug and to achieve the synergistic effect for cancer therapies. OBJECTIVE The aim of this study was to develop an effective drug delivery system for the simultaneous topical delivery of two anti-tumor agents, cisplatin and imiquimod. MATERIAL AND METHODS The preformulation studies were carried out in terms of tests for identification, solubility profile, determination of partition coefficient and simultaneous estimation of both drugs by UV-Visible spectrophotometer and High Performance Liquid Chromatography (HPLC). Drug-drug and drug-excipients interactions were examined by thin layer chromatography, infrared spectroscopy, differential scanning calorimetry (DSC) and X-ray diffraction (XRD). Provesicular drug delivery system (protransfersome gel formulation) have been prepared and characterized by in vitro and in vivo parameters. RESULTS The mean size, poly dispersity index (PDI) and zeta potential of transfersomal vesicles formed by protransfersome hydration were 429.5 nm, 0.631 and -68.1 Mv, respectively. The prepared formulation showed toxicity on cutaneous squamous cell carcinoma cell line (A-431) at 200 µg (cisplatin) and 1 mg (imiquimod) concentration of drug in combination against control. The cisplatin- and imiquimod-loaded provesicular dual-drug delivery system achieved an optimal antitumor effect, increase in lifespan, antiviral, and toxicity reduction, revealing the advantage of site specific drug delivery and the modified combination therapy. DISCUSSION Cisplatin delivery through protransfersome gel in combination with imiquimod may potentiate the activity against solid tumors of epidermal origin. CONCLUSION Data revealed that combination therapy considerably enhances antitumor efficacy of the drug for skin-cited malignancies.
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Affiliation(s)
- Vandana Gupta
- School of Pharmaceutical Sciences, Rajiv Gandhi Technical University , Bhopal, Madhya Pradesh , India
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20
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Hsiao YP, Yang JH, Wu WJ, Lin MH, Sheu GT. E6 and E7 of human papillomavirus type 18 and UVB irradiation corporately regulate interleukin-6 and interleukin-8 expressions in basal cell carcinoma. Exp Dermatol 2013; 22:672-4. [DOI: 10.1111/exd.12223] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/09/2013] [Indexed: 12/23/2022]
Affiliation(s)
| | | | - Wen-Jun Wu
- Institute of Medicine; School of Medicine; Chung Shan Medical University; Taichung City; Taiwan
| | - Meng-Hsuan Lin
- Institute of Medicine; School of Medicine; Chung Shan Medical University; Taichung City; Taiwan
| | - Gwo-Tarng Sheu
- Institute of Medicine; School of Medicine; Chung Shan Medical University; Taichung City; Taiwan
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21
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Majewski S, Jablonska S. The role of HPVs in benign and malignant cutaneous proliferations. ACTA ACUST UNITED AC 2013. [DOI: 10.1179/095741903235001650] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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22
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De Luca JF, Severino R, Lee YS, Johnson D. Dermatologist and gastroenterologist awareness of the potential of immunosuppressants used to treat inflammatory bowel disease to cause non-melanoma skin cancer. Int J Dermatol 2013; 52:955-9. [PMID: 23556532 DOI: 10.1111/j.1365-4632.2012.5612.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Immunosuppressants used to treat inflammatory bowel disease (IBD) may contribute towards the development of non-melanoma skin cancer (NMSC). Few studies have documented this increase in risk. METHODS A mail-in survey was sent to practicing dermatologists and gastroenterologists in the state of Hawaii, USA. These physicians were asked if they had patients with IBD on immunosuppressants with NMSC and if they were aware of an association between immunosuppressants used in IBD and the occurrence of NMSC. Physicians were located via the Yellow Pages telephone directory and the websites http://www.healthgrades.com and http://www.ucomparehealthcare.com. RESULTS Of the 96 surveys delivered, 45 were returned for analysis. Overall, 73.3% of responding physicians knew about an association between NMSC and immunosuppressants for IBD, but 26.7% had no knowledge of this association. When respondents were categorized according to specialty, 90.9% of dermatologists reported knowing about this association, but only 46.2% of responding gastroenterologists reported this awareness (P = 0.0034). Of the respondents who did not provide details of their specialty, 70.0% reported knowledge of the association. CONCLUSIONS Immunosuppressants are helpful in controlling IBD symptoms and progression but should only be used after a thorough assessment of their risks and benefits in each patient. After the initiation of immunosuppressants, patients should have access to appropriate preventative and treatment modalities for NMSC.
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23
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Wlodek C, Ali FR, Lear JT. Use of photodynamic therapy for treatment of actinic keratoses in organ transplant recipients. BIOMED RESEARCH INTERNATIONAL 2012; 2013:349526. [PMID: 23509711 PMCID: PMC3591189 DOI: 10.1155/2013/349526] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/27/2012] [Accepted: 09/05/2012] [Indexed: 12/25/2022]
Abstract
Solid organ transplant recipients are predisposed to actinic keratoses (AK) and nonmelanoma skin cancers, owing to the lifelong immunosuppression required. Today, increasing numbers of organ transplants are being performed and organ transplant recipients (OTRs) are surviving much longer. Photodynamic therapy (PDT) is proving a highly effective treatment modality for AK amongst this susceptible group of patients. Following an overview of the pathogenesis of AK amongst OTRs, the authors review current safety and efficacy data and how this relates to the role of PDT for the treatment of AK in OTRs.
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Affiliation(s)
- Christina Wlodek
- St Thomas' Hospital, Westminster Bridge Road, London SE1 7EH, UK
| | - Faisal R. Ali
- The Dermatology Centre, Manchester Academic Health Science Centre, University of Manchester, Salford Royal NHS Foundation Trust, Manchester M6 8HD, UK
| | - John T. Lear
- The Dermatology Centre, Manchester Academic Health Science Centre, University of Manchester, Salford Royal NHS Foundation Trust, Manchester M6 8HD, UK
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24
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Zakrzewska K, Regalbuto E, Pierucci F, Arvia R, Mazzoli S, Gori A, de Giorgi V. Pattern of HPV infection in basal cell carcinoma and in perilesional skin biopsies from immunocompetent patients. Virol J 2012; 9:309. [PMID: 23244448 PMCID: PMC3545977 DOI: 10.1186/1743-422x-9-309] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2012] [Accepted: 12/07/2012] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND The association between human papillomavirus (HPV) infection and non-melanoma skin cancers (NMSCs) such as squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) is not yet fully understood. We analysed the prevalence and spectrum of cutaneous beta-HPV types and mucosal/genital HPV types in paired biopsies (tumour and corresponding perilesional skin) obtained from 50 BCC immunocompetent patients. A small group of SCC patients (n=9) was also included. We also evaluated some previously postulated risk factors for HPV infection in NMSC patients. RESULTS All biopsies were negative for mucosal/genital HPV types. Overall, beta-HPV DNA was detected more often in SCC compared to BCC patients (78% vs 55% of total samples). The frequency of infection increased with the patient's age [OR=4.88 (95% CI 1.29-18.39)]. There was no significant correlation between beta-HPV positivity and sex, skin type and UV exposure. The prevalence of beta-HPV species 1 types was significantly higher than those belonging to other beta-HPV species in biopsies from BCC (p=0.022) but not from SCC subjects (p=0.091). There was no significant difference in the overall prevalence of beta-HPV infection and the number of viral types between tumour lesions and perilesional skin. BCC samples were significantly more likely to be infected with beta-HPV species 1 types compared to perilesional skin (p=0.036) and showed a higher frequency of mixed infections (p=0.028). CONCLUSIONS These findings demonstrate that beta-HPV types belonging to species 1 are the most common HPV types detected in the skin of BCC patients. Moreover beta-1-HPV types and mixed infections are significantly more frequent in tumour samples than in healthy perilesional skin. Our results suggest that beta-1-HPVs as well as co-infection with more than one viral type could be important in NMSC and in particular in BCC.Further studies aimed to compare the biological activity of viral types in tumours and in healthy skin (viral replication and expression, interference of infection with cellular functions) are necessary to understand the role of HPV infection in skin cancer.
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Affiliation(s)
- Krystyna Zakrzewska
- Department of Public Health, University of Florence, Viale Morgagni 48, Florence, 50134, Italy.
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Wititsuwannakul J, Ko CJ. Myrmecia wart inclusions as an incidental histopathologic finding. J Cutan Pathol 2012; 39:936-9. [PMID: 22882280 DOI: 10.1111/j.1600-0560.2012.01968.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2012] [Revised: 05/30/2012] [Accepted: 06/29/2012] [Indexed: 11/27/2022]
Abstract
BACKGROUND Latent infection by human papillomavirus (HPV) has been described for genital (mucosal) and epidermodysplasia verruciformis subtypes. Only rarely has cutaneotropic, non-oncogenic HPV been found by polymerase chain reaction studies in normal skin. METHODS We noted myrmecia wart inclusions as an incidental histopathologic finding in four specimens from diverse sites (eyebrow, scalp, forehead, leg). The final diagnoses for these four cases were intradermal nevus, scarring alopecia, benign keratosis and stasis dermatitis. Anti-HPV antibody staining was performed in all cases. This antibody detects HPV-1,6,11,16,18 and 31 in formalin-fixed paraffin-embedded tissue. RESULTS The foci of myrmecia wart inclusions were characterized by smooth to angular cytoplasmic inclusions in the granular layer, spanning one to three rete. The inclusions stained with an anti-HPV antibody in three specimens. CONCLUSIONS This finding of incidental myrmecia wart inclusions in skin biopsies supports latent infection by cutaneotropic, non-carcinogenic HPV.
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Affiliation(s)
- Jade Wititsuwannakul
- Department of Dermatology, Yale University School of Medicine, New Haven, CT 06520, USA.
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Ekeowa-Anderson AL, Purdie KJ, Gibbon K, Byrne CR, Arbeit JM, Harwood CA, O'Shaughnessy RFL. AKT1 loss correlates with episomal HPV16 in vulval intraepithelial neoplasia. PLoS One 2012; 7:e38608. [PMID: 22685591 PMCID: PMC3369856 DOI: 10.1371/journal.pone.0038608] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2011] [Accepted: 05/08/2012] [Indexed: 11/23/2022] Open
Abstract
Anogenital malignancy has a significant association with high-risk mucosal alpha-human papillomaviruses (alpha-PV), particularly HPV 16 and 18 whereas extragenital SCC has been linked to the presence of cutaneous beta and gamma–HPV types. Vulval skin may be colonised by both mucosal and cutaneous (beta-, mu-, nu- and gamma-) PV types, but there are few systematic studies investigating their presence and their relative contributions to vulval malignancy. Dysregulation of AKT, a serine/threonine kinase, plays a significant role in several cancers. Mucosal HPV types can increase AKT phosphorylation and activity whereas cutaneous HPV types down-regulate AKT1 expression, probably to weaken the cornified envelope to promote viral release. We assessed the presence of mucosal and cutaneous HPV in vulval malignancy and its relationship to AKT1 expression in order to establish the corresponding HPV and AKT1 profile of normal vulval skin, vulval intraepithelial neoplasia (VIN) and vulval squamous cell carcinoma (vSCC). We show that HPV16 is the principle HPV type present in VIN, there were few detectable beta types present and AKT1 loss was not associated with the presence of these cutaneous HPV. We show that HPV16 early gene expression reduced AKT1 expression in transgenic mouse epidermis. AKT1 loss in our VIN cohort correlated with presence of high copy number, episomal HPV16. Maintained AKT1 expression correlated with low copy number, an increased frequency of integration and increased HPV16E7 expression, a finding we replicated in another untyped cohort of vSCC. Since expression of E7 reflects tumour progression, these findings suggest that AKT1 loss associated with episomal HPV16 may have positive prognostic implications in vulval malignancy.
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Affiliation(s)
- Arucha L. Ekeowa-Anderson
- Centre for Cutaneous Research, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
- Department of Dermatology, Whipps Cross University Hospital, London, United Kingdom
| | - Karin J. Purdie
- Centre for Cutaneous Research, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Karen Gibbon
- Centre for Cutaneous Research, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
- Department of Dermatology, Whipps Cross University Hospital, London, United Kingdom
| | - Carolyn R. Byrne
- Centre for Cutaneous Research, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Jeffrey M. Arbeit
- Division of Urologic Surgery, Washington University School of Medicine, St Louis, Missouri, United States of America
| | - Catherine A. Harwood
- Centre for Cutaneous Research, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Ryan F. L. O'Shaughnessy
- Centre for Cutaneous Research, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
- Departments of Immunobiology and Dermatology, Institute of Child Health, University College London, London, United Kingdom
- * E-mail:
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Matić S, Masenga V, Poli A, Rinaldi R, Milne RG, Vecchiati M, Noris E. Comparative analysis of recombinant Human Papillomavirus 8 L1 production in plants by a variety of expression systems and purification methods. PLANT BIOTECHNOLOGY JOURNAL 2012; 10:410-21. [PMID: 22260326 DOI: 10.1111/j.1467-7652.2011.00671.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Human papillomavirus 8 (HPV-8), one of the high-risk cutaneous papillomaviruses (cHPVs), is associated with epidermodysplasia verruciformis and nonmelanoma skin cancer in immuno-compromised individuals. Currently, no vaccines against cHPVs have been reported; however, recent studies on cross-neutralizing properties of their capsid proteins (CP) have fostered an interest in vaccine production against these viruses. We examined the potential of producing HPV-8 major CP L1 in Nicotiana benthamiana by agroinfiltration of different transient expression vectors: (i) the binary vector pBIN19 with or without silencing suppressor constructs, (ii) the nonreplicating Cowpea mosaic virus-derived expression vector pEAQ-HT and (iii) a replicating Tobacco mosaic virus (TMV)-based vector alone or with signal peptides. Although HPV-8 L1 was successfully expressed using pEAQ-HT and TMV, a 15-fold increase was obtained with pEAQ-HT. In contrast, no L1 protein could be immune detected using pBIN19 irrespective of whether silencing suppressors were coexpressed, although such constructs were required for identifying L1-specific transcripts. A fourfold yield increase in L1 expression was obtained when 22 C-terminal amino acids were deleted (L1ΔC22), possibly eliminating a nuclear localization signal. Electron microscopy showed that plant-made HPV-8 L1 proteins assembled in appropriate virus-like particles (VLPs) of T = 1 or T = 7 symmetry. Ultrathin sections of L1ΔC22-expressing cells revealed their accumulation in the cytoplasm in the form of VLPs or paracrystalline arrays. These results show for the first time the production and localization of HPV-8 L1 protein in planta and its assembly into VLPs representing promising candidate for potential vaccine production.
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Affiliation(s)
- Slavica Matić
- Istituto di Virologia Vegetale, Consiglio Nazionale delle Ricerche, Strada delle Cacce, Turin, Italy
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Basset-Seguin N, Baumann Conzett K, Gerritsen M, Gonzalez H, Haedersdal M, Hofbauer G, Aguado L, Kerob D, Lear J, Piaserico S, Ulrich C. Photodynamic therapy for actinic keratosis in organ transplant patients. J Eur Acad Dermatol Venereol 2011; 27:57-66. [DOI: 10.1111/j.1468-3083.2011.04356.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Cutaneous squamous cell carcinoma with mucinous metaplasia on the sole associated with high-risk human papillomavirus type 18. Am J Dermatopathol 2011; 33:317-22. [PMID: 20847640 DOI: 10.1097/dad.0b013e3181ddc969] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
A case of superficially invasive cutaneous squamous cell carcinoma (SCC) of the sole containing numerous mucin-producing vacuolated cells resembling "signet-ring" cells is reported. The 2 cellular components of the tumor, both squamous and mucinous, were atypical with pleomorphic nuclei, and expressed the same immunophenotype, consistent in weak and focal positivity for cytokeratin 5/6 and epithelial membrane antigen (EMA) and weak cytoplasmic and nuclear positivity for p16. Real-time PCR genotyping demonstrated the presence of high-risk human papillomavirus (HPV) type 18. We diagnose our case as "cutaneous SCC with mucinous metaplasia" and discuss the differential diagnoses with other skin tumors exhibiting mucin-containing cells, in particular with adenosquamous carcinoma and mucoepidermoid carcinoma. Although HPV 18 is not uncommon in cervico-vaginal pathology, where is often associated with mucinous adenocarcinoma or adenosquamous carcinoma of the cervix, its detection has been rarely reported in cutaneous SCC. In our case, the association of mucinous metaplasia and oncogenic high-risk HPV 18 in a cutaneous SCC may be of interest to the dermatopathologist. Further observations need to confirm whether the histopathologic finding of mucinous metaplasia in an atypical squamous cell proliferation could be a clue for investigating the presence of oncogenic high-risk HPV infection, with particular regard to HPV 18 subtype.
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Paradisi A, Waterboer T, Sampogna F, Tabolli S, Simoni S, Pawlita M, Abeni D. Seropositivity for human papillomavirus and incidence of subsequent squamous cell and basal cell carcinomas of the skin in patients with a previous nonmelanoma skin cancer. Br J Dermatol 2011; 165:782-91. [PMID: 21561438 DOI: 10.1111/j.1365-2133.2011.10403.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND Infection with human papillomaviruses (HPVs) is a risk factor for several epithelial cancers, but its relationship with keratinocyte tumours has not yet been established. Objective In this prospective study we investigated the possible role of different HPVs in the incidence of a subsequent nonmelanoma skin cancer (NMSC). METHODS One hundred and fifty-three patients with squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) enrolled in a previous case-control study were re-contacted, and a follow-up visit was offered. Demographic and clinical data, date of first NMSC presentation, Fitzpatrick skin type and history of NMSC during the follow-up period were ascertained. Recurrences and new second cancers were considered together as 'outcomes' in time-to-event analyses and in Cox proportional hazard models. RESULTS Clinical data were obtained in 107 patients. HPV seropositivity at baseline was strongly associated with the risk of developing a second SCC after 5 years for a number of beta and gamma HPV types. For example, HPV-24-seropositive patients with an SCC at baseline had a 4-fold increased risk of developing a subsequent SCC (hazard ratio 4·35, 95% confidence interval 1·2-15·6, P = 0·024). No association between serological status for any HPV type tested and an increased risk of BCC was found. CONCLUSIONS We observed a consistent pattern of a positive association between seropositivity for beta and gamma HPV types and the risk of a subsequent SCC in patients with a previous SCC. Our data corroborate the results of previous case-control studies and may spur further prospective studies on the causal role of HPVs in NMSC.
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Affiliation(s)
- A Paradisi
- Health Services Research Unit and Day Surgery Unit, Istituto Dermopatico dell'Immacolata, IDI-IRCCS, Via dei Monti di Creta 104, 00167 Rome, Italy
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Abstract
PURPOSE To review characteristics of patients who develop premalignant and malignant skin lesions while on sorafenib therapy and discuss implications for subsequent treatment of their primary malignancies. BACKGROUND Sorafenib is a newly developed multitargeted protein kinase inhibitor reported to induce a variety of adverse cutaneous effects, rarely including actinic keratoses, keratocanthomas, and squamous cell carcinomas (SCCs). METHODS Published reports of individuals who have developed cutaneous lesions demonstrating atypia of the epidermis are reviewed. In addition, a 77-year-old man who developed not only an SCC but also verrucas within one month of taking sorafenib monotherapy for metastatic adenocarcinoma of the lung is described. RESULTS Cutaneous lesions develop most commonly in Caucasian men older than 40 years without previous histories of skin cancer, within two weeks to three years of starting sorafenib therapy. Currently there is no definitive explanation for the relationship between sorafenib and cutaneous neoplasms. Management typically involves treatment of skin lesions with cryotherapy or excision with at least a brief discontinuation of sorafenib. In patients whose primary malignancies were responding well, sorafenib therapy was continued with close follow-up. CONCLUSIONS The possibility of rapidly developing actinic keratoses, keratocanthomas, verrucas, and SCC during treatment with sorafenib, warrants close dermatologic follow-up and a lower threshold for biopsy and treatment of suspicious cutaneous lesions. Development of a sorafenib-induced SCC is not an absolute contraindication for continued use of sorafenib therapy; however, the drug should be briefly discontinued until lesions are treated.
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Abstract
Cutaneous squamous cell carcinoma (SCC) is the second most common human cancer and can behave aggressively. Mohs micrographic surgery offers the highest cure rates for high-risk SCCs and is particularly useful for SCCs on challenging anatomic sites.
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Affiliation(s)
- Daniel Belkin
- Department of Dermatology, Weill Cornell Medical College, 1305 York Avenue, New York, NY 10021, USA
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Buitrago-Pérez A, Garaulet G, Vázquez-Carballo A, Paramio JM, García-Escudero R. Molecular Signature of HPV-Induced Carcinogenesis: pRb, p53 and Gene Expression Profiling. Curr Genomics 2011; 10:26-34. [PMID: 19721808 PMCID: PMC2699838 DOI: 10.2174/138920209787581235] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2008] [Revised: 11/30/2008] [Accepted: 12/05/2008] [Indexed: 01/15/2023] Open
Abstract
The infection by mucosal human papillomavirus (HPV) is causally associated with tumor development in cervix and oropharynx. The mechanisms responsible for this oncogenic potential are mainly due to the product activities of two early viral oncogenes: E6 and E7. Although a large number of cellular targets have been described for both oncoproteins, the interaction with tumor suppressors p53 and retinoblastoma protein (pRb) emerged as the key functional activities. E6 degrades tumor suppressor p53, thus inhibiting p53-dependent functions, whereas E7 binds and degrades pRb, allowing the transcription of E2F-dependent genes. Since these two tumor suppressors exert their actions through transcriptional modulation, functional genomics has provided a large body of data that reflects the altered gene expression of HPVinfected cells or tissues. Here we will review the similarities and differences of these findings, and we also compare them with those obtained with transgenic mouse models bearing the deletion of some of the viral oncogene targets. The comparative analysis supports molecular evidences about the role of oncogenes E6 and E7 in the interference with the mentioned cellular functions, and also suggests that the mentioned transgenic mice can be used as models for HPV-associated diseases such as human cervical, oropharynx, and skin carcinomas.
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Affiliation(s)
- Agueda Buitrago-Pérez
- Molecular Oncology Unit, Molecular Biomedicine Division, CIEMAT, Ave. Complutense 22, E-28040 Madrid, Spain
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Corbalán-Vélez R, Oviedo-Ramírez I, Ruiz-Maciá J, Conesa-Zamora P, Sánchez-Hernández M, Martínez-Barba E, Brufau-Redondo C, López-Lozano J. Immunohistochemical Staining of p16 in Squamous Cell Carcinomas of the Genital and Extragenital Area. ACTAS DERMO-SIFILIOGRAFICAS 2011. [DOI: 10.1016/j.adengl.2011.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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Tinción inmunohistoquímica p16 en carcinomas epidermoides del área genital y extragenital. ACTAS DERMO-SIFILIOGRAFICAS 2011; 102:439-47. [DOI: 10.1016/j.ad.2011.02.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2010] [Revised: 02/02/2011] [Accepted: 02/23/2011] [Indexed: 11/21/2022] Open
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Leto MDGP, Santos Júnior GFD, Porro AM, Tomimori J. Infecção pelo papilomavírus humano: etiopatogenia, biologia molecular e manifestações clínicas. An Bras Dermatol 2011; 86:306-17. [DOI: 10.1590/s0365-05962011000200014] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2010] [Indexed: 01/15/2023] Open
Abstract
O papilomavírus humano (HPV) é um vírus DNA que apresenta tropismo por células epiteliais, causando infecções na pele e nas mucosas. A replicação do HPV ocorre no núcleo das células escamosas e o seu ciclo de vida é diretamente relacionado ao programa de diferenciação da célula hospedeira. Até o momento, foram completamente caracterizados cerca de 100 tipos diferentes de HPVs e há um grande número adicional de tipos ainda não sequenciados. Além de ser o responsável por lesões benignas de pele e mucosas, o HPV também está envolvido no desenvolvimento de diversos tumores cutaneomucosos: doença de Bowen, cânceres de pele não melanoma e carcinomas genitais. Esta revisão aborda as características do HPV, quadros cutâneos e mucosos benignos e malignos causados por ele e os principais métodos empregados em sua detecção e tipagem.
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Mertz K, Schmid M, Burger B, Itin P, Palmedo G, Schärer L, Kutzner H, Fernández Figueras M, Cribier B, Pfaltz M, Kempf W. Detection of Merkel Cell Polyomavirus in Epidermodysplasia-Verruciformis-Associated Skin Neoplasms. Dermatology 2010; 222:87-92. [DOI: 10.1159/000321880] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2010] [Accepted: 09/30/2010] [Indexed: 11/19/2022] Open
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Escutia B, Ledesma E, Serra-Guillen C, Gimeno C, Vilata J, Guillén C, Nagore E. Detection of human papilloma virus in normal skin and in superficial and nodular basal cell carcinomas in immunocompetent subjects. J Eur Acad Dermatol Venereol 2010; 25:832-8. [DOI: 10.1111/j.1468-3083.2010.03875.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Purdie KJ, Pourreyron C, Fassihi H, Cepeda-Valdes R, Frew JW, Volz A, Weissenborn SJ, Pfister H, Proby CM, Bruckner-Tuderman L, Murrell DF, Salas-Alanis JC, McGrath JA, Leigh IM, Harwood CA, South AP. No evidence that human papillomavirus is responsible for the aggressive nature of recessive dystrophic epidermolysis bullosa-associated squamous cell carcinoma. J Invest Dermatol 2010; 130:2853-5. [PMID: 20739945 DOI: 10.1038/jid.2010.243] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Hufbauer M, Lazić D, Akgül B, Brandsma J, Pfister H, Weissenborn S. Enhanced human papillomavirus type 8 oncogene expression levels are crucial for skin tumorigenesis in transgenic mice. Virology 2010; 403:128-36. [DOI: 10.1016/j.virol.2010.04.013] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2009] [Revised: 03/01/2010] [Accepted: 04/14/2010] [Indexed: 12/25/2022]
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Hussain SK, Sundquist J, Hemminki K. Incidence Trends of Squamous Cell and Rare Skin Cancers in the Swedish National Cancer Registry Point to Calendar Year and Age-Dependent Increases. J Invest Dermatol 2010; 130:1323-8. [DOI: 10.1038/jid.2009.426] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Lansbury L, Leonardi‐Bee J, Perkins W, Goodacre T, Tweed JA, Bath‐Hextall FJ. Interventions for non-metastatic squamous cell carcinoma of the skin. Cochrane Database Syst Rev 2010; 2010:CD007869. [PMID: 20393962 PMCID: PMC10816961 DOI: 10.1002/14651858.cd007869.pub2] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND Squamous cell carcinoma (SCC) is the second most common skin cancer, and is becoming increasingly common around the world. Left untreated, it may spread to other parts of the body, and, although the risk is low, it may ultimately lead to death. Surgical excision is the first line of treatment for most skin SCCs, although other forms of treatment are also used depending upon the nature and site of the tumour and individual participant factors. A multi-professional approach is therefore required for the management of people with this condition. OBJECTIVES To assess the effects of treatments for primary non-metastatic squamous cell carcinoma of the skin. SEARCH STRATEGY In February 2010 we searched for relevant trials in The Cochrane Skin Group Specialised Register, The Cochrane Library (Issue 1, 2010), MEDLINE, EMBASE, PsycINFO, AMED, LILACS, and the ongoing trials registries. SELECTION CRITERIA We only included randomised controlled trials (RCTs) of interventions for primary SCC of the skin. Inclusion criteria were: adults with one or more histologically proven primary SCCs of the skin which had not metastasised. The primary outcome measures were time to recurrence one to five years after treatment, and quality of life. Secondary outcomes included early treatment failure within six months, number of adverse events by the end of treatment, aesthetic appearance as assessed by the participant and clinician, discomfort to the participant during and after treatment, and death. DATA COLLECTION AND ANALYSIS Two authors (LL, FB-H) independently carried out study selection and assessment of methodological quality and data extraction. MAIN RESULTS One trial involving 65 people was included. This compared the time to recurrence in participants with aggressive skin SCC who were randomised to receive either adjuvant 13-cis-retinoic acid and interferon alpha after surgery with or without radiation treatment, or no adjuvant therapy after their initial treatment. There was no significant difference in time to recurrence of tumour between the two groups (hazard ratio 1.08, 95% confidence intervals 0.43 to 2.72).Most studies identified from the searches were excluded as they were either uncontrolled case series, did not include participants with invasive primary SCC, or included only participants with recurrent or metastatic disease. AUTHORS' CONCLUSIONS Little evidence from RCTs comparing the efficacy of different interventions for primary cutaneous SCCs exists. There is a clear need for well-designed randomised studies in order to improve the evidence base for the management of this condition.
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Affiliation(s)
- Louise Lansbury
- The University of NottinghamCentre of Evidence Based DermatologyKing's Meadow CampusLenton LaneNottinghamUKNG7 2NR
| | - Jo Leonardi‐Bee
- The University of NottinghamDivision of Epidemiology and Public HealthClinical Sciences BuildingNottingham City Hospital NHS Trust Campus, Hucknall RoadNottinghamUKNG5 1PB
| | - William Perkins
- Queen's Medical CentreDepartment of DermatologyC Floor, South BlockDerby RoadNottinghamUKNG7 2UH
| | - Timothy Goodacre
- John Radcliffe HospitalDepartment of Plastic SurgeryHeadingtonOxfordUKOX3 9DU
| | - John A Tweed
- The University of Nottinghamc/o Cochrane Skin GroupKing's Meadow CampusLenton LaneNottinghamUKNG7 2NR
| | - Fiona J Bath‐Hextall
- The University of NottinghamSchool of Health SciencesRoom D83, Medical schoolQueens medical centreNottinghamUKNG7 2UH
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Donalisio M, Poli A, Civra A, Landolfo S, Lembo D. Effects of cytokines on long control region transcriptional activity in high-risk cutaneous human papillomavirus types 5 and 8. Arch Virol 2010; 155:583-7. [DOI: 10.1007/s00705-010-0615-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2009] [Accepted: 01/06/2010] [Indexed: 01/24/2023]
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Gottschling M, Göker M, Köhler A, Lehmann MD, Stockfleth E, Nindl I. Cutaneotropic Human β-/γ-Papillomaviruses Are Rarely Shared between Family Members. J Invest Dermatol 2009; 129:2427-34. [DOI: 10.1038/jid.2009.94] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Ruer JB, Pépin L, Gheit T, Vidal C, Kantelip B, Tommasino M, Prétet JL, Mougin C, Aubin F. Detection of alpha- and beta-human papillomavirus (HPV) in cutaneous melanoma: a matched and controlled study using specific multiplex PCR combined with DNA microarray primer extension. Exp Dermatol 2009; 18:857-62. [DOI: 10.1111/j.1600-0625.2009.00866.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Identification of B-cell epitopes on virus-like particles of cutaneous alpha-human papillomaviruses. J Virol 2009; 83:12692-701. [PMID: 19793806 DOI: 10.1128/jvi.01582-09] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Human papillomavirus (PV) (HPV) types 2, 27, and 57 are closely related and, hence, represent a promising model system to study the correlation of phylogenetic relationship and immunological distinctiveness of PVs. These HPV types cause a large fraction of cutaneous warts occurring in immunocompromised patients. Therefore, they constitute a target for the development of virus-like particle (VLP)-based vaccines. However, the immunogenic structure of HPV type 2, 27, and 57 capsids has not been studied yet. Here we provide, for the first time, a characterization of the B-cell epitopes on VLPs of cutaneous alpha-HPVs using a panel of 94 monoclonal antibodies (MAbs) generated upon immunization with capsids from HPV types 2, 27, and 57. The MAbs generated were characterized regarding their reactivities with glutathione S-transferase-L1 fusion proteins from 18 different PV types, the nature of their recognized epitopes, their isotypes, and their ability to neutralize HPV type 2, 27, 57, or 16. In total, 33 of the 94 MAbs (35%) showed type-specific reactivity. All type-specific MAbs recognize linear epitopes, most of which map to the hypervariable surface loop regions of the L1 amino acid sequence. Four of the generated MAbs neutralized pseudovirions of the inoculated HPV type efficiently. All four MAbs recognized epitopes within the BC loop, which is required and sufficient for their neutralizing activity. Our data highlight the immunological distinctiveness of individual HPV types, even in comparison to their closest relatives, and they provide a basis for the development of VLP-based vaccines against cutaneous alpha-HPVs.
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Vajdic CM, van Leeuwen MT. Cancer incidence and risk factors after solid organ transplantation. Int J Cancer 2009; 125:1747-54. [PMID: 19444916 DOI: 10.1002/ijc.24439] [Citation(s) in RCA: 282] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Iatrogenic immunosuppression is a unique setting for investigating immune-related mechanisms of carcinogenesis. Solid organ transplant recipients have a 3-fold excess risk of cancer relative to the age- and sex-matched general population. Population-based studies utilizing cancer registry records indicate that a wide range of cancers, mostly those with a viral etiology, occur at excess rates. To date, cancer risk has predominantly been examined in adult kidney transplant recipients in Western countries. It is yet to be established whether a similar incidence profile exists in the long-term for other solid organ, pediatric and non-Western transplant recipients. The cancer incidence profile before and after kidney transplantation strongly suggests a relatively minor contribution by both preexisting cancer risk factors and the conditions underlying end-stage kidney disease, and points to a causal role for immunosuppression. Within-cohort risk factor analyses have largely been performed on cohorts with voluntary cancer notification, and very few have incorporated biomarkers of the level of immunosuppression, the current receipt of immunosuppressive agents, or genetic risk factors. Because of their markedly high risk of certain cancers, findings from comprehensive studies in transplant recipients have the potential to raise new avenues for investigation into causal mechanisms and preventive measures against immune-related and infectious causes of cancer.
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Affiliation(s)
- Claire M Vajdic
- UNSW Cancer Research Centre, Prince of Wales Clinical School, University of New South Wales, Sydney, Randwick New South Wales 2031, Australia.
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Zaravinos A, Kanellou P, Spandidos DA. Viral DNA detection and RAS mutations in actinic keratosis and nonmelanoma skin cancers. Br J Dermatol 2009; 162:325-31. [PMID: 19849697 DOI: 10.1111/j.1365-2133.2009.09480.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Actinic keratosis (AK) is a well-established precancerous skin lesion that has the potential to progress to squamous cell carcinoma (SCC). Basal cell carcinoma (BCC) is a locally aggressive slowly growing tumour that rarely metastasizes. A number of viruses have been proposed to play a role in the development of nonmelanoma skin cancers (NMSC), but the most plausible evidence to date suggests that cutaneous human papillomavirus (HPV) is the key instigating factor. OBJECTIVES To evaluate the prevalence of HPV, cytomegalovirus (CMV), herpes simplex virus (HSV) and Epstein-Barr virus (EBV) and investigate their relationship with the presence of RAS gene mutations in cutaneous lesions obtained from nonimmunosuppressed patients. METHODS HPV, CMV, HSV and EBV detection was performed using polymerase chain reaction (PCR) in skin biopsies (26 AK, 12 SCC and 15 BCC samples) that were collected from immunocompetent patients. The RAS mutation incidence was also investigated in all cutaneous lesions by use of PCR/restriction fragment length polymorphism and direct DNA sequencing. RESULTS Seventeen out of 53 (32%) skin lesions were found to be positive for HPV DNA. The highest incidences of HPV infection were five of 15 (33%) in BCC and four of 12 (33%) in SCC specimens. The HPV incidence was eight of 26 (31%) in AK and eight of 53 (15%) in normal skin tissue. Twelve out of 53 (23%) skin lesions were CMV-positive. The highest incidence of CMV infection was six of 15 (40%), observed in BCC specimens. The CMV incidence was two of 26 (8%) in AK and four of 12 (33%) in SCC. No normal skin biopsy was found to be positive for CMV. All cutaneous samples were negative for HSV and EBV DNA, as assessed by our PCR-based assays. Only three samples, one AK (4%), one BCC (6%) and one SCC (8%), were found to carry a G>T transversion at the second position of HRAS codon 12. Both HRAS mutant SCC and BCC biopsies were HPV- and CMV-positive, as well. CONCLUSIONS HPV DNA is detected in NMSC, AK and normal skin biopsies. Our results also indicate that CMV is involved in NMSC at higher levels than in premalignant lesions, whereas the virus was not detected in normal skin biopsies. HSV and EBV do not appear to be involved in the pathogenesis of cutaneous lesions. Moreover, we suggest that the HRAS codon 12 mutation is not a very common event in AK or NMSC. Finally, both viral infection and HRAS activation appear to represent independent factors in the aetiology of NMSC, samples of which were obtained from immunocompetent patients.
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Affiliation(s)
- A Zaravinos
- Laboratory of Clinical Virology, Medical School, University of Crete, Heraklion 71003, Crete, Greece
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Turowski CB, Ross AS, Cusack CA. Human papillomavirus-associated squamous cell carcinoma of the nail bed in African-American patients. Int J Dermatol 2009; 48:117-20. [PMID: 19200182 DOI: 10.1111/j.1365-4632.2009.03450.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Human papillomavirus (HPV) has been implicated in the development of digital squamous cell carcinoma (SCC). Case reports in the literature mostly identify HPV type 16 present in tumors, but HPV types 2, 31, 34, 35, and 73 have also been isolated. METHODS Two cases of digital SCC associated with HPV 16 in young African-American men are presented. RESULTS AND CONCLUSIONS Digital SCC associated with HPV may be difficult to evaluate and treat, particularly in African-Americans and patients with human immunodeficiency virus (HIV). We discuss the need for careful evaluation, treatment, and follow-up of these individuals.
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Affiliation(s)
- Cheryl Bansal Turowski
- Department of Dermatology, Drexel University College of Medicine, Philadelphia, Pennsylvania 19107, USA
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