A polymerase chain reaction (PCR) investigation of oral verrucae which contain HPV types 2 and 57 by in situ hybridization

Focal epithelial hyperplasia - an update

Focal epithelial hyperplasia (FEH) is an asymptomatic benign mucosal disease, which is mostly observed in specific groups in certain geographical regions. FEH is usually a disease of childhood and adolescence and is generally associated with people who live in poverty and of low socioeconomic status. Clinically, FEH is typically characterized by multiple, painless, soft, sessile papules, plaques or nodules, which may coalesce to give rise to larger lesions. Human papillomavirus (HPV), especially genotypes 13 and 32, have been associated and detected in the majority of FEH lesions. The clinical examination and social history often allow diagnosis, but histopathological examination of lesional tissue is usually required to confirm the exact diagnosis. FEH sometimes resolves spontaneously however, treatment is often indicated as a consequence of aesthetic effects or any interference with occlusion. There remains no specific therapy for FEH, although surgical removal, laser excision or possibly topical antiviral agents may be of benefit. There remains no evidence that FEH is potentially malignant.

Molecular epidemiological study on prevalence of human papillomaviruses in patients with common warts in Beijing area

OBJECTIVE

To study the circulation, distribution, and genomic diversity of HPVs in common warts in Beijing area of China.

METHODS

Forty eight patients with pathologically diagnosed common warts were screened for the presence of HPV with HPV type-specific PCR and direct sequencing analysis. The genomic diversity of HPVs prevalent in Chinese patients was analyzed based on LCR.

RESULTS

Forty one (85.5%) samples were positive for HPV DNA, 13 (31.7%)--HPV-57, 12 (29.3%)--HPV-1a, 7 (17%)--HPV-27 and 5(12.2%)--HPV-2a. Four cases were infected with two different HPV types, two (4.9%) with HPV-1a and HPV-27, one (2.4%) with HPV-1 and HPV-57 and one (2.4%) with HPV-27 and HPV-57. In contrast to the prevalence of single strain of novel HPV-57 variant and HPV-1 prototype, two HPV-2 and three HPV-27 novel variants were found to circulate in Beijing.

CONCLUSION

HPV-1, -2, -27 and -57 are predominantly prevalent in patients with common warts in Beijing.

Prevalência do papilomavírus humano (HPV) na cavidade oral e na orofaringe

A prevalência do papilomavírus humano (HPV) na cavidade oral e na orofaringe ainda não está bem esclarecida como nos estudos do trato genital, na qual é bem definida. Entretanto, novas pesquisas estão surgindo após o aparecimento dos exames de biologia molecular. Neste estudo foi realizada uma revisão da literatura com o objetivo de verificar a prevalência do papilomavírus humano na cavidade oral e na orofaringe. Os resultados desta pesquisa mostraram uma prevalência do HPV 16 na mucosa oral normal (infecção latente). Já nas lesões benignas orais associadas ao HPV mostraram uma prevalência do HPV 6 e 11 em papilomas de células escamosas e condilomas, e, nas verrugas, uma prevalência do HPV 2 e 57, enquanto na hiperplasia epitelial focal prevaleceram os HPVs 13 e 32, e no câncer oral, principalmente, no carcinoma de células escamosas (CCE), foi evidenciada uma alta prevalência do HPV 16, o que sugere sua participação na carcinogênese oral, apesar de ser um assunto controverso. Constatou-se também uma enorme discrepância nos resultados da prevalência do papilomavírus humano (HPV) na mucosa oral normal (infecção latente) e no câncer oral, enquanto nas lesões benignas associadas ao vírus, os resultados foram confirmatórios.

Prevalence of human papillomavirus (HPV) in oral cavity and oropharynx

The prevalence of human papillomavirus (HPV) in the oral cavity and oropharynx has not yet been as well studied as its infection of the vaginal tract. However, new study are emerge after the development of molecular biology techniques. The objective of this study is to show the prevalence of HPV in the oral cavity and the oropharynx. An ample bibliographic review was done showing a prevalence of HPV 6, 11 in a normal oral mucous membrane (latent infection). In oral benign lesions associated with HPV, a prevalence of HPV 6 and 11 was observed in squamous cell papilloma (SCP) and condylomas acuminatum, while HPV 2 and 57 were more prevalent in verruca vulgaris lesions. As for focal epithelial hyperplasia (FEH) and oral cancer, especially squamous cell carcinoma (SCC), the prevalence was of HPV 13 and 32, and HPV 16, respectively. The last findings are, nonetheless, controversial. The last findings are, nonetheless, controversial. Showed also discrepancy result the prevalence of human papillomavírus (HPV) in normal oral mucous (latent infection) and in oral cancer, however evidenced confirmatory result in oral benign lesions associated with virus.

Human papillomaviruses in the normal oral cavity of children in Japan

The purpose of this study was to determine the frequency of human papillomavirus (HPV) infections in the normal oral cavity of children in Japan. Oral squamous cell specimens were collected from 77 children (44 boys and 33 girls), aged 3 and 5 years. Extracted DNA was evaluated for HPV infections by polymerase chain reaction (PCR) methods, using consensus primers for the L1 region, specific primers, and direct DNA sequencing analysis. Thirty-seven of 77 specimens (48.1%) were positive for HPV DNA. Positive rates of boys and girls in all specimens were 28.3 (22/77) and 19.5 (15/77)%, respectively. The positive rate in 3-year-old children was 45.2 (14/31)%, and positive rates in boys and girls were 52.6 (10/19) and 33.3 (4/12)%, respectively. The positive rate in 5-year-old children was 50.0 (23/46)%, and positive rates in boys and girls were 48.0 (12/25) and 52.4 (11/21)%, respectively. HPV types were determined by specific PCR and direct DNA sequencing analysis. Frequent HPV types in the specimens of all children were HPV-16 (11/37; 29.7%),-1 (6/37; 16.2%),-2 (6/37; 16.2%),-75 (6/37; 16.2%). The results of the present investigation indicate that many HPVs, including HPV-16 (a high-risk type for cancer), are present in the oral cavity of 3- and 5-year-old children. It is suggested, therefore, that the oral cavity is already a reservoir of HPVs in childhood where later HPV-associated diseases, such as oral cancer and other oral lesions, may develop.

Human papillomavirus type 38 infection in oral squamous cell carcinomas

In this study, 53 paraffin-embedded oral squamous cell carcinoma (OSCC) biopsy specimens were used. Human papillomavirus type 38 (HPV-38) infection was demonstrated in OSCCs using the PCR technique, DNA sequencing analysis, in situ hybridization, and immunohistochemical techniques. Additionally, the correlation between HPV-38 infection and expressions of proliferating cell nuclear antigens (PCNA) or p53 protein was analyzed immunohistochemically. Using consensus primers for the L1 region (L1-PCR), we identified 35 of 53 specimens (66%) as positive for HPV-38 DNA. Furthermore, specimens from patients over 60 years of age revealed a lower prevalence for the HPV-38 (56.7%) than did those below that age (78.3%). Immunohistochemically, positive stainings for PCNA and p53 protein were more frequently detected in HPV-38 positive OSCCs than HPV negative ones. These results indicate that HPV-38 positive OSCCs were higher in proliferative cellular activity than HPV negative ones. Moreover, the findings suggest that HPV-38 infection may cause malignant transformation of the oral mucosal epithelium.

Global nail dystrophy associated with human papillomavirus type 57 infection

Verrucae vulgares frequently induce nail dystrophy when infection of the nail matrix occurs. Classic periungual warts are easily recognized by the experienced physician. We report a very unusual presentation of human papillomavirus (HPV) infection of the nail matrix and nail bed involving all 20 nails in an otherwise immunocompetent patient. Viral typing by in situ hybridization revealed HPV type 57. To our knowledge, this is the first association between dystrophy of all 20 nails and HPV infection. However, as the ease of HPV typing improves, a variety of previously unrecognized cutaneous lesions is likely to be associated with HPV infection.

Oral wart associated with human papillomavirus type 2

More than 100 human papillomavirus (HPV) types have been identified to date. Of these, 24 types have been described as being associated with oral lesions. HPV-2 has been frequently associated with skin lesions, but the reports of oral lesions as features of mucosal infection are limited. A biopsy specimen of an oral wart on the right palate was taken from a 48-year-old man and examined for the presence of HPV The sections showed papillary growth of the epithelium with hyperkeratosis and parakeratosis, and koilocytotic changes of the cells located in the upper layers of the oral squamous cell epithelium. These histological features corresponded well to those of verruca vulgaris on the skin. Immunohistochemically, papillomavirus genus-specific capsid antigen was detected in most of the koilocytotic cells. In addition, Southern blot hybridization analysis revealed that the lesion harbored HPV-2 DNA. In situ hybridization with a biotinylated HPV-2 DNA probe clearly demonstrated viral DNA in the nuclei of squamous cells, which were located in a deeper layer of the epithelium than viral antigen-positive cells.

Human papilloma virus type 16 E6 gene expression in oral exophytic epithelial lesions as detected by in situ rtPCR

OBJECTIVE

We adopted an in situ reverse transcriptase polymerase chain reaction method of detecting and determining the frequency of early (E6) gene expression of human papilloma virus type 16 at the individual cell level in a sample of oral exophytic lesions with various degrees of epithelial hyperplasia and dysplasia in immunosuppressed and immunocompetent patients.

STUDY DESIGN

The significance of differences between the study groups was determined by Mantel-Haenszel chi-square analysis and calculation of odds ratios, accounting for immunosuppression and degree of dysplasia, respectively.

RESULTS

Grouped together, the lesions of dysplasia (mild to severe) and squamous cell carcinoma were found to be 16 times more likely to express human papilloma virus E6 mRNA than the benign lesions (P = .0013); in the lesions of immunosuppressed patients, human papilloma virus 16 E6 was roughly 10 times more likely to be expressed than in those of the immunocompetent patients (P = .0008, accounting for dysplasia).

CONCLUSIONS

Our data indicate that human papilloma virus 16 E6 gene expression, and perhaps integration of the virus in the host genome, might play a role in the development of oral neoplasia in association with immunosuppression.

Expression of keratin 13, 14 and 19 in oral squamous cell carcinomas from Sudanese snuff dippers: lack of association with human papillomavirus infection

In stratified squamous epithelia, altered expression of keratins (Ks) is one possible marker of malignant potential. In the epithelium of the uterine cervix, presence of human papillomaviruses (HPVs) is increasingly regarded as a marker of risk for cervical cancer. However, a similar role in oral cancer and precancer remains controversial. To address these questions, formalin-fixed, paraffin-embedded oral carcinomas from Sudanese snuff dippers (n=14) and oral carcinomas from Sudanese (n=14), Swedish (n=19) and Norwegian (n=41) non-snuff dippers were examined by immunohistochemistry for expression of K types 13, 14 and 19 using monoclonal antibodies. HPV infection was searched for in all the carcinomas by in situ hybridization (ISH) using the cocktail HPV OmniProbe and the ViraType probe. Carcinomas from Sudanese (snuff dippers/non-snuff dippers) were also examined for HPV infection by polymerase chain reaction (PCR) using the general HPV primers GP5+/GP6+. For the oral carcinomas from snuff dippers, moderate to intense expression of K13 (71%; 10/14), K14 (86%; 12/14) and K19 (93%; 13/14) was found. For the oral carcinomas from non-snuff dippers, weak to moderate expression of K13 (64%; 47/74), K14 (43%; 32/74) and K19 (45%; 33/74) was found. HPV DNA was not detected in any of the carcinomas from three countries when examined by ISH. The Sudanese (from snuff dippers/non-snuff dippers) oral carcinomas were also negative for HPV DNA with the PCR. The present study shows that (i) there is a high level of expression of K13, K14 and K19 in oral carcinomas from snuff dippers compared to those from non-snuff dippers, (ii) this high level of expression may arise from dysregulation of keratinocyte proliferation and maturation caused by damaging effects of snuff, (iii) the HPV genome is not found in Sudanese (snuff dippers/non-snuff dippers), Swedish or Norwegian oral carcinomas, and (iv) this may suggest that these viruses do not play a prominent role in the aetiology of oral carcinomas from these countries.

Expression of p53, Ki-67 and cytokeratin-4 (CK4) in oral papillomas

P53 is overexpressed in more than 50% of all human cancers. A previous study suggested that p53 was also overexpressed in oral papillomas. This study was carried out to investigate whether p53 expression was correlated with expression of the cellular proliferation marker Ki-67 and the epithelial differentiation marker cytokeratin-4 (CK4) in oral papillomas. Formalin-fixed paraffin-embedded sections of 30 oral papilloma specimens and 30 unmatched normal oral mucosal specimens were processed for immunohistochemistry, using an avidin-biotin-peroxidase procedure and monoclonal antibodies. A semiquantification analysis on p53 and Ki-67 labeling indices was performed. Twenty-eight of 30 (93%) papilloma specimens were positive for p53. The percentage of p53-positive cells in the basal layer was 60.4 +/- 14.8 (mean +/- SD, n = 28), and that of Ki-67-positive cells was 26.7 +/- 14.4. There was no correlation between expression of p53 and that of Ki-67. Expression of CK4 was inversely correlated with the expression of Ki-67 but not correlated with the expression of p53.

Human papillomavirus-associated tumors of the skin and mucosa

This review discusses diseases of the lower genital tract in which the presence of human papillomavirus (HPV) DNA is well documented. We discuss epidemiologic, clinical, and experimental data supporting a causative role for HPV in mucosal malignancies, with emphasis on the role of viral and host factors in their pathogenesis. Of special interest is the recently discovered association of cutaneous tumors with HPVs, previously known only for tumors in epidermodysplasia verruciformis (EV). The frequent detection of EV-specific or EV-related HPVs in immunosuppressed persons and in cutaneous tumors in the general population supports the importance of EV as a model of cutaneous oncogenesis. We also discuss recent serologic findings based on enzyme-linked immunosorbent assay results with the use of viruslike particles. This is important both for detection of present or past HPV infection and for epidemiologic and immunologic studies. Novel therapeutic modalities for HPV tumors and prospects for prophylactic and therapeutic vaccination are presented.