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Chen CC, Luo CW, Tsai SCS, Huang JY, Yang SF, Lin FCF. Synergistic Effect of Human Papillomavirus and Environmental Factors on Skin Squamous Cell Carcinoma, Basal Cell Carcinoma, and Melanoma: Insights from a Taiwanese Cohort. Cancers (Basel) 2024; 16:2284. [PMID: 38927988 PMCID: PMC11201942 DOI: 10.3390/cancers16122284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Revised: 06/12/2024] [Accepted: 06/19/2024] [Indexed: 06/28/2024] Open
Abstract
Human papillomavirus (HPV) has been implicated in various cancers, including those affecting the skin. The study assessed the long-term risk of skin cancer associated with HPV infection in Taiwan region, using data from the National Health Insurance Research Database between 2007 and 2015. Our analysis revealed a significant increase in skin cancer risk among those with HPV, particularly for squamous cell carcinoma (SCC), the subtype with the highest observed adjusted hazard ratio (aHR) = 5.97, 95% CI: 4.96-7.19). The overall aHR for HPV-related skin cancer was 5.22 (95% CI: 4.70-5.80), indicating a notably higher risk in the HPV-positive group. The risk of skin cancer was further stratified by type, with basal cell carcinoma (aHR = 4.88, 95% CI: 4.14-5.74), and melanoma (aHR = 4.36, 95% CI: 2.76-6.89) also showing significant associations with HPV. The study also highlighted regional variations, with increased risks in southern Taiwan and the Kaohsiung-Pingtung area. Key findings emphasize the importance of sun protection, particularly in regions of high UV exposure and among individuals in high-risk occupations. This research contributes to a better understanding of the complex interactions between HPV and skin cancer risk, reinforcing the importance of preventive strategies in public health.
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Affiliation(s)
- Chun-Chia Chen
- Institute of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan; (C.-C.C.); (J.-Y.H.); (S.-F.Y.)
- Division of Plastic Surgery, Department of Surgery, Chi Mei Medical Center, Tainan 71004, Taiwan
| | - Ci-Wen Luo
- Department of Medical Research, Tungs’ Taichung MetroHarbor Hospital, Taichung 43503, Taiwan;
| | - Stella Chin-Shaw Tsai
- Superintendent Office, Tungs’ Taichung MetroHarbor Hospital, Taichung 43503, Taiwan
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Shin University, Taichung 402202, Taiwan
| | - Jing-Yang Huang
- Institute of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan; (C.-C.C.); (J.-Y.H.); (S.-F.Y.)
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung 40201, Taiwan
| | - Shun-Fa Yang
- Institute of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan; (C.-C.C.); (J.-Y.H.); (S.-F.Y.)
| | - Frank Cheu-Feng Lin
- School of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan
- Department of Surgery, Chung Shan Medical University Hospital, Taichung 40201, Taiwan
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2
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Bray ER, Tosti A, Morrison BW. Update on Squamous Cell Carcinoma of the Nail Unit: An Human Papillomavirus-Associated Condition. Skin Appendage Disord 2024; 10:199-206. [PMID: 38835716 PMCID: PMC11147528 DOI: 10.1159/000537760] [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: 12/08/2023] [Accepted: 02/08/2024] [Indexed: 06/06/2024] Open
Abstract
Background Squamous cell carcinoma (SCC) and SCC in situ (Bowen's disease) are the most common malignancies of the nail unit. They are frequently seen in men over 50 and most commonly affect the fingers. The role of high-risk human papillomavirus (HPV) infection has been identified as a key contributor to the development of nail unit SCC. Summary In this review, we aimed to summarize the current state of our understanding of how HPV contributes to nail unit SCC, the role of genitodigital transmission of HPV, and the clinical features of HPV-associated nail unit SCC. We also review current advances in the treatment of nail unit SCC, with a focus on the potential role of HPV vaccination in the treatment and prevention of nail unit SCC. Key Messages Nail unit SCC should be recognized as an HPV-associated disease. HPV vaccination may represent a non-surgical modality for the management of these challenging malignancies in the appropriate clinical setting.
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Affiliation(s)
- Eric R Bray
- Philip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Antonella Tosti
- Philip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Brian W Morrison
- Philip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
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3
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Johnson LH, Son HG, Ha DT, Strickley JD, Joh J, Demehri S. Compromised T Cell Immunity Links Increased Cutaneous Papillomavirus Activity to Squamous Cell Carcinoma Risk. JID INNOVATIONS 2022; 3:100163. [PMID: 36714811 PMCID: PMC9879970 DOI: 10.1016/j.xjidi.2022.100163] [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] [Received: 05/09/2022] [Revised: 09/17/2022] [Accepted: 09/19/2022] [Indexed: 02/06/2023] Open
Abstract
Cutaneous squamous cell carcinoma (cSCC) is the second most common cancer, with increased incidence in immunosuppressed patients. β-Human papillomavirus has been proposed as a contributor to cSCC risk partly on the basis of increased β-human papillomavirus viral load and seropositivity observed among patients with cSCC. Experimental data in mice colonized with mouse papillomavirus type 1 suggest that T cell immunity against β-human papillomavirus suppresses skin cancer in immunocompetent hosts, and the loss of this immunity leads to the increased risk of cSCC. In this study, we show that CD8+ T cell depletion in mouse papillomavirus type 1‒colonized mice that underwent skin carcinogenesis protocol led to increased viral load in the skin and seropositivity for anti‒mouse papillomavirus type 1 antibodies. These findings provide evidence that compromised T cell immunity can be the link that connects increased β-human papillomavirus detection to cSCC risk.
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Affiliation(s)
- Luke H. Johnson
- University of Louisville School of Medicine, Louisville, Kentucky, USA,Center for Cancer Immunology, Center for Cancer Research, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA,Cutaneous Biology Research Center, Department of Dermatology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA,Department of Medicine, University of Louisville School of Medicine, Louisville, Kentucky, USA
| | - Heehwa G. Son
- Center for Cancer Immunology, Center for Cancer Research, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA,Cutaneous Biology Research Center, Department of Dermatology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Dat Thinh Ha
- Center for Cancer Immunology, Center for Cancer Research, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA,Cutaneous Biology Research Center, Department of Dermatology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA,Department of Medicine, University of Louisville School of Medicine, Louisville, Kentucky, USA
| | - John D. Strickley
- University of Louisville School of Medicine, Louisville, Kentucky, USA,Center for Cancer Immunology, Center for Cancer Research, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA,Cutaneous Biology Research Center, Department of Dermatology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA,Department of Medicine, University of Louisville School of Medicine, Louisville, Kentucky, USA
| | - Joongho Joh
- Department of Medicine, University of Louisville School of Medicine, Louisville, Kentucky, USA
| | - Shadmehr Demehri
- Center for Cancer Immunology, Center for Cancer Research, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA,Cutaneous Biology Research Center, Department of Dermatology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA,Correspondence: Shadmehr Demehri, Department of Dermatology and Cancer Center, Massachusetts General Hospital, 149 13th Street, 3rd Floor, Boston, Massachusetts 02114-2621, USA.
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4
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Kricker A, Weber MF, Pawlita M, Sitas F, Hodgkinson VS, Rahman B, van Kemenade CH, Armstrong BK, Waterboer T. Cutaneous beta HPVs, sun exposure and risk of squamous and basal cell skin cancers in Australia. Cancer Epidemiol Biomarkers Prev 2021; 31:614-624. [PMID: 34933956 DOI: 10.1158/1055-9965.epi-21-1000] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 10/24/2021] [Accepted: 12/07/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Sun exposure causes cutaneous squamous (SCC) and basal cell (BCC) carcinomas. Human papillomavirus (HPV) infection might cause SCC. METHODS We examined associations of beta and gamma HPV infection in skin-swab DNA and serum antibodies with skin cancer risk, and modification of the carcinogenic effects of sun exposure by them, in case-control studies of 385 SCC cases, 832 BCC cases and 1100 controls nested in an Australian prospective cohort study (enrolled 2006-2009). RESULTS Presence of beta-1 and beta-3 HPV DNA appeared to increase risks for SCC and BCC by 30%-40% (P adjusted <0.01). BCC was also associated with genus beta DNA, OR=1.48; 95%CI 1.10-2.00 (P adjusted <0.01). Associations were strengthened with each additional positive beta HPV DNA type: SCC (OR=1.07; 95%CI 1.02-1.12) and BCC (OR=1.06; 95%CI 1.03-1.10), P trend <0.01. Positivity to genus beta or gamma in serology, and genus gamma in DNA, was not associated with either cancer. There was little evidence that any beta HPV type was more strongly associated than others with either cancer. A weaker association of sun-exposure with SCC and BCC in the presence of beta-3 HPVs than in their absence suggests that beta-3 HPVs modify sun exposure's effect. CONCLUSIONS Our substantive findings are at the level of genus beta HPV. Like SCC, BCC risk may increase with increasing numbers of beta HPV types on skin. IMPACT The consistency in our findings that HPV infection may moderate the effects of sun exposure, the main environmental cause of SCC and BCC, merits further investigation.
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Affiliation(s)
- Anne Kricker
- The Daffodil Centre, a joint venture with Cancer Council NSW, Sydney School of Public Health, The University of Sydney
| | - Marianne F Weber
- The Daffodil Centre, a joint venture with Cancer Council NSW, Sydney School of Public Health, The University of Sydney
| | - Michael Pawlita
- Infections and Cancer Epidemiology, German Cancer Research Center
| | - Freddy Sitas
- Centre for Primary Health Care and Equity, University of New South Wales
| | | | | | | | - Bruce K Armstrong
- School of Population and Global Health, University of Western Australia
| | - Tim Waterboer
- Infections and Cancer Epidemiology, German Cancer Research Center
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5
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Rollison DE, Amorrortu RP, Zhao Y, Messina JL, Schell MJ, Fenske NA, Cherpelis BS, Giuliano AR, Sondak VK, Pawlita M, McKay-Chopin S, Gheit T, Waterboer T, Tommasino M. Cutaneous Human Papillomaviruses and the Risk of Keratinocyte Carcinomas. Cancer Res 2021; 81:4628-4638. [PMID: 34266893 PMCID: PMC8416805 DOI: 10.1158/0008-5472.can-21-0805] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 06/04/2021] [Accepted: 07/14/2021] [Indexed: 11/16/2022]
Abstract
Cutaneous human papillomavirus (cuHPV) infections may be novel targets for skin cancer prevention and treatment, but critical information regarding the development of virus-positive skin cancers following cuHPV infection has been lacking. In this study, baseline cuHPV infection was measured by serology and viral DNA detection in eyebrow hairs (EBH) and forearm skin swabs (SSW) among 1,008 individuals undergoing routine skin cancer screening exams and followed for incidence of basal cell carcinoma (BCC) and cutaneous squamous cell carcinoma (cuSCC). Baseline β-HPV detection, particularly in SSW, significantly predicted cuSCC (HR = 4.32; 95% confidence interval, 1.00-18.66), whereas serologic evidence of past β-HPV infection was not associated with cuSCC. Less than 5% of baseline β-HPV types detected in SSW were present in subsequent cuSCC tumors, and cuHPV detected in SSW with higher mean fluorescence intensity values were more likely to be present in cuSCC compared with those with lower levels (P < 0.001). β-HPV-positive cuSCC occurred more often in areas of highly sun-damaged skin than did β-HPV-negative cuSCC. Overall, no clear patterns were observed between baseline β-HPV detection and subsequent development of BCC, or between baseline γ-HPV detection and either cuSCC or BCC. Collectively, these results demonstrate that β-HPV detection in SSW is a significant predictor of cuSCC risk, although evidence suggests only a small subset of cuSCC is etiologically linked to β-HPV infection. SIGNIFICANCE: β-HPV positivity may be a useful biomarker for identifying individuals who could benefit from increased screening or novel cutaneous squamous cell carcinoma prevention strategies.
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MESH Headings
- Aged
- Aged, 80 and over
- Alphapapillomavirus
- Biomarkers, Tumor/metabolism
- Carcinoma, Basal Cell/diagnosis
- Carcinoma, Basal Cell/metabolism
- Carcinoma, Basal Cell/virology
- Carcinoma, Squamous Cell/diagnosis
- Carcinoma, Squamous Cell/metabolism
- Carcinoma, Squamous Cell/virology
- DNA, Viral
- Early Detection of Cancer
- Female
- Follow-Up Studies
- Hair/metabolism
- Humans
- Keratinocytes/cytology
- Male
- Middle Aged
- Neoplasms, Basal Cell/diagnosis
- Neoplasms, Basal Cell/metabolism
- Neoplasms, Basal Cell/virology
- Papillomavirus Infections/diagnosis
- Papillomavirus Infections/metabolism
- Prospective Studies
- Risk Factors
- Skin Neoplasms/diagnosis
- Skin Neoplasms/metabolism
- Skin Neoplasms/virology
- Specimen Handling
- Surveys and Questionnaires
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Affiliation(s)
- Dana E Rollison
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida.
| | | | - Yayi Zhao
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida
| | - Jane L Messina
- Department of Anatomic Pathology, Moffitt Cancer Center, Tampa, Florida
- Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, Florida
| | - Michael J Schell
- Biostatistics and Bioinformatics Shared Resource, Moffitt Cancer Center, Tampa, Florida
| | - Neil A Fenske
- Department of Dermatology and Cutaneous Surgery, University of South Florida College of Medicine, Tampa, Florida
| | - Basil S Cherpelis
- Department of Dermatology and Cutaneous Surgery, University of South Florida College of Medicine, Tampa, Florida
| | - Anna R Giuliano
- Center for Immunization and Infection Research in Cancer, Moffitt Cancer Center, Tampa, Florida
| | - Vernon K Sondak
- Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, Florida
| | - Michael Pawlita
- Infections and Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | | | - Tarik Gheit
- International Agency for Research on Cancer, WHO, Lyon, France
| | - Tim Waterboer
- Infections and Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
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6
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Zhao Y, Amorrortu RP, Fenske NA, Cherpelis B, Messina JL, Sondak VK, Giuliano AR, Schell MJ, Waterboer T, Pawlita M, McKay‐Chopin S, Gheit T, Tommasino M, Rollison DE. Cutaneous viral infections associated with ultraviolet radiation exposure. Int J Cancer 2021; 148:448-458. [PMID: 32818302 PMCID: PMC7754468 DOI: 10.1002/ijc.33263] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 07/13/2020] [Accepted: 07/28/2020] [Indexed: 01/16/2023]
Abstract
The complex interplay between ultraviolet radiation (UVR) and cutaneous viral infections in the context of cancer etiology is challenging to unravel, given the limited information on the independent association between UVR and cutaneous viral infections. Using multiple biomarkers of infection with 24 types of cutaneous human papillomavirus (HPV) and 4 types of polyomaviruses (HPyV), we investigated cross-sectional associations with recent UVR exposure, using skin pigmentation measured by spectrophotometer. Age- and sex-adjusted associations between UVR and viral seropositivity, viral DNA present in eyebrow hairs (EBH) and skin swabs (SSW) were estimated using logistic regression. Beta-HPV seropositivity was associated with viral DNA positivity in EBH (OR = 1.40, 95% CI = 1.05-1.88) and SSW (OR = 1.86, 95% CI = 1.25-2.74). Similar associations were observed for Merkel cell polyomavirus. Participants in the highest tertile of UVR exposure were more likely to be seropositive for beta-HPV (OR = 1.81, 95% CI = 1.16-2.38), and have beta-HPV DNA in EBH (OR = 1.57, 95% CI = 1.06-2.33) and SSW (OR = 2.22, 95% CI = 1.25-3.96), compared to participants with the lowest tertile of UVR exposure. UVR exposure was positively associated with three different markers of beta-HPV infection. Therefore, future studies of HPV associated KC development should address more directly the role of HPV and UVR exposure as potential co-carcinogens.
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Affiliation(s)
- Yayi Zhao
- Department of Cancer EpidemiologyMoffitt Cancer CenterTampaFloridaUSA
| | | | - Neil A. Fenske
- Department of Dermatology and Cutaneous SurgeryUniversity of South Florida College of MedicineTampaFloridaUSA
| | - Basil Cherpelis
- Department of Dermatology and Cutaneous SurgeryUniversity of South Florida College of MedicineTampaFloridaUSA
| | - Jane L. Messina
- Department of Dermatology and Cutaneous SurgeryUniversity of South Florida College of MedicineTampaFloridaUSA
- Department of Anatomic PathologyMoffitt Cancer CenterTampaFloridaUSA
- Department of Cutaneous OncologyMoffitt Cancer CenterTampaFloridaUSA
| | - Vernon K. Sondak
- Department of Cutaneous OncologyMoffitt Cancer CenterTampaFloridaUSA
| | - Anna R. Giuliano
- Center for Immunization and Infection Research in CancerMoffitt Cancer CenterTampaFloridaUSA
| | - Michael J. Schell
- Biostatistics and Bioinformatics Shared ResourceMoffitt Cancer CenterTampaFloridaUSA
| | - Tim Waterboer
- Infections and Cancer EpidemiologyGerman Cancer Research Center (DKFZ)HeidelbergGermany
| | - Michael Pawlita
- Infections and Cancer EpidemiologyGerman Cancer Research Center (DKFZ)HeidelbergGermany
| | - Sandrine McKay‐Chopin
- Infections and Cancer Biology GroupInternational Agency for Research on Cancer‐World Health OrganizationLyonFrance
| | - Tarik Gheit
- Infections and Cancer Biology GroupInternational Agency for Research on Cancer‐World Health OrganizationLyonFrance
| | - Massimo Tommasino
- Infections and Cancer Biology GroupInternational Agency for Research on Cancer‐World Health OrganizationLyonFrance
| | - Dana E. Rollison
- Department of Cancer EpidemiologyMoffitt Cancer CenterTampaFloridaUSA
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Chen ML, Wang SH, Wei JCC, Yip HT, Hung YM, Chang R. The Impact of Human Papillomavirus Infection on Skin Cancer: A Population-Based Cohort Study. Oncologist 2020; 26:e473-e483. [PMID: 33191546 DOI: 10.1002/onco.13593] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 10/22/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND This study investigated the correlation between a history of human papillomavirus (HPV) infection and skin cancer risk. MATERIALS AND METHODS The study cohort comprised 26,919 patients with newly diagnosed HPV infection between 2000 and 2012; with the use of computer-generated numbers, patients without previous HPV infection were randomly selected as the comparison cohort. The patients in the HPV infection cohort were matched to comparison individuals at a 1:4 ratio by demographic characteristics and comorbidities. All study individuals were followed up until they developed skin cancer, withdrew from the National Health Insurance program, were lost to follow-up, or until the end of 2013. The primary outcome was subsequent skin cancer development. Cox proportional hazards regression analysis was used to analyze the risk of skin cancer with hazard ratios (HRs) and 95% confidence intervals (CIs) between the HPV and control cohort. RESULTS The adjusted HR of skin cancer for patients with HPV relative to controls was 2.45 after adjusting sex, age and comorbidities. (95% CI, 1.44-4.18, p < .01). The subgroup analysis indicated that a patient with HPV infection had a significantly greater risk of skin cancer if they were aged >40 years. Notably, a risk of skin cancer was found in the group diagnosed with HPV within the first 5 years after the index date (adjusted HR, 3.12; with 95% CI, 1.58-5.54). Sensitivity analysis by propensity score, matching with balanced sex, age, and comorbidities, showed consistent results. CONCLUSION A history of HPV infection is associated with the development of subsequent skin cancer in Taiwanese subjects, and the risk wanes 5 years later. IMPLICATIONS FOR PRACTICE In this Taiwan nationwide cohort study, there was a 2.45-fold increased risk of developing new-onset skin cancers for patients with incident human papillomavirus (HPV) infection, compared with the matched controls. Furthermore, the risk was noticeably significant among patients aged >40 years. A prominent risk of skin cancers was found in the group diagnosed with HPV within the first 5 years after the index date in this study. The results of this analysis may raise consensus on the effect of HPV infection on the risk of skin cancers. Clinicians are encouraged to implement prudently on the differential diagnosis of skin cancers and HPV prevention and treatment, especially in older patients.
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Affiliation(s)
- Ming-Li Chen
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Shuo-Hsuan Wang
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - James Cheng-Chung Wei
- Division of Allergy, Immunology and Rheumatology, Chung Shan Medical University, Taichung, Taiwan.,Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.,Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan
| | - Hei-Tung Yip
- Management office for Health Data, China Medical University, Taichung, Taiwan.,College of Medicine, China Medical University, Taichung, Taiwan.,Institute of Public Health (Biostatistics), National Yangming University, Taiwan
| | - Yao-Min Hung
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.,Department of Internal Medicine, Kaohsiung Municipal United Hospital, Kaohsiung, Taiwan.,Shu-Zen Junior College of Medicine and Management, Kaohsiung, Taiwan.,Tajen University, Pingtung, Taiwan
| | - Renin Chang
- Department of Emergency Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.,Department of Recreation Sports Management, Tajen University, Pingtung, Taiwan
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8
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Minoni L, Romero-Medina MC, Venuti A, Sirand C, Robitaille A, Altamura G, Le Calvez-Kelm F, Viarisio D, Zanier K, Müller M, Accardi R, Tommasino M. Transforming Properties of Beta-3 Human Papillomavirus E6 and E7 Proteins. mSphere 2020; 5:e00398-20. [PMID: 32669468 PMCID: PMC7364212 DOI: 10.1128/msphere.00398-20] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 06/26/2020] [Indexed: 12/12/2022] Open
Abstract
The beta human papillomaviruses (HPVs) are subdivided into 5 species (beta-1 to beta-5), and they were first identified in the skin. However, the beta-3 species appears to be more highly represented in the mucosal epithelia than in the skin. Functional studies have also highlighted that beta-3 HPV49 shares some functional similarities with mucosal high-risk (HR) HPV16. Here, we describe the characterization of the in vitro transforming properties of the entire beta-3 species, which includes three additional HPV types: HPV75, HPV76, and HPV115. HPV49, HPV75, and HPV76 E6 and E7 (E6/E7), but not HPV115 E6 and E7, efficiently inactivate the p53 and pRb pathways and immortalize or extend the life span of human foreskin keratinocytes (HFKs). As observed for HR HPV16, cell cycle deregulation mediated by beta-3 HPV E6/E7 expression leads to p16INK4a accumulation, whereas no p16INK4a was detected in beta-2 HPV38 E6/E7 HFKs. As shown for HPV49 E6, HPV75 and HPV76 E6s degrade p53 by an E6AP/proteasome-mediated mechanism. Comparative analysis of cellular gene expression patterns of HFKs containing E6 and E7 from HR HPV16, beta-3 HPV types, and beta-2 HPV38 further highlights the functional similarities of HR HPV16 and beta-3 HPV49, HPV75, and HPV76. The expression profiles of these four HPV HFKs show some similarities and diverge substantially from those of beta-3 HPV115 E6/E7 and beta-2 HPV38 E6/E7 HFKs. In summary, our data show that beta-3 HPV types share some mechanisms with HR HPV types and pave the way for additional studies aiming to evaluate their potential role in human pathologies.IMPORTANCE Human papillomaviruses are currently classified in different genera. Mucosal HPVs belonging to the alpha genus have been clearly associated with carcinogenesis of the mucosal epithelium at different sites. Beta HPV types have been classified as cutaneous. Although findings indicate that some beta HPVs from species 1 and 2 play a role, together with UV irradiation, in skin cancer, very little is known about the transforming properties of most of the beta HPVs. This report shows the transforming activity of E6 and E7 from beta-3 HPV types. Moreover, it highlights that beta-3 HPVs share some biological properties more extensively with mucosal high-risk HPV16 than with beta-2 HPV38. This report provides new paradigms for a better understanding of the biology of the different HPV types and their possible association with lesions at mucosal and/or cutaneous epithelia.
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Affiliation(s)
- Lucia Minoni
- International Agency for Research on Cancer (IARC), World Health Organization, Lyon, France
- Deutsches Krebsforschungszentrum (DKFZ), Heidelberg, Germany
| | | | - Assunta Venuti
- International Agency for Research on Cancer (IARC), World Health Organization, Lyon, France
| | - Cécilia Sirand
- International Agency for Research on Cancer (IARC), World Health Organization, Lyon, France
| | - Alexis Robitaille
- International Agency for Research on Cancer (IARC), World Health Organization, Lyon, France
| | - Gennaro Altamura
- Department of Veterinary Medicine and Animal Productions, University of Naples Federico II, Naples, Italy
| | | | | | - Katia Zanier
- Equipe labellisée Ligue, Biotechnologie et signalisation cellulaire UMR 7242, Ecole Supérieure de Biotechnologie de Strasbourg, Illkirch, France
| | - Martin Müller
- Deutsches Krebsforschungszentrum (DKFZ), Heidelberg, Germany
| | - Rosita Accardi
- International Agency for Research on Cancer (IARC), World Health Organization, Lyon, France
| | - Massimo Tommasino
- International Agency for Research on Cancer (IARC), World Health Organization, Lyon, France
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9
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Bandolin L, Borsetto D, Fussey J, Da Mosto MC, Nicolai P, Menegaldo A, Calabrese L, Tommasino M, Boscolo-Rizzo P. Beta human papillomaviruses infection and skin carcinogenesis. Rev Med Virol 2020; 30:e2104. [PMID: 32232924 DOI: 10.1002/rmv.2104] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Revised: 03/12/2020] [Accepted: 03/15/2020] [Indexed: 12/17/2022]
Abstract
During the last decade, the worldwide incidence of keratinocyte carcinomas (KC) has increased significantly. They are now the most common malignancy, representing approximately 30% of all cancers. The role of ultraviolet (UV) radiation as a major environmental risk factor for skin cancers is well recognized. The aim of this review is to analyse the current understanding of the nature of beta-human papillomavirus (HPV) and its association with KC and explore the implications for the management and prevention of these cancers. A comprehensive review of the literature on beta-HPV and its association with KC was undertaken, the results reported in the form of a narrative review. A subgroup of HPV that infects the mucosal epithelia of the genital tract has been firmly associated with carcinogenesis. In addition, some HPV types with cutaneous tropism have been proposed to cooperate with UV in the development of KC. The first evidence for this association was reported in 1922 in patients with epidermodysplasia verruciformis (EV). Since then, epidemiological studies have highlighted the higher risk of skin cancer in patients with EV and certain cutaneous HPV types, and in vitro studies have elucidated molecular mechanisms and transforming properties of beta-HPV. Furthermore, in vivo research conducted on transgenic mice models has shown the possible role of beta-HPV in cutaneous carcinogenesis as a co-factor with UV radiation and immunosuppression. There is good evidence supporting the role of beta-HPV in the oncogenesis of KC. The high prevalence of beta-HPV in human skin and the worldwide burden of KC makes the search for an effective vaccine relevant and worthwhile.
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Affiliation(s)
- Luigia Bandolin
- Department of Neurosciences, Section of Otolaryngology, University of Padova, Padova, Italy
| | | | - Jonathan Fussey
- Department of Otolaryngology, Royal Devon and Exeter Hospital, Exeter, UK
| | | | - Piero Nicolai
- Department of Neurosciences, Section of Otolaryngology, University of Padova, Padova, Italy
| | - Anna Menegaldo
- Department of Neurosciences, Section of Otolaryngology, University of Padova, Padova, Italy
| | - Luca Calabrese
- Head and Neck Department, Ospedale di Bolzano, Bolzano, Italy
| | - Massimo Tommasino
- Infections and Cancer Biology Group, International Agency for Research on Cancer, Lyon, France
| | - Paolo Boscolo-Rizzo
- Department of Neurosciences, Section of Otolaryngology, University of Padova, Padova, Italy
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10
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Human genetic dissection of papillomavirus-driven diseases: new insight into their pathogenesis. Hum Genet 2020; 139:919-939. [PMID: 32435828 DOI: 10.1007/s00439-020-02183-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 05/11/2020] [Indexed: 02/07/2023]
Abstract
Human papillomaviruses (HPVs) infect mucosal or cutaneous stratified epithelia. There are 5 genera and more than 200 types of HPV, each with a specific tropism and virulence. HPV infections are typically asymptomatic or result in benign tumors, which may be disseminated or persistent in rare cases, but a few oncogenic HPVs can cause cancers. This review deals with the human genetic and immunological basis of interindividual clinical variability in the course of HPV infections of the skin and mucosae. Typical epidermodysplasia verruciformis (EV) is characterized by β-HPV-driven flat wart-like and pityriasis-like cutaneous lesions and non-melanoma skin cancers in patients with inborn errors of EVER1-EVER2-CIB1-dependent skin-intrinsic immunity. Atypical EV is associated with other infectious diseases in patients with inborn errors of T cells. Severe cutaneous or anogenital warts, including anogenital cancers, are also driven by certain α-, γ-, μ or ν-HPVs in patients with inborn errors of T lymphocytes and antigen-presenting cells. The genetic basis of HPV diseases at other mucosal sites, such as oral multifocal epithelial hyperplasia or juvenile recurrent respiratory papillomatosis (JRRP), remains poorly understood. The human genetic dissection of HPV-driven lesions will clarify the molecular and cellular basis of protective immunity to HPVs, and should lead to novel diagnostic, preventive, and curative approaches in patients.
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11
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Tampa M, Mitran CI, Mitran MI, Nicolae I, Dumitru A, Matei C, Manolescu L, Popa GL, Caruntu C, Georgescu SR. The Role of Beta HPV Types and HPV-Associated Inflammatory Processes in Cutaneous Squamous Cell Carcinoma. J Immunol Res 2020; 2020:5701639. [PMID: 32322596 PMCID: PMC7165336 DOI: 10.1155/2020/5701639] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 03/25/2020] [Indexed: 11/21/2022] Open
Abstract
Cutaneous squamous cell carcinoma (cSCC) is a common form of skin cancer with a complex but not fully understood pathogenesis. Recent research suggests the role of beta human papillomavirus (HPV) types and HPV-associated inflammatory processes in cSCC development. Beta HPV types are components of the normal flora; however, under the influence of certain cofactors, the virus may trigger a malignant process. Dysregulation of the immune system (chronic inflammation and immunosuppression), environmental factors (ultraviolet radiation), and genetic factors are the most important cofactors involved in beta HPV-related carcinogenesis. In addition, the oncoproteins E6 and E7 of beta HPV types differ biochemically from their counterparts in the structure of alpha HPV types, resulting in different mechanisms of action in carcinogenesis. The aim of our manuscript is to present an updated point of view on the involvement of beta HPV types in cSCC pathogenesis.
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Affiliation(s)
- Mircea Tampa
- “Carol Davila” University of Medicine and Pharmacy, 37 Dionisie Lupu, 020021 Bucharest, Romania
- “Victor Babes” Clinical Hospital for Infectious Diseases, 281 Mihai Bravu, 030303 Bucharest, Romania
| | - Cristina Iulia Mitran
- “Carol Davila” University of Medicine and Pharmacy, 37 Dionisie Lupu, 020021 Bucharest, Romania
| | - Madalina Irina Mitran
- “Carol Davila” University of Medicine and Pharmacy, 37 Dionisie Lupu, 020021 Bucharest, Romania
| | - Ilinca Nicolae
- “Victor Babes” Clinical Hospital for Infectious Diseases, 281 Mihai Bravu, 030303 Bucharest, Romania
| | - Adrian Dumitru
- “Carol Davila” University of Medicine and Pharmacy, 37 Dionisie Lupu, 020021 Bucharest, Romania
- Emergency University Hospital Bucharest, 169 Splaiul Independenței, 050098 Bucharest, Romania
| | - Clara Matei
- “Carol Davila” University of Medicine and Pharmacy, 37 Dionisie Lupu, 020021 Bucharest, Romania
| | - Loredana Manolescu
- “Carol Davila” University of Medicine and Pharmacy, 37 Dionisie Lupu, 020021 Bucharest, Romania
| | - Gabriela Loredana Popa
- “Carol Davila” University of Medicine and Pharmacy, 37 Dionisie Lupu, 020021 Bucharest, Romania
- Colentina Clinical Hospital, 19-21 Ștefan cel Mare, 020125 Bucharest, Romania
| | - Constantin Caruntu
- “Carol Davila” University of Medicine and Pharmacy, 37 Dionisie Lupu, 020021 Bucharest, Romania
- “Prof. N. Paulescu” National Institute of Diabetes, Nutrition and Metabolic Diseases, 22-24 Gr. Manolescu, Bucharest 011233, Romania
| | - Simona Roxana Georgescu
- “Carol Davila” University of Medicine and Pharmacy, 37 Dionisie Lupu, 020021 Bucharest, Romania
- “Victor Babes” Clinical Hospital for Infectious Diseases, 281 Mihai Bravu, 030303 Bucharest, Romania
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12
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Amorrortu RP, Fenske NA, Cherpelis BS, Vijayan L, Zhao Y, Balliu J, Messina JL, Sondak VK, Giuliano AR, Waterboer T, Pawlita M, Gheit T, Tommasino M, Rollison DE. Viruses in Skin Cancer (VIRUSCAN): Study Design and Baseline Characteristics of a Prospective Clinic-Based Cohort Study. Cancer Epidemiol Biomarkers Prev 2020; 29:39-48. [PMID: 31427307 PMCID: PMC6954275 DOI: 10.1158/1055-9965.epi-19-0446] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 06/26/2019] [Accepted: 08/13/2019] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Accumulating evidence suggests that cutaneous viral infections are risk factors for the development of keratinocyte carcinomas. The Viruses in Skin Cancer (VIRUSCAN) Study, a prospective cohort study, was established in 2014 to investigate the risk of keratinocyte carcinoma associated with cutaneous human papillomavirus and polyomavirus infection and the possible interaction with ultraviolet radiation exposure (UVR). METHODS/RESULTS VIRUSCAN incorporates repeated measures of viral infection using multiple markers of infection and quantitative measures of UVR using a spectrophotometer. Participants were recruited between July 14, 2014 and August 31, 2017 at the University of South Florida Dermatology Clinic in Tampa, FL. After excluding 124 individuals with prevalent keratinocyte carcinomas at baseline, 1,179 participants (53.2% women, 46.8% men, all ages 60 years and older) were followed for up to 4 years with routine skin exams occurring every 6 to 12 months. Here, we present the VIRUSCAN Study design, methods, and baseline characteristics, including demographics, sun exposure behavior, quantitative UVR exposure measurements, and cutaneous viral prevalence, for the full study cohort. CONCLUSIONS The VIRUSCAN Study will provide critical temporal evidence needed to assess the causality of the role cutaneous viral infections play in the development of keratinocyte carcinomas, as well as the potential interaction between cutaneous viral infections and UVR exposure. IMPACT Study findings will be valuable in future development of novel keratinocyte carcinoma prevention strategies.
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MESH Headings
- Aged
- Carcinoma, Basal Cell/epidemiology
- Carcinoma, Basal Cell/etiology
- Carcinoma, Basal Cell/pathology
- Carcinoma, Merkel Cell/diagnosis
- Carcinoma, Merkel Cell/epidemiology
- Carcinoma, Merkel Cell/pathology
- Carcinoma, Merkel Cell/virology
- Carcinoma, Squamous Cell/epidemiology
- Carcinoma, Squamous Cell/etiology
- Carcinoma, Squamous Cell/pathology
- Female
- Follow-Up Studies
- Humans
- Keratinocytes/pathology
- Keratinocytes/radiation effects
- Keratinocytes/virology
- Male
- Middle Aged
- Prevalence
- Prospective Studies
- Research Design
- Risk Factors
- Skin/cytology
- Skin/pathology
- Skin/radiation effects
- Skin/virology
- Skin Neoplasms/diagnosis
- Skin Neoplasms/epidemiology
- Skin Neoplasms/etiology
- Skin Neoplasms/pathology
- Spectrophotometry, Ultraviolet
- Ultraviolet Rays/adverse effects
- Warts/diagnosis
- Warts/epidemiology
- Warts/pathology
- Warts/virology
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Affiliation(s)
| | - Neil A Fenske
- Department of Dermatology and Cutaneous Surgery, University of South Florida College of Medicine, Tampa, Florida
| | - Basil S Cherpelis
- Department of Dermatology and Cutaneous Surgery, University of South Florida College of Medicine, Tampa, Florida
| | - Laxmi Vijayan
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida
| | - Yayi Zhao
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida
| | - Juliana Balliu
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida
| | - Jane L Messina
- Department of Dermatology and Cutaneous Surgery, University of South Florida College of Medicine, Tampa, Florida
- Department of Anatomic Pathology, Moffitt Cancer Center, Tampa, Florida
- Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, Florida
| | - Vernon K Sondak
- Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, Florida
| | - Anna R Giuliano
- Center for Immunization and Infection Research in Cancer, Moffitt Cancer Center, Tampa, Florida
| | - Tim Waterboer
- Infections and Cancer Epidemiology Group, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Michael Pawlita
- Infections and Cancer Epidemiology Group, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Tarik Gheit
- Infections and Cancer Biology Group, International Agency for Research on Cancer-World Health Organization, Lyon, France
| | - Massimo Tommasino
- Infections and Cancer Biology Group, International Agency for Research on Cancer-World Health Organization, Lyon, France
| | - Dana E Rollison
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida.
- Center for Immunization and Infection Research in Cancer, Moffitt Cancer Center, Tampa, Florida
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13
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Abstract
Human papillomaviruses (HPVs) infect squamous epithelia and can induce hyperproliferative lesions. More than 220 different HPV types have been characterized and classified into five different genera. While mucosal high-risk HPVs have a well-established causal role in anogenital carcinogenesis, the biology of cutaneous HPVs is less well understood.From patients with the rare genetic disorder epidermodysplasia verruciformis (EV) and animal models, evidence is accumulating that cutaneous PV of genus β synergize with ultraviolet (UV) radiation in the development of cutaneous squamous cell carcinoma (cSCC). In 2009, the International Agency for Research on Cancer (IARC) classified the genus β-HPV types 5 and 8 as "possible carcinogenic" biological agents (group 2B) in EV disease. Epidemiological and biological studies indicate that genus β-PV infection may also play a role in UV-mediated skin carcinogenesis in non-EV patients. However, they rather act at early stages of carcinogenesis and become dispensable for the maintenance of the malignant phenotype, compatible with a "hit-and-run" mechanism.This chapter will give an overview on genus β-PV infections and discuss similarities and differences of cutaneous and genus α mucosal high-risk HPV in epithelial carcinogenesis.
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14
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Rollison DE, Schell MJ, Fenske NA, Cherpelis B, Messina JL, Giuliano AR, Epling-Burnette PK, Hampras SS, Amorrortu RP, Balliu J, Vijayan L, Naqvi SMH, Zhao Y, Parab K, McKay-Chopin S, Gheit T, Tommasino M. Cutaneous Viral Infections Across 2 Anatomic Sites Among a Cohort of Patients Undergoing Skin Cancer Screening. J Infect Dis 2019; 219:711-722. [PMID: 30260406 DOI: 10.1093/infdis/jiy577] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Accepted: 09/21/2018] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Findings from previous studies of cutaneous human papillomavirus (cuHPV) infection and keratinocyte carcinomas have varied due to several factors, including use of different sample types for cuHPV DNA detection. Elucidating the relationship between cuHPV infection in eyebrow hairs (EBHs) and skin swabs (SSWs) is critical for advancing the design of future studies. METHODS DNA corresponding to 46 β-HPV and 52 γ-HPV types was measured in EBHs and SSWs obtained from 370 individuals undergoing routine skin cancer screening examinations. RESULTS Prevalence of β-HPV/γ-HPV was 92%/84% and 73%/43% in SSWs and EBHs, respectively, with 71%/39% of patients testing positive for β-HPV/γ-HPV in both sample types. Number of cuHPV types detected and degree of infection were correlated across SSWs and EBHs. When the EBH was positive for a given β-HPV/γ-HPV type, the SSW was positive for that same type 81%/72% of the time. CONCLUSIONS Testing SSWs captures more cuHPV infection than EBHs, with EBH infections usually representing a subset of SSW infections. The importance of optimizing sensitivity of cuHPV infection detection using SSWs vs specificity using EBHs (or a combination of the 2) will be ascertained in an ongoing cohort study investigating cuHPV associations with subsequent keratinocyte carcinomas.
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Affiliation(s)
- Dana E Rollison
- Department of Cancer Epidemiology, Tampa, Florida.,Center for Immunization and Infection Research in Cancer, Tampa, Florida
| | - Michael J Schell
- Department of Biostatistics and Bioinformatics, Moffitt Cancer Center, Tampa, Florida
| | - Neil A Fenske
- Department of Dermatology and Cutaneous Surgery, University of South Florida College of Medicine, Tampa, Florida
| | - Basil Cherpelis
- Department of Dermatology and Cutaneous Surgery, University of South Florida College of Medicine, Tampa, Florida
| | - Jane L Messina
- Department of Dermatology and Cutaneous Surgery, University of South Florida College of Medicine, Tampa, Florida.,Department of Anatomic Pathology, Tampa, Florida.,Department of Cutaneous Oncology, Tampa, Florida
| | - Anna R Giuliano
- Center for Immunization and Infection Research in Cancer, Tampa, Florida
| | | | | | | | | | | | | | - Yayi Zhao
- Department of Cancer Epidemiology, Tampa, Florida
| | | | - Sandrine McKay-Chopin
- Infections and Cancer Biology Group, International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Tarik Gheit
- Infections and Cancer Biology Group, International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Massimo Tommasino
- Infections and Cancer Biology Group, International Agency for Research on Cancer, World Health Organization, Lyon, France
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15
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Kricker A, Weber MF, Brenner N, Banks E, Pawlita M, Sitas F, Hodgkinson VS, Rahman B, van Kemenade CH, Armstrong BK, Waterboer T. High Ambient Solar UV Correlates with Greater Beta HPV Seropositivity in New South Wales, Australia. Cancer Epidemiol Biomarkers Prev 2019; 29:49-56. [PMID: 31597664 DOI: 10.1158/1055-9965.epi-19-0400] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 07/28/2019] [Accepted: 10/01/2019] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Human papillomavirus (HPV) infection is highly prevalent worldwide and may have a role, with sun exposure, in causing cutaneous squamous cell carcinoma. Little is known about the relationship of UV exposure and seroprevalence of cutaneous HPVs in the general population. METHODS Using multiplex serology, we estimated the seroprevalence of 23 beta and 7 gamma HPVs and 7 other antigens (mu HPV1, HPV63, nu HPV41, alpha HPV16; polyomaviruses HPyV7 and MCV; p53) in a population-based sample of 1,161 Australian 45 and Up Study participants with valid data from blood specimens collected from 2010 to 2012. We calculated prevalence ratios (PR) for the association of each antigen with residential ambient solar UV and other UV-related variables. RESULTS Seropositivity for at least one beta or gamma HPV was high at 88% (beta HPVs 74%, gamma HPVs 70%), and less in women than men [e.g., PR beta-2 HPV38 = 0.70; 95% confidence interval (CI), 0.56-0.87; any gamma = 0.90; 95% CI, 0.84-0.97]. A high ambient UV level in the 10 years before study enrollment was associated with elevated seroprevalence for genus beta (PRtertile3vs1 any beta = 1.17; 95% CI, 1.07-1.28), and beta-1 to beta-3 species, but not for gamma HPVs. Other UV-related measures had less or no evidence of an association. CONCLUSIONS Seroprevalence of cutaneous beta HPVs is higher with higher ambient UV exposure in the past 10 years. IMPACT The observed association between ambient UV in the past 10 years and cutaneous HPVs supports further study of the possible joint role of solar UV and HPV in causing skin cancer.
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Affiliation(s)
- Anne Kricker
- Sydney School of Public Health, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.
| | - Marianne F Weber
- Cancer Research Division, Cancer Council New South Wales, Sydney, New South Wales, Australia
| | - Nicole Brenner
- Infections and Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Emily Banks
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, Australia.,Sax Institute, Sydney, New South Wales, Australia
| | - Michael Pawlita
- Infections and Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Freddy Sitas
- Sydney School of Public Health, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.,School of Public Health and Community Medicine, University of New South Wales, New South Wales, Australia
| | | | - Bayzid Rahman
- School of Public Health and Community Medicine, University of New South Wales, New South Wales, Australia
| | - Cathelijne H van Kemenade
- Sydney School of Public Health, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
| | - Bruce K Armstrong
- Sydney School of Public Health, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.,School of Population and Global Health, University of Western Australia, Perth, Western Australia, Australia
| | - Tim Waterboer
- Infections and Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
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16
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Ehteram H, Sadat Mousavian M, Mazoochi T, Khamehchian T, Karimian M. Association of Some High-Risk Mucosal Types of Human Papillomavirus with Cutaneous Squamous Cell Carcinoma in an Iranian Population. IRANIAN JOURNAL OF PATHOLOGY 2019; 14:313-316. [PMID: 31754361 PMCID: PMC6824775 DOI: 10.30699/ijp.2019.101544.2011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 07/18/2019] [Indexed: 11/06/2022]
Abstract
BACKGROUND & OBJECTIVE Squamous cell carcinoma (SCC) is the second most common non-melanoma skin cancer that may be caused by Human papillomavirus (HPV), especially in immunosuppressed patients. However, the role of the mucosal types of HPV in SCC patients with normal immunity has not been extensively confirmed. The aim of this study was to investigate the association of some high-risk mucosal types of HPV with cutaneous SCC in an Iranian population. METHODS Sixty-five formalin-fixed, paraffin-embedded tissue specimens with a diagnosis of cutaneous SCC as the case group and sixty-five healthy skin specimens as the control group were included in our case-control study. Genomic DNA was extracted from tissue samples and then PCR was used for the detection of HPV genotypes by a commercial kit. RESULTS Our data revealed that 6 out of 65 SCC samples (9.2%) were infected by high-risk mucosal types of HPV whereas none of the 65 control samples were infected by the mentioned HPVs. Statistical analysis showed a significant association between these types of HPV infection and SCC risk in our studied population (P=0.028). CONCLUSION These findings suggested that some high-risk mucosal types of HPV are significant risk factors for cutaneous SCC.
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Affiliation(s)
- Hassan Ehteram
- Department of Pathology, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | | | - Tahereh Mazoochi
- Gametogenesis Research Center, Kashan University of Medical Sciences, Kashan, Iran
| | - Tahereh Khamehchian
- Department of Pathology, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Mohammad Karimian
- Anatomical Sciences Research Center, Kashan University of Medical Sciences, Kashan, Iran
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17
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Rotola A, Musmeci D, Gentili V, Reale D, Borghi A, Rizzo R, Corazza M. Generalized eruptive keratoacanthoma of the Grzybowski type: some considerations on treatment and pathogenesis. Int J Dermatol 2019; 58:e242-e245. [DOI: 10.1111/ijd.14548] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 04/12/2019] [Accepted: 05/20/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Antonella Rotola
- Department of Medical Sciences, Section of Microbiology and Medical Genetics University of Ferrara Ferrara Italy
| | - Dario Musmeci
- Department of Medical Sciences, Section of Dermatology and Infectious Diseases University of Ferrara Ferrara Italy
| | - Valentina Gentili
- Department of Medical Sciences, Section of Microbiology and Medical Genetics University of Ferrara Ferrara Italy
| | - Domenico Reale
- Pathology Division St Anna University Hospital Ferrara Italy
| | - Alessandro Borghi
- Department of Medical Sciences, Section of Dermatology and Infectious Diseases University of Ferrara Ferrara Italy
| | - Roberta Rizzo
- Department of Medical Sciences, Section of Microbiology and Medical Genetics University of Ferrara Ferrara Italy
| | - Monica Corazza
- Department of Medical Sciences, Section of Dermatology and Infectious Diseases University of Ferrara Ferrara Italy
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18
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Tommasino M. HPV and skin carcinogenesis. PAPILLOMAVIRUS RESEARCH (AMSTERDAM, NETHERLANDS) 2019; 7:129-131. [PMID: 30953864 PMCID: PMC6460321 DOI: 10.1016/j.pvr.2019.04.003] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/09/2019] [Revised: 04/01/2019] [Accepted: 04/02/2019] [Indexed: 12/22/2022]
Abstract
Epidemiological and biological studies provide several lines of evidence for the involvement of cutaneous beta human papillomaviruses (HPVs), together with ultraviolet (UV) radiation, in the development of cutaneous squamous cell carcinoma. These viruses appear to act with a hit-and-run mechanism, being necessary at an early stage of carcinogenesis and being dispensable for the maintenance of the malignant phenotype. Studies in experimental models show that beta HPVs, mainly via the E6 and E7 oncoproteins, are able to promote proliferation and to circumvent cellular stresses induced by UV radiation. These findings support a model of skin carcinogenesis in which beta HPV-infected keratinocytes remain alive despite the accumulation of UV-induced DNA mutations. In this manner, these cells become highly susceptible to progression towards malignancy. Thus, UV radiation is the main driver of skin cancer development, while beta HPVs act as facilitators of the accumulation of UV-induced DNA mutations.
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Affiliation(s)
- Massimo Tommasino
- Infections and Cancer Biology Group, International Agency for Research on Cancer (IARC), Lyon, France.
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19
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Hampras SS, Tommasino M, Zhao Y, Messina JL, Giuliano AR, Fenske NA, Cherpelis B, Hesterberg RS, Akuffo AA, Amorrortu RP, Balliu J, Vijayan L, Gheit T, Epling-Burnette PK, Rollison DE. Cross-sectional associations between cutaneous viral infections and regulatory T lymphocytes in circulation. Br J Dermatol 2019; 180:1449-1458. [PMID: 30431148 PMCID: PMC6520211 DOI: 10.1111/bjd.17429] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2018] [Indexed: 12/19/2022]
Abstract
BACKGROUND Cutaneous viral infections and immune suppression are risk factors for some forms of nonmelanoma skin cancer; however, their interrelationship is poorly understood. OBJECTIVES To examine cross-sectional associations between cutaneous viral infections and circulating forkhead-box P3 (FOXP3)-expressing T-regulatory (Treg) cells, suppressive cells that dampen effective antitumour immunity. MATERIALS AND METHODS Blood, eyebrow hair (EBH) and skin swab (SSW) samples were collected from 352 patients 60 years and older undergoing skin screening, without prevalent skin cancer, while participating in an ongoing prospective cohort study of cutaneous viral infections and skin cancer. DNA corresponding to 98 cutaneous human papillomavirus (HPV) types and five human polyomaviruses (HPyV) was assessed in EBH and SSW. Distinct classes of circulating Treg-cell subpopulations were defined by flow cytometry including cutaneous lymphocyte antigen (CLA) and CCR4high Treg cells, both previously associated with cutaneous diseases. Age- and sex-adjusted associations between circulating T-cell populations and infection were estimated using logistic regression. RESULTS Total Treg-cell proportion in peripheral blood was not associated with β HPV or HPyV infection. However, the proportion of circulating CLA+ Treg cells was inversely associated with γ HPV EBH infection [odds ratio (OR) 0·54, 95% confidence interval (CI) 0·35-0·84]. Interestingly, circulating Treg cells expressing markers indicative of antigen activation (CD27- CD45RA- FOXP3+ CD4+ ) were also inversely associated with γ HPV infection in SSW (OR 0·55, 95% CI 0·30-0·99) and EBH (OR 0·56, 95% CI 0·36-0·86). CONCLUSIONS Inverse associations between circulating Treg cells and γ HPV infection suggest that localized viral infection may promote immunosuppressive cell migration into skin.
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Affiliation(s)
- S S Hampras
- Department of Cancer Epidemiology, 12902 Magnolia Drive, Tampa, FL, 33612, U.S.A
| | - M Tommasino
- Infections and Cancer Biology Group, International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Y Zhao
- Department of Cancer Epidemiology, 12902 Magnolia Drive, Tampa, FL, 33612, U.S.A
| | - J L Messina
- Department of Dermatology and Cutaneous Surgery, University of South Florida College of Medicine, Tampa, FL, U.S.A
- Department of Cutaneous Oncology, 12902 Magnolia Drive, Tampa, FL, 33612, U.S.A
- Department of Anatomic Pathology, 12902 Magnolia Drive, Tampa, FL, 33612, U.S.A
| | - A R Giuliano
- Center for Immunization and Infection Research in Cancer, 12902 Magnolia Drive, Tampa, FL, 33612, U.S.A
| | - N A Fenske
- Department of Dermatology and Cutaneous Surgery, University of South Florida College of Medicine, Tampa, FL, U.S.A
| | - B Cherpelis
- Department of Dermatology and Cutaneous Surgery, University of South Florida College of Medicine, Tampa, FL, U.S.A
| | - R S Hesterberg
- Department of Immunology, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL, 33612, U.S.A
| | - A A Akuffo
- Department of Immunology, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL, 33612, U.S.A
| | - R P Amorrortu
- Department of Cancer Epidemiology, 12902 Magnolia Drive, Tampa, FL, 33612, U.S.A
| | - J Balliu
- Department of Cancer Epidemiology, 12902 Magnolia Drive, Tampa, FL, 33612, U.S.A
| | - L Vijayan
- Department of Cancer Epidemiology, 12902 Magnolia Drive, Tampa, FL, 33612, U.S.A
| | - T Gheit
- Infections and Cancer Biology Group, International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - P K Epling-Burnette
- Department of Immunology, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL, 33612, U.S.A
| | - D E Rollison
- Department of Cancer Epidemiology, 12902 Magnolia Drive, Tampa, FL, 33612, U.S.A
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20
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Gheit T. Mucosal and Cutaneous Human Papillomavirus Infections and Cancer Biology. Front Oncol 2019; 9:355. [PMID: 31134154 PMCID: PMC6517478 DOI: 10.3389/fonc.2019.00355] [Citation(s) in RCA: 144] [Impact Index Per Article: 28.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 04/17/2019] [Indexed: 12/13/2022] Open
Abstract
Papillomaviridae is a family of small non-enveloped icosahedral viruses with double-stranded circular DNA. More than 200 different human papillomaviruses (HPVs) have been listed so far. Based on epidemiological data, a subgroup of alphapapillomaviruses (alpha HPVs) was referred to as high-risk (HR) HPV types. HR HPVs are the etiological agents of anogenital cancer and a subset of head and neck cancers. The cutaneous HPV types, mainly from beta and gamma genera, are widely present on the surface of the skin in the general population. However, there is growing evidence of an etiological role of betapapillomaviruses (beta HPVs) in non-melanoma skin cancer (NMSC), together with ultraviolet (UV) radiation. Studies performed on mucosal HR HPV types, such as 16 and 18, showed that both oncoproteins E6 and E7 play a key role in cervical cancer by altering pathways involved in the host immune response to establish a persistent infection and by promoting cellular transformation. Continuous expression of E6 and E7 of mucosal HR HPV types is essential to initiate and to maintain the cellular transformation process, whereas expression of E6 and E7 of cutaneous HPV types is not required for the maintenance of the skin cancer phenotype. Beta HPV types appear to play a role in the initiation of skin carcinogenesis, by exacerbating the accumulation of UV radiation-induced DNA breaks and somatic mutations (the hit-and-run mechanism), and they would therefore act as facilitators rather than direct actors in NMSC. In this review, the natural history of HPV infection and the transforming properties of various HPV genera will be described, with a particular focus on describing the state of knowledge about the role of cutaneous HPV types in NMSC.
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Affiliation(s)
- Tarik Gheit
- Infections and Cancer Biology Group, International Agency for Research on Cancer (IARC), Lyon, France
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21
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Rollison DE, Viarisio D, Amorrortu RP, Gheit T, Tommasino M. An Emerging Issue in Oncogenic Virology: the Role of Beta Human Papillomavirus Types in the Development of Cutaneous Squamous Cell Carcinoma. J Virol 2019; 93:e01003-18. [PMID: 30700603 PMCID: PMC6430537 DOI: 10.1128/jvi.01003-18] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Evidence suggests that beta human papillomaviruses (HPVs), together with ultraviolet radiation, contribute to the development of cutaneous squamous cell carcinoma. Beta HPVs appear to be not the main drivers of carcinogenesis but rather facilitators of the accumulation of ultraviolet-induced DNA mutations. Beta HPVs are promoters of skin carcinogenesis, although they are dispensable for the maintenance of the malignant phenotype. Therefore, beta HPV represents a target for skin cancer prevention, especially in high-risk populations.
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Affiliation(s)
- Dana E Rollison
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida, USA
| | - Daniele Viarisio
- Infection and Cancer Epidemiology, Deutsches Krebsforschungszentrum, Heidelberg, Germany
| | | | - Tarik Gheit
- Infections and Cancer Biology Group, International Agency for Research on Cancer (IARC), Lyon, France
| | - Massimo Tommasino
- Infections and Cancer Biology Group, International Agency for Research on Cancer (IARC), Lyon, France
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22
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Brancaccio RN, Robitaille A, Dutta S, Cuenin C, Santare D, Skenders G, Leja M, Fischer N, Giuliano AR, Rollison DE, Grundhoff A, Tommasino M, Gheit T. Generation of a novel next-generation sequencing-based method for the isolation of new human papillomavirus types. Virology 2018; 520:1-10. [PMID: 29747121 PMCID: PMC9280450 DOI: 10.1016/j.virol.2018.04.017] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Revised: 04/23/2018] [Accepted: 04/26/2018] [Indexed: 01/15/2023]
Abstract
With the advent of new molecular tools, the discovery of new papillomaviruses (PVs) has accelerated during the past decade, enabling the expansion of knowledge about the viral populations that inhabit the human body. Human PVs (HPVs) are etiologically linked to benign or malignant lesions of the skin and mucosa. The detection of HPV types can vary widely, depending mainly on the methodology and the quality of the biological sample. Next-generation sequencing is one of the most powerful tools, enabling the discovery of novel viruses in a wide range of biological material. Here, we report a novel protocol for the detection of known and unknown HPV types in human skin and oral gargle samples using improved PCR protocols combined with next-generation sequencing. We identified 105 putative new PV types in addition to 296 known types, thus providing important information about the viral distribution in the oral cavity and skin.
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Affiliation(s)
| | | | | | - Cyrille Cuenin
- International Agency for Research on Cancer, Lyon, France
| | - Daiga Santare
- Institute of Clinical and Preventive Medicine, University of Latvia, Riga, Latvia
| | - Girts Skenders
- Institute of Clinical and Preventive Medicine, University of Latvia, Riga, Latvia
| | - Marcis Leja
- Institute of Clinical and Preventive Medicine, University of Latvia, Riga, Latvia
| | - Nicole Fischer
- Institute for Medical Microbiology, Virology and Hygiene, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; German Center for Infection Research, partner site Hamburg, Borstel, Lübeck, Riems, Germany
| | - Anna R Giuliano
- Center for Infection Research in Cancer, Moffitt Cancer Center, Tampa, FL, USA
| | - Dana E Rollison
- Center for Infection Research in Cancer, Moffitt Cancer Center, Tampa, FL, USA; Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL, USA
| | - Adam Grundhoff
- German Center for Infection Research, partner site Hamburg, Borstel, Lübeck, Riems, Germany; Heinrich-Pette Institute, Leibniz Institute for Experimental Virology, Hamburg, Germany
| | | | - Tarik Gheit
- International Agency for Research on Cancer, Lyon, France.
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Bouwes Bavinck JN, Feltkamp MCW, Green AC, Fiocco M, Euvrard S, Harwood CA, Nasir S, Thomson J, Proby CM, Naldi L, Diphoorn JCD, Venturuzzo A, Tessari G, Nindl I, Sampogna F, Abeni D, Neale RE, Goeman JJ, Quint KD, Halk AB, Sneek C, Genders RE, de Koning MNC, Quint WGV, Wieland U, Weissenborn S, Waterboer T, Pawlita M, Pfister H. Human papillomavirus and posttransplantation cutaneous squamous cell carcinoma: A multicenter, prospective cohort study. Am J Transplant 2018; 18:1220-1230. [PMID: 29024374 PMCID: PMC5947129 DOI: 10.1111/ajt.14537] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Revised: 09/20/2017] [Accepted: 10/03/2017] [Indexed: 01/25/2023]
Abstract
Organ transplant recipients (OTRs) have a 100-fold increased risk of cutaneous squamous cell carcinoma (cSCC). We prospectively evaluated the association between β genus human papillomaviruses (βPV) and keratinocyte carcinoma in OTRs. Two OTR cohorts without cSCC were assembled: cohort 1 was transplanted in 2003-2006 (n = 274) and cohort 2 was transplanted in 1986-2002 (n = 352). Participants were followed until death or cessation of follow-up in 2016. βPV infection was assessed in eyebrow hair by using polymerase chain reaction-based methods. βPV IgG seroresponses were determined with multiplex serology. A competing risk model with delayed entry was used to estimate cumulative incidence of histologically proven cSCC and the effect of βPV by using a multivariable Cox regression model. Results are reported as adjusted hazard ratios (HRs). OTRs with 5 or more different βPV types in eyebrow hair had 1.7 times the risk of cSCC vs OTRs with 0 to 4 different types (HR 1.7, 95% confidence interval 1.1-2.6). A similar risk was seen with high βPV loads (HR 1.8, 95% confidence interval 1.2-2.8). No significant associations were seen between serum antibodies and cSCC or between βPV and basal cell carcinoma. The diversity and load of βPV types in eyebrow hair are associated with cSCC risk in OTRs, providing evidence that βPV is associated with cSCC carcinogenesis and may present a target for future preventive strategies.
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Affiliation(s)
| | - Mariet C. W. Feltkamp
- Department of Medical MicrobiologyLeiden University Medical CenterLeidenThe Netherlands
| | - Adele C. Green
- QIMR Berghofer Medical Research InstituteBrisbaneAustralia
| | - Marta Fiocco
- Department of Medical Statistics and BioinformaticsLeiden University Medical CenterLeidenThe Netherlands,Institute of MathematicsLeiden UniversityLeidenThe Netherlands
| | - Sylvie Euvrard
- Department of DermatologyEdouard Herriot HospitalHospices Civils de LyonLyonFrance
| | - Catherine A. Harwood
- Centre for Cell Biology and Cutaneous ResearchBlizard Institute, Barts and The London School of Medicine and DentistryQueen Mary University of LondonUK
| | - Shaaira Nasir
- Centre for Cell Biology and Cutaneous ResearchBlizard Institute, Barts and The London School of Medicine and DentistryQueen Mary University of LondonUK
| | - Jason Thomson
- Centre for Cell Biology and Cutaneous ResearchBlizard Institute, Barts and The London School of Medicine and DentistryQueen Mary University of LondonUK
| | - Charlotte M. Proby
- Division of Cancer ResearchUniversity of DundeeNinewells Hospital and Medical SchoolDundeeUK
| | - Luigi Naldi
- Department of DermatologyAzienda Ospedaliera papa Giovanni XXIII, and GISED Study CenterBergamoItaly
| | - Janouk C. D. Diphoorn
- Department of DermatologyAzienda Ospedaliera papa Giovanni XXIII, and GISED Study CenterBergamoItaly
| | - Anna Venturuzzo
- Department of DermatologyAzienda Ospedaliera papa Giovanni XXIII, and GISED Study CenterBergamoItaly
| | - Gianpaolo Tessari
- Department of MedicineSection of DermatologyUniversity of Veronac/o Ospedale Civile MaggioreVeronaItaly
| | - Ingo Nindl
- Department of DermatologyUniversity Hospital CharitéSkin Cancer Center CharitéBerlinGermany
| | | | | | | | - Jelle J. Goeman
- Department of Medical Statistics and BioinformaticsLeiden University Medical CenterLeidenThe Netherlands
| | - Koen D. Quint
- Department of DermatologyLeiden University Medical CenterLeidenThe Netherlands
| | - Anne B. Halk
- Department of DermatologyLeiden University Medical CenterLeidenThe Netherlands
| | - Carmen Sneek
- Department of DermatologyLeiden University Medical CenterLeidenThe Netherlands
| | - Roel E. Genders
- Department of DermatologyLeiden University Medical CenterLeidenThe Netherlands
| | | | | | - Ulrike Wieland
- Institute of VirologyUniversity of CologneCologneGermany
| | | | - Tim Waterboer
- German Cancer Research Center (DKFZ)HeidelbergGermany
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24
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Wendel SO, Wallace NA. Loss of Genome Fidelity: Beta HPVs and the DNA Damage Response. Front Microbiol 2017; 8:2250. [PMID: 29187845 PMCID: PMC5694782 DOI: 10.3389/fmicb.2017.02250] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Accepted: 10/31/2017] [Indexed: 12/28/2022] Open
Abstract
While the role of genus alpha human papillomaviruses in the tumorigenesis and tumor maintenance of anogenital and oropharyngeal cancers is well-established, the role of genus beta human papilloviruses (β-HPVs) in non-melanoma skin cancers (NMSCs) is less certain. Persistent β-HPV infections cause NMSCs in sun-exposed skin of people with a rare genetic disorder, epidermodysplasia verruciformis. However, β-HPV infections in people without epidermodysplasia verruciformis are typically transient. Further, β-HPV gene expression is not necessary for tumor maintenance in the general population as on average there is fewer than one copy of the β-HPV genome per cell in NMSC tumor biopsies. Cell culture, epidemiological, and mouse model experiments support a role for β-HPV infections in the initiation of NMSCs through a "hit and run" mechanism. The virus is hypothesized to act as a cofactor, augmenting the genome destabilizing effects of UV. Supporting this idea, two β-HPV proteins (β-HPV E6 and E7) disrupt the cellular response to UV exposure and other genome destabilizing events by abrogating DNA repair and deregulating cell cycle progression. The aberrant damage response increases the likelihood of oncogenic mutations capable of driving tumorigenesis independent of a sustained β-HPV infection or continued viral protein expression. This review summarizes what is currently known about the deleterious effects of β-HPV on genome maintenance in the context of the virus's putative role in NMSC initiation.
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25
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Hampras SS, Rollison DE, Giuliano AR, McKay-Chopin S, Minoni L, Sereday K, Gheit T, Tommasino M. Prevalence and Concordance of Cutaneous Beta Human Papillomavirus Infection at Mucosal and Cutaneous Sites. J Infect Dis 2017; 216:92-96. [PMID: 28549147 DOI: 10.1093/infdis/jix245] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Accepted: 05/16/2017] [Indexed: 12/12/2022] Open
Abstract
Background Cutaneous beta human papillomavirus (HPV) infection across cutaneous and mucosal tissues within individuals has not been examined. Methods A subcohort of men (n = 87) participating in the HPV Infection in Men (HIM) study provided eyebrow hairs, forearm skin swabs, genital skin swabs, oral rinse samples, and anal swabs. Beta-HPV DNA in the 5 tissues was detected using a multiplex assay, and site-specific beta-HPV prevalence was examined. Results Any beta-HPV was most prevalent in genital skin (81.6%), followed by forearm skin (64.4%), eyebrow hairs (60.9%), oral mucosa (35.6%), and anal mucosa (33.3%). Most prevalent beta-HPV types included HPV-38 (beta-2) in both genital skin (32.2%) and eyebrow hairs (16.1%), HPV-12 (beta-1) in forearm skin (23%) and oral mucosa (9.2%), and HPV-76 (beta-3) in anal mucosa (14.9%). Concordance of any beta-HPV infection was greater (31.0%) across the 3 keratinized tissue sites (genital skin, eyebrow hairs, forearm skin) than across the 2 mucosal sites (anal and oral mucosa, 6.9%). Conclusions Prevalence of beta-HPV varied by anatomic site of infection. Biological properties of beta-HPV types detected at mucosal sites and their role in disease pathogenesis should be examined.
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Affiliation(s)
| | | | - Anna R Giuliano
- Center for Infection Research in Cancer, Moffitt Cancer Center, Tampa, Florida
| | - Sandrine McKay-Chopin
- Infections and Cancer Biology Group, International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Lucia Minoni
- Infections and Cancer Biology Group, International Agency for Research on Cancer, World Health Organization, Lyon, France
| | | | - Tarik Gheit
- Infections and Cancer Biology Group, International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Massimo Tommasino
- Infections and Cancer Biology Group, International Agency for Research on Cancer, World Health Organization, Lyon, France
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26
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Viarisio D, Gissmann L, Tommasino M. Human papillomaviruses and carcinogenesis: well-established and novel models. Curr Opin Virol 2017; 26:56-62. [PMID: 28778034 DOI: 10.1016/j.coviro.2017.07.014] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Revised: 06/20/2017] [Accepted: 07/18/2017] [Indexed: 10/19/2022]
Abstract
Human papillomaviruses (HPVs) infect the cutaneous or mucosal epithelia and are classified phylogenetically as genera and species. Persistent infections by the mucosal high-risk (HR) HPV types from genus alpha are associated with cancer development of the genital and upper respiratory tracts. The products of two early genes, E6 and E7, are the major HR HPV oncoproteins, being essential in all steps of the carcinogenic process. Cutaneous beta HPV types are proposed, together with ultraviolet (UV) radiation, to promote non-melanoma skin cancer development. However, in contrast to the HR HPV types, beta HPV types appear to be required only at an early stage of carcinogenesis, facilitating the accumulation of UV-induced DNA mutations. Although findings in experimental models also suggest that beta HPV types and other carcinogens may synergize in the induction of malignancies, these possibilities need to be confirmed in human studies.
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Affiliation(s)
| | - Lutz Gissmann
- DKFZ, Im Neuenheimer Feld 280, 69120 Heidelberg, Germany
| | - Massimo Tommasino
- International Agency for Research on Cancer, World Health Organization, 150 Cours Albert Thomas, 69372 Lyon Cedex 08, France.
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27
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Hufbauer M, Akgül B. Molecular Mechanisms of Human Papillomavirus Induced Skin Carcinogenesis. Viruses 2017; 9:v9070187. [PMID: 28708084 PMCID: PMC5537679 DOI: 10.3390/v9070187] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Revised: 07/07/2017] [Accepted: 07/07/2017] [Indexed: 12/21/2022] Open
Abstract
Infection of the cutaneous skin with human papillomaviruses (HPV) of genus betapapillomavirus (βHPV) is associated with the development of premalignant actinic keratoses and squamous cell carcinoma. Due to the higher viral loads of βHPVs in actinic keratoses than in cancerous lesions, it is currently discussed that these viruses play a carcinogenic role in cancer initiation. In vitro assays performed to characterize the cell transforming activities of high-risk HPV types of genus alphapapillomavirus have markedly contributed to the present knowledge on their oncogenic functions. However, these assays failed to detect oncogenic functions of βHPV early proteins. They were not suitable for investigations aiming to study the interactive role of βHPV positive epidermis with mesenchymal cells and the extracellular matrix. This review focuses on βHPV gene functions with special focus on oncogenic mechanisms that may be relevant for skin cancer development.
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Affiliation(s)
- Martin Hufbauer
- Institute of Virology, University of Cologne, Fürst-Pückler-Str. 56, 50935 Cologne, Germany.
| | - Baki Akgül
- Institute of Virology, University of Cologne, Fürst-Pückler-Str. 56, 50935 Cologne, Germany.
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28
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Abstract
The beta genus comprises more than 50 beta human papillomavirus (HPV) types that are suspected to be involved, together with ultraviolet (UV) irradiation, in the development of non-melanoma skin cancer (NMSC), the most common form of human cancer. Two members of the genus beta, HPV5 and HPV8, were first identified in patients with a genetic disorder, epidermodysplasia verruciformis (EV), that confers high susceptibility to beta HPV infection and NMSC development. The fact that organ transplant recipients (OTRs) with an impaired immune system have an elevated risk of NMSC raised the hypothesis that beta HPV types may also be involved in skin carcinogenesis in non-EV patients. Epidemiological studies have shown that serological and viral DNA markers are weakly, but significantly, associated with history of NMSC in OTRs and the general population. Functional studies on mucosal high-risk (HR) HPV types have clearly demonstrated that the products of two early genes, E6 and E7, are the main viral oncoproteins, which are able to deregulate events closely linked to transformation, such as cell cycle progression and apoptosis. Studies on a small number of beta HPV types have shown that their E6 and E7 oncoproteins also have the ability to interfere with the regulation of key pathways/events associated with cellular transformation. However, the initial functional data indicate that the molecular mechanisms leading to cellular transformation are different from those of mucosal HR HPV types. Beta HPV types may act only at early stages of carcinogenesis, by potentiating the deleterious effects of other carcinogens, such as UV radiation.
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Kalu NN, Johnson FM. Do CDK4/6 inhibitors have potential as targeted therapeutics for squamous cell cancers? Expert Opin Investig Drugs 2017; 26:207-217. [PMID: 28042706 DOI: 10.1080/13543784.2017.1274731] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Introduction Dysregulation of cell cycle progression has an established link to neoplasia and cancer progression. Components of the cyclin D-CDK4/6-INK4-Rb pathway are frequently altered in squamous cell carcinomas (SCCs) by diverse mechanisms, including viral oncogene-induced degradation, mutation, deletion, and amplification. Activation of the CDK4/6 pathway may predict response to CDK4/6 inhibitors and provide clinical biomarkers. Recently, the CDK4/6 inhibitor palbociclib showed clinical efficacy in combination with cetuximab in HNSCC patients. Areas covered This review focuses on the current research on the use of CDK4/6 inhibitors, comprising preclinical animal studies through phase II clinical trials across all SCCs. Expert opinion CDK4/6 inhibitors have a proven clinical benefit in breast cancer, but data on SCCs are sparse. Although frequent dysregulation of the cyclin D-CDK4/6-INK4-Rb pathway in SCCs suggests that targeting CDK4/6 may hold promise for improved clinical outcomes, single-agent activity has been modest in preclinical studies and absent in clinical studies. Combinations with immunotherapy or inhibitors of the PI3 K/mTOR or EGFR pathway may be effective. Given that SCCs caused by human papillomavirus have high levels of p16 and low levels of Rb, the CDK4/6 inhibitors are predicted to be ineffective in these cancers.
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Affiliation(s)
- Nene N Kalu
- a Department of Thoracic/Head & Neck Medical Oncology , The University of Texas MD Anderson Cancer Center , Houston , TX , USA
| | - Faye M Johnson
- a Department of Thoracic/Head & Neck Medical Oncology , The University of Texas MD Anderson Cancer Center , Houston , TX , USA.,b The University of Texas Graduate School of Biomedical Sciences , Houston , TX , USA
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30
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Rahman S, Pierce Campbell CM, Waterboer T, Rollison DE, Ingles DJ, Torres BN, Michel A, Sudenga SL, Pawlita M, Villa LL, Lazcano Ponce E, Borenstein AR, Wang W, Giuliano AR. Seroprevalence of cutaneous human papillomaviruses (HPVs) among men in the multinational HPV Infection in Men study. J Gen Virol 2016; 97:3291-3301. [PMID: 27902363 PMCID: PMC5756495 DOI: 10.1099/jgv.0.000620] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Accepted: 09/28/2016] [Indexed: 02/06/2023] Open
Abstract
Data on cutaneous human papillomavirus (HPV) seroprevalence are primarily derived from skin cancer case-control studies. Few studies have reported the seroprevalence of cutaneous HPV among healthy men. This study investigated the seroprevalence of cutaneous HPV types and associated risk factors among men residing in Brazil, Mexico and the USA. Six hundred men were randomly selected from the HPV Infection in Men study. Archived serum specimens were tested for antibodies against 14 cutaneous HPV genotypes, β-HPV types (5/8/12/14/17/22/23/24/38/48), α-HPV 27, γ-HPV 4, µ-HPV1 and ν-HPV 41 using a glutathione S-transferase L1-based multiplex serology assay. Risk factor data were collected by a questionnaire. Binomial proportions were used to estimate seroprevalence, and logistic regression to examine factors associated with seropositivity. Overall, 65.4 % of men were seropositive to ≥1 of the 14 cutaneous HPV types, and 39.0 % were positive for ≥1 β-HPV types. Seroprevalence was 8.9, 30.9, 28.6 and 9.4 % for α-HPV 27, γ-HPV 4, µ-HPV 1 and ν-HPV 41, respectively. In multivariate analyses, seropositivity for any cutaneous HPV type was associated with higher education [adjusted odds ratio (AOR) 1.75; 95 % confidence interval (CI) 1.08-2.83], and seropositivity of any β-HPV type was significantly associated with increasing age (AOR 1.72; 95 % CI 1.12-2.63, for men aged 31-44 years vs men aged 18-30 years). Other factors associated with various type-specific cutaneous HPV seropositivity included country, circumcision and lifetime number of male sexual partners. These data indicate that exposure to cutaneous HPV is common. Future studies are needed to assess the role of cutaneous HPV in diseases.
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Affiliation(s)
- Shams Rahman
- Department of Cancer Epidemiology, Center for Infection Research in Cancer, Moffitt Cancer Center, Tampa, FL, USA
- Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, Tampa, FL, USA
| | - Christine M. Pierce Campbell
- Department of Cancer Epidemiology, Center for Infection Research in Cancer, Moffitt Cancer Center, Tampa, FL, USA
| | - Tim Waterboer
- Molecular Diagnostics of Oncogenic Infections Division, Infection, Inflammation and Cancer Research Program, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Dana E. Rollison
- Department of Cancer Epidemiology, Center for Infection Research in Cancer, Moffitt Cancer Center, Tampa, FL, USA
| | | | - B. Nelson Torres
- Department of Biostatistics, Center for Infection Research in Cancer, Moffitt Cancer Center, Tampa, FL, USA
| | - Angelika Michel
- Molecular Diagnostics of Oncogenic Infections Division, Infection, Inflammation and Cancer Research Program, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Staci L. Sudenga
- Department of Cancer Epidemiology, Center for Infection Research in Cancer, Moffitt Cancer Center, Tampa, FL, USA
| | - Michael Pawlita
- Molecular Diagnostics of Oncogenic Infections Division, Infection, Inflammation and Cancer Research Program, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Luisa L. Villa
- School of Medicine, Universidade de São Paulo, São Paulo, Brazil
| | | | - Amy R. Borenstein
- Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, Tampa, FL, USA
| | - Wei Wang
- Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, Tampa, FL, USA
| | - Anna R. Giuliano
- Department of Cancer Epidemiology, Center for Infection Research in Cancer, Moffitt Cancer Center, Tampa, FL, USA
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31
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Rahman S, Rollison DE, Pierce Campbell CM, Waterboer T, Michel A, Pawlita M, Villa LL, Lazcano Ponce E, Wang W, Borenstein AR, Giuliano AR. Seroprevalence of Cutaneous Human Papillomaviruses and the Risk of External Genital Lesions in Men: A Nested Case-Control Study. PLoS One 2016; 11:e0167174. [PMID: 27893841 PMCID: PMC5125700 DOI: 10.1371/journal.pone.0167174] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Accepted: 11/09/2016] [Indexed: 12/11/2022] Open
Abstract
Background A variety of cutaneous human papillomaviruses (HPV) are detectable in genital epithelial lesions in men and non-melanoma skin cancer patients. It remains unclear whether these viruses are associated causally with skin lesions. To date, no study has prospectively examined the association between cutaneous HPV seropositivity and development of external genital lesions (EGLs) in men. Objectives To examine the association between seropositivity to cutaneous HPV types and the risk of subsequent development of EGLs. Methods A nested case-control study including 163 incident EGL cases and 352 EGL-free controls in the HPV Infection in Men (HIM) Study cohort was conducted. Cases were ascertained at each of up to 10 biannual clinical visits and verified through biopsy and pathological diagnoses. EGLs were categorized as condyloma, suggestive of condyloma, penile intraepithelial neoplasia (PeIN), and other EGLs. Archived serum specimens collected at baseline were tested for antibodies against 14 cutaneous HPV types (β types (5, 8, 12, 14, 17, 22, 23, 24, 38, and 47), α type 27, γ type 4, μ type 1, and ν type 41) using a GST L1-based multiplex serology assay. Socio-demographic and sexual behavior data were collected through a questionnaire. Using logistic regression, adjusted odds ratios (AOR) and 95% confidence intervals (CI) were estimated. Results Overall, seropositivity to ≥1 cutaneous HPV type (any-HPV) and ≥1 β types (any-β) was 58.3% and 37.5% among other EGL cases, 71.6% and 46.8% among condyloma, 66.8% and 50.0% among PeIN, and 71.9% and 38.4% among controls, respectively. Type-specific seropositivity was most common for ɤ-HPV 4, μ-HPV 1, and β-HPV 8. No statistically significant association was observed between any-HPV, any-β, and type-specific HPV seropositivity and subsequent development of EGLs across all pathological diagnoses. Conclusions Overall, seropositivity to cutaneous HPV was common among men; however, it appears that cutaneous HPV is not associated with the development of genital lesions in men.
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Affiliation(s)
- Shams Rahman
- Center for Infection Research in Cancer, Moffitt Cancer Center, Tampa, United States
- Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, Tampa, United States
| | - Dana E. Rollison
- Center for Infection Research in Cancer, Moffitt Cancer Center, Tampa, United States
| | | | - Tim Waterboer
- Infection, Inflammation and Cancer Research Program, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Angelika Michel
- Infection, Inflammation and Cancer Research Program, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Michael Pawlita
- Infection, Inflammation and Cancer Research Program, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Luisa L. Villa
- School of Medicine, University of São Paulo, São Paulo, Brazil
| | | | - Wei Wang
- Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, Tampa, United States
| | - Amy R. Borenstein
- Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, Tampa, United States
| | - Anna R. Giuliano
- Center for Infection Research in Cancer, Moffitt Cancer Center, Tampa, United States
- * E-mail:
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Hampras SS, Reed RA, Bezalel S, Cameron M, Cherpelis B, Fenske N, Sondak VK, Messina J, Tommasino M, Gheit T, Rollison DE. Cutaneous Human Papillomavirus Infection and Development of Subsequent Squamous Cell Carcinoma of the Skin. J Skin Cancer 2016; 2016:1368103. [PMID: 27891253 PMCID: PMC5116506 DOI: 10.1155/2016/1368103] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Revised: 10/05/2016] [Accepted: 10/16/2016] [Indexed: 12/17/2022] Open
Abstract
The role of cutaneous human papillomavirus (HPV) infection in the development of subsequent cutaneous squamous cell carcinoma (SCC) is unknown. Pathologically confirmed cases of SCC (n = 150) enrolled in a previously conducted case-control study were included in a retrospective cohort study to examine the association of cutaneous HPV at the time of SCC diagnosis with the risk of subsequent SCC development. Data on HPV seropositivity, HPV DNA in eyebrow hairs (EB) and SCC tumors were available from the parent study. Incidence of subsequent SCC was estimated using person-years of follow up. Cox Proportional Hazards ratios were estimated to evaluate the associations of both, HPV seropositivity and HPV DNA positivity with subsequent SCC. The five year cumulative incidence of subsequent SCC was 72%. Seropositivity to cutaneous HPV was not associated with the risk of subsequent SCC (HR = 0.83, 95% CI = 0.41-1.67). Any beta HPV infection in EB was associated with reduced risk (HR = 0.30, 95% CI = 0.11-0.78) of subsequent SCC among cases who were positive for beta HPV DNA in tumor tissue. Infection with beta HPV type 2 (HR = 0.32, 95% CI = 0.12-0.86) in EB was associated with reduced risk of subsequent SCC among HPV DNA positive SCCs. In conclusion, beta HPV infection was inversely associated with the risk of subsequent SCC.
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Affiliation(s)
- Shalaka S. Hampras
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida, USA
| | - Rhianna A. Reed
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida, USA
| | - Spencer Bezalel
- University of South Florida, Morsani College of Medicine, Tampa, Florida, USA
| | - Michael Cameron
- University of South Florida, Morsani College of Medicine, Tampa, Florida, USA
| | - Basil Cherpelis
- Department of Dermatology, University of South Florida, College of Medicine, Tampa, FL, USA
- Department of Cutaneous Surgery, University of South Florida, College of Medicine, Tampa, FL, USA
| | - Neil Fenske
- Department of Dermatology, University of South Florida, College of Medicine, Tampa, FL, USA
- Department of Cutaneous Surgery, University of South Florida, College of Medicine, Tampa, FL, USA
| | - Vernon K. Sondak
- Cutaneous Oncology Program, Moffitt Cancer Center, Tampa, Florida, USA
| | - Jane Messina
- Department of Dermatology, University of South Florida, College of Medicine, Tampa, FL, USA
- Cutaneous Oncology Program, Moffitt Cancer Center, Tampa, Florida, USA
- Departments of Pathology and Cell Biology, University of South Florida, College of Medicine, Tampa, FL, USA
| | - Massimo Tommasino
- Infections and Cancer Biology Group, International Agency for Research on Cancer-World Health Organization, Lyon 69372, France
| | - Tarik Gheit
- Infections and Cancer Biology Group, International Agency for Research on Cancer-World Health Organization, Lyon 69372, France
| | - Dana E. Rollison
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida, USA
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33
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Pierce Campbell CM, Gheit T, Tommasino M, Lin HY, Torres BN, Messina JL, Stoler MH, Rollison DE, Sirak BA, Abrahamsen M, Carvalho da Silva RJ, Sichero L, Villa LL, Lazcano-Ponce E, Giuliano AR. Cutaneous beta human papillomaviruses and the development of male external genital lesions: A case-control study nested within the HIM Study. Virology 2016; 497:314-322. [PMID: 27518539 PMCID: PMC5997247 DOI: 10.1016/j.virol.2016.08.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Revised: 07/29/2016] [Accepted: 08/02/2016] [Indexed: 12/12/2022]
Abstract
BACKGROUND Cutaneous human papillomaviruses (HPVs) increase the risk of non-melanoma skin cancer in sun-exposed skin. We examined the role of beta-HPV in the development of male external genital lesions (EGLs), a sun-unexposed site. METHODS In this nested case-control study (67 men with pathologically-confirmed EGLs and 134 controls), exfoliated cells collected from the surface of lesions and normal genital skin 0, 6, and 12 months preceding EGL development were tested for beta-HPV DNA using a type-specific multiplex genotyping assay. Beta-HPV prevalence was estimated and conditional logistic regression was used to evaluate the association with condyloma, the most common EGL. RESULTS While beta-HPV prevalence among controls remained stable, the prevalence among cases was lowest on the surface of lesion. Detecting beta-HPV on the normal genital skin was not associated with the presence or development of condyloma. CONCLUSIONS Cutaneous beta-HPV does not appear to be contributing to pathogenesis in male genital skin.
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Affiliation(s)
- Christine M Pierce Campbell
- Center for Infection Research in Cancer, Moffitt Cancer Center and Research Institute, Tampa, FL, USA; Department of Cancer Epidemiology, Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Tarik Gheit
- Infections and Cancer Biology Group, International Agency for Research on Cancer, Lyon, France
| | - Massimo Tommasino
- Infections and Cancer Biology Group, International Agency for Research on Cancer, Lyon, France
| | - Hui-Yi Lin
- Biostatistics Program, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA, USA
| | - B Nelson Torres
- Department of Cancer Epidemiology, Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Jane L Messina
- Departments of Anatomic Pathology and Cutaneous Oncology, Moffitt Cancer Center and Research Institute, Tampa, FL, USA; Departments of Oncologic Sciences, Pathology, and Cell Biology and Dermatology, University of South Florida Morsani College of Medicine, Tampa, FL, USA
| | - Mark H Stoler
- Department of Pathology, University of Virginia Health System, Charlottesville, VA, USA
| | - Dana E Rollison
- Center for Infection Research in Cancer, Moffitt Cancer Center and Research Institute, Tampa, FL, USA; Department of Cancer Epidemiology, Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Bradley A Sirak
- Center for Infection Research in Cancer, Moffitt Cancer Center and Research Institute, Tampa, FL, USA; Department of Cancer Epidemiology, Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Martha Abrahamsen
- Center for Infection Research in Cancer, Moffitt Cancer Center and Research Institute, Tampa, FL, USA; Department of Cancer Epidemiology, Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | | | - Laura Sichero
- Center for Translational Research in Oncology, Instituto do Câncer do Estado de São Paulo (ICESP), São Paulo, Brazil
| | - Luisa L Villa
- Center for Translational Research in Oncology, Instituto do Câncer do Estado de São Paulo (ICESP), São Paulo, Brazil; Department of Radiology and Oncology, School of Medicine, Universidade de São Paulo, São Paulo, Brazil
| | - Eduardo Lazcano-Ponce
- Center for Population Health Research, Instituto Nacional de Salud Pública (INSP), Cuernavaca, México
| | - Anna R Giuliano
- Center for Infection Research in Cancer, Moffitt Cancer Center and Research Institute, Tampa, FL, USA; Department of Cancer Epidemiology, Moffitt Cancer Center and Research Institute, Tampa, FL, USA.
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34
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Correa RM, Vladimirsky S, Heideman DAM, Coringrato M, Abeldaño A, Olivares L, Del Aguila R, Alonio LV, Snijders PJF, Picconi MA. Cutaneous human papillomavirus genotypes in different kinds of skin lesions in Argentina. J Med Virol 2016; 89:352-357. [PMID: 27420901 DOI: 10.1002/jmv.24631] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/08/2016] [Indexed: 12/13/2022]
Abstract
Cutaneous human papillomaviruses (HPVs) comprise a large and highly heterogeneous virus group. Some of the cutaneous HPVs of the genus Beta have been suggested as a co-factor in the development of non-melanoma skin cancer (NMSC). The aim of this study was to determine cutaneous HPV prevalence and type-specific distribution in different kinds of skin lesions from Argentine patients visiting Dermatology Departments of three hospitals from Buenos Aires. A cross-sectional analysis was performed. HPV DNA was analyzed in (i) 3 patients with Epidermodysplasia verruciformis (EV) harboring benign lesions (BL) (n = 1) and squamous cell carcinoma (SCC) (n = 4); (ii) 240 non-EV patients harboring: (a) BL (n = 38), (b) Actinic Keratosis (AK) (n = 83), (c) SCC (n = 74), and (d) basal cell carcinoma (BCC) (n = 96). Detection and genotyping of 35 cutaneous HPV DNA was carried out by BGC-PCR and GP5+/6 + PCR followed by reverse line blot assay. In EV patients, Beta types were found in all lesions (5/5), including the potentially high-risk HPV types 5 and 8, mostly in multiple infections. In non-EV patients, cutaneous types were found in 50.0% of BL, 43.4% of AK, 31.1% of SCC, and 16.7% of BCC. Beta HPVs were the most frequently found in all lesions, being present in all AK and SCC cases that were positive for HPV. No type-specific correlation with lesion severity was found. In our series, a wide spectrum of cutaneous HPV types was detected in different skin lesions. A possible role for these HPVs in skin carcinogenesis deserves further study. J. Med. Virol. 89:352-357, 2017. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Rita Mariel Correa
- Department of Virology, National Institute of Infectious Diseases-ANLIS "Dr. Carlos G. Malbrán", Buenos Aires, Argentina
| | - Sara Vladimirsky
- Department of Virology, National Institute of Infectious Diseases-ANLIS "Dr. Carlos G. Malbrán", Buenos Aires, Argentina
| | | | | | - Alejandra Abeldaño
- Hospital General de Agudos "Dr. Cosme Argerich", Buenos Aires, Argentina
| | | | | | - Lidia Virginia Alonio
- Department of Virology, National Institute of Infectious Diseases-ANLIS "Dr. Carlos G. Malbrán", Buenos Aires, Argentina
| | - Peter J F Snijders
- Department of Pathology, VU University Medical Center, Amsterdam, The Netherlands
| | - María Alejandra Picconi
- Department of Virology, National Institute of Infectious Diseases-ANLIS "Dr. Carlos G. Malbrán", Buenos Aires, Argentina
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35
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Prevalence and Associated Risk Factors of Human Papillomavirus in Healthy Skin Specimens Collected from Rural Anyang, China, 2006-2008. J Invest Dermatol 2016; 136:1191-1198. [PMID: 26916390 DOI: 10.1016/j.jid.2016.02.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2015] [Revised: 02/02/2016] [Accepted: 02/05/2016] [Indexed: 12/20/2022]
Abstract
Skin infections with cutaneous human papillomavirus (HPV) have been linked to the development of non-melanoma skin cancer, in which mucosal HPV may also play a crucial role. However, systematic investigations of the distribution and associated factors of HPV infection in healthy skin of the general population are scarce. HPV DNA from palmar exfoliated cells of 2,087 individuals was detected by FAP6085/64 and SPF1/GP6+ primers followed by sequencing. A total of 338 papillomavirus types were detected, with HPV-3, HPV-57, and HPV-49 being the most dominant types. The overall prevalence for HPV DNA on skin was 79.92% and for alpha-, beta-, and gamma-HPV were 27.07%, 38.76%, and 29.56%, respectively. Having multiple lifetime sexual partners (adjusted odds ratio 1.60), being a migrant worker (adjusted odds ratio 2.05, reference: farmers), and frequent bathing (Ptrend = 0.001) were associated with alpha-HPV DNA presence. Advancing age increased the detection risk of beta-HPV (Ptrend = 0.001). Higher education (Ptrend = 0.017) and frequent bathing (Ptrend = 0.001) were positively related to gamma-HPV positivity. This study demonstrates that alpha-HPV commonly exists on healthy skin of the general population in rural China, and alpha- and gamma-HPV infections are related to certain behaviors, different from beta-HPV infection. These findings are crucial to better understanding the biology of HPV infection and may be suggestive of the potential transmission of these viruses.
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36
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Park LS, Hernández-Ramírez RU, Silverberg MJ, Crothers K, Dubrow R. Prevalence of non-HIV cancer risk factors in persons living with HIV/AIDS: a meta-analysis. AIDS 2016; 30:273-91. [PMID: 26691548 PMCID: PMC4689318 DOI: 10.1097/qad.0000000000000922] [Citation(s) in RCA: 125] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE The burden of cancer among persons living with HIV/AIDS (PLWHA) is substantial and increasing. We assessed the prevalence of modifiable cancer risk factors among adult PLWHA in Western high-income countries since 2000. DESIGN Meta-analysis. METHODS We searched PubMed to identify articles published in 2011-2013 reporting prevalence of smoking, alcohol consumption, overweight/obesity, and infection with human papillomavirus (HPV), hepatitis C virus (HCV) and hepatitis B virus (HBV) among PLWHA. We conducted random effects meta-analyses of prevalence for each risk factor, including estimation of overall, sex-specific, and HIV-transmission-group-specific prevalence. We compared prevalence in PLWHA with published prevalence estimates in US adults. RESULTS The meta-analysis included 113 publications. Overall summary prevalence estimates were current smoking, 54% [95% confidence interval (CI) 49-59%] versus 20-23% in US adults; cervical high-risk HPV infection, 46% (95% CI 34-58%) versus 29% in US females; oral high-risk HPV infection, 16% (95% CI 10-23%) versus 4% in US adults; anal high-risk HPV infection (men who have sex with men), 68% (95% CI 57-79%), with no comparison estimate available; chronic HCV infection, 26% (95% CI 21-30%) versus 0.9% in US adults; and HBV infection, 5% (95% CI 4-5%) versus 0.3% in US adults. Overweight/obesity prevalence (53%; 95% CI 46-59%) was below that of US adults (68%). Meta-analysis of alcohol consumption prevalence was impeded by varying assessment methods. Overall, we observed considerable study heterogeneity in prevalence estimates. CONCLUSION Prevalence of smoking and oncogenic virus infections continues to be extraordinarily high among PLWHA, indicating a vital need for risk factor reduction efforts.
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Affiliation(s)
- Lesley S Park
- aDivision of Endocrinology, Gerontology, and Metabolism, Department of Medicine and Division of Epidemiology, Department of Health Policy and Research, Stanford University School of Medicine, Stanford, CaliforniabDepartment of Chronic Disease Epidemiology, Yale School of Public Health, Yale School of Medicine, New Haven, ConnecticutcDivision of Research, Kaiser Permanente, Oakland, CaliforniadDivision of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Washington School of Medicine, Seattle, Washington, USA.*Lesley S. Park and Raúl U. Hernández-Ramírez contributed equally to this article
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37
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Hampras SS, Rollison DE, Tommasino M, Gheit T, Schabath MB, Messina JL, Fenske NA, Cherpelis BS, Sondak VK, Iannacone MR, Schmitt M, Pawlita M. Genetic variations in the epidermodysplasia verruciformis (EVER/TMC) genes, cutaneous human papillomavirus infection and squamous cell carcinoma of the skin. Br J Dermatol 2015; 173:1532-5. [PMID: 26126409 DOI: 10.1111/bjd.13991] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- S S Hampras
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL, 33612, U.S.A
| | - D E Rollison
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL, 33612, U.S.A
| | - M Tommasino
- Infections and Cancer Biology Group, International Agency for Research on Cancer-World Health Organization, Lyon, 69372, France
| | - T Gheit
- Infections and Cancer Biology Group, International Agency for Research on Cancer-World Health Organization, Lyon, 69372, France
| | - M B Schabath
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL, 33612, U.S.A
| | - J L Messina
- Cutaneous Oncology Program, Moffitt Cancer Center, Tampa, FL, 33612, U.S.A.,Department of Pathology and Cell Biology, University of South Florida College of Medicine, Tampa, FL, U.S.A.,Department of Dermatology, University of South Florida College of Medicine, Tampa, FL, U.S.A
| | - N A Fenske
- Department of Dermatology, University of South Florida College of Medicine, Tampa, FL, U.S.A.,Department of Cutaneous Surgery, University of South Florida College of Medicine, Tampa, FL, U.S.A
| | - B S Cherpelis
- Department of Dermatology, University of South Florida College of Medicine, Tampa, FL, U.S.A.,Department of Cutaneous Surgery, University of South Florida College of Medicine, Tampa, FL, U.S.A
| | - V K Sondak
- Cutaneous Oncology Program, Moffitt Cancer Center, Tampa, FL, 33612, U.S.A
| | - M R Iannacone
- QIMR Berghofer Medical Research Institute, Cancer and Population Studies, Royal Brisbane Hospital, Herston, QLD, Australia
| | - M Schmitt
- GATC Biotech AG, Konstanz, Germany.,Infection and Cancer Program, German Cancer Research Center, Heidelberg, Germany
| | - M Pawlita
- Infection and Cancer Program, German Cancer Research Center, Heidelberg, Germany
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38
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Donà MG, Gheit T, Latini A, Benevolo M, Torres M, Smelov V, McKay-Chopin S, Giglio A, Cristaudo A, Zaccarelli M, Tommasino M, Giuliani M. Alpha, beta and gamma Human Papillomaviruses in the anal canal of HIV-infected and uninfected men who have sex with men. J Infect 2015; 71:74-84. [PMID: 25698067 DOI: 10.1016/j.jinf.2015.02.001] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Revised: 01/30/2015] [Accepted: 02/10/2015] [Indexed: 02/06/2023]
Abstract
OBJECTIVES Anal infection by cutaneous Human Papillomaviruses (HPV) has been rarely investigated. We aimed to assess the prevalence, genotype diversity, and determinants of mucosal (alpha) and cutaneous (beta and gamma) anal HPV infection in men who have sex with men (MSM). METHODS Anal samples were collected with a Dacron swab. Alpha HPVs were detected using the Linear Array HPV genotyping test, while beta and gamma HPVs using a PCR combined with Luminex technology. RESULTS A total of 609 MSM (437 HIV-uninfected and 172 HIV-infected, most of which were undergoing cART) were enrolled. Alpha, beta, and gamma HPVs were detected in 78.0%, 27.6% and 29.3% of the participants. Only alpha HPV prevalence was significantly higher among HIV-infected compared to uninfected MSM (93.0% vs. 72.1%, p < 0.0001). Beta2 and gamma10 represented the most frequent cutaneous HPV species, with no significant differences between HIV-infected and uninfected individuals. The most common alpha, beta, and gamma genotypes were HPV16, HPV111, HPV121, respectively. Alpha HPV infection was significantly associated with lifetime number of partners, receptive anal sex, and HIV status. Beta and/or gamma HPV infection showed no significant association with HIV status, socio-demographic or sexual behavioral factors. CONCLUSIONS A wide spectrum of mucosal and cutaneous HPV types is present in the anal canal. Only mucosal HPV prevalence increased significantly in cases of concomitant HIV infection.
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Affiliation(s)
- Maria Gabriella Donà
- STI/HIV Unit, San Gallicano Dermatologic Institute, IRCCS, Via Elio Chianesi 53, 00144, Rome, Italy.
| | - Tarik Gheit
- Infections and Cancer Biology Group, International Agency for Research on Cancer, 150 Cours Albert Thomas, 69372, Lyon, France
| | - Alessandra Latini
- STI/HIV Unit, San Gallicano Dermatologic Institute, IRCCS, Via Elio Chianesi 53, 00144, Rome, Italy
| | - Maria Benevolo
- Pathology Department, Regina Elena National Cancer Institute, IRCCS, Via Elio Chianesi 53, 00144, Rome, Italy
| | - Montserrat Torres
- Infections and Cancer Biology Group, International Agency for Research on Cancer, 150 Cours Albert Thomas, 69372, Lyon, France
| | - Vitaly Smelov
- Infections and Cancer Biology Group, International Agency for Research on Cancer, 150 Cours Albert Thomas, 69372, Lyon, France
| | - Sandrine McKay-Chopin
- Infections and Cancer Biology Group, International Agency for Research on Cancer, 150 Cours Albert Thomas, 69372, Lyon, France
| | - Amalia Giglio
- Clinical Pathology and Microbiology Department, San Gallicano Dermatologic Institute, IRCCS, Via Elio Chianesi 53, 00144, Rome, Italy
| | - Antonio Cristaudo
- STI/HIV Unit, San Gallicano Dermatologic Institute, IRCCS, Via Elio Chianesi 53, 00144, Rome, Italy
| | - Mauro Zaccarelli
- National Institute for Infectious Diseases "Lazzaro Spallanzani", IRCCS, Via Portuense 292, 00149, Rome, Italy
| | - Massimo Tommasino
- Infections and Cancer Biology Group, International Agency for Research on Cancer, 150 Cours Albert Thomas, 69372, Lyon, France
| | - Massimo Giuliani
- STI/HIV Unit, San Gallicano Dermatologic Institute, IRCCS, Via Elio Chianesi 53, 00144, Rome, Italy
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The Presence of Betapapillomavirus Antibodies around Transplantation Predicts the Development of Keratinocyte Carcinoma in Organ Transplant Recipients: A Cohort Study. J Invest Dermatol 2015; 135:1275-1282. [DOI: 10.1038/jid.2014.456] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Revised: 08/19/2014] [Accepted: 10/06/2014] [Indexed: 02/08/2023]
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40
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Beta genus papillomaviruses and skin cancer. Virology 2015; 479-480:290-6. [PMID: 25724416 DOI: 10.1016/j.virol.2015.02.004] [Citation(s) in RCA: 131] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Revised: 01/20/2015] [Accepted: 02/05/2015] [Indexed: 11/23/2022]
Abstract
A role for the beta genus HPVs in keratinocyte carcinoma (KC) remains to be established. In this article we examine the potential role of the beta HPVs in cancer revealed by the epidemiology associating these viruses with KC and supported by oncogenic properties of the beta HPV proteins. Unlike the cancer associated alpha genus HPVs, in which transcriptionally active viral genomes are invariably found associated with the cancers, that is not the case for the beta genus HPVs and keratinocyte carcinomas. Thus a role for the beta HPVs in KC would necessarily be in the carcinogenesis initiation and not in the maintenance of the tumor.
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41
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Li YY, Hanna GJ, Laga AC, Haddad RI, Lorch JH, Hammerman PS. Genomic analysis of metastatic cutaneous squamous cell carcinoma. Clin Cancer Res 2015; 21:1447-56. [PMID: 25589618 DOI: 10.1158/1078-0432.ccr-14-1773] [Citation(s) in RCA: 203] [Impact Index Per Article: 22.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
PURPOSE A rare 5% of cutaneous squamous cell carcinomas (cSCC) metastasize, lack FDA-approved therapies, and carry a poor prognosis. Our aim was to identify recurrent genomic alterations in this little-studied population of metastatic cSCCs. EXPERIMENTAL DESIGN We performed targeted sequencing of 504 cancer-associated genes on lymph node metastases in 29 patients with cSCC and identified mutations and somatic copy-number alterations associated with metastatic cSCC. We determined significantly mutated, deleted, and amplified genes and associated genomic alterations with clinical variables. RESULTS The cSCC genome is heterogeneous with widely varying numbers of genomic alterations and does not appear to be associated with human papillomavirus. We found previously identified recurrently altered genes (TP53, CDKN2A, NOTCH1/2) but also a wide spectrum of oncogenic mutations affecting RAS/RTK/PI3K, squamous differentiation, cell cycle, and chromatin remodeling pathway genes. Specific mutations in known oncogenic drivers and pathways were correlated with inferior patient outcomes. Our results suggest potential therapeutic targets in metastatic cSCC, including PIK3CA, FGFR3, BRAF, and EGFR, similar to those reported in SCCs of the lung and head and neck, suggesting that clinical trials could be developed to accrue patients with SCCs from multiple sites of origin. CONCLUSIONS We have genomically characterized a rare cohort of 29 metastatic cSCCs and identified a diverse array of oncogenic alterations that can guide future studies of this disease.
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Affiliation(s)
- Yvonne Y Li
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts. Broad Institute, Cambridge, Massachusetts
| | - Glenn J Hanna
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Alvaro C Laga
- Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Robert I Haddad
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts. Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts. Department of Medicine, Harvard Medical School, Boston, Massachusetts
| | - Jochen H Lorch
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts. Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts. Department of Medicine, Harvard Medical School, Boston, Massachusetts.
| | - Peter S Hammerman
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts. Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts. Department of Medicine, Harvard Medical School, Boston, Massachusetts.
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42
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Schmidt SAJ, Hamilton-Dutoit SJ, Farkas DK, Steiniche T, Sørensen HT. Human papillomavirus and the incidence of nonmelanoma and melanoma skin cancer using cervical conization as a surrogate marker: a nationwide population-based Danish cohort study. Ann Epidemiol 2015; 25:293-296.e2. [PMID: 25560876 DOI: 10.1016/j.annepidem.2014.12.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Revised: 11/28/2014] [Accepted: 12/03/2014] [Indexed: 02/07/2023]
Abstract
PURPOSE Human papillomavirus' (HPV's) role in skin cancer is controversial. To examine whether an individual is prone to develop a chronic oncogenic infection, we conducted a nationwide population-based cohort study of the risk of skin cancer after another HPV-related neoplasia-that is, cervical high-grade dysplasia or carcinoma-using cervical conization as a surrogate marker. METHODS Using Danish registries, we identified all women who underwent conization from 1978 to 2011 (n = 87,164) and followed them until first-time skin cancer diagnosis, death, emigration, or 31 December 2011, whichever came first. We calculated standardized incidence ratios (SIRs) and 95% confidence intervals (CIs) for basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and malignant melanoma (MM) according to national incidence rates. RESULTS The 1-year absolute risks were 0.0012%, 0.045%, and 0.029% for SCC, BCC, and MM, respectively. Conization was clearly associated with increased incidence of SCC (SIR = 1.37; 95% CI: 1.13-1.65), but not MM (SIR = 1.00; 95% CI: 0.91-1.11). BCC risk was slightly increased (SIR = 1.08; 95% CI: 1.02-1.13). CONCLUSIONS The association between conization and cutaneous SCC provides evidence for conization as a marker of underlying general susceptibility to oncogenic HPV.
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Affiliation(s)
| | | | | | - Torben Steiniche
- Institute of Pathology, Aarhus University Hospital, Aarhus C, Denmark
| | - Henrik Toft Sørensen
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus N, Denmark
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Abstract
Human papillomaviruses (HPVs) infect the squamous epithelium and can induce benign and malignant lesions. To date, more than 200 different HPV types have been identified and classified into five genera, α, β, γ, μ, and ν. While high-risk α mucosal HPVs have a well-established role in cervical carcinoma and a significant percentage of other anogenital tract and oral carcinomas, the biology of the cutaneous β HPVs and their contribution to non-melanoma skin cancer (NMSC) has been less studied. Although the association of β HPV infection with NMSC in patients with a rare, genetically determined condition, epidermodysplasia verruciformis has been well established, the role of β HPV infection with NMSC in the normal population remains controversial. In stark contrast to α HPV-associated cancers, the presence of the β HPV genome does not appear to be mandatory for the maintenance of the malignant phenotype. Moreover, the mechanism of action of the β HPV E6 and E7 oncoproteins differs from the β HPV oncoproteins.
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Affiliation(s)
- Margaret E McLaughlin-Drubin
- Division of Infectious Diseases, Brigham and Women's Hospital, Department of Medicine, Harvard Medical School, Boston, MA.
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44
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Accardi R, Gheit T. Cutaneous HPV and skin cancer. Presse Med 2014; 43:e435-43. [DOI: 10.1016/j.lpm.2014.08.008] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Accepted: 08/25/2014] [Indexed: 12/31/2022] Open
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45
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Schrama D, Groesser L, Ugurel S, Hafner C, Pastrana DV, Buck CB, Cerroni L, Theiler A, Becker JC. Presence of human polyomavirus 6 in mutation-specific BRAF inhibitor-induced epithelial proliferations. JAMA Dermatol 2014; 150:1180-6. [PMID: 24943872 PMCID: PMC8369517 DOI: 10.1001/jamadermatol.2014.1116] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
IMPORTANCE A frequent adverse effect of mutation-specific BRAF inhibitor therapy is the induction of epithelial proliferations including cutaneous squamous cell carcinomas. To date, the only factor identified contributing to their development is the activation of the mitogen-activated signal transduction cascade by mutations in the RAS genes. However, these mutations explain only 60% of the tumors; hence, it is important to identify what is causing the remaining tumors. OBJECTIVE To test for the presence of human papillomaviruses (HPVs) and the recently identified human polyomaviruses (HPyVs), Merkel cell polyomavirus (MCPyV), and trichodysplasia spinulosa-associated polyomavirus (TSPyV), as well as HPyV-6, HPyV-7, HPyV-9, and HPyV-10, in epithelial proliferations occurring after BRAF inhibitor therapy to determine whether these oncogenic viruses may contribute to BRAF inhibitor-induced skin tumors. DESIGN, SETTING, AND PARTICIPANTS Retrospective study at a university hospital in Austria of epithelial proliferations that developed in patients with melanoma after initiation of treatment with the BRAF inhibitor vemurafenib. Samples were analyzed for (1) presence of the most frequently observed RAS mutations by SNaPshot technology, (2) detection of the viruses by real-time polymerase chain reaction, and (3) presence of capsid proteins of the most abundantly detected virus by immunohistochemical analysis. MAIN OUTCOMES AND MEASURES RAS mutational status, as well as HPV and HPyV presence, in BRAF inhibitor-induced epithelial proliferations. RESULTS Eighteen biopsy samples from 6 patients were retrieved from our hospital's archive. We identified RAS mutations in 10 (62%) of the 16 samples with clear results. DNA of HPyV-9, HPyV-10, and TSPyV were virtually absent in the samples. MCPyV DNA was present in 13 of 18 samples, and HPV, HPyV-6, and HPyV-7 DNA were present in all samples. In general, the amount of DNA encoding the latter viruses was rather low, with the exception of HPyV-6 in several samples of 1 individual patient. Notably, the relevance of the presence of HPyV-6 in the epithelial proliferation was underlined by immunohistochemical detection of the core protein VP1 of HPyV-6. CONCLUSIONS AND RELEVANCE The presence of both high HPyV-6 DNA load and VP1 protein suggests that polyomaviruses may contribute to the epithelial proliferations observed in patients receiving BRAF inhibitor therapy, albeit the relative impact as compared with that of RAS mutations appears circumstantial.
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Affiliation(s)
- David Schrama
- Department of Dermatology, Medical University of Graz, Graz, Austria2Department of Dermatology, University Hospital Würzburg, Würzburg, Germany
| | - Leopold Groesser
- Department of Dermatology, University Hospital Regensburg, Regensburg, Germany
| | - Selma Ugurel
- Department of Dermatology, University Hospital Würzburg, Würzburg, Germany
| | - Christian Hafner
- Department of Dermatology, University Hospital Regensburg, Regensburg, Germany
| | - Diana V Pastrana
- Laboratory of Cellular Oncology, National Cancer Institute, Bethesda, Maryland
| | - Christopher B Buck
- Laboratory of Cellular Oncology, National Cancer Institute, Bethesda, Maryland
| | - Lorenzo Cerroni
- Department of Dermatology, Medical University of Graz, Graz, Austria
| | - Anna Theiler
- Department of Dermatology, Medical University of Graz, Graz, Austria
| | - Jürgen C Becker
- Department of Dermatology, Medical University of Graz, Graz, Austria
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46
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Hampras SS, Giuliano AR, Lin HY, Fisher KJ, Abrahamsen ME, Sirak BA, Iannacone MR, Gheit T, Tommasino M, Rollison DE. Natural history of cutaneous human papillomavirus (HPV) infection in men: the HIM study. PLoS One 2014; 9:e104843. [PMID: 25198694 PMCID: PMC4157763 DOI: 10.1371/journal.pone.0104843] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2014] [Accepted: 07/16/2014] [Indexed: 12/13/2022] Open
Abstract
Accumulating evidence suggests that cutaneous human papillomavirus (HPV) infection is associated with non-melanoma skin cancer (NMSC). Little is known about the natural history of cutaneous HPV. A sub-cohort of 209 men with no NMSC history, initially enrolled in the HPV infection in men (HIM) study, were followed for a median of 12.6 months. Epidemiological data were collected through self-administered questionnaires. Cutaneous HPV DNA was measured in normal skin swabs (SS) and eyebrow hairs (EB) for 25 and 16 HPV types in genera β and γ, respectively. Any β HPV infection was more prevalent in SS (67.3%) compared to EB (56.5%, p = 0.04). Incidence in SS was higher than 20 per 1,000 person-months for HPV types 4, 5, 23, 38 and 76. Median duration of persistence of β and γ HPV infection was 8.6 and 6.1 months in EB, respectively, and 11.3 months and 6.3 months, in SS, respectively. Older age (>44 years vs. 18-30 years) was significantly associated with prevalent (SS OR = 3.0, 95% CI = 1.2–7.0) and persistent β HPV infection (EB OR = 6.1, 95% CI = 2.6–14.1). History of blistering sunburn was associated with prevalent (OR = 2.8, 95% CI = 1.3–5.8) and persistent (OR = 2.3, 95% CI = 1.2–4.6) β HPV infection in SS. Cutaneous HPV is highly prevalent in men, with age and blistering sunburn being significant risk factors for cutaneous β HPV infection.
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Affiliation(s)
- Shalaka S. Hampras
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida, United States of America
| | - Anna R. Giuliano
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida, United States of America
| | - Hui-Yi Lin
- Department of Biostatistics, Moffitt Cancer Center, Tampa, Florida, United States of America
| | - Kate J. Fisher
- Department of Biostatistics, Moffitt Cancer Center, Tampa, Florida, United States of America
| | - Martha E. Abrahamsen
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida, United States of America
| | - Bradley A. Sirak
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida, United States of America
| | - Michelle R. Iannacone
- QIMR Berghofer Medical Research Institute, Cancer and Population Studies, Royal Brisbane Hospital, Brisbane, Queensland, Australia
| | - Tarik Gheit
- Infections and Cancer Biology Group, International Agency for Research on Cancer-World Health Organization, Lyon, France
| | - Massimo Tommasino
- Infections and Cancer Biology Group, International Agency for Research on Cancer-World Health Organization, Lyon, France
| | - Dana E. Rollison
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida, United States of America
- * E-mail:
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47
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Cobos C, Figueroa JA, Mirandola L, Colombo M, Summers G, Figueroa A, Aulakh A, Konala V, Verma R, Riaz J, Wade R, Saadeh C, Rahman RL, Pandey A, Radhi S, Nguyen DD, Jenkins M, Chiriva-Internati M, Cobos E. The role of human papilloma virus (HPV) infection in non-anogenital cancer and the promise of immunotherapy: a review. Int Rev Immunol 2014; 33:383-401. [PMID: 24811210 DOI: 10.3109/08830185.2014.911857] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Over the past 30 years, human papilloma virus (HPV) has been shown to play a role in the development of various cancers. Most notably, HPV has been linked to malignant progression in neoplasms of the anogenital region. However, high-risk HPV has also been suggested to play a significant role in the development of cancers in other anatomic locations, such as the head and neck, lung, breast and bladder. In 2006, the first vaccine for HPV, Gardasil, was approved for the prevention of subtypes 6, 11, 16 and 18. A few years later, Cevarix was approved for the prevention of subtypes 16 and 18, the HPV subtypes most frequently implicated in malignant progression. Although increased awareness and vaccination could drastically decrease the incidence of HPV-positive cancers, these approaches do not benefit patients who have already contracted HPV and developed cancer as a result. For this reason, researchers need to continue developing treatment modalities, such as targeted immunotherapies, for HPV-positive lesions. Here, we review the potential evidence linking HPV infection with the development of non-anogenital cancers and the potential role of immunotherapy in the prevention and eradication of HPV infection and its oncogenic sequela.
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Affiliation(s)
- Chris Cobos
- 1Department of Internal Medicine at the Division of Hematology & Oncology, Texas Tech University Health Sciences Center and Southwest Cancer Treatment and Research Center, Lubbock, TX, USA
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48
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Farzan SF, Karagas MR, Christensen BC, Li Z, Kuriger JK, Nelson HH. RNASEL and MIR146A SNP-SNP interaction as a susceptibility factor for non-melanoma skin cancer. PLoS One 2014; 9:e93602. [PMID: 24699816 PMCID: PMC3974770 DOI: 10.1371/journal.pone.0093602] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2013] [Accepted: 03/06/2014] [Indexed: 02/02/2023] Open
Abstract
Immunity and inflammatory pathways are important in the genesis of non-melanoma skin cancers (NMSC). Functional genetic variation in immune modulators has the potential to affect disease etiology. We investigated associations between common variants in two key regulators, MIR146A and RNASEL, and their relation to NMSCs. Using a large population-based case-control study of basal cell (BCC) and squamous cell carcinoma (SCC), we investigated the impact of MIR146A SNP rs2910164 on cancer risk, and interaction with a SNP in one of its putative targets (RNASEL, rs486907). To examine associations between genotype and BCC and SCC, occurrence odds ratios (OR) and 95% confidence intervals (95%CI) were calculated using unconditional logistic regression, accounting for multiple confounding factors. We did not observe an overall change in the odds ratios for SCC or BCC among individuals carrying either of the RNASEL or MIR146A variants compared with those who were wild type at these loci. However, there was a sex-specific association between BCC and MIR146A in women (ORGC = 0.73, [95%CI = 0.52-1.03]; ORCC = 0.29, [95% CI = 0.14-0.61], p-trend<0.001), and a reduction in risk, albeit not statistically significant, associated with RNASEL and SCC in men (ORAG = 0.88, [95%CI = 0.65-1.19]; ORAA = 0.68, [95%CI = 0.43-1.08], p-trend = 0.10). Most striking was the strong interaction between the two genes. Among individuals carrying variant alleles of both rs2910164 and rs486907, we observed inverse relationships with SCC (ORSCC = 0.56, [95%CI = 0.38-0.81], p-interaction = 0.012) and BCC (ORBCC = 0.57, [95%CI = 0.40-0.80], p-interaction = 0.005). Our results suggest that genetic variation in immune and inflammatory regulators may influence susceptibility to NMSC, and novel SNP-SNP interaction for a microRNA and its target. These data suggest that RNASEL, an enzyme involved in RNA turnover, is controlled by miR-146a and may be important in NMSC etiology.
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Affiliation(s)
- Shohreh F. Farzan
- Department of Community and Family Medicine, Section of Biostatistics and Epidemiology, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, United States of America
- Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, United States of America
| | - Margaret R. Karagas
- Department of Community and Family Medicine, Section of Biostatistics and Epidemiology, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, United States of America
- Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, United States of America
| | - Brock C. Christensen
- Department of Community and Family Medicine, Section of Biostatistics and Epidemiology, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, United States of America
- Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, United States of America
- Department of Pharmacology and Toxicology, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, United States of America
| | - Zhongze Li
- Department of Community and Family Medicine, Section of Biostatistics and Epidemiology, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, United States of America
- Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, United States of America
| | - Jacquelyn K. Kuriger
- Division of Epidemiology and Community Health, The Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - Heather H. Nelson
- Division of Epidemiology and Community Health, The Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota, United States of America
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49
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Tommasino M. The human papillomavirus family and its role in carcinogenesis. Semin Cancer Biol 2013; 26:13-21. [PMID: 24316445 DOI: 10.1016/j.semcancer.2013.11.002] [Citation(s) in RCA: 255] [Impact Index Per Article: 23.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2013] [Revised: 11/22/2013] [Accepted: 11/27/2013] [Indexed: 01/17/2023]
Abstract
Human papillomaviruses (HPVs) are a family of small double-stranded DNA viruses that have a tropism for the epithelia of the genital and upper respiratory tracts and for the skin. Approximately 150 HPV types have been discovered so far, which are classified into several genera based on their DNA sequence. Approximately 15 high-risk mucosal HPV types are clearly associated with cervical cancer; HPV16 and HPV18 are the most carcinogenic since they are responsible for approximately 50% and 20% of all cervical cancers worldwide, respectively. It is now also clear that these viruses are linked to a subset of other genital cancers, as well as head and neck cancers. Due to their high level of carcinogenic activity, HPV16 and HPV18 are the most studied HPV types so far. Biological studies have highlighted the key roles in cellular transformation of the products of two viral early genes, E6 and E7. Many of the mechanisms of E6 and E7 in subverting the regulation of fundamental cellular events have been fully characterized, contributing not only to our knowledge of how the oncogenic viruses promote cancer development but also to our understanding of basic cell biology. Despite HPV research resulting in extraordinary achievements in the last four decades, significantly improving the screening and prophylaxis of HPV-induced lesions, additional research is necessary to characterize the biology and epidemiology of the vast number of HPV types that have been poorly investigated so far, with a final aim of clarifying their potential roles in other human diseases.
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Affiliation(s)
- Massimo Tommasino
- Infections and Cancer Biology Group, International Agency for Research on Cancer - World Health Organization, 150 Cours Albert-Thomas, 69372 Lyon cedex 08, France.
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50
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Iannacone MR, Gheit T, Pfister H, Giuliano AR, Messina JL, Fenske NA, Cherpelis BS, Sondak VK, Roetzheim RG, Silling S, Pawlita M, Tommasino M, Rollison DE. Case-control study of genus-beta human papillomaviruses in plucked eyebrow hairs and cutaneous squamous cell carcinoma. Int J Cancer 2013; 134:2231-44. [PMID: 24136717 DOI: 10.1002/ijc.28552] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2013] [Accepted: 09/27/2013] [Indexed: 12/17/2022]
Abstract
Cutaneous human papillomaviruses (HPV) have been reported in cutaneous squamous cell carcinoma (SCC). We conducted a clinic-based case-control study to investigate the association between genus-beta HPV DNA in eyebrow hairs (EBH) and SCC. EBH from 168 SCC cases and 290 controls were genotyped for genus-beta HPV DNA. SCC tumors from a subset of cases (n = 142) were also genotyped. Viral load was determined in a subset of specimens positive for a single HPV type. Associations with SCC were estimated by odds ratios (OR) and 95% confidence intervals (CI) adjusted for age and sex using logistic regression. Statistical tests were two-sided. EBH DNA prevalence was greater in cases (87%) than controls (73%) (p < 0.05), and the association with SCC increased with the number of HPV types present, (≥ 4 types vs. HPV-negative: OR = 2.02, 95% CI = 1.07-3.80; p(trend) = 0.02). Type-specific associations were observed between SCC and DNA in EBH for HPV23 (OR = 1.90, 95% CI = 1.10-3.30) and HPV38 (OR = 1.84, 95% CI = 1.04-3.24). Additionally, when compared with the controls, the DNA prevalence in EBH was significantly higher among cases for 11 of the 25 genus-beta types tested, when accounting for DNA for the same HPV type in the tumor (ORs = 3.44-76.50). Compared to controls, the mean viral DNA load in EBH among the selected cases was greater for HPV5, HPV8 and HPV24, but lower for HPV38. SCC cases were more likely than controls to have HPV DNA+ EBH for single and multiple HPV types, providing additional support for the potential role of genus-beta HPV infections in SCC development.
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Affiliation(s)
- Michelle R Iannacone
- Infections and Cancer Biology (ICB) Group, International Agency for Research on Cancer, Lyon, Cedex, 08, France
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