Human BK Polyomavirus-The Potential for Head and Neck Malignancy and Disease

Cytomegalovirus in Adenoma and Carcinoma Lesions: Detecting Mono-Infection and Co-Infection in Salivary Glands

Salivary glands' neoplasms are hard to diagnose and present a complex etiology. However, several viruses have been detected in these neoplasms, such as HCMV, which can play a role in certain cancers through oncomodulation. The co-infections between HCMV with betaherpesviruses (HHV-6 and HHV-7) and polyomaviruses (JCV and BKV) has been investigated. The aim of the current study is to describe the frequency of HCMV and co-infections in patients presenting neoplastic and non-neoplastic lesions, including in the salivary gland. Multiplex quantitative polymerase chain reaction was used for betaherpesvirus and polyomavirus quantification purposes after DNA extraction. In total, 50.7% of the 67 analyzed samples were mucocele, 40.3% were adenoma pleomorphic, and 8.9% were mucoepidermoid carcinoma. Overall, 20.9% of samples presented triple-infections with HCMV/HHV-6/HHV-7, whereas 9.0% were co-infections with HCMV/HHV-6 and HCMV/HHV-7. The largest number of co-infections was detected in pleomorphic adenoma cases. All samples tested negative for polyomaviruses, such as BKV and JCV. It was possible to conclude that HCMV can be abundant in salivary gland lesions. A high viral load can be useful to help better understand the etiological role played by viruses in these lesions. A lack of JCV and BKV in the samples analyzed herein does not rule out the involvement of these viruses in one or more salivary gland lesion subtypes.

BK polyomavirus: latency, reactivation, diseases and tumorigenesis

The identification of the first human polyomavirus BK (BKV) has been over half century, The previous epidemiological and phylogenetic studies suggest that BKV prevailed and co-evolved with humans, leading to high seroprevalence all over the world. In general, BKV stays latent and symptomless reactivation in healthy individuals. BKV has been mainly interlinked with BKV-associated nephropathy (BKVAN) in kidney-transplant recipients and hemorrhagic cystitis (HC) in hematopoietic stem cell transplant recipients (HSCTRs). However, the mechanisms underlying BKV latency and reactivation are not fully understood and lack of extensive debate. As Merkel cell polyomavirus (MCV) was identified as a pathogenic agent of malignant cutaneous cancer Merkel cell carcinoma (MCC) since 2008, linking BKV to tumorigenesis of urologic tumors raised concerns in the scientific community. In this review, we mainly focus on advances of mechanisms of BKV latency and reactivation, and BKV-associated diseases or tumorigenesis with systematical review of formerly published papers following the PRISMA guidelines. The potential tumorigenesis of BKV in two major types of cancers, head and neck cancer and urologic cancer, was systematically updated and discussed in depth. Besides, BKV may also play an infectious role contributing to HIV-associated salivary gland disease (HIVSGD) presentation. As more evidence indicates the key role of BKV in potential tumorigenesis, it is important to pay more attention on its etiology and pathogenicity in vitro and in vivo.

Polyomavirus JCPyV infrequently detectable in adenoid cystic carcinoma of the oral cavity and the airways

Our objective was to assess the presence of three polyomaviruses, namely SV40, JCPyV, and BKPyV, and human papillomaviruses (HPV) in adenoid cystic carcinomas (ACC) of the minor salivary glands (MiSG) in the head and neck region. The study comprised 68 MiSG ACC patients operated during 1974–2012 at the Helsinki University Hospital (Helsinki, Finland). Medical records and 68 histological samples were reviewed. Polyomaviruses were detected with quantitative PCR and the DNA-positive samples were further analyzed for the presence of viral tumor T antigen (T-ag) with immunohistochemistry. HPV genotyping was performed with a Multiplex HPV Genotyping Kit. Only JCPyV DNA was found in ACC samples, being present in 7 (10.3%) out of the 68 samples. The viral load of JCPyV was low varying between 1 to 226 copies/μg DNA. The JCPyV-positive samples originated from trachea (two samples), paranasal sinuses (one), and oral cavity (two). Additionally, JCPyV positivity was found in one lung metastasis of a tracheal tumor and one local disease failure of an oral cavity tumor. Three JCPyV DNA-positive samples showed weak nuclear staining for large T-ag. In conclusion, only JCPyV but not SV40, BKPyV, or HPV was found in ACC from the upper and lower airways. JCPyV copy numbers were low which might support its role as a “hit and run agent” in ACC carcinogenesis.

BK Virus in Cancer Development

Polyomavirus (PyV) was discovered by accident in 1950 in the course of describing an infectious factor causing multiple tumours in rodents. The term is derived from two Greek words: poly (many) and oma (tumour). At present the family of human polyomaviruses (HPyV) consists of 10 members. One of the first members was BK virus, isolated in 1971 from the urine of a renal transplant patient. Serological examinations have shown that due to its ability to cause latent infection, about 90% of the general population can have specific antibodies attesting infection. In the case of infected persons with normal immunity, this virus is not dangerous. In the impaired immunity, however, loss of immunity results in virus reactivation and development of many life-threatening illnesses. Serological examinations have also reveal that BK polyomavirus considerably affects the development of cancers in humans. Hence, in 2012 a group of 26 researchers from 11 countries associated with the International Agency for Research on Cancer (a part of the World Health Organisation) classified BK polyomavirus within group 2B - “potentially carcinogenic to humans”

Coinfection with Epstein-Barr Virus (EBV), Human Papilloma Virus (HPV) and Polyoma BK Virus (BKPyV) in Laryngeal, Oropharyngeal and Oral Cavity Cancer

Most research providing evidence for the role of oncogenic viruses in head and neck squamous cell carcinoma (SCC) development is focused on one type of virus without analyzing possible interactions between two or more types of viruses. The aim of this study was to analyse the prevalence of co-infection with human papillomavirus (HPV), Epstein–Barr virus (EBV) and polyoma BK virus (BKPyV) in oral, oropharyngeal and laryngeal squamous cell carcinomas in Polish patients. The correlations between viral infection, SCC, demographic parameters, evidence of metastases and grading were also investigated. Fresh-frozen tumour tissue samples were collected from 146 patients with laryngeal, oropharyngeal and oral cancer. After DNA extraction, the DNA of the studied viruses was detected using polymerase chain rection (PCR) assay. Males (87.7%) with a history of smoking (70.6%) and alcohol abuse (59.6%) prevailed in the studied group. Histological type G2 was recognized in 64.4% cases. The patients were most frequently diagnosed with T2 stage (36.3%) and with N1 stage (45.8%). Infection with at least two viruses was detected in 56.2% of patients. In this group, co-infection with HPV/EBV was identified in 34.1% of cases, EBV/BKV in 23.2%, HPV/BKV in 22.0%, and HPV/EBV/BKV in 20.7%. No difference of multiple infection in different locations of cancer was observed. The prevalence of poorly differentiated tumours (G3) was more frequent in co-infection with all three viruses than EBV or BKV alone. A significant correlation was observed between tumour dimensions (T) and lymph-node involvement (N) in co-infected patients compared to single infection. Further studies are necessary to clarify whether co-infection plays an important role in the initiation and/or progression of oncogenic transformation of oral, oropharyngeal and laryngeal epithelial cells.

The Association between the History of HIV Diagnosis and Oral Health

Unmet oral care needs are high among people living with human immunodeficiency virus (HIV)/AIDS (PLWH). Oral health care is of increasing importance as life expectancy is being prolonged extensively among PLWH. The benefit of oral health care in relation to time since HIV diagnosis has not previously been assessed. A retrospective multivariable analysis of the Special Project of National Significance Oral Health Initiative observational cohort study ( N = 2,178) was performed to estimate the odds ratios (ORs) of oral health outcomes comparing historically diagnosed subjects (>1 y since HIV diagnosis) to newly diagnosed subjects (≤1 y since HIV diagnosis). ORs were adjusted for age, study site, language, income, last dental care visit, and dental insurance. Historically diagnosed subjects were more likely to report oral problems than newly HIV-diagnosed subjects (OR, 2.10). Historically diagnosed subjects were more likely to require oral surgery (OR, 1.52), restorative treatment (OR, 1.35), endodontic treatment (OR, 1.63), and more than 10 oral clinic visits over the 24-mo study period (OR, 2.02). The crude cumulative 2-y risk of requiring prosthetic (risk difference [RD], 0.21) and endodontic (RD, 0.11) treatment was higher among historically than newly diagnosed subjects, despite no significance postadjustment. Furthermore, poor oral health outcomes were exacerbated among non-highly active antiretroviral therapy users. Summarizing, the authors found that historically diagnosed subjects were more likely to report oral problems and require dental procedures compared with newly diagnosed subjects, suggesting that oral health among PLWH declines over time since HIV diagnosis. Hence, newly diagnosed PLWH may benefit from the implementation of early oral interventions.