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Wijesekera A, Weeramange CE, Vasani S, Kenny L, Knowland E, Seneviratne J, Punyadeera C. Surveillance of human papillomavirus through salivary diagnostics - A roadmap to early detection of oropharyngeal cancer in men. Tumour Virus Res 2024; 17:200278. [PMID: 38442788 PMCID: PMC10937231 DOI: 10.1016/j.tvr.2024.200278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 02/23/2024] [Accepted: 02/26/2024] [Indexed: 03/07/2024] Open
Abstract
Human papillomavirus (HPV) is the most common sexually transmitted disease. Certain strains have the potential to cause malignancy in multiple anatomical sites if not cleared by the immune system. In most infected people, HPV is cleared within two years. However, HPV may persist in susceptible individuals with certain risk factors, eventually leading to malignancy. New evidence suggests that over 75% of all oropharyngeal cancers (OPC) are directly attributable to HPV. It is estimated that prophylactic HPV vaccination alone may take at least 25 years to have a significant impact on reducing the incidence of OPC. The temporal link between detection of oral HPV, persistence of the infection and the subsequent development of OPC have been well established. Moreover, men have threefold higher risk than women for acquiring HPV-OPC. This comprehensive review focuses on OPC development in men, highlighting the risk factors associated with malignant transformation of HPV-OPC. Current evidence is insufficient to determine whether early identification of at-risk demographics, screening, and prompt diagnosis result in improved outcomes. Hitherto, the effectiveness of an oral HPV screening program in this regard has not been investigated. Nevertheless, the potential to emulate the success of the cervical screening program remains a very real possibility.
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Affiliation(s)
- Akila Wijesekera
- Griffith Institute for Drug Discovery, School of Environment and Science, Griffith University, Queensland, Australia; Royal Brisbane and Women's Hospital, Queensland, Australia.
| | - Chameera Ekanayake Weeramange
- Griffith Institute for Drug Discovery, School of Environment and Science, Griffith University, Queensland, Australia
| | - Sarju Vasani
- Griffith Institute for Drug Discovery, School of Environment and Science, Griffith University, Queensland, Australia; Royal Brisbane and Women's Hospital, Queensland, Australia
| | - Liz Kenny
- Royal Brisbane and Women's Hospital, Queensland, Australia; Faculty of Medicine, University of Queensland, Queensland, Australia
| | - Emma Knowland
- Metro North Sexual Health and HIV Service, Queensland, Australia
| | | | - Chamindie Punyadeera
- Griffith Institute for Drug Discovery, School of Environment and Science, Griffith University, Queensland, Australia; Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.
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Amato M, Santonocito S, Bruno MT, Polizzi A, Mastroianni A, Chaurasia A, Isola G. Oral and periodontal manifestation related during human papilloma virus infections: Update on early prognostic factors. Heliyon 2024; 10:e31061. [PMID: 38813162 PMCID: PMC11133762 DOI: 10.1016/j.heliyon.2024.e31061] [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: 02/07/2024] [Revised: 04/11/2024] [Accepted: 05/09/2024] [Indexed: 05/31/2024] Open
Abstract
Human Papilloma Virus (HPV) is considered one of the most common sexually transmitted infections and has been shown to play an important role in the pathogenesis of squamous cell carcinomas (SCC) of the cervix and head and neck. Manifestations of HPV infections can be manifold, ranging from asymptomatic infections to benign or potentially malignant lesions to intraepithelial neoplasms and invasive carcinomas. The heterogeneity of clinical manifestations from HPV infection depends on the interactions between the viral agent and the host, a direct consequence of the ability on the part of HPV is to remain silent and to evade and convey the action of the host immune system. The oral mucosa represents one of the tissues for which HPV has a distinct tropism and is frequently affected by infection. While much information is available on the role that HPV infection plays in the development of SCC in the oral cavity, there is less information on asymptomatic infections and benign HPV-induced oral lesions. Therefore, the purpose of this review is to analyze, in light of current knowledge, the early clinical and bio-humoral prognostic features related to the risk of HPV malignant transformation, focusing on subclinical conditions, benign lesions, and the correlation between oral infection and infection in other districts. The data show that the main risk associated with HPV infection is related to malignant transformation of lesions. Although HPV-driven OPSCC is associated with a better prognosis than non-HPV-driven OPSCC, primary prevention and early detection of the infection and affected genotype are essential to reduce the risk of malignant neoplastic complications and improve the prognosis.
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Affiliation(s)
- Mariacristina Amato
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, AOU "Policlinico-San Marco", Via S. Sofia 78, 95124, Catania, Italy
| | - Simona Santonocito
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, AOU "Policlinico-San Marco", Via S. Sofia 78, 95124, Catania, Italy
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, University of Messina, 98100 Messina, Italy
| | - Maria Teresa Bruno
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, AOU "Policlinico-San Marco", Via S. Sofia 78, 95124, Catania, Italy
- Research Center of “Human Papilloma Virus” University of Catania, AOU "Policlinico-San Marco", Via S. Sofia 78, 95124, Catania, Italy
| | - Alessandro Polizzi
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, AOU "Policlinico-San Marco", Via S. Sofia 78, 95124, Catania, Italy
| | - Alessandro Mastroianni
- Dentistry Unit, Department of Clinical Sciences and Translational Medicine, University of Tor Vergata, 00133, Rome, Italy
| | - Akhilanand Chaurasia
- Department of Oral Medicine & Radiology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Gaetano Isola
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, AOU "Policlinico-San Marco", Via S. Sofia 78, 95124, Catania, Italy
- Research Center of “Human Papilloma Virus” University of Catania, AOU "Policlinico-San Marco", Via S. Sofia 78, 95124, Catania, Italy
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Ekanayake Weeramange C, Tang KD, Irwin D, Hartel G, Langton-Lockton J, Ladwa R, Kenny L, Taheri T, Whitfield B, Vasani S, Punyadeera C. Human papillomavirus (HPV) DNA methylation changes in HPV-associated head and neck cancer. Carcinogenesis 2024; 45:140-148. [PMID: 38270218 PMCID: PMC10925951 DOI: 10.1093/carcin/bgae001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 10/23/2023] [Accepted: 01/23/2024] [Indexed: 01/26/2024] Open
Abstract
Despite the rising incidence, currently, there are no early detection methods for HPV-driven HNC (HPV-HNC). Cervical cancer studies suggest that HPV DNA methylation changes can be used as a biomarker to discriminate cancer patients from HPV-infected individuals. As such, this study was designed to establish a protocol to evaluate DNA methylation changes in HPV late genes and long control region (LCR) in saliva samples of HPV-HNC patients and HPV-positive controls. Higher methylation levels were detected in HPV late genes (L1 and L2) in both tumour and saliva samples of HPV-HNC patients compared with HPV-positive controls. Moreover, methylation patterns between tumours and corresponding saliva samples were observed to have a strong correlation (Passing-Bablok regression analysis; τ = 0.7483, P < 0.0001). Considering the differences between HNC and controls in methylation levels in late genes, and considering primer amplification efficiencies, 13 CpG sites located at L1 and L2 genes were selected for further evaluation. A total of 18 HNC saliva samples and 10 control saliva samples were assessed for the methylation levels in the selected sites. From the CpG sites evaluated statistically significant differences were identified for CpG sites at L2-CpG 6 (P = 0.0004), L1-CpG 3 (P = 0.0144), L1-CpG 2 (P = 0.0395) and L2-CpG 19 (P = 0.0455). Our pilot data indicate that higher levels of DNA methylation in HPV late genes are indicative of HPV-HNC risk, and it is a potential supplementary biomarker for salivary HPV detection-based HPV-HNC screening.
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Affiliation(s)
- Chameera Ekanayake Weeramange
- Saliva and Liquid Biopsy Translational Laboratory, Griffith Institute for Drug Discovery (GRIDD), Griffith University, Nathan, Queensland 4111, Australia
- Menzies Health Institute Queensland (MIHQ), Griffith University, Gold Coast, Queensland 4222, Australia
- Faculty of Health, School of Biomedical Science, Centre for Biomedical Technologies, Queensland University of Technology, Kelvin Grove, Queensland 4059, Australia
- Department of Medical Laboratory Sciences, Faculty of Health Sciences, The Open University of Sri Lanka, Nugegoda, Sri Lanka
| | - Kai Dun Tang
- EDA School of Biological Sciences and Biotechnology, Nankai International Advanced Research Institute (Shenzhen Futian), Nankai University, Tianjin, 300071, P.R. China
| | - Darryl Irwin
- Agena Bioscience, Bowen Hills, Queensland 4006, Australia
| | - Gunter Hartel
- Statistics Unit, QIMR Berghofer Medical Research Institute, Herston, Queensland 4006, Australia
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
- School of Nursing, Queensland University of Technology, Brisbane, Queensland, Australia
| | | | - Rahul Ladwa
- Department of Cancer Care Services, Princess Alexandra Hospital, Woolloongabba, Queensland 4102, Australia
- Faculty of Medicine, The University of Queensland, Herston, Queensland 4006, Australia
| | - Lizbeth Kenny
- Faculty of Medicine, The University of Queensland, Herston, Queensland 4006, Australia
- Department of Cancer Care Services, Royal Brisbane and Women’s Hospital, Herston, Queensland 4006, Australia
| | - Touraj Taheri
- Faculty of Medicine, The University of Queensland, Herston, Queensland 4006, Australia
- Department of Anatomical Pathology, Royal Brisbane and Women’s Hospital, Herston, Queensland 4006, Australia
| | - Bernard Whitfield
- Department of Otolaryngology, Head and Neck Surgery, Princess Alexandra and Logan Hospitals, Meadowbrook, Queensland 4131, Australia
- School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland 4222, Australia
| | - Sarju Vasani
- Faculty of Medicine, The University of Queensland, Herston, Queensland 4006, Australia
- Department of Otolaryngology, Royal Brisbane and Women’s Hospital, Herston, Queensland 4006, Australia
| | - Chamindie Punyadeera
- Saliva and Liquid Biopsy Translational Laboratory, Griffith Institute for Drug Discovery (GRIDD), Griffith University, Nathan, Queensland 4111, Australia
- Menzies Health Institute Queensland (MIHQ), Griffith University, Gold Coast, Queensland 4222, Australia
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Tang KD, Amenábar JM, Schussel JL, Torres-Pereira CC, Bonfim C, Dimitrova N, Hartel G, Punyadeera C. Profiling salivary miRNA expression levels in Fanconi anemia patients - a pilot study. Odontology 2024; 112:299-308. [PMID: 37458838 PMCID: PMC10776736 DOI: 10.1007/s10266-023-00834-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 06/25/2023] [Indexed: 01/10/2024]
Abstract
The overarching goal of this study is to predict the risk of developing oral squamous cell carcinoma (OSCC) in Fanconi anemia (FA) patients. We have compared the microRNA (miRNA, miR) expression levels in saliva samples from FA patients (n = 50) who are at a low-moderate and/or high risk of developing OSCC to saliva samples from healthy controls (n = 16). The miRNA expression levels in saliva samples were quantified using qPCR. We observed that miR-744, miR-150-5P, and miR-146B-5P had the best discriminatory capacity between FA patients and controls, with an area under the curve (AUC) of 94.0%, 92.9% and 85.3%, respectively. Our data suggest that miR-1, miR-146B-5P, miR-150-5P, miR-155-5P, and miR-744 could be used as panel to predict the risk of developing OSCC in FA patients, with a 89.3% sensitivity and a 68.2% specificity (AUC = 81.5%). Our preliminary data support the notion that the expression levels of salivary miRNAs have the potential to predict the risk of developing OSCC in FA patients and in the future may reduce deaths associated with OSCC.
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Affiliation(s)
- Kai Dun Tang
- Faculty of Health, School of Biomedical Sciences, Centre for Biomedical Technology, Queensland University of Technology, Saliva & Liquid Biopsy Translational Laboratory and Translational Research Institute, Griffith University, 46 Don Yong Road, Nathan, Brisbane, QLD, Australia
| | - José M Amenábar
- Faculty of Health, School of Biomedical Sciences, Centre for Biomedical Technology, Queensland University of Technology, Saliva & Liquid Biopsy Translational Laboratory and Translational Research Institute, Griffith University, 46 Don Yong Road, Nathan, Brisbane, QLD, Australia
- Stomatology Department, Universidade Federal Do Paraná, Curitiba, Brazil
| | - Juliana L Schussel
- Stomatology Department, Universidade Federal Do Paraná, Curitiba, Brazil
| | | | - Carmem Bonfim
- Bone Marrow Transpantation Unit, Hospital de Clínicas, Universidade Federal Do Paraná, Curitiba, Brazil
| | | | - Gunter Hartel
- Statistics Unit, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Chamindie Punyadeera
- Faculty of Health, School of Biomedical Sciences, Centre for Biomedical Technology, Queensland University of Technology, Saliva & Liquid Biopsy Translational Laboratory and Translational Research Institute, Griffith University, 46 Don Yong Road, Nathan, Brisbane, QLD, Australia.
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Müller Bark J, Trevisan França de Lima L, Zhang X, Broszczak D, Leo PJ, Jeffree RL, Chua B, Day BW, Punyadeera C. Proteome profiling of salivary small extracellular vesicles in glioblastoma patients. Cancer 2023; 129:2836-2847. [PMID: 37254878 PMCID: PMC10952188 DOI: 10.1002/cncr.34888] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 04/15/2023] [Accepted: 04/24/2023] [Indexed: 06/01/2023]
Abstract
BACKGROUND Extracellular vesicles (EVs) play a critical role in intercellular communication under physiological and pathological conditions, including cancer. EVs cargo reflects their cell of origin, suggesting their utility as biomarkers. EVs are detected in several biofluids, and their ability to cross the blood-brain barrier has highlighted their potential as prognostic and diagnostic biomarkers in gliomas, including glioblastoma (GBM). Studies have demonstrated the potential clinical utility of plasma-derived EVs in glioma. However, little is known about the clinical utility of saliva-derived EVs in GBM. METHODS Small EVs were isolated from whole mouth saliva of GBM patients pre- and postoperatively. Isolation was performed using differential centrifugation and/or ultracentrifugation. EVs were characterized by concentration, size, morphology, and EVs cell-surface protein markers. Protein cargo in EVs was profiled using mass spectrometry. RESULTS There were no statistically significant differences in size and concentration of EVs derived from pre- and post GBM patients' saliva samples. A higher number of proteins were detected in preoperative samples compared to postoperative samples. The authors found four highly abundant proteins (aldolase A, 14-3-3 protein ε, enoyl CoA hydratase 1, and transmembrane protease serine 11B) in preoperative saliva samples from GBM patients with poor outcomes. Functional enrichment analysis of pre- and postoperative saliva samples showed significant enrichment of several pathways, including those related to the immune system, cell cycle and programmed cell death. CONCLUSIONS This study, for the first time, demonstrates the feasibility of isolating and characterizing small EVs from pre- and postoperative saliva samples from GBM patients. Preliminary findings encourage further large cohort validation studies on salivary small EVs to evaluate prognosis in GBM.
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Affiliation(s)
- Juliana Müller Bark
- Centre for Biomedical TechnologiesThe School of Biomedical SciencesFaculty of HealthQueensland University of TechnologyBrisbaneQueenslandAustralia
- Saliva and Liquid Biopsy Translational LaboratoryGriffith Institute for Drug Discovery Griffith UniversityBrisbaneQueenslandAustralia
- Translational Research InstituteBrisbaneQueenslandAustralia
| | - Lucas Trevisan França de Lima
- Centre for Biomedical TechnologiesThe School of Biomedical SciencesFaculty of HealthQueensland University of TechnologyBrisbaneQueenslandAustralia
- Saliva and Liquid Biopsy Translational LaboratoryGriffith Institute for Drug Discovery Griffith UniversityBrisbaneQueenslandAustralia
- Translational Research InstituteBrisbaneQueenslandAustralia
- Gallipoli Medical Research InstituteGreenslopes Private HospitalBrisbaneQueenslandAustralia
| | - Xi Zhang
- Centre for Biomedical TechnologiesThe School of Biomedical SciencesFaculty of HealthQueensland University of TechnologyBrisbaneQueenslandAustralia
- Saliva and Liquid Biopsy Translational LaboratoryGriffith Institute for Drug Discovery Griffith UniversityBrisbaneQueenslandAustralia
- Translational Research InstituteBrisbaneQueenslandAustralia
| | - Daniel Broszczak
- School of Biomedical SciencesFaculty of HealthQueensland University of TechnologyBrisbaneQueenslandAustralia
| | - Paul J. Leo
- Translational Research InstituteBrisbaneQueenslandAustralia
- Translational Genomics GroupQueensland University of TechnologyTranslational Research InstituteWoolloongabbaQueenslandAustralia
| | - Rosalind L. Jeffree
- Faculty of MedicineUniversity of QueenslandBrisbaneQueenslandAustralia
- Kenneth G. Jamieson Department of NeurosurgeryRoyal Brisbane and Women's HospitalHerstonQueenslandAustralia
| | - Benjamin Chua
- Faculty of MedicineUniversity of QueenslandBrisbaneQueenslandAustralia
- Cancer Care ServicesRoyal Brisbane and Women's HospitalBrisbaneQueenslandAustralia
| | - Bryan W. Day
- Cell and Molecular Biology DepartmentSid Faithfull Brain Cancer LaboratoryQIMR Berghofer MRIBrisbaneQueenslandAustralia
| | - Chamindie Punyadeera
- Centre for Biomedical TechnologiesThe School of Biomedical SciencesFaculty of HealthQueensland University of TechnologyBrisbaneQueenslandAustralia
- Saliva and Liquid Biopsy Translational LaboratoryGriffith Institute for Drug Discovery Griffith UniversityBrisbaneQueenslandAustralia
- Menzies Health Institute (MHIQ)Griffith UniversityGold CoastQueenslandAustralia
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Huang X, Duijf PHG, Sriram S, Perera G, Vasani S, Kenny L, Leo P, Punyadeera C. Circulating tumour DNA alterations: emerging biomarker in head and neck squamous cell carcinoma. J Biomed Sci 2023; 30:65. [PMID: 37559138 PMCID: PMC10413618 DOI: 10.1186/s12929-023-00953-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 07/16/2023] [Indexed: 08/11/2023] Open
Abstract
Head and Neck cancers (HNC) are a heterogeneous group of upper aero-digestive tract cancer and account for 931,922 new cases and 467,125 deaths worldwide. About 90% of these cancers are of squamous cell origin (HNSCC). HNSCC is associated with excessive tobacco and alcohol consumption and infection with oncogenic viruses. Genotyping tumour tissue to guide clinical decision-making is becoming common practice in modern oncology, but in the management of patients with HNSCC, cytopathology or histopathology of tumour tissue remains the mainstream for diagnosis and treatment planning. Due to tumour heterogeneity and the lack of access to tumour due to its anatomical location, alternative methods to evaluate tumour activities are urgently needed. Liquid biopsy approaches can overcome issues such as tumour heterogeneity, which is associated with the analysis of small tissue biopsy. In addition, liquid biopsy offers repeat biopsy sampling, even for patients with tumours with access limitations. Liquid biopsy refers to biomarkers found in body fluids, traditionally blood, that can be sampled to provide clinically valuable information on both the patient and their underlying malignancy. To date, the majority of liquid biopsy research has focused on blood-based biomarkers, such as circulating tumour DNA (ctDNA), circulating tumour cells (CTCs), and circulating microRNA. In this review, we will focus on ctDNA as a biomarker in HNSCC because of its robustness, its presence in many body fluids, adaptability to existing clinical laboratory-based technology platforms, and ease of collection and transportation. We will discuss mechanisms of ctDNA release into circulation, technological advances in the analysis of ctDNA, ctDNA as a biomarker in HNSCC management, and some of the challenges associated with translating ctDNA into clinical and future perspectives. ctDNA provides a minimally invasive method for HNSCC prognosis and disease surveillance and will pave the way in the future for personalized medicine, thereby significantly improving outcomes and reducing healthcare costs.
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Affiliation(s)
- Xiaomin Huang
- Saliva and Liquid Biopsy Translational Laboratory, Griffith Institute for Drug Discovery (GRIDD), School of Environment and Science, Griffith University, QLD, Brisbane, Australia
| | - Pascal H G Duijf
- School of Biomedical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
- Centre for Genomics and Personalised Health, Queensland University of Technology, Brisbane, QLD, Australia
- Centre for Data Science, Queensland University of Technology, Brisbane, QLD, Australia
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Medical Genetics, Oslo University Hospital, Oslo, Norway
- University Queensland Diamantina Institute, The University of Queensland, Translational Research Institute, Brisbane, QLD, Australia
| | - Sharath Sriram
- Functional Materials and Microsystems Research Group and the Micro Nano Research Facility, RMIT University, Melbourne, Australia
| | - Ganganath Perera
- Functional Materials and Microsystems Research Group and the Micro Nano Research Facility, RMIT University, Melbourne, Australia
| | - Sarju Vasani
- Department of Otolaryngology, Royal Brisbane Women's Hospital, Brisbane, QLD, Australia
- The School of Medicine, University of Queensland, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia
| | - Lizbeth Kenny
- The School of Medicine, University of Queensland, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia
| | - Paul Leo
- School of Biomedical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
- Centre for Genomics and Personalised Health, Queensland University of Technology, Brisbane, QLD, Australia
- Australian Translational Genomics Centre, Brisbane, QLD, Australia
| | - Chamindie Punyadeera
- Saliva and Liquid Biopsy Translational Laboratory, Griffith Institute for Drug Discovery (GRIDD), School of Environment and Science, Griffith University, QLD, Brisbane, Australia.
- Menzies Health Institute Queensland (MIHQ), Griffith University, Gold coast, QLD, Australia.
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Trevisan França de Lima L, Crawford DH, Broszczak DA, Zhang X, Bridle R. K, Punyadeera C. A salivary biomarker panel to detect liver cirrhosis. iScience 2023; 26:107015. [PMID: 37360686 PMCID: PMC10285560 DOI: 10.1016/j.isci.2023.107015] [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: 02/06/2023] [Revised: 04/14/2023] [Accepted: 05/29/2023] [Indexed: 06/28/2023] Open
Abstract
Limited access to diagnostic tests for liver fibrosis remains one of the main reasons for late diagnosis, especially in rural and remote communities. Saliva diagnostics is accessible with excellent patient compliance. The aim of this study was to develop a saliva-based diagnostic tool for liver fibrosis/cirrhosis. Salivary concentrations of hyaluronic acid (HA), tissue inhibitor of metalloproteinase-1 (TIMP-1), and α-2-macroglobulin (A2MG) were significantly increased (p < 0.05) in patients with liver fibrosis/cirrhosis. By combining these biomarkers, we developed the Saliva Liver Fibrosis (SALF) score, which identified patients with liver cirrhosis with an area under the receiver operating characteristic curve (AUROC) of 0.970 and 0.920 in a discovery and validation cohorts, respectively. The SALF score had a performance that was similar to that of the current Fibrosis-4 (AUROC:0.740) and Hepascore (AUROC:0.979). We demonstrated the clinical utility of saliva to diagnose liver fibrosis/cirrhosis with a potential to improve the screening for cirrhosis in asymptomatic populations.
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Affiliation(s)
- Lucas Trevisan França de Lima
- The School of Environment and Science, Griffith Institute for Drug Discovery (GRIDD), Griffith University, Brisbane, QLD, Australia
- Gallipoli Medical Research Foundation, Greenslopes Private Hospital, Greenslopes, QLD, Australia
| | - Darrell H.G. Crawford
- Gallipoli Medical Research Foundation, Greenslopes Private Hospital, Greenslopes, QLD, Australia
- The University of Queensland, Faculty of Medicine, Herston, QLD, Australia
| | - Daniel A. Broszczak
- School of Biomedical Sciences, Faculty of Health, Queensland University of Technology, Kelvin Grove Campus, Brisbane, QLD, Australia
| | - Xi Zhang
- The School of Environment and Science, Griffith Institute for Drug Discovery (GRIDD), Griffith University, Brisbane, QLD, Australia
| | - Kim Bridle R.
- Gallipoli Medical Research Foundation, Greenslopes Private Hospital, Greenslopes, QLD, Australia
- The University of Queensland, Faculty of Medicine, Herston, QLD, Australia
| | - Chamindie Punyadeera
- The School of Environment and Science, Griffith Institute for Drug Discovery (GRIDD), Griffith University, Brisbane, QLD, Australia
- Menzies Health Institute Queensland (MIHQ), Griffith University, Gold Coast, QLD, Australia
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Ekanayake Weeramange C, Tang KD, Barrero RA, Hartel G, Liu Z, Ladwa R, Langton‐Lockton J, Frazer I, Kenny L, Vasani S, Punyadeera C. Salivary micro RNAs as biomarkers for oropharyngeal cancer. Cancer Med 2023; 12:15128-15140. [PMID: 37278132 PMCID: PMC10417169 DOI: 10.1002/cam4.6185] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 05/19/2023] [Accepted: 05/20/2023] [Indexed: 06/07/2023] Open
Abstract
BACKGROUND Despite the rising incidence, particularly of the human papillomavirus (HPV)-associated fraction of oropharyngeal cancer (OPC), there are no early detection methods for OPC. Considering the close association between saliva and head and neck cancers, this study was designed to investigate salivary micro RNA (miRNAs) associated with OPC, especially focusing on HPV-positive OPC. METHODS Saliva was collected from OPC patients at diagnosis and patients were clinically followed up ≤5 years. Salivary small RNA isolated from HPV-positive OPC patients (N = 6), and HPV-positive (N = 4) and negative controls (N = 6) were analysed by next-generation sequencing to identify dysregulated miRNAs. Discovered miRNAs were validated by quantitative PCR using two different assays in a separate cohort of patients (OPC = 91, controls = 92). The relative expression was calculated considering SNORD-96A as the normalizer. Candidate miRNAs with diagnostic and prognostic potential were evaluated by generalized logistic regression. RESULTS A panel consisting of nine miRNAs was identified to have the best diagnostic performance to discriminate HPV-positive OPC from HPV-positive controls (AUC- validation-1 = 94.8%, validation-2 = 98%). Further, a panel consisting of six miRNAs were identified to discriminate OPC from controls regardless of the HPV status (AUC- validation-1 = 77.2%, validation-2 = 86.7%). In addition, the downregulation of hsa-miR-7-5p was significantly associated with poor overall survival of OPC patients (HR = 0.638). A panel consisting of nine miRNAs were identified for the prediction of the overall survival of the OPC patients (log-rank test-p = 0.0008). CONCLUSION This study highlights that salivary miRNAs can play an essential role in the detection and prognostication of OPC.
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Affiliation(s)
- Chameera Ekanayake Weeramange
- Saliva and Liquid Biopsy Translational LaboratoryGriffith Institute for Drug Discovery (GRIDD) and Menzies Health Institute Queensland (MIHQ)Griffith UniversityNathanQueenslandAustralia
- Menzies Health Institute Queensland (MIHQ)Griffith UniversityNathanQueenslandAustralia
- School of Biomedical ScienceCentre for Biomedical TechnologiesFaculty of HealthQueensland University of TechnologyBrisbaneQueenslandAustralia
- Department of Medical Laboratory SciencesFaculty of Health SciencesThe Open University of Sri LankaNugegodaSri Lanka
| | - Kai Dun Tang
- School of Biomedical ScienceCentre for Biomedical TechnologiesFaculty of HealthQueensland University of TechnologyBrisbaneQueenslandAustralia
- EDA School of Biological Sciences and Biotechnology and Nankai International Advanced Research Institute (Shenzhen Futian)Nankai UniversityTianjinPeople's Republic of China
| | - Roberto A. Barrero
- eResearch, Academic DivisionQueensland University of TechnologyBrisbaneQueenslandAustralia
| | - Gunter Hartel
- Statistics UnitQIMR Berghofer Medical Research InstituteHerstonQueenslandAustralia
| | - Zhen Liu
- Department of OtolaryngologyRoyal Brisbane and Women's HospitalBrisbaneQueenslandAustralia
- Faculty of MedicineThe University of QueenslandHerstonQueenslandAustralia
| | - Rahul Ladwa
- Faculty of MedicineThe University of QueenslandHerstonQueenslandAustralia
- Department of Cancer Care ServicesPrincess Alexandra HospitalWoolloongabbaQueenslandAustralia
| | | | - Ian Frazer
- Faculty of MedicineThe University of QueenslandHerstonQueenslandAustralia
| | - Lizbeth Kenny
- Faculty of MedicineThe University of QueenslandHerstonQueenslandAustralia
- Department of Cancer Care ServicesRoyal Brisbane and Women's HospitalBrisbaneQueenslandAustralia
| | - Sarju Vasani
- Saliva and Liquid Biopsy Translational LaboratoryGriffith Institute for Drug Discovery (GRIDD) and Menzies Health Institute Queensland (MIHQ)Griffith UniversityNathanQueenslandAustralia
- Department of OtolaryngologyRoyal Brisbane and Women's HospitalBrisbaneQueenslandAustralia
- Faculty of MedicineThe University of QueenslandHerstonQueenslandAustralia
| | - Chamindie Punyadeera
- Saliva and Liquid Biopsy Translational LaboratoryGriffith Institute for Drug Discovery (GRIDD) and Menzies Health Institute Queensland (MIHQ)Griffith UniversityNathanQueenslandAustralia
- Menzies Health Institute Queensland (MIHQ)Griffith UniversityNathanQueenslandAustralia
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Balakittnen J, Weeramange CE, Wallace DF, Duijf PHG, Cristino AS, Kenny L, Vasani S, Punyadeera C. Noncoding RNAs in oral cancer. WILEY INTERDISCIPLINARY REVIEWS. RNA 2023; 14:e1754. [PMID: 35959932 PMCID: PMC10909450 DOI: 10.1002/wrna.1754] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 06/09/2022] [Accepted: 07/05/2022] [Indexed: 05/13/2023]
Abstract
Oral cancer (OC) is the most prevalent subtype of cancer arising in the head and neck region. OC risk is mainly attributed to behavioral risk factors such as exposure to tobacco and excessive alcohol consumption, and a lesser extent to viral infections such as human papillomaviruses and Epstein-Barr viruses. In addition to these acquired risk factors, heritable genetic factors have shown to be associated with OC risk. Despite the high incidence, biomarkers for OC diagnosis are lacking and consequently, patients are often diagnosed in advanced stages. This delay in diagnosis is reflected by poor overall outcomes of OC patients, where 5-year overall survival is around 50%. Among the biomarkers proposed for cancer detection, noncoding RNA (ncRNA) can be considered as one of the most promising categories of biomarkers due to their role in virtually all cellular processes. Similar to other cancer types, changes in expressions of ncRNAs have been reported in OC and a number of ncRNAs have diagnostic, prognostic, and therapeutic potential. Moreover, some ncRNAs are capable of regulating gene expression by various mechanisms. Therefore, elucidating the current literature on the four main types of ncRNAs namely, microRNA, lncRNA, snoRNA, piwi-RNA, and circular RNA in the context of OC pathogenesis is timely and would enable further improvements and innovations in diagnosis, prognosis, and treatment of OC. This article is categorized under: RNA in Disease and Development > RNA in Disease RNA in Disease and Development > RNA in Development.
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Affiliation(s)
- Jaikrishna Balakittnen
- The Centre for Biomedical Technologies, The School of Biomedical Sciences, Faculty of HealthQueensland University of TechnologyKelvin GroveQueenslandAustralia
- Saliva & Liquid Biopsy Translational Laboratory, Griffith Institute for Drug DiscoveryGriffith UniversityNathanQueenslandAustralia
- Department of Medical Laboratory Sciences, Faculty of Allied Health SciencesUniversity of JaffnaJaffnaSri Lanka
| | - Chameera Ekanayake Weeramange
- Saliva & Liquid Biopsy Translational Laboratory, Griffith Institute for Drug DiscoveryGriffith UniversityNathanQueenslandAustralia
| | - Daniel F. Wallace
- Centre for Genomics and Personalised Health, School of Biomedical Sciences, Faculty of HealthQueensland University of TechnologyBrisbaneQueenslandAustralia
| | - Pascal H. G. Duijf
- Centre for Genomics and Personalised Health, School of Biomedical Sciences, Faculty of HealthQueensland University of TechnologyBrisbaneQueenslandAustralia
- Queensland University of Technology, School of Biomedical SciencesFaculty of Health at the Translational Research InstituteWoolloongabbaQueenslandAustralia
- Centre for Data Science, Queensland University of Queensland, TechnologyBrisbaneQueenslandAustralia
- Institute of Clinical Medicine, Faculty of Medicine, HerstonUniversity of OsloOsloNorway
- Department of Medical GeneticsOslo University HospitalOsloNorway
- University of Queensland Diamantina InstituteThe University of QueenslandBrisbaneQueenslandAustralia
| | | | - Liz Kenny
- Royal Brisbane and Women's Hospital, Cancer Care ServicesHerstonQueenslandAustralia
- Faculty of MedicineThe University of QueenslandBrisbaneQueenslandAustralia
| | - Sarju Vasani
- Royal Brisbane and Women's Hospital, Cancer Care ServicesHerstonQueenslandAustralia
- Department of OtolaryngologyRoyal Brisbane and Women's HospitalHerstonQueenslandAustralia
| | - Chamindie Punyadeera
- Saliva & Liquid Biopsy Translational Laboratory, Griffith Institute for Drug DiscoveryGriffith UniversityNathanQueenslandAustralia
- Queensland University of Technology, School of Biomedical SciencesFaculty of Health at the Translational Research InstituteWoolloongabbaQueenslandAustralia
- Menzies Health InstituteGriffith UniversityGold CoastQueenslandAustralia
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10
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Rumianek B, Hillman R, Jeoffreys N, Ghazanfar S, Schifter M, Ajwani S. Prevalence of oral HPV in the adult sample population in Sydney. Aust Dent J 2023; 68:19-25. [PMID: 36281543 DOI: 10.1111/adj.12943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/08/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Oropharyngeal squamous cell carcinomas are increasing in incidence. Risk factors include sexual behaviour, high-risk oral HPV infection and poor oral hygiene. We aimed to provide initial information on the prevalence and assess the feasibility of testing in dental settings. METHODS Patients ≥18 years old attending dental clinics in Sydney, Australia, were recruited, oral hygiene assessed, and 10 mL saline oral rinses obtained. Rinses were tested for HBG and HPV by PCR. Participants completed demographic and behavioural questionnaires. RESULTS The mean age was 48 years, of whom 131 (43.6%) were male. HPV genotypes, one each of 16, 66, 51, 35 and 58 in five participants, and 18 and 52 in one participant, were detected in six samples (2.0%), all men. Oral sex was reported by 89 (67.9%) male participants. One participant (4.3%) of the 23 with poor OH had at least one HPV genotype detected. DISCUSSION With dental patients willing to provide rinse samples and disclose potentially sensitive information, we found the hrHPV prevalence of 2%. Given large proportions of the general population attending dental clinics regularly, dentists may be ideally placed to screen for oropharyngeal carcinoma and contribute to the currently limited knowledge of oral HPV prevalence in Australian adults. © 2022 Australian Dental Association.
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Affiliation(s)
- B Rumianek
- The University of Sydney, Camperdown, Australia
| | - R Hillman
- University of New South Wales, Sydney, Australia
| | - N Jeoffreys
- Westmead Institute for Medical Research, Westmead, Australia
| | - S Ghazanfar
- The University of Sydney, Camperdown, Australia
| | - M Schifter
- The University of Sydney, Camperdown, Australia
| | - S Ajwani
- The University of Sydney, Camperdown, Australia
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11
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Head and neck cancer patient-derived tumouroid cultures: opportunities and challenges. Br J Cancer 2023; 128:1807-1818. [PMID: 36765173 PMCID: PMC10147637 DOI: 10.1038/s41416-023-02167-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 01/11/2023] [Accepted: 01/16/2023] [Indexed: 02/12/2023] Open
Abstract
Head and neck cancers (HNC) are the seventh most prevalent cancer type globally. Despite their common categorisation, HNCs are a heterogeneous group of malignancies arising in various anatomical sites within the head and neck region. These cancers exhibit different clinical and biological manifestations, and this heterogeneity also contributes to the high rates of treatment failure and mortality. To evaluate patients who will respond to a particular treatment, there is a need to develop in vitro model systems that replicate in vivo tumour status. Among the methods developed, patient-derived cancer organoids, also known as tumouroids, recapitulate in vivo tumour characteristics including tumour architecture. Tumouroids have been used for general disease modelling and genetic instability studies in pan-cancer research. However, a limited number of studies have thus far been conducted using tumouroid-based drug screening. Studies have concluded that tumouroids can play an essential role in bringing precision medicine for highly heterogenous cancer types such as HNC.
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12
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Minhas S, Kashif M, Rehman Z, Idrees M, Ansari F. Molecular characterization and risk factors of oral high-risk human papillomavirus among females in Punjab, Pakistan. J Med Virol 2023; 95:e27893. [PMID: 35644904 DOI: 10.1002/jmv.27893] [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: 01/22/2022] [Revised: 05/14/2022] [Accepted: 05/26/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND The development of oral and oropharyngeal cancers is associated with human papillomavirus (HPV) infection. However, debate exists about the prevalence of high-risk oral HPV (HR-HPV) and its associated risk factors. This study evaluated the distribution of genotypes and associated risk factors of oral HR-HPV infection in the normal oral mucosa of the Pakistani female population with general gynecological problems. METHODS A total of 200 females from a regional gynecological hospital in Pakistan were included in this cross-sectional study. A self-administered questionnaire was carried out, followed by the study participants' oral and dental examinations. Whole saliva was collected by a drooling method. The viral DNA extraction and oral HR-HPV genotyping were detected via real-time polymerase chain reaction. RESULTS Among the 200 females (mean age, 37.76 years), 22 females (11%) were positive for oral HR-HPV DNA. Single oral HR-HPV infection was seen in 8%, whereas co-infection was observed in 3% with HPV16 and HPV18 most common genotypes. Comparison of the risk factors like oral sex history odds ratio (OR 8.21, 95% confidence interval [CI] 1.85-28.16; p < 0.005), and open-mouth kissing (OR, 5.17; 95% CI 1.48-27.41; p = 0.005) with oral HR-HPV infection was found to be significantly associated. CONCLUSION In Pakistan, oral HR-HPV-positive infection is not uncommon; HPV16 and HPV18 are the most frequent genotypes. Furthermore, this study also provides data that oral HR-HPV positive infection was significantly associated with sexual behaviors. Therefore, preventive health efforts, like health education and vaccination, should be practiced.
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Affiliation(s)
- Sadia Minhas
- Department of Microbiology, Institute of Molecular Biology & Biotechnology, The University of Lahore, Lahore, Pakistan.,Department of Oral Pathology, Dental Section, Akhtar Saeed Medical and Dental College, Lahore, Pakistan
| | - Muhammad Kashif
- Department of Oral Pathology, Bakhtawar Amin Medical and Dental College, Multan, Pakistan
| | - Zobaria Rehman
- Center of Applied Molecular Biology (CAMB), University of the Punjab, Lahore, Pakistan
| | - Muhammad Idrees
- Center of Excellence in Molecular Biology (CEMB), University of the Punjab, Lahore, Pakistan
| | - Farheen Ansari
- Department of Microbiology, Institute of Molecular Biology & Biotechnology, The University of Lahore, Lahore, Pakistan
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13
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Pittman TW, Decsi DB, Punyadeera C, Henry CS. Saliva-based microfluidic point-of-care diagnostic. Theranostics 2023; 13:1091-1108. [PMID: 36793864 PMCID: PMC9925318 DOI: 10.7150/thno.78872] [Citation(s) in RCA: 23] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 01/11/2023] [Indexed: 02/04/2023] Open
Abstract
There has been a long-standing interest in point-of-care (POC) diagnostics as a tool to improve patient care because it can provide rapid, actionable results near the patient. Some of the successful examples of POC testing include lateral flow assays, urine dipsticks, and glucometers. Unfortunately, POC analysis is somewhat limited by the ability to manufacture simple devices to selectively measure disease specific biomarkers and the need for invasive biological sampling. Next generation POCs are being developed that make use of microfluidic devices to detect biomarkers in biological fluids in a non-invasive manner, addressing the above-mentioned limitations. Microfluidic devices are desirable because they can provide the ability to perform additional sample processing steps not available in existing commercial diagnostics. As a result, they can provide more sensitive and selective analysis. While most POC methods make use of blood or urine as a sample matrix, there has been a growing push to use saliva as a diagnostic medium. Saliva represents an ideal non-invasive biofluid for detecting biomarkers because it is readily available in large quantities and analyte levels reflect those in blood. However, using saliva in microfluidic devices for POC diagnostics is a relatively new and an emerging field. The overarching aim of this review is to provide an update on recent literature focused on the use of saliva as a biological sample matrix in microfluidic devices. We will first cover the characteristics of saliva as a sample medium and then review microfluidic devices that are developed for the analysis of salivary biomarkers.
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Affiliation(s)
- Trey W Pittman
- Department of Chemistry, Colorado State University, Fort Collins, Colorado 80523, USA
| | - Daniel Balazs Decsi
- Centre for Biomedical Technologies, School of Biomedical Sciences, Faculty of Health, QUT.,Griffith Institute for Drug Discover, Griffith University, Nathan, Australia
| | - Chamindie Punyadeera
- Griffith Institute for Drug Discover, Griffith University, Nathan, Australia.,Menzies Health Institute, Griffith University, Gold Coast, Australia.,Translational Research Institute, Woolloongabba, Australia
| | - Charles S Henry
- Department of Chemistry, Colorado State University, Fort Collins, Colorado 80523, USA.,Metallurgy and Materials Science Research Institute, Chulalongkorn University, Soi Chula 12, Phayathai Rd., Pathumwan, Bangkok 10330, Thailand
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14
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Ali A, Rumbold AR, Kapellas K, Lassi ZS, Hedges J, Jamieson L. Association between self-reported periodontitis and high-risk oral human papillomavirus infection among Indigenous South Australians: A cross-sectional study. PLoS One 2022; 17:e0265840. [PMID: 35324953 PMCID: PMC8946737 DOI: 10.1371/journal.pone.0265840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 03/08/2022] [Indexed: 11/18/2022] Open
Abstract
Introduction
The incidence of oropharyngeal squamous cell carcinoma (OPSCC) is increasing globally, reflecting an increase in human papillomavirus (HPV)-related lesions. Indigenous populations are disproportionately affected by OPSCCs. Currently, testing for oral HPV is not recommended as a screening tool to permit early detection of OPSCCs due to the high population prevalence of HPV infection. Periodontitis may be a marker of oral HPV infection, but previous research evaluating this association has been inconclusive. Here we report a large population-based study examining the association between high-risk oral HPV infection and periodontitis among Indigenous South Australians.
Methods
We utilised a large convenience sample of Indigenous South Australians aged 18+ years recruited between February 2018 and February 2020. Of the original cohort (n = 1011), 748 (73.9%) participants participated in the 12 month follow-up. Detailed information on sociodemographic characteristics, health-related behaviours, and sexual history were collected at enrolment. Saliva samples were collected at 12 months and tested for the presence of oral HPV DNA using the optimized general primer (GP) + PCR system. The primary outcomes were the prevalence of any high-risk oral HPV DNA, and separately, HPV 16 and/or 18. Periodontitis was assessed at follow-up by using validated self-reported periodontitis screening questions. Logistic regression analyses were undertaken to assess the association between self-reported periodontitis and oral HPV infection with adjustment for potential sociodemographic and behavioural confounders, with estimates presented as odds ratios (OR) and 95% confidence interval (CI).
Results
Data on 673 participants (89.9% of the follow-up cohort) were available. Participants ranged in age from 18 to 80 (mean age 42.2, SD 14.7) and 31.5% were male. Overall, 115 (17.1%) participants had self-reported periodontitis, 40 (5.9%) had any high-risk oral HPV and 14 (2.1%) had HPV 16 and/or 18. Any high-risk HPV was detected among seven (17.5%) participants and HPV 16 and/or 18 was detected in three (21.4%) who self-reported periodontitis. In the regression analyses no significant association was found between self-reported periodontitis and high-risk oral HPV (adjusted OR: 1.10; 95% CI: 0.45–2.70) or HPV 16 and/or 18 (adjusted OR: 1.27; 95% CI: 0.32–5.03).
Conclusion
This study did not find any association between self-reported periodontitis and high-risk oral HPV among Indigenous South Australians. Further targeted studies with standardized clinical measures of periodontal disease are needed to clarify the link between high-risk oral HPV and periodontal disease. If confirmed this would add further weight to the importance of recommendations about the utility of periodontitis screening to identify individuals at risk of carrying high-risk oral HPV, who may benefit from more intensive screening and ongoing monitoring.
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Affiliation(s)
- Anna Ali
- Robinson Research Institute, School of Medicine, The University of Adelaide, Adelaide, South Australia, Australia
- Australian Research Centre for Population Oral Health, The University of Adelaide, Adelaide, South Australia, Australia
- * E-mail:
| | - Alice R. Rumbold
- Robinson Research Institute, School of Medicine, The University of Adelaide, Adelaide, South Australia, Australia
- South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Kostas Kapellas
- Australian Research Centre for Population Oral Health, The University of Adelaide, Adelaide, South Australia, Australia
| | - Zohra S. Lassi
- Robinson Research Institute, School of Medicine, The University of Adelaide, Adelaide, South Australia, Australia
| | - Joanne Hedges
- Australian Research Centre for Population Oral Health, The University of Adelaide, Adelaide, South Australia, Australia
| | - Lisa Jamieson
- Australian Research Centre for Population Oral Health, The University of Adelaide, Adelaide, South Australia, Australia
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15
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Zargaran M, Azizi Jalilian F. Investigation of the Relationship between Oral Human Papillomavirus Infection and Oral Health. JOURNAL OF DENTISTRY (SHIRAZ, IRAN) 2022; 23:65-71. [PMID: 35291678 PMCID: PMC8918643 DOI: 10.30476/dentjods.2021.88551.1338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Revised: 02/08/2021] [Accepted: 04/11/2021] [Indexed: 11/19/2022]
Abstract
Statement of the Problem Oral health status has been suggested as one of the possible risk factors for oral human papillomavirus (OHPV) infection. There is inconsistent evidence concerning its relationship with the presence of OHPV. Purpose This study aimed to compare oral health status between two groups of patients with and without OHPV infection. Materials and Method This cross-sectional study was performed on 272 oral rinse samples, collected from our previous study population. After signing the written informed consents, the oral examination was performed to determine some clinical parameters of oral health status including periodontal disease status, oral hygiene status, decayed, missing, and filled teeth (DMFT) of participants. Next, viral deoxyribonucleic acid (DNA) extraction, polymerase chain reaction (PCR), and HPV genotyping tests were performed on the samples. Results OHPV DNA was detected in a total 31 (11.40%) samples that were considered as OHPV+ group. None of the determined clinical parameters of oral health status was significantly different between OHPV+ and OHPV DNA negative (OHPV-) groups (p> 0.05). Conclusion The findings of the current study did not indicate a significant association between oral health status and OHPV. Further studies with larger sample size are recommended to reach a definite conclusion.
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Affiliation(s)
- Massoumeh Zargaran
- Dept. of Oral and Maxillofacial Pathology, Faculty of Dentistry, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Farid Azizi Jalilian
- Dept. of Medical Virology, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
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16
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Trevisan França de Lima L, Müller Bark J, Rasheduzzaman M, Ekanayake Weeramange C, Punyadeera C. Saliva as a matrix for measurement of cancer biomarkers. Cancer Biomark 2022. [DOI: 10.1016/b978-0-12-824302-2.00008-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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17
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Wee CW, Lee HJ, Lee JR, Lee H, Kwoen MJ, Jeong WJ, Eom KY. Effect of National Oral Health Screening Program on the Risk of Head and Neck Cancer: A Korean National Population-Based. Cancer Res Treat 2021; 54:709-718. [PMID: 34696565 PMCID: PMC9296931 DOI: 10.4143/crt.2021.834] [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: 07/22/2021] [Accepted: 10/21/2021] [Indexed: 11/21/2022] Open
Abstract
Purpose Poor oral health is associated with head and neck cancer (HNC). We evaluated whether a national oral health screening program (OHSP) could reduce the risk of HNC. Materials and Methods Data from 408,247 healthy individuals aged ≥ 40 years from the National Health Insurance System-National Health Screening program during 2003 and 2004 in Korea were analyzed. The risk of HNC was compared between subjects who underwent OHSP (HEALS-Dental+, n=165,292) and routine health check-ups only (HEALS-Dental‒, n=242,955). The impact of individual oral health-related factors on HNC risk was evaluated in HEALS-Dental+. Results A total of 1,650 HNC cases were diagnosed. The 10-year HNC-free rate was 99.684% with a median follow-up of 11 years. The risk of all HNC (hazard ratio [HR], 1.16; 95% confidence interval [CI], 1.03 to 1.29; p=0.011) and oropharyngeal cancer (HR, 1.48; 95% CI, 1.13 to 1.94; p=0.005) was significantly higher in HEALS-Dental‒ than in HEALS-Dental+. In HEALS-Dental+, oral cavity cancer was marginally reduced (p=0.085), and missing teeth was a significant factor for HNC (HR, 1.24; 95% CI, 1.02 to 1.50; p=0.032). Toothbrushing was a significant factor in univariate analysis (p=0.028), but not in multivariate analysis (p=0.877). Conclusion The National OHSP significantly reduced the long-term HNC risk, particularly the incidence of oropharyngeal cancer. Routine OHSP should be considered at the population level.
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Affiliation(s)
- Chan Woo Wee
- Department of Radiation Oncology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea
| | - Hyo-Jung Lee
- Section of Dentistry Medicine, Department of Periodontology, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Jae-Ryun Lee
- Department of Family Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Hyejin Lee
- Department of Family Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Min-Jeong Kwoen
- Section of Dentistry Medicine, Department of Periodontology, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Woo-Jin Jeong
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Keun-Yong Eom
- Department of Radiation Oncology, Seoul National University Bundang Hospital, Seongnam, Korea
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18
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Carlton M, Voisey J, Jones L, Parker TJ, Punyadeera C, Cuttle L. An exploratory study demonstrating that salivary cytokine profiles are altered in children with small area thermal injury. J Burn Care Res 2021; 43:613-624. [PMID: 34323997 DOI: 10.1093/jbcr/irab147] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Serum can be used to investigate changes in cytokine concentration following burn injury in children, however for children receiving treatment in an outpatient setting, blood is not routinely collected and therefore cannot be used for monitoring. The aim of this study was to investigate the use of saliva as a non-invasive tool for predicting burn outcomes by measuring the concentration of salivary cytokines in children with small area burns. A multiplex cytokine assay was used to measure 17 cytokines in the saliva of paediatric patients with burns (n = 20) and healthy controls (n = 20). After the removal of cytokines that had >30% of samples below the assay lower detection limit, six cytokines including IL-1β, IL-4, IL-7, IL-8, MCP-1 and TNFα were analysed for association with burns. IL-1β and IL-4 were found to be significantly elevated in the paediatric burn patients compared to healthy controls. Interestingly, IL-1β was also significantly elevated in scald burns, compared to contact burns. In addition, biologically meaningful differences in cytokine concentration were identified in patients with different burn characteristics, which warrant further investigation. This exploratory study provides evidence that cytokines can be detected in the saliva of children and that salivary cytokine profiles differ between healthy controls and children with burns. Overall, this study demonstrates the value of saliva for the investigation of cytokines and its potential application in paediatric diagnostics, specifically in situations where blood collection is not appropriate.
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Affiliation(s)
- Morgan Carlton
- School of Biomedical Science, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia.,Centre for Children's Burn and Trauma Research, Centre for Children's Health Research, Queensland University of Technology, South Brisbane, Queensland, Australia
| | - Joanne Voisey
- Centre for Genomics and Personalised Health, School of Biomedical Science, Faculty of Health, Queensland University of Technology
| | - Lee Jones
- Research Methods Group & Centre for Healthcare Transformation, School of Public Health and Social Work, Queensland University of Technology, Kelvin Grove, Queensland, Australia
| | - Tony J Parker
- School of Biomedical Science, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Chamindie Punyadeera
- Saliva and Liquid Biopsy Translational Research Team, School of Biomedical Sciences, Queensland University of Technology, Kelvin Grove, Queensland, Australia.,Translational Research Institute, Woolloongabba, Queensland, Australia
| | - Leila Cuttle
- School of Biomedical Science, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia.,Centre for Children's Burn and Trauma Research, Centre for Children's Health Research, Queensland University of Technology, South Brisbane, Queensland, Australia
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19
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Weeramange CE, Liu Z, Hartel G, Li Y, Vasani S, Langton-Lockton J, Kenny L, Morris L, Frazer I, Tang KD, Punyadeera C. Salivary High-Risk Human Papillomavirus DNA as a Biomarker for Human Papillomavirus-Driven Head and Neck Cancers. J Mol Diagn 2021; 23:1334-1342. [PMID: 34325059 DOI: 10.1016/j.jmoldx.2021.07.005] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 06/21/2021] [Accepted: 07/08/2021] [Indexed: 10/20/2022] Open
Abstract
High-risk human papillomavirus (HR-HPV) infection is a major risk factor of head and neck cancers (HNCs). Despite the rising prevalence of HPV-driven HNC (HPV-HNC), biomarkers for detection, prognostication, and disease monitoring are lacking. To evaluate the capacity of salivary HR-HPV DNA as a biomarker of HPV-HNC, the salivary HR-HPV statuses of 491 and 10 patients with primary and recurrent HNC, respectively, were determined at diagnosis, using quantitative real-time PCR, with tumor cyclin-dependent kinase inhibitor 2A (p16) expression determined by IHC analysis. Patients with oropharyngeal cancer (OPC) (n = 215) were followed up for ≤5 years. Survival characteristics were evaluated in terms of event-free and cause-specific survival. Of the primary-HNC cohort, 43.2% were positive for salivary HR-HPV DNA, with most having OPC. Salivary HR-HPV DNA was detected in 81.4% of tumor p16-positive OPC patients at diagnosis. Prognosis in salivary HR-HPV-positive OPC patients was favorable compared with that in salivary HR-HPV-negative patients (event-free survival, hazard ratio = 0.42 [95% CI, 0.21-0.81, P = 0.010]; cause-specific survival, hazard ratio = 0.39 [95% CI, 0.18-0.86, P = 0.019]). In the recurrent-HNC cohort, salivary HR-HPV DNA was detected in 83.3% of those who previously had tumor p16-positive HNC. These findings indicate that this liquid biopsy-based, noninvasive biomarker could be essential in the detection and management of HPV-HNC.
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Affiliation(s)
- Chameera E Weeramange
- Saliva & Liquid Biopsy Translational Laboratory, Faculty of Health, School of Biomedical Science, Queensland University of Technology, Brisbane, Queensland, Australia; Translational Research Institute, Brisbane, Queensland, Australia; Department of Medical Laboratory Sciences, Faculty of Health Sciences, The Open University of Sri Lanka, Nugegoda, Sri Lanka
| | - Zhen Liu
- Department of Otolaryngology, The University of Queensland, Brisbane, Queensland, Australia; Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Gunter Hartel
- Statistics Unit, QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia
| | - Yinan Li
- Saliva & Liquid Biopsy Translational Laboratory, Faculty of Health, School of Biomedical Science, Queensland University of Technology, Brisbane, Queensland, Australia; Translational Research Institute, Brisbane, Queensland, Australia
| | - Sarju Vasani
- Department of Otolaryngology, The University of Queensland, Brisbane, Queensland, Australia; Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Julian Langton-Lockton
- Metro-North Sexual Health and HIV Service, Metro North Health, Brisbane, Queensland, Australia
| | - Lizbeth Kenny
- Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia; Department of Cancer Care Services, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia; Central Integrated Regional Cancer Service, Queensland Health, Brisbane, Queensland, Australia
| | - Luc Morris
- Memorial Sloan-Kettering Cancer Center, New York, New York
| | - Ian Frazer
- Translational Research Institute, Brisbane, Queensland, Australia; Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Kai D Tang
- Saliva & Liquid Biopsy Translational Laboratory, Faculty of Health, School of Biomedical Science, Queensland University of Technology, Brisbane, Queensland, Australia; Translational Research Institute, Brisbane, Queensland, Australia.
| | - Chamindie Punyadeera
- Saliva & Liquid Biopsy Translational Laboratory, Faculty of Health, School of Biomedical Science, Queensland University of Technology, Brisbane, Queensland, Australia; Translational Research Institute, Brisbane, Queensland, Australia.
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20
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Tang KD, Wan Y, Zhang X, Bozyk N, Vasani S, Kenny L, Punyadeera C. Proteomic Alterations in Salivary Exosomes Derived from Human Papillomavirus-Driven Oropharyngeal Cancer. Mol Diagn Ther 2021; 25:505-515. [PMID: 34080172 DOI: 10.1007/s40291-021-00538-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/16/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND Increasing evidence supports the notion that human papillomavirus (HPV) DNA integration onto the human genome can influence and alter the molecular cargo in the exosomes derived from head and neck cancer cells. However, the molecular cargo of salivary exosomes derived from HPV-driven oropharyngeal cancer (HPV-driven OPC) remains unelucidated. METHODS AND MATERIALS Salivary exosomes morphology and molecular characterizations were examined using the nanoparticle tracking (NTA), western blot analysis, transmission electron microscopy (TEM) and mass spectrometry analysis. RESULTS We report that HPV16 DNA was detected (80%) in isolated salivary exosomes of HPV-driven OPC patients. Importantly, we demonstrate elevated protein levels of six main glycolytic enzymes [i.e., aldolase (ALDOA), glyceraldehye-3-phosphate dehydrogenase (GAPDH), lactate dehydrogenase A/B (LDHA and LDHB), phosphoglycerate kinase 1 (PGK1) and pyruvate kinase M1/2 (PKM)] in isolated salivary exosomes of HPV-driven OPC patients, suggesting a novel mechanism underlying the potential role of salivary exosomes in mediating the reciprocal interplay between glucose metabolism and HPV-driven OPC. CONCLUSION Our data demonstrate the potential diagnostic value of HPV16 DNA and glycolytic enzymes in salivary exosomes in discriminating healthy controls from HPV-driven OPC patients, thereby opening new avenues in the future for clinical translation studies.
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Affiliation(s)
- Kai Dun Tang
- Saliva and Liquid Biopsy Translational Laboratory, The Translational Research Institute, The School of Biomedical Sciences, Queensland University of Technology (QUT), 60 Musk Avenue, GPO Box 2434, Brisbane, QLD, 4059, Australia
| | - Yunxia Wan
- Saliva and Liquid Biopsy Translational Laboratory, The Translational Research Institute, The School of Biomedical Sciences, Queensland University of Technology (QUT), 60 Musk Avenue, GPO Box 2434, Brisbane, QLD, 4059, Australia
| | - Xi Zhang
- Saliva and Liquid Biopsy Translational Laboratory, The Translational Research Institute, The School of Biomedical Sciences, Queensland University of Technology (QUT), 60 Musk Avenue, GPO Box 2434, Brisbane, QLD, 4059, Australia
| | - Natalie Bozyk
- Saliva and Liquid Biopsy Translational Laboratory, The Translational Research Institute, The School of Biomedical Sciences, Queensland University of Technology (QUT), 60 Musk Avenue, GPO Box 2434, Brisbane, QLD, 4059, Australia
| | - Sarju Vasani
- Department of Otolaryngology, Royal Brisbane and Women's Hospital, Herston, QLD, 4029, Australia
| | - Liz Kenny
- Royal Brisbane and Women's Hospital, Central Integrated Regional Cancer Service, The University of Queensland School of Medicine, Queensland Health, Brisbane, QLD, 4029, Australia
| | - Chamindie Punyadeera
- Saliva and Liquid Biopsy Translational Laboratory, The Translational Research Institute, The School of Biomedical Sciences, Queensland University of Technology (QUT), 60 Musk Avenue, GPO Box 2434, Brisbane, QLD, 4059, Australia.
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21
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Shigeishi H, Sugiyama M, Ohta K. Relationship between the prevalence of oral human papillomavirus DNA and periodontal disease (Review). Biomed Rep 2021; 14:40. [PMID: 33728046 PMCID: PMC7953200 DOI: 10.3892/br.2021.1416] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 02/02/2021] [Indexed: 12/16/2022] Open
Abstract
Human papillomavirus (HPV) is a small DNA virus that infects the basal keratinocytes of squamous epithelium in the skin, and in the oral and genital mucosa. Smoking and sexual behavior have been recognized as significant risk factors for oral HPV infection. In the present review, the findings of recent studies of oral HPV infection in relation to periodontitis are discussed, as well as periodontopathic bacteria and periodontal herpes virus. Previous research suggests that HPV localizes to the inflammatory periodontal tissue. Inflammatory periodontal pockets may thus act as a reservoir for HPV. The interactions between HPV and periodontopathic bacteria remain unclear, but it is hypothesized that oral HPV infection may be related to a characteristic oral microbiome. Smoking is associated with HPV and periodontitis, as smoking induces destruction of periodontal tissue and suppresses the host defense, allowing HPV to infect periodontal tissue. Carcinogenic HPV and periodontitis may lead to the development of oral cavity cancer. However, oral HPV E6/E7 expression (transcriptionally active HPV) has not yet been fully investigated in patients with periodontitis. Collectively, the evidence suggests that oral HPV prevalence may be associated with periodontitis. The effect of clinical factors (age, sex, smoking, immunosuppressive condition and vaccination) on oral HPV DNA prevalence should be considered when clarifying the relationship between oral HPV and periodontitis. Additionally, the sampling method should be carefully chosen to directly detect HPV DNA in periodontal tissues.
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Affiliation(s)
- Hideo Shigeishi
- Department of Public Oral Health, Program of Oral Health Sciences, Graduate School of Biomedical and Health Sciences, Hiroshima University, Minami-ku, Hiroshima 734-8553, Japan
| | - Masaru Sugiyama
- Department of Public Oral Health, Program of Oral Health Sciences, Graduate School of Biomedical and Health Sciences, Hiroshima University, Minami-ku, Hiroshima 734-8553, Japan
| | - Kouji Ohta
- Department of Public Oral Health, Program of Oral Health Sciences, Graduate School of Biomedical and Health Sciences, Hiroshima University, Minami-ku, Hiroshima 734-8553, Japan
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22
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Lim Y, Tang KD, Karpe AV, Beale DJ, Totsika M, Kenny L, Morrison M, Punyadeera C. Chemoradiation therapy changes oral microbiome and metabolomic profiles in patients with oral cavity cancer and oropharyngeal cancer. Head Neck 2021; 43:1521-1534. [PMID: 33527579 DOI: 10.1002/hed.26619] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 01/06/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Patients with oral cavity cancer (OCC) and oropharyngeal cancer (OPC) are often seen with locoregionally advanced disease requiring complex multimodality treatments. These treatments may have detrimental effects on the oral microbiome, which is critical to maintaining physiological balance and health. METHODS The effects of different OCC and OPC treatment types on the oral microbiome and metabolomic profiles for 24-month post-treatment in patients with OCC and OPC were investigated using 16S rRNA gene amplicon next-generation sequencing and gas chromatography-mass spectrometry (GC-MS), respectively. RESULTS Chemoradiation resulted in oral dysbiosis with specific depletion of genera which regulate the enterosalivary nitrate-nitrite-nitric oxide pathway. These data also correlate with the oral metabolomic profiles with nitric oxide-related precursor, modulator, or catalyst significantly downregulated in saliva samples from patients' postchemoradiation. CONCLUSIONS Together, we have shown that oral dysbiosis due to the effects of chemoradiation could potentially have an impact on OCC and OPC patient's quality of life post-treatment.
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Affiliation(s)
- Yenkai Lim
- The Saliva and Liquid Biopsy Translational Research Team, School of Biomedical Sciences, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia.,The Translational Research Institute, Brisbane, Queensland, Australia
| | - Kai Dun Tang
- The Saliva and Liquid Biopsy Translational Research Team, School of Biomedical Sciences, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia.,The Translational Research Institute, Brisbane, Queensland, Australia
| | - Avinash V Karpe
- The Land and Water, Commonwealth Scientific and Industrial Research Organisation, Ecosciences Precinct Dutton Park, Brisbane, Queensland, Australia
| | - David J Beale
- The Land and Water, Commonwealth Scientific and Industrial Research Organisation, Ecosciences Precinct Dutton Park, Brisbane, Queensland, Australia
| | - Makrina Totsika
- School of Biomedical Sciences, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Liz Kenny
- The School of Medicine, University of Queensland, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Mark Morrison
- The University of Queensland Diamantina Institute, University of Queensland, Translational Research Institute, Brisbane, Queensland, Australia
| | - Chamindie Punyadeera
- The Saliva and Liquid Biopsy Translational Research Team, School of Biomedical Sciences, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia.,The Translational Research Institute, Brisbane, Queensland, Australia
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23
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Shigeishi H, Su CY, Kaneyasu Y, Matsumura M, Nakamura M, Ishikawa M, Saito A, Ohta K, Sugiyama M. Association of oral HPV16 infection with periodontal inflammation and the oral microbiome in older women. Exp Ther Med 2020; 21:167. [PMID: 33456534 DOI: 10.3892/etm.2020.9598] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 01/29/2020] [Indexed: 12/11/2022] Open
Abstract
The present preliminary study aimed to investigate the association between oral human papillomavirus type 16 (HPV16) DNA prevalence and periodontal inflammation in older women. The association between oral HPV16 infection and oral health status has not been fully elucidated in older Japanese women. The present study investigated older women aged ≥60 years who visited Hiroshima University Hospital. The present study excluded subjects with clinical factors affecting HPV infection, such as current smoking, oral cancer and pre-malignant lesions, and immunodeficiency. Finally, 46 female patients (mean age, 74.6 years) were analyzed. Quantitative PCR analysis was performed to detect HPV16 DNA in oral rinse samples. A total of 4 participants (8.7%) were HPV16 DNA positive. There was a significant association between the HPV16 DNA positivity rate and bleeding on probing (P=0.03). Additionally, Prevotella intermedia positive cases exhibited a significantly higher HPV16 DNA positivity rate than negative cases (33.3 vs 3.8%). Furthermore, analysis of 16S ribosomal RNA in bacterial flora was performed to examine microbiome diversity in participants with ≥6 mm periodontal pockets and bleeding on probing. Importantly, the average percentage of Porphyromonas was significantly higher in HPV16 DNA positive cases compared with in HPV16 DNA negative cases (5.57 vs. 1.44%). By contrast, the average percentage of Veillonella was significantly lower in HPV16 DNA positive cases than in HPV16 DNA negative cases (2.43 vs. 8.51%). Prevotella was also lower in HPV16 DNA positive cases than in HPV16 DNA negative cases (4.0 vs. 8.23%). These results indicated that people with both deep periodontal pocket inflammation and oral HPV16 infection may not have Prevotella- or Veillonella-dominant oral microbiomes, and their microbiomes may exhibit their own distinctive characteristics. In conclusion, the results suggested that oral HPV16 infection may be associated with periodontal inflammation in older Japanese women. Further research is required to clarify the detailed association between oral HPV infection and the oral microbiome.
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Affiliation(s)
- Hideo Shigeishi
- Department of Public Oral Health, Program of Oral Health Sciences, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8553, Japan
| | - Cheng-Yih Su
- Department of Oral Health Management, Program of Oral Health Sciences, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8553, Japan
| | - Yoshino Kaneyasu
- Department of Public Oral Health, Program of Oral Health Sciences, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8553, Japan
| | - Mari Matsumura
- Department of Public Oral Health, Program of Oral Health Sciences, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8553, Japan
| | - Mariko Nakamura
- Department of Public Oral Health, Program of Oral Health Sciences, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8553, Japan
| | - Momoko Ishikawa
- Department of Public Oral Health, Program of Oral Health Sciences, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8553, Japan
| | - Ayumi Saito
- Department of Public Oral Health, Program of Oral Health Sciences, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8553, Japan
| | - Kouji Ohta
- Department of Public Oral Health, Program of Oral Health Sciences, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8553, Japan
| | - Masaru Sugiyama
- Department of Public Oral Health, Program of Oral Health Sciences, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8553, Japan
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24
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Ali A, Lassi ZS, Kapellas K, Jamieson L, Rumbold AR. A systematic review and meta-analysis of the association between periodontitis and oral high-risk human papillomavirus infection. J Public Health (Oxf) 2020; 43:e610-e619. [PMID: 32915228 DOI: 10.1093/pubmed/fdaa156] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Revised: 07/12/2020] [Accepted: 08/10/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The incidence of human papillomavirus (HPV)-related oropharyngeal squamous cell carcinomas (OPSCCs) is increasing globally. Common oral conditions such as periodontitis may contribute. We undertook a meta-analysis to quantify the association between periodontitis, oral HPV and OPSCCs. METHODS Multiple electronic databases were searched until 12 February 2020. Studies conducted in males and/or females aged ≥ 18 years that examined periodontitis, periodontal procedures, oral HPV infection, and where possible, oral cancers, were eligible. Meta-analyses were conducted and the GRADE approach was used to examine the quality of evidence. RESULTS Of 2709 studies identified, 13 met the eligibility criteria. Five studies could be included in the meta-analyses. There was no significant increase in the odds of high-risk oral HPV infection among individuals with confirmed periodontitis (odds ratio 4.71, 95% confidence interval 0.57-38.97). Individuals with periodontitis had a 3.65 times higher odds of having any type of oral HPV infection compared with those without periodontitis (95% confidence interval 1.67-8.01). The overall body of evidence was rated as low to very-low certainty. CONCLUSION Meta-analysis confirms there is a positive association between periodontitis and oral HPV infection, although the overall quality of this evidence is low. Evidence for an association between periodontitis and high-risk oral HPV infection is inconclusive.
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Affiliation(s)
- Anna Ali
- Robinson Research Institute, The University of Adelaide, Adelaide, SA 5005 Australia
| | - Zohra S Lassi
- Robinson Research Institute, The University of Adelaide, Adelaide, SA 5005 Australia
| | - Kostas Kapellas
- Australian Research Centre for Population Oral Health Adelaide Health and Medical Sciences, The University of Adelaide, Adelaide, SA 5005 Australia
| | - Lisa Jamieson
- Australian Research Centre for Population Oral Health Adelaide Health and Medical Sciences, The University of Adelaide, Adelaide, SA 5005 Australia
| | - Alice R Rumbold
- Robinson Research Institute, The University of Adelaide, Adelaide, SA 5005 Australia.,South Australian Health and Medical Research Institute, Adelaide, SA 5000, Australia
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25
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Tang KD, Vasani S, Menezes L, Taheri T, Walsh LJ, Hughes BGM, Frazer IH, Kenny L, Scheper GC, Punyadeera C. Oral HPV16 DNA as a screening tool to detect early oropharyngeal squamous cell carcinoma. Cancer Sci 2020; 111:3854-3861. [PMID: 32713038 PMCID: PMC7540991 DOI: 10.1111/cas.14585] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 07/09/2020] [Accepted: 07/14/2020] [Indexed: 12/28/2022] Open
Abstract
Given that oropharyngeal squamous cell carcinoma (OPSCC) have now surpassed cervical cancer as the most common human papillomavirus (HPV)‐driven cancer, there is an interest in developing non‐invasive predictive biomarkers to early detect HPV‐driven OPSCC. In total, 665 cancer‐free individuals were recruited from Queensland, Australia. Oral HPV16 DNA positivity in those individuals was determined by our in‐house developed sensitive PCR method. Individuals with (n = 9) or without (n = 12) oral HPV16 infections at baseline were followed for a median duration of 24 mo. Individuals with persistent oral HPV16 infection (≥ 30 mo) were invited for clinical examination of their oral cavity and oropharynx by an otolaryngologist. Oral HPV16 DNA was detected in 12 out of 650 cancer‐free individuals (1.8%; 95% confidence interval [CI]: 1.0‐3.2). Of the 3 individuals with persistent oral HPV16 infection, the first individual showed no clinical evidence of pathology. The second individual was diagnosed with a 2 mm invasive squamous cell carcinoma (T1N0M0) positive for both p16INK4a expression and HPV16 DNA. The third individual was found to have a mildly dysplastic lesion in the tonsillar region that was negative for p16INK4a expression and HPV16 DNA and she continues to have HPV16 DNA in her saliva. Taken together, our data support the value of using an oral HPV16 DNA assay as a potential screening tool for the detection of microscopic HPV‐driven OPSCC. Larger multicenter studies across various geographic regions recruiting populations at a higher risk of developing HPV‐driven OPSCC are warranted to extend and confirm the results of the current investigation.
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Affiliation(s)
- Kai D Tang
- Saliva & Liquid Biopsy Translational Laboratory, The School of Biomedical Sciences, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia.,Translational Research Institute, Woolloongabba, QLD, Australia
| | - Sarju Vasani
- Department of Otolaryngology, Royal Brisbane and Women's Hospital, Herston, QLD, Australia
| | - Lilian Menezes
- Saliva & Liquid Biopsy Translational Laboratory, The School of Biomedical Sciences, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia
| | - Touraj Taheri
- Department of Anatomical Pathology, Royal Brisbane and Women's Hospital, Herston, QLD, Australia.,The University of Queensland School of Medicine, Saint Lucia, QLD, Australia
| | - Laurence J Walsh
- The University of Queensland School of Dentistry, Saint Lucia, QLD, Australia
| | - Brett G M Hughes
- The University of Queensland School of Medicine, Saint Lucia, QLD, Australia.,Department of Cancer Care Services, Royal Brisbane and Women's Hospital, Herston, QLD, Australia
| | - Ian H Frazer
- Faculty of Medicine, The University of Queensland, Translational Research Institute, Brisbane, QLD, Australia
| | - Liz Kenny
- The University of Queensland School of Medicine, Saint Lucia, QLD, Australia.,Department of Cancer Care Services, Royal Brisbane and Women's Hospital, Herston, QLD, Australia.,Central Integrated Regional Cancer Service, Queensland Health, Brisbane, QLD, Australia
| | - Gert C Scheper
- Janssen Vaccines & Prevention BV, Leiden, the Netherlands
| | - Chamindie Punyadeera
- Saliva & Liquid Biopsy Translational Laboratory, The School of Biomedical Sciences, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia.,Translational Research Institute, Woolloongabba, QLD, Australia
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26
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Tang KD, Vasani S, Taheri T, Walsh LJ, Hughes BGM, Kenny L, Punyadeera C. An Occult HPV-Driven Oropharyngeal Squamous Cell Carcinoma Discovered Through a Saliva Test. Front Oncol 2020; 10:408. [PMID: 32296641 PMCID: PMC7136454 DOI: 10.3389/fonc.2020.00408] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 03/09/2020] [Indexed: 12/21/2022] Open
Abstract
Oropharyngeal cancer (OPC) caused by human papillomavirus (HPV) is a rising global concern. Early lesions are small and are often located in difficult to access areas (such as the crypts of the tonsils or base of tongue). Unlike cervical cancer, there is no standard or routine screening program for HPV-driven OPC. HPV DNA from OPC tumors may shed directly into saliva, and this can be used as a biomarker for early diagnosis. In this study, we report the first-ever clinically occult OPC in an asymptomatic patient discovered through a saliva test. This case relied upon serial measurements of HPV-16 DNA in saliva, which fell to undetectable levels following low morbidity, curative treatment.
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Affiliation(s)
- Kai Dun Tang
- Saliva and Liquid Biopsy Translational Research Team, The School of Biomedical Sciences, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia
- Institute of Health and Biomedical Innovation, Translational Research Institute, Brisbane, QLD, Australia
| | - Sarju Vasani
- Department of Otolaryngology, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia
| | - Touraj Taheri
- Department of Anatomical Pathology, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia
- School of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Laurence J. Walsh
- The University of Queensland School of Dentistry, Brisbane, QLD, Australia
| | - Brett G. M. Hughes
- School of Medicine, The University of Queensland, Brisbane, QLD, Australia
- Department of Cancer Care Services, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia
| | - Lizbeth Kenny
- School of Medicine, The University of Queensland, Brisbane, QLD, Australia
- Department of Cancer Care Services, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia
- Central Integrated Regional Cancer Service, Queensland Health, Brisbane, QLD, Australia
| | - Chamindie Punyadeera
- Saliva and Liquid Biopsy Translational Research Team, The School of Biomedical Sciences, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia
- Institute of Health and Biomedical Innovation, Translational Research Institute, Brisbane, QLD, Australia
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27
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Oral HPV16 Prevalence in Oral Potentially Malignant Disorders and Oral Cavity Cancers. Biomolecules 2020; 10:biom10020223. [PMID: 32028653 PMCID: PMC7072384 DOI: 10.3390/biom10020223] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 01/28/2020] [Accepted: 01/30/2020] [Indexed: 12/16/2022] Open
Abstract
The role of human papillomavirus type 16 (HPV16) in oral potentially malignant disorders (OPMD) and oral cavity carcinoma (OC) is still under debate. We investigated HPV16 prevalence in unstimulated saliva, oral rinse samples, oral swabs and tumour biopsies collected from OPMD (n = 83) and OC (n = 106) patients. HPV16 genotype, viral load, physical status (episomal vs. integrated) and tumour p16INK4a expression were determined. Oral HPV16 prevalence was higher in OC than in OPMD, but this difference was not statistically significant (7.5% (8/106) versus 3.6% (3/83), odds ratio (OR): 2.18, 95% confidence interval (CI): 0.56, 8.48, p = 0.26). There was a significant association (p < 0.05) between oral HPV16 infection and heavy tobacco consumption. Real-time PCR results indicated that no integration events occurred in either OPMD or OC cases based on the HPV16 E2/E6 ratio. HPV16 positive OPMD and OC patients had similar HPV16 E2 and E6 viral loads. The inter-rater agreement between tumour p16INK4a expression and oral HPV16 infection was considered as fair (k = 0.361) for OC. Our data suggest that the involvement of HPV16 in oral carcinogenesis is limited.
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28
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Salivary Protein Panel to Diagnose Systolic Heart Failure. Biomolecules 2019; 9:biom9120766. [PMID: 31766659 PMCID: PMC6995570 DOI: 10.3390/biom9120766] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 11/18/2019] [Accepted: 11/19/2019] [Indexed: 12/24/2022] Open
Abstract
Screening for systolic heart failure (SHF) has been problematic. Heart failure management guidelines suggest screening for structural heart disease and SHF prevention strategies should be a top priority. We developed a multi-protein biomarker panel using saliva as a diagnostic medium to discriminate SHF patients and healthy controls. We collected saliva samples from healthy controls (n = 88) and from SHF patients (n = 100). We developed enzyme linked immunosorbent assays to quantify three specific proteins/peptide (Kallikrein-1, Protein S100-A7, and Cathelicidin antimicrobial peptide) in saliva samples. The analytical and clinical performances and predictive value of the proteins were evaluated. The analytical performances of the immunoassays were all within acceptable analytical ranges. The multi-protein panel was able to significantly (p < 0.001) discriminate saliva samples collected from patients with SHF from controls. The multi-protein panel demonstrated good performance with an overall diagnostic accuracy of 81.6% (sensitivity of 79.2% and specificity of 85.7%) when distinguishing SHF patients from healthy individuals. In conclusion, we have developed immunoassays to measure the salivary concentrations of three proteins combined as a panel to accurately distinguish SHF patients from healthy controls. While this requires confirmation in larger cohorts, our findings suggest that this three-protein panel has the potential to be used as a biomarker for early detection of SHF.
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29
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Mosmann JP, Talavera AD, Criscuolo MI, Venezuela RF, Kiguen AX, Panico R, Ferreyra De Prato R, López De Blanc SA, ré V, Cuffini CG. Sexually transmitted infections in oral cavity lesions: Human papillomavirus, Chlamydia trachomatis, and Herpes simplex virus. J Oral Microbiol 2019; 11:1632129. [PMID: 31275530 PMCID: PMC6598522 DOI: 10.1080/20002297.2019.1632129] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Accepted: 06/10/2019] [Indexed: 01/18/2023] Open
Abstract
Objective: Provide evidence of HPV, C. trachomatis, and HSV infection in the oral cavity from patients with different types of stomatological lesions. Materials and Methods: Oral swabs samples were collected from a total of 318 patients. The infectious agents were analyzed using the PCR technique. HPV genotyping and HSV type were studied using the RFLP method. Results: We studied 137 benign lesions (B), 96 potentially malignant disorders (PMD) and 85 oral squamous cell carcinomas (OSCC). The prevalence of HPV was 34%. The most frequently genotypes detected were 6 low risk and 16 high risk. The prevalence of C. trachomatis was 16% and HSV 3%. Co-infections were detected mostly in benign lesions as following: HPV-C. trachomatis in 4%, C. trachomatis- HSV in 1.8% and HPV-HSV in 0.3%. Conclusion: This report is the first contribution to the identification and genotype characterization of HPV in a scenario little studied in our area, and it also contributes to improving our understanding on sexually transmitted infectious agents and their associations with the oral cavity. Besides, we detect the presence of C. trachomatis and HSV and co-infection with HPV in the oral cavity, which they should be taken into account for diagnostic and treatment purposes.
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Affiliation(s)
- Jessica P. Mosmann
- Instituto de Virología “Dr. J. M. Vanella”, Facultad de Ciencias Médicas – Universidad Nacional de Córdoba, Córdoba, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Córdoba, Argentina
| | - Angel D. Talavera
- Cátedra de Estomatología, Facultad de Odontología- Universidad Nacional de Córdoba, Córdoba, Argentina
| | - María I. Criscuolo
- Cátedra de Estomatología, Facultad de Odontología- Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Raúl F. Venezuela
- Instituto de Virología “Dr. J. M. Vanella”, Facultad de Ciencias Médicas – Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Ana X. Kiguen
- Instituto de Virología “Dr. J. M. Vanella”, Facultad de Ciencias Médicas – Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Rene Panico
- Cátedra de Estomatología, Facultad de Odontología- Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Ruth Ferreyra De Prato
- Cátedra de Estomatología, Facultad de Odontología- Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Silvia A. López De Blanc
- Cátedra de Estomatología, Facultad de Odontología- Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Viviana ré
- Instituto de Virología “Dr. J. M. Vanella”, Facultad de Ciencias Médicas – Universidad Nacional de Córdoba, Córdoba, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Córdoba, Argentina
| | - Cecilia G. Cuffini
- Instituto de Virología “Dr. J. M. Vanella”, Facultad de Ciencias Médicas – Universidad Nacional de Córdoba, Córdoba, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Córdoba, Argentina
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30
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Abstract
Papillomaviruses are one of the oldest viruses known, dating back 330 million years. During this long evolution, human papillomaviruses (HPV) have developed into hijackers of human cellular and immune systems in which they replicate and remain silent. Systematic studies on oral HPV infections and their outcomes are still scarce. Oral HPV infections have been linked to sexual behaviour, but recent evidence supports their horizontal, mouth‐to‐mouth, transmission. Most HPV infections in infants are acquired vertically from the mother during the intrauterine period, during delivery, or later via saliva. The best‐known benign clinical manifestations of HPV infection are oral papilloma/condyloma and focal epithelial hyperplasia. Evidence is emerging which suggests that some oral HPV infections might persist. Persistent HPV infection is mandatory for HPV‐associated malignant transformation. However, progression of HPV‐induced lesions to malignancy requires additional cofactors. In the early 1980s, we provided the first evidence that a subset of oral cancers and other head and neck cancers might be causally linked to HPV infection. This review summarizes current knowledge on the virus itself, its transmission modes, as well as the full spectrum of oral HPV infections – from asymptomatic infections to benign, potentially malignant oral lesions, and squamous cell carcinoma.
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Affiliation(s)
- Stina Syrjänen
- Department of Oral Pathology and Oral Radiology, Institute of Dentistry, Faculty of Medicine, University of Turku, Turku, Finland.,Department of Pathology, Turku University Hospital, Turku, Finland
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Unlocking the Potential of Saliva-Based Test to Detect HPV-16-Driven Oropharyngeal Cancer. Cancers (Basel) 2019; 11:cancers11040473. [PMID: 30987261 PMCID: PMC6521163 DOI: 10.3390/cancers11040473] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 03/19/2019] [Accepted: 03/26/2019] [Indexed: 12/12/2022] Open
Abstract
The incidence of human papillomavirus (HPV)-positive oropharyngeal cancer (OPC) is rising in high-income countries, including Australia. Increasing evidence suggests that accurate HPV testing is pivotal for clinical decision making and treatment planning in these patients. Recently, the eighth edition of the American Joint Committee on Cancer/Union for International Cancer Control (AJCC/UICC) tumor-node-metastasis (TNM) staging system for OPC (based on the p16INK4a (p16) status) was proposed and has been implemented. However, the applicability of this new staging system is still far from clear. In our study, n = 127 OPC patients from Queensland, Australia were recruited, and the tumor p16 expression in these patients was examined using immunohistochemical (IHC) analysis. HPV-16 genotyping, viral load, and physical status (episomal versus integrated) in the saliva samples of OPC patients were determined using the qPCR method. A good inter-rater agreement (k = 0.612) was found between tumor p16 expression and oral HPV-16 infection in OPC. Importantly, according to the eighth edition staging system, HPV-16 DNA viral load (>10 copies/50 ng) was significantly associated with the advanced stages of OPC. In concordance with previous studies, a mixed HPV-16 form (partially or fully integrated) was predominately found in OPC patients. Taken together, our data support HPV-16 detection in saliva as a screening biomarker to identify people within the community who are at risk of developing OPC.
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Abstract
Purpose of Review Research suggests that periodontal tissue might serve as a reservoir for oral human papillomavirus (HPV) infection, while another hypothesis is that chronic inflammation of the tissue might perpetuate an infection with oral HPV infection. In this narrative review, we summarize the evidence related to a potential association between oral HPV infection and periodontitis. Recent Findings Twelve articles were identified, and their key findings summarized. Studies vary in sample size, study population, study design, and methods for assessment of oral HPV and periodontitis. Although results are conflicting and still inconclusive, various studies have found an association between oral HPV infection and periodontitis, which is supported by biological plausibility. Summary Future longitudinal studies should further evaluate this association, using clinical definitions of oral HPV infection and periodontitis, and focusing on high-risk populations for oral HPV infection. Studying this association is important since periodontitis might help identify at-risk individuals for oral HPV infection and potentially HPV-related oropharyngeal cancers.
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Tang KD, Kenny L, Frazer IH, Punyadeera C. High‐risk human papillomavirus detection in oropharyngeal cancers: Comparison of saliva sampling methods. Head Neck 2018; 41:1484-1489. [DOI: 10.1002/hed.25578] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 09/04/2018] [Accepted: 12/05/2018] [Indexed: 12/12/2022] Open
Affiliation(s)
- Kai Dun Tang
- The School of Biomedical Sciences, Institute of Health and Biomedical InnovationQueensland University of Technology Kelvin Grove Queensland Australia
- The Translational Research Institute Brisbane Queensland Australia
| | - Liz Kenny
- School of MedicineUniversity of Queensland Brisbane Queensland Australia
- Royal Brisbane and Women's Hospital Brisbane Queensland Australia
- Central Integrated Regional Cancer ServiceQueensland Health Brisbane Queensland Australia
| | - Ian H. Frazer
- Faculty of Medicine, Translational Research InstituteThe University of Queensland Brisbane Queensland Australia
| | - Chamindie Punyadeera
- The School of Biomedical Sciences, Institute of Health and Biomedical InnovationQueensland University of Technology Kelvin Grove Queensland Australia
- The Translational Research Institute Brisbane Queensland Australia
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Lim Y, Fukuma N, Totsika M, Kenny L, Morrison M, Punyadeera C. The Performance of an Oral Microbiome Biomarker Panel in Predicting Oral Cavity and Oropharyngeal Cancers. Front Cell Infect Microbiol 2018; 8:267. [PMID: 30123780 PMCID: PMC6085444 DOI: 10.3389/fcimb.2018.00267] [Citation(s) in RCA: 71] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Accepted: 07/17/2018] [Indexed: 12/23/2022] Open
Abstract
The oral microbiome can play a role in the instigation and progression of oral diseases that can manifest into other systemic conditions. These associations encourage the exploration of oral dysbiosis leading to the pathogenesis of cancers. In this study, oral rinse was used to characterize the oral microbiome fluctuation associated with oral cavity cancer (OCC) and oropharyngeal cancers (OPC). The study cohort consists of normal healthy controls (n = 10, between 20 and 30 years of age; n = 10, above 50 years of age), high-risk individuals (n = 11, above 50 years of age with bad oral hygiene and/or oral diseases) and OCC and OPC patients (n = 31, HPV-positive; n = 21, HPV-negative). Oral rinse samples were analyzed using 16S rRNA gene amplicon sequencing on the MiSeq platform. Kruskal–Wallis rank test was used to identify genera associated with OCC and OPC. A logistic regression analysis was carried out to determine the performance of these genera as a biomarker panel to predict OCC and OPC. In addition, a two-fold cross-validation with a bootstrap procedure was carried out in R to investigate how well the panel would perform in an emulated clinical scenario. Our data indicate that the oral microbiome is able to predict the presence of OCC and OPC with sensitivity and specificity of 100 and 90%, respectively. With further validation, the panel could potentially be implemented into clinical diagnostic and prognostic workflows for OCC and OPC.
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Affiliation(s)
- Yenkai Lim
- The School of Biomedical Sciences, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia.,Translational Research Institute, Brisbane, QLD, Australia
| | - Naoki Fukuma
- The Department of Life and Food Science, Obihiro University of Agriculture and Veterinary Medicine, Obihiro, Japan
| | - Makrina Totsika
- The School of Biomedical Sciences, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia
| | - Liz Kenny
- The School of Medicine, University of Queensland, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia
| | - Mark Morrison
- Translational Research Institute, University of Queensland Diamantina Institute, University of Queensland, Brisbane, QLD, Australia
| | - Chamindie Punyadeera
- The School of Biomedical Sciences, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia.,Translational Research Institute, Brisbane, QLD, Australia
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Fung N, Faraji F, Kang H, Fakhry C. The role of human papillomavirus on the prognosis and treatment of oropharyngeal carcinoma. Cancer Metastasis Rev 2018; 36:449-461. [PMID: 28812214 DOI: 10.1007/s10555-017-9686-9] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Human papillomavirus positive oropharyngeal cancer (HPV-positive OPC) is a distinct subtype of head and neck carcinoma (HNC) distinguished from HPV-negative HNC by its risk factor profile, clinical behavior, and molecular biology. Compared to HPV-negative HNC, HPV-positive OPC exhibits significantly better prognosis and an enhanced response to treatment. Recognition of the survival benefit of HPV-positive tumors has led to therapeutic de-intensification strategies aiming to mitigate treatment-related toxicities while maintaining high response rates. In this review, we summarize key aspects of oral HPV infection and the molecular mechanisms of HPV-related carcinogenesis. We review the clinical and molecular characteristics of HPV-positive OPC that contribute to its improved prognosis compared to HPV-negative HNC. We also discuss current and emerging treatment strategies, emphasizing potential mechanisms of treatment sensitivity and the role of therapeutic de-intensification in HPV-positive OPC. Lastly, we examine literature on the management and prognosis of recurrent/metastatic HPV-positive OPC with a focus on the role of salvage surgery in its management.
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Affiliation(s)
- Nicholas Fung
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, 601 N. Caroline Street, Sixth Floor, Baltimore, MD, 21287, USA
| | - Farhoud Faraji
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, 601 N. Caroline Street, Sixth Floor, Baltimore, MD, 21287, USA
| | - Hyunseok Kang
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Carole Fakhry
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, 601 N. Caroline Street, Sixth Floor, Baltimore, MD, 21287, USA. .,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
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Dalla Torre D, Burtscher D, Sölder E, Rasse M, Puelacher W. The correlation between the quality of oral hygiene and oral HPV infection in adults: a prospective cross-sectional study. Clin Oral Investig 2018; 23:179-185. [PMID: 29574499 DOI: 10.1007/s00784-018-2425-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Accepted: 03/19/2018] [Indexed: 12/29/2022]
Abstract
OBJECTIVES Various risk factors for oral human papillomavirus (HPV) infections have been described, including tobacco smoking and sexual behavior. However, less is known about the influence of oral health on such infections. The present study aimed to determine a possible association between the quality of oral hygiene and the presence of oral HPV. METHODS In a prospective analysis, the approximal plaque index (API), the gingival bleeding index (GBI), and the lifetime number of extracted teeth was determined in 187 patients. Additionally, the presence of oral low-risk and/or high-risk HPV was investigated by brush smear testing in all participants. RESULTS Seventy-four patients had an API < 20%, 84 participants showed an API of 20-40%, and in 29 cases, an API > 40% was recorded. Ninety-six patients presented a GBI < 20%, 75 had a GBI of 20-40%, and 16 showed a GBI > 40%. One hundred four patients had experienced one to three extractions, and 36 had lost more than three teeth. Thirty-nine participants had a positive oral HPV testing (27 high-risk HPV, 26 low-risk HPV, 14 low- and high-risk HPV). A higher API respectively GBI and a greater number of extracted teeth were significantly correlated with the presence of high-risk HPV. The presence of low-risk HPV was significantly higher in patients with API > 40% and GBI > 40% (OR 7.89). Similar results were found regarding the number of extracted teeth. CONCLUSION The present analysis confirms a relationship between the quality of oral hygiene, determined by objective markers. Thus, improvement of oral health may reduce the incidence of oral HPV infection. CLINICAL SIGNIFICANCE The present article investigates the relationship between oral hygiene and the presence of oral HPV. As a significant correlation between these two factors could be recorded, improvement of oral hygiene may reduce actively the incidence of oral HPV. Thereby, good oral hygiene may contribute oral cancer prevention.
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Affiliation(s)
- Daniel Dalla Torre
- University Clinic of Craniomaxillofacial Surgery, Medical University Innsbruck, Anichstrasse 35, Innsbruck, Austria.
| | - D Burtscher
- University Clinic of Prosthodontics, Medical University Innsbruck, Innsbruck, Austria
| | - E Sölder
- University Clinic of Obstetrics and Gynecology, Medical University Innsbruck, Innsbruck, Austria
| | - M Rasse
- University Clinic of Craniomaxillofacial Surgery, Medical University Innsbruck, Anichstrasse 35, Innsbruck, Austria
| | - W Puelacher
- University Clinic of Craniomaxillofacial Surgery, Medical University Innsbruck, Anichstrasse 35, Innsbruck, Austria
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Gipson BJ, Robbins HA, Fakhry C, D'Souza G. Sensitivity and specificity of oral HPV detection for HPV-positive head and neck cancer. Oral Oncol 2018; 77:52-56. [PMID: 29362127 PMCID: PMC5788034 DOI: 10.1016/j.oraloncology.2017.12.008] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Revised: 12/09/2017] [Accepted: 12/13/2017] [Indexed: 12/29/2022]
Abstract
BACKGROUND The incidence of HPV-related head and neck squamous cell carcinoma (HPV-HNSCC) is increasing. Oral samples are easy and non-invasive to collect, but the diagnostic accuracy of oral HPV detection methods for classifying HPV-positive HNSCC tumors has not been well explored. METHODS In a systematic review, we identified eight studies of HNSCC patients meeting our eligibility criteria of having: (1) HPV detection in oral rinse or oral swab samples, (2) tumor HPV or p16 testing, (3) a publication date within the last 10 years (January 2007-May 2017, as laboratory methods change), and (4) at least 15 HNSCC cases. Data were abstracted from each study and a meta-analysis performed to calculate sensitivity and specificity. RESULTS Eight articles meeting inclusion criteria were identified. Among people diagnosed with HNSCC, oral HPV detection has good specificity (92%, 95% CI = 82-97%) and moderate sensitivity (72%, 95% CI = 45-89%) for HPV-positive HNSCC tumor. Results were similar when restricted to studies with only oropharyngeal cancer cases, with oral rinse samples, or testing for HPV16 DNA (instead of any oncogenic HPV) in the oral samples. DISCUSSION Among those who already have HNSCC, oral HPV detection has few false-positives but may miss one-half to one-quarter of HPV-related cases (false-negatives). Given these findings in cancer patients, the utility of oral rinses and swabs as screening tests for HPV-HNSCC among healthy populations is probably limited.
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Affiliation(s)
- Brooke J Gipson
- Department of Global and Community Health, George Mason University College of Health and Human Services, United States; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, United States
| | - Hilary A Robbins
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, United States
| | - Carole Fakhry
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, United States
| | - Gypsyamber D'Souza
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, United States.
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Tang KD, Kenny L, Perry C, Frazer I, Punyadeera C. The overexpression of salivary cytokeratins as potential diagnostic biomarkers in head and neck squamous cell carcinomas. Oncotarget 2017; 8:72272-72280. [PMID: 29069786 PMCID: PMC5641129 DOI: 10.18632/oncotarget.19731] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Accepted: 06/28/2017] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Cytokeratin (CK) intermediate filaments are demonstrated to have enormous potential in regulating cellular motility and cancer progression. There are more than 20 divergent CKs that have been identified, of which CK 8, 17, 18 and 19 are reported to be elevated in the tumour biopsies of head and neck cancer squamous cell carcinoma (HNSCC) patients. However, CK expression profiles in the saliva of HNSCC patients have not been investigated. We aim to investigate the mRNA expression profiles of CKs in saliva collected from healthy controls, HPV-negative and -positive HNSCC patients. METHODS Oral rinse samples were collected from 42 cancer-free healthy controls (age-matched) and patients who have been diagnosed with HPV-negative (n = 20) and -positive (n = 48) HNSCC. RESULTS Here, we report that the mRNA expression profiles of CKs differed in saliva collected from healthy controls and HNSCC patients. The mRNA expression levels of CK 8 and 18 were significantly elevated in saliva collected from HPV-negative HNSCC patients; whilst, CK 17 and 19 were expressed at a higher mRNA level in saliva collected from HPV-positive HNSCC patients compared to healthy controls. Importantly, receiver operating characteristic (ROC) analysis showed salivary CK 8 and 18 to have superior sensitivity and specificity in discriminating the HPV-negative HNSCC patients from healthy controls (80% and 86%) as well as between HPV-negative and -positive HNSCC patients (75% and 81%). CONCLUSION In summary, we have demonstrated that an aberrant expression of salivary CKs may serve as a potential non-invasive diagnostic biomarker in HNSCC.
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Affiliation(s)
- Kai Dun Tang
- The School of Biomedical Sciences, Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia.,The Translational Research Institute, Woolloongabba, Australia
| | - Liz Kenny
- School of Medicine, University of Queensland, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.,Central Integrated Regional Cancer Service, Queensland Health, Brisbane, Queensland, Australia
| | - Chris Perry
- Department of Otolaryngology, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
| | - Ian Frazer
- The University of Queensland Diamantina Institute, Translational Research Institute, Woolloongabba, Queensland, Australia
| | - Chamindie Punyadeera
- The School of Biomedical Sciences, Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia.,The Translational Research Institute, Woolloongabba, Australia
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Abstract
INTRODUCTION MicroRNAs (miRs) are short (~20 nucleotides) non-coding ribonuecleic acids (ncRNAs) known to be involved in cellular processes such as proliferation, differentiation, immune response, pathogenicity and tumourigenesis, among many others. The regulatory mechanisms exerted by miRs have been implicated in many cancers, including Human Papillomavirus (HPV)-associated cancers. Areas covered: In this review, the authors discuss the involvement of miRs (-143, -375, -21, -200, -296 etc.) that have been shown to be dysregulated in HPV-associated cancers. This review also encompasses both intracellular and exosomal miRs, and their potential as diagnostic biomarkers in saliva and blood. The authors have also attempted to dissect the functional impact of miRs on cellular processes such as changes in cellular polarity, loss of apoptosis and tumour suppression, and unchecked and uncontrolled cell cycle regulation, all of which ultimately lead to aberrant cellular proliferation. Expert commentary: Identification of dysregulated miRs in HPV-associated cancers opens up new opportunities to develop diagnostic, therapeutic and prognostic biomarkers. Studies on global expression patterns of miRs dysregulated in HPV-associated cancers can be instrumental in developing broader therapeutic strategies. Therapies like anti-miR, miR-replacement and those based on alternative natural products targeting miRs, need to be improved and better synchronized to be cost-effective and have better treatment outcomes.
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