Focal Epithelial Hyperplasia

Focal epithelial hyperplasia (FEH) or Heck’s disease is a rare, benign, oral condition that is associated with infection by human papillomavirus type 13, 32 or both. The whiteish to mucosal-colored, soft, papular or nodular elevated lesions in the oral cavity are normally asymptomatic but can grow to a size or at a location where treatment is needed. The diagnosis is often based on clinical presentation and histopathology, and the HPV genotype can be determined using PCR utilizing specific primers or DNA sequencing. While FEH was reported to often affect several members of the same family and exist primarily among indigenous populations around the world, the number of reported cases within the European region is increasing. This contemporary review summarizes the main findings in relation to HPV genotypes, impact of superinfection exclusion and vaccination, transmission, diagnosis, geographical and ethnical distribution, comorbidities and treatment of FEH with an emphasis on including the most recent case reports within the field. Furthermore, we describe for the first time a FEH lesion infected with the low-risk HPV90.

Human papillomavirus type 13: Genome amplification and characterization data

As for 2020 only two complete genomes of Human papillomavirus type 13 (HPV13) are publicly available in GenBank database. In addition, reports of partial sequences of genetic regions are very limited. Therefore, genomic research that contributes to knowledge of viral components involved in HPV13 pathogenesis, and molecular mechanisms associated to multifocal epithelial hyperplasia (MEH) disease are urged. In the accompanying paper [1], we aimed to obtain the complete genome sequence of HPV13 associated to MEH disease, obtained from a Mayan boy living in Yucatan, Mexico. Coding sequences were annotated, and viral proteins traduced and deposited in GenBank with accession number MT068446. In this data report, we present the oligonucleotide list used to amplify the complete genome, a graphical abstract of process employed for the amplification of circular HPV13 genome, a representative figure of PCR products obtained for sequencing and multiple sequence alignments with the translated coding sequences of the existing genomes: X62843 is the first HPV13 genome reported [2]; it was generated from a clone obtained from a Turkish patient; DQ344807 was originally obtained from a patient in the Amazonian region [3]. The multiple sequence alignments show the main viral proteins (predicted). This provides relevant information for future molecular analysis and epidemiological studies because HPV13 is an understudied genotype associated to a neglected disease that appears more commonly in children. Additionally, the description of the methods can help in future sequencing of HPV genomes. We hope that our solutions will help researchers who do not have next-generation sequencing (NGS) platforms. A more comprehensive analysis of this data may be obtained from “Genomic characterization of Human papillomavirus type 13, associated to Multifocal Epithelial Hyperplasia, in a Mayan community” [1].

Genomic characterization of human papillomavirus type 13, associated to multifocal epithelial hyperplasia, in a Mayan community

Human papillomavirus type 13 (HPV13) is a low-risk HPV type associated with Multifocal Epithelial Hyperplasia (MEH). It is considered a rare pathology of oral mucosa, more prevalent in certain ethnical groups, such as the Maya from Yucatan in Mexico. As for 2020 only two complete genomes of HPV13 are publicly available in Genbank database (one from Turkey one from the Amazonian). We aimed to obtain the complete genome sequence of HPV13 associated to MEH, obtained from a community in the Mayan area from Mexico. A bank of oral swabs from children with MEH were used. To enrich the sample, a Rolling Cycle Amplification (RCA) method was performed followed by overlapping end-point PCR of 500 bp fragments, Sanger sequencing and assembly. Eight open reading frames (ORFs) were annotated (E1, E2, E4, E5, E6, E7, L1 and L2 genes). When compared with the other two previously reported genomes the identity at nucleotide level is high 98.9% and 99.6%, respectively. The phylogenetic tree shows that Yucatan HPV13 is more closely related to HPV13 obtained from the Amazonian. Most changes identified at amino acid level are substitutions derived from nucleotide variations or SNPs in coding regions. Amino-acid changes were observed in E2 and E1 proteins (n ≥ 8), and in L1, L2, E6 and E5 proteins (n ≤ 5). E7 protein from Yucatan has 100% identity with the reported from Amazonian and differs (94.1% identity) with the one from Turkey due to 3 substitutions and three missing amino acids. In conclusion, the genome from HPV13 (7831 bp, 49 nt missing) associated to MEH in the Mayan area from Yucatan was obtained from stored swabs; this is the first effort in Mexico, the second in Latin America, and the third of the world. More research that contributes to the knowledge of the determinants underlying this neglected pathology are urged.

Epidemiology of oral HPV in the oral mucosa in women without signs of oral disease from Yucatan, Mexico

High-risk human papillomaviruses (HR-HPV) are considered necessary for the development of cervical cancer. Furthermore, there is no doubt that some types of oral squamous cell carcinoma are associated with HR-HPV. The epidemiology of oral HPV infections in healthy subjects remains unclear due to a lack of knowledge. The objective of this study was to investigate the epidemiology of human papillomavirus infections of the oral mucosa without pathology. A cross-sectional study was performed; samples from 390 women seeking prenatal care, Pap smears, family planning or gynecological diseases were studied. Oral cells were collected by direct swab sampling. Information regarding sociodemographic status, sexual behavior, infectious diseases, contraceptive history and tobacco and alcohol consumption were obtained through direct interviews. HPV and genotypes were detected by type-specific polymerase chain reaction. Our results revealed that 14% of the women studied had an oral HPV infection. Women ≤ 20 years of age had the highest HPV prevalence (24.5%). In total, seven genotypes were identified, including the high-risk genotypes 16, 18, 58 and 59 and the low-risk genotypes 6, 81 and 13, the latter of which is a type exclusive to oral mucosa. Sexual behavior was not associated with the presence of genital HPV types in the oral mucosa. Genital HPV types were present in the oral mucosa of women without associated clinical manifestations; however, sexual behavior was not associated with infection, and therefore others routes of transmission should be explored.