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Samimi M, Molet L, Fleury M, Laude H, Carlotti A, Gardair C, Baudin M, Gouguet L, Maubec E, Avenel-Audran M, Esteve E, Wierzbicka-Hainaut E, Beneton N, Aubin F, Rozenberg F, Dupin N, Avril MF, Lorette G, Guyetant S, Coursaget P, Touzé A. Prognostic value of antibodies to Merkel cell polyomavirus T antigens and VP1 protein in patients with Merkel cell carcinoma. Br J Dermatol 2016; 174:813-22. [PMID: 26600395 DOI: 10.1111/bjd.14313] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/16/2015] [Indexed: 02/01/2023]
Abstract
BACKGROUND Merkel cell polyomavirus (MCPyV) is the main aetiological agent of Merkel cell carcinoma (MCC). Serum antibodies against the major MCPyV capsid protein (VP1) are detected in the general population, whereas antibodies against MCPyV oncoproteins (T antigens) have been reported specifically in patients with MCC. OBJECTIVES The primary aim was to assess whether detection of serum antibodies against MCPyV proteins at baseline was associated with disease outcome in patients with MCC. The secondary aim was to establish whether evolution of these antibodies during follow-up was associated with the course of the disease. METHODS Serum T-antigen and VP1 antibodies were assessed by enzyme-linked immunosorbent assay using recombinant proteins in a cohort of 143 patients with MCC, including 84 patients with serum samples available at baseline. RESULTS Low titres of VP1 antibodies at baseline (< 10 000) were significantly and independently associated with increased risk of recurrence [hazard ratio (HR) 2·71, 95% confidence interval (CI) 1·13-6·53, P = 0·026] and death (HR 3·74, 95% CI 1·53-9·18, P = 0·004), whereas T-antigen antibodies were not found to be associated with outcome. VP1 antibodies did not differ between patients in remission and those with recurrence or progression during follow-up. However, T-antigen antibodies were more frequently detected in patients with recurrence or progression at 12 months (P = 0·020) and 24 months (P = 0·016) after diagnosis. CONCLUSIONS VP1 antibodies constitute a prognostic marker at baseline, whereas T-antigen antibodies constitute a marker of disease recurrence or progression if detected > 12 months after diagnosis.
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Affiliation(s)
- M Samimi
- Université François Rabelais, Tours, France.,INRA, UMR 1282 ISP, 31 Avenue Monge, 37200, Tours, France.,Dermatology Department, CHU Tours, Avenue de la République, 37170, Tours, France
| | - L Molet
- Assistance Publique des Hôpitaux de Paris, Virology, Pathology and Dermatology Departments, Hôpital Cochin, 27 Rue du Fbg Saint-Jacques, 75679, Paris CEDEX 14, France.,Institut Cochin, Inserm U1016, Université Paris Descartes, 22 Rue Méchain, 75014, Paris, France
| | - M Fleury
- Université François Rabelais, Tours, France.,INRA, UMR 1282 ISP, 31 Avenue Monge, 37200, Tours, France.,LUNAM Université, Groupe d'Etude des Interactions Hôte-Pathogéne, UPRES EA 3142, Angers, France
| | - H Laude
- Assistance Publique des Hôpitaux de Paris, Virology, Pathology and Dermatology Departments, Hôpital Cochin, 27 Rue du Fbg Saint-Jacques, 75679, Paris CEDEX 14, France.,Institut Cochin, Inserm U1016, Université Paris Descartes, 22 Rue Méchain, 75014, Paris, France
| | - A Carlotti
- Assistance Publique des Hôpitaux de Paris, Virology, Pathology and Dermatology Departments, Hôpital Cochin, 27 Rue du Fbg Saint-Jacques, 75679, Paris CEDEX 14, France
| | - C Gardair
- Université François Rabelais, Tours, France.,Pathology Department, CHU Tours, Avenue de la République, 37170, Tours, France
| | - M Baudin
- Université François Rabelais, Tours, France.,INRA, UMR 1282 ISP, 31 Avenue Monge, 37200, Tours, France
| | - L Gouguet
- Université François Rabelais, Tours, France.,INRA, UMR 1282 ISP, 31 Avenue Monge, 37200, Tours, France
| | - E Maubec
- Assistance Publique des Hôpitaux de Paris, Dermatology Department, Hôpital Bichat, 46 Rue Henri Huchard, 75877, Paris CEDEX 18, France.,Assistance Publique des Hôpitaux de Paris, Dermatology Department, Hôpital Avicenne, 125, rue de Stalingrad, 93009, Bobigny, France
| | - M Avenel-Audran
- LUNAM Université, CHU Angers, Dermatology Department, 4 Rue Larrey, 49933, Angers, France
| | - E Esteve
- CHR Orléans, Dermatology Department, 14 Avenue de l'Hôpital, 45067, Orléans CEDEX 2, France
| | - E Wierzbicka-Hainaut
- CHU Poitiers, Dermatology Department, 2 Rue de la Milétrie, 86021, Poitiers CEDEX, France
| | - N Beneton
- CHR Le Mans, Dermatology Department, 194 Avenue Rubillard, 72037, Le Mans CEDEX 09, France
| | - F Aubin
- Université de Franche Comté, EA3181, SFR 4234, CHU Besançon, Dermatology Department, 2 Boulevard Fleming, 25030, Besançon, France
| | - F Rozenberg
- Assistance Publique des Hôpitaux de Paris, Virology, Pathology and Dermatology Departments, Hôpital Cochin, 27 Rue du Fbg Saint-Jacques, 75679, Paris CEDEX 14, France.,Institut Cochin, Inserm U1016, Université Paris Descartes, 22 Rue Méchain, 75014, Paris, France
| | - N Dupin
- Assistance Publique des Hôpitaux de Paris, Virology, Pathology and Dermatology Departments, Hôpital Cochin, 27 Rue du Fbg Saint-Jacques, 75679, Paris CEDEX 14, France.,Institut Cochin, Inserm U1016, Université Paris Descartes, 22 Rue Méchain, 75014, Paris, France
| | - M F Avril
- Assistance Publique des Hôpitaux de Paris, Virology, Pathology and Dermatology Departments, Hôpital Cochin, 27 Rue du Fbg Saint-Jacques, 75679, Paris CEDEX 14, France.,Institut Cochin, Inserm U1016, Université Paris Descartes, 22 Rue Méchain, 75014, Paris, France
| | - G Lorette
- Université François Rabelais, Tours, France.,INRA, UMR 1282 ISP, 31 Avenue Monge, 37200, Tours, France.,Dermatology Department, CHU Tours, Avenue de la République, 37170, Tours, France
| | - S Guyetant
- Université François Rabelais, Tours, France.,Pathology Department, CHU Tours, Avenue de la République, 37170, Tours, France
| | - P Coursaget
- Université François Rabelais, Tours, France.,INRA, UMR 1282 ISP, 31 Avenue Monge, 37200, Tours, France
| | - A Touzé
- Université François Rabelais, Tours, France.,INRA, UMR 1282 ISP, 31 Avenue Monge, 37200, Tours, France
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Samimi M, Touzé A, Laude H, Le Bidre E, Arnold F, Carpentier A, Gardair C, Carlotti A, Maubec E, Dupin N, Aubin F, Avril MF, Rozenberg F, Avenel-Audran M, Guyetant S, Lorette G, Machet L, Coursaget P. Vitamin D deficiency is associated with greater tumor size and poorer outcome in Merkel cell carcinoma patients. J Eur Acad Dermatol Venereol 2013; 28:298-308. [PMID: 23368852 DOI: 10.1111/jdv.12101] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2012] [Accepted: 12/20/2012] [Indexed: 12/31/2022]
Abstract
BACKGROUND Merkel cell polyomavirus has been recognized to be associated with Merkel cell carcinoma (MCC), but the evolution of this cancer probably depends on various factors. Vitamin D deficiency, defined by serum 25-hydroxyvitamin D levels <50 nmol/L, seems to influence cancer behavior and progression, but has never been assessed in MCC patients. OBJECTIVES First, to evaluate whether vitamin D deficiency was associated with tumor characteristics and prognosis in a cohort of MCC patients. Second, to assess expression of the vitamin D receptor (VDR) in MCC tumors. METHODS Clinical findings, Merkel cell polyomavirus markers and vitamin D status were assessed in a cohort of French MCC patients. The study was limited to the 89 patients for whom the serum sample had been collected within 3 years after the diagnosis of MCC. Correlation between vitamin D deficiency and MCC characteristics and outcome were determined in regression analyses. VDR expression in MCC tumours was assessed by immunohistochemistry. RESULTS Vitamin D deficiency was noted in 65.1% of the patients and was independently associated with greater tumor size at diagnosis (P = 0.006) and with metastasis recurrence (HR, 2.89; 95% CI, 1.03 to 8.13; P = 0.043), but not with death from MCC, although there was a trend (HR, 5.28; 95% CI, 0.75 to 36.96; P = 0.093). VDR was found to be strongly expressed in all 28 MCC tumor specimens investigated. CONCLUSION The association between vitamin D deficiency and MCC characteristics and outcome, together with detection of the VDR in MCC cells, suggest that vitamin D could influence the biology of MCC.
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Affiliation(s)
- M Samimi
- INRA ISP, UMR 1282, Tours, France; Université François Rabelais, Tours, France; CHRU de Tours, Service de Dermatologie, Tours, France
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