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Papasavvas E, Surrey LF, Glencross DK, Azzoni L, Joseph J, Omar T, Feldman MD, Williamson AL, Siminya M, Swarts A, Yin X, Liu Q, Firnhaber C, Montaner LJ. High-risk oncogenic HPV genotype infection associates with increased immune activation and T cell exhaustion in ART-suppressed HIV-1-infected women. Oncoimmunology 2016; 5:e1128612. [PMID: 27467943 DOI: 10.1080/2162402x.2015.1128612] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Revised: 12/01/2015] [Accepted: 12/02/2015] [Indexed: 10/22/2022] Open
Abstract
Persistence of human papillomavirus (HPV) and cervical disease in the context of HIV co-infection can be influenced by introduction of antiretroviral therapy (ART) and sustained immune activation despite ART. We conducted a cross-sectional study in order to evaluate immune activation/exhaustion in ART-suppressed HIV(+) women with or without high-risk (HR) HPV-related cervical intraepithelial neoplasia (CIN). 55 South African women were recruited in three groups: HR (-) (n = 16) and HR (+) (n = 15) HPV with negative cervical histopathology, and HR (+) HPV with CIN grade 1/2/3 (n = 24). Sampling included endocervical brushing (HPV DNA genotyping), Pap smear (cytology), colposcopic punch biopsy (histopathology, histochemical evaluation of immune cells), and peripheral blood (clinical assessment, flow cytometry-based immune subset characterization). Statistics were done using R2.5.1. Irrespective of the presence of CIN, HR (+) HPV women had higher circulating levels of T cells expressing markers of activation/exhaustion (CD38, PD1, CTLA-4, BTLA, CD160), Tregs, and myeloid subsets expressing corresponding ligands (PDL1, PDL2, CD86, CD40, HVEM) than HR (-) HPV women. A decrease in circulating NK cells was associated with CIN grade. CD4(+) T cell count associated negatively with T cell exhaustion and expression of negative regulators on myeloid cells. Women with CIN when compared to HR (-) HPV women, had higher cervical cell density in stroma and epithelium for CD4(+), CD68(+), and CD11c(+) cells, and only in stroma for CD8(+) cells. We conclude that in ART-suppressed HIV-infected women with HPV co-infection the levels of T and myeloid cell activation/exhaustion are associated with the presence of HR HPV genotypes.
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Affiliation(s)
| | - Lea F Surrey
- Division of Molecular Pathology, Hospital of the University of Pennsylvania , Philadelphia, PA, USA
| | - Deborah K Glencross
- Faculty of Health Science Department of Molecular Medicine and Haematology, University of Witwatersrand, Johannesburg, South Africa; National Health Laboratory Service, Johannesburg, South Africa
| | | | | | - Tanvier Omar
- National Health Laboratory Service, Johannesburg, South Africa; Faculty of Health Science Department of Anatomical Pathology, University of Witwatersrand, Johannesburg, South Africa
| | - Michael D Feldman
- Division of Surgical Pathology, Hospital of the University of Pennsylvania , Philadelphia, PA, USA
| | - Anna-Lise Williamson
- Institute of Infectious Disease and Molecular Medicine and Department of Pathology, University of Cape Town, Cape Town, South Africa; National Health Laboratory Service, Cape Town, South Africa
| | - Maureen Siminya
- Faculty of Health Science Department of Internal Medicine, University of Witwatersrand, Johannesburg, South Africa; Right to Care, Johannesburg, South Africa
| | - Avril Swarts
- Faculty of Health Science Department of Internal Medicine, University of Witwatersrand, Johannesburg, South Africa; Right to Care, Johannesburg, South Africa
| | | | - Qin Liu
- The Wistar Institute , Philadelphia, PA, USA
| | - Cynthia Firnhaber
- Faculty of Health Science Department of Internal Medicine, University of Witwatersrand, Johannesburg, South Africa; Right to Care, Johannesburg, South Africa
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2
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Beverley PC, Sadovnikova E, Zhu X, Hickling J, Gao L, Chain B, Collins S, Crawford L, Vousden K, Stauss HJ. Strategies for studying mouse and human immune responses to human papillomavirus type 16. CIBA FOUNDATION SYMPOSIUM 2007; 187:78-86; discussion 86-96. [PMID: 7540971 DOI: 10.1002/9780470514672.ch6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Cytotoxic T lymphocytes (CTL) are an important protective mechanism in viral infection and can be effective against tumours. We have investigated the tumour-associated E6 and E7 genes of human papillomavirus type 16 as CTL targets. In H-2b mice we have defined epitopes in E6 and E7 which can readily generate CTL in vivo and we have shown that HLA-A2.1 transgenic mice can generate an HLA-A2.1-restricted response. We have been unable to reveal a primed CTL response in humans. These paradoxical findings imply that human papillomavirus may fail to stimulate a systemic CTL response and/or employ strategies for evading or down-regulating such a response.
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Affiliation(s)
- P C Beverley
- ICRF Tumour Immunology Unit, University College London Medical School, UK
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Stopińska-Głuszak U, Waligóra J, Grzela T, Głuszak M, Jóźwiak J, Radomski D, Roszkowski PI, Malejczyk J. Effect of estrogen/progesterone hormone replacement therapy on natural killer cell cytotoxicity and immunoregulatory cytokine release by peripheral blood mononuclear cells of postmenopausal women. J Reprod Immunol 2005; 69:65-75. [PMID: 16236362 DOI: 10.1016/j.jri.2005.07.006] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2004] [Revised: 07/06/2005] [Accepted: 07/07/2005] [Indexed: 11/22/2022]
Abstract
Sex steroids are known to affect immune responses; however, information on immunomodulatory effects of estrogen/progesterone hormone replacement therapy (HRT) is still limited. Therefore, the present study aimed to investigate the effect of estrogen/medroxyprogesterone HRT on natural killer (NK) cell cytotoxicity and immunoregulatory cytokine (IL-2, IL-4 and IFN-gamma) release by phytohemaglutinin (PHA)-stimulated peripheral blood mononuclear cells (PBMC) from 15 selected healthy postmenopausal women. NK cell cytotoxicity, cytokine production and serum levels of 17beta-estradiol (E2), progesterone (P) and FSH were tested in each patient before and after 90-days HRT. NK cell cytotoxicity was tested by (51)Cr-release assay using K562 erythroleukemic cells as target. Specific cytokine production and serum hormone levels were evaluated by enzyme-linked immunosorbent assay (ELISA) and immunochemiluminescent assays, respectively. HRT resulted in a significant decrease of Kupperman index, an increase of E2 and a decrease of FSH levels. These changes were associated with a significant decrease of NK cell cytotoxicity, IL-2 and IFN-gamma production. The levels of IL-4 production remained unchanged. Changes of NK cell cytotoxicity and cytokine release in individual patients did not correlate with changes of serum sex hormone levels. Nevertheless, the present results imply strongly that estrogen/progesterone HRT may affect cell-mediated immunity, thus being a potential factor influencing development and course of autoimmune disorders and neoplastic diseases.
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Affiliation(s)
- Urszula Stopińska-Głuszak
- Department of Histology and Embryology, Center of Biostructure Research, Medical University of Warsaw, Chałubińskiego 5, PL-02004 Warsaw, Poland
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Ko MJ, Chu CY. Disseminated human papillomavirus type 11 infection in a patient with pemphigus vulgaris: Confirmed by DNA analysis. J Am Acad Dermatol 2004; 51:S190-3. [PMID: 15577767 DOI: 10.1016/j.jaad.2004.04.037] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Depending on the type of epithelium infected, human papillomaviruses (HPVs) are often subclassified as "cutaneous" or "mucosal" types of HPV. HPV type 11 is a mucosal type of virus and infects the genital tract or larynx. Disseminated HPV-11 infection involving multiple body sites in cases of pemphigus vulgaris (PV) has not been reported. We report here an unusual case of severe pemphigus vulgaris associated with disseminated HPV-11 infection on the arms, hands, axillae, chest, abdomen, and both thighs from the genital area, confirmed by the same DNA sequence.
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Affiliation(s)
- Mei-Ju Ko
- Department of Dermatology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
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Onon TS, Kitchener HC, Duggan-Keen M, Stern PL. No alteration in NK function or zeta chain expression in NK and T cells of cervical cancer patients. Gynecol Oncol 2003; 89:120-8. [PMID: 12694665 DOI: 10.1016/s0090-8258(03)00009-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To investigate in vitro natural killer (NK) cell activity and expression of signal-transducing zeta chains in patients with cervical cancer. PATIENTS AND METHODS Experiments were performed with frozen lymphocytes from patients at all disease stages and from healthy controls. Thawed NK were activated by overnight incubation in interferon-gamma (IFN-gamma); activity against two target cell lines was assessed by 4-h (51)Cr release assay. Targets chosen were K562, an erythroleukemic cell line, and a cervical carcinoma cell line designated 808. T and NK cell zeta chain expression was measured by flow cytometry. RESULTS Patients' NK were found to be as cytotoxic as those of normal controls against cell lines K562 and 808. Patient T and NK cells did not show significant down-regulation of the zeta chain. CONCLUSIONS We have found no evidence to suggest that loss of zeta chains is a mechanism for immunocompromise in patients with cervical carcinoma. IFN-recoverable patient NK activity is not reduced compared to matched controls. This may be clinically relevant since NK are active against cells exhibiting class I human leukocyte antigen (HLA) down-regulation and many cervical cancers show loss of HLA.
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Affiliation(s)
- Toli S Onon
- Department of Immunology, Paterson Institute for Cancer Research, Christie Hospital, Manchester, United Kingdom.
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Abstract
There are a surprisingly large number of human natural killer (NK) cell deficiency states that provide insight into the role of NK cells in defense against human infectious disease. Many disorders associated with NK cell defects are caused by single gene mutations and, thus, give additional understanding concerning the function of specific molecules in NK cell development and activities. A resounding theme of NK cell deficiencies is susceptibility to herpesviruses, suggesting that unexplained severe herpesviral infection should raise the possibility of an NK cell deficit.
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Affiliation(s)
- Jordan S Orange
- Division of Immunology, Children's Hospital and Department of Pediatrics, Harvard Medical School, 300 Longwood Avenue, MA, Boston, USA.
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Abstract
The nature of the interaction between papillomaviruses (PV) and their infected host has led to the identification of ways in which the viral oncoproteins can transform the infected host cells into cancer cells. As viral persistence is required for malignancy, and persistence requires avoidance of immune attack by the host, defining the relationship between PV and the immune system is also paramount in understanding tumorigenesis. It has emerged that PV have evolved several ways in which to prevent clearance by the host immune system. The limitation of the PV replication cycle to the epithelium, together with low level expression of the virus proteins and an absence of inflammation, minimises the exposure of virus to immune cells. In addition, more recently it has been shown that, like many other viruses, PV can directly subvert the immune response, including interference with the interferon pathway, modulation of antigen presentation, inhibition of interleukin-18 activity and down-regulation of major histocompatibility class I on infected cells. Collectively these mechanisms explain how PV lesions are able to persist for long periods of time in immunocompetent hosts.
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Affiliation(s)
- Philippa M O'Brien
- Department of Veterinary Pathology, Institute of Comparative Medicine, University of Glasgow, Garscube Estate, Bearsden Road, G61 1QH, Scotland, Glasgow, UK
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Scott M, Nakagawa M, Moscicki AB. Cell-mediated immune response to human papillomavirus infection. CLINICAL AND DIAGNOSTIC LABORATORY IMMUNOLOGY 2001; 8:209-20. [PMID: 11238198 PMCID: PMC96039 DOI: 10.1128/cdli.8.2.209-220.2001] [Citation(s) in RCA: 169] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- M Scott
- Department of Pediatrics, School of Medicine, University of California San Francisco, San Francisco, California 94143, USA.
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Malejczyk J, Majewski S, Jabłońska S. Cellular immunity in cutaneous and genital HPV infections. Clin Dermatol 1997; 15:261-74. [PMID: 9167910 DOI: 10.1016/s0738-081x(97)00049-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- J Malejczyk
- Department of Histology and Embryology, Warsaw Medical School, Poland
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Jablonska S, Majewski S. Human papillomavirus infection in women. Special aspects of infectious diseases in women. Clin Dermatol 1997; 15:67-79. [PMID: 9034657 DOI: 10.1016/s0738-081x(96)00111-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- S Jablonska
- Department of Dermatology, Warsaw School of Medicine, Poland
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Hoos A, D'Incan C, Gissmann L, Altmann A, Momburg F, Nindl I, Osen W, Schönning BH, Jochmus I. Human papillomavirus type 16 (HPV 16) E7 and major histocompatibility complex (MHC) class I and II expression in human keratinocytes in culture. Arch Virol 1996; 141:449-58. [PMID: 8645087 DOI: 10.1007/bf01718309] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The low expression of major histocompatibility complex (MHC) class I antigens on human papillomavirus (HPV)-infected cervical carcinoma cells may be responsible for an insufficient cytotoxic T cell response against these cells. To investigate in vitro whether the HPV type 16 early gene product E7 influences cell surface expression of MHC class I and II molecules the HPV negative keratinocyte cell line HaCaT was either stably transfected with the E7 gene or infected with E7-recombinant vaccinia viruses. No difference in MHC class I transcription was detected between E7-transfected and untransfected HaCaT cells. MHC class I cell surface expression as determined by FACS analysis was stronger in some of the transfectants and less intensive in others when compared to untransfected HaCaT cells. In wildtype as well as in E7-recombinant vaccinia virus infected HaCaT cells downregulation of MHC class I molecules on protein and transcriptional level was observed. The alterations in MHC class I expression were independent of the presence and amount of E7-specific transcripts. None of the transfectants or infected HaCaT cells had MHC class II molecules on their cell surface. Hence, our data did not show a correlation between HPV 16 E7 and MHC expression in vitro.
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Affiliation(s)
- A Hoos
- Deutsches Krebsforschungszentrum, Forschungsschwerpunkt Angewandte Tumorvirologie, Heidelberg, Federal Republic of Germany
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Strickler HD, Rattray C, Escoffery C, Manns A, Schiffman MH, Brown C, Cranston B, Hanchard B, Palefsky JM, Blattner WA. Human T-cell lymphotropic virus type I and severe neoplasia of the cervix in Jamaica. Int J Cancer 1995; 61:23-6. [PMID: 7705929 DOI: 10.1002/ijc.2910610105] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Human T-cell lymphotropic virus type I (HTLV-I) was associated with carcinoma of the cervix in Japan in a recent study that compared hospital cases with healthy population-based controls. To test this relationship in women more alike for cervical neoplasia risk factors (including sexual behavior and human papilloma virus; HPV), we enrolled consecutive patients from a colposcopy clinic in Kingston, Jamaica (an HTLV-I endemic area). Patients underwent Pap smear, colposcopy, biopsy and cervical swab for detection of HPV by polymerase chain reaction. Cases were defined as women with CIN-3 or invasive cancer (CIN-3/CA). Controls included all patients with either CIN-I or koilocytotic atypia, atypical squamous cells of undetermined significance or benign cervical pathology (all but one had at least inflammatory changes). Patients with CIN-2 were excluded to minimize risk of case-control misclassification. Cases were much more likely to be HTLV-I seropositive than controls. Although mean age differed significantly between cases (mean age = 39 years) and controls (mean age = 33 years), control for age did not explain the relation of CIN-3/CA with HTLV-I. Among HPV DNA positive subjects the age-adjusted association was not diminished but lost statistical significance. HTLV-I seroprevalence may be independently associated with progression to severe neoplasia of the cervix.
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Affiliation(s)
- H D Strickler
- Viral and Environmental Epidemiology Branches, National Cancer Institute, Bethesda, MD, USA
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Abstract
Human papillomaviruses (HPVs) have been associated with benign and malignant epithelial proliferations in either skin or mucosa. Two HPV oncogenic proteins, E6 and E7, are important in the induction and maintenance of cellular transformation and are co-expressed in the majority of HPV-containing carcinomas. Therefore, vaccines targeted to these proteins may provide an opportunity to prevent and treat HPV-associated malignancies. The encouraging results from recent experimental vaccination systems in animal models suggest that continued exploration in these systems might lead to trials on human subjects and might allow us to prevent HPV infection or control its potentially life-threatening consequences.
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Affiliation(s)
- T C Wu
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287
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Strickler HD, Dillner J, Schiffman MH, Eklund C, Glass AG, Greer C, Scott DR, Sherman ME, Kurman RJ, Manos M. A seroepidemiologic study of HPV infection and incident cervical squamous intraepithelial lesions. Viral Immunol 1994; 7:169-77. [PMID: 7576031 DOI: 10.1089/vim.1994.7.169] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
The seroepidemiology of genital human papillomavirus (HPV) and incident cervical squamous intraepithelial lesions (SIL) was studied in subjects selected from a large cohort monitored for the development of SIL. Serum IgG and IgA responses to 10 epitopes derived from HPV were measured in 21 incident cases of SIL and 56 matched controls. Cases showed elevated antibody (i.e., IgG and/or IgA) seroprevalence to 245:16, a peptide antigen derived from the E2 open reading frame of HPV 16 (OR = 5.76; 95% CI: 1.24, 26.81). The type of HPV DNA detected in cervical lavage specimens had no effect on this relationship. Multivariate analysis also showed that IgG to 245:6, an analogous peptide derived from HPV 6, was negatively associated with SIL (OR = 0.12; 95% CI: 0.02, 0.77). No other antibody responses tested were associated with SIL. Furthermore, no antibody responses were positively associated with detection of HPV DNA in women without SIL. We conclude that incident SIL is positively associated with antibody to an epitope derived from the E2 region of HPV 16, and negatively associated with antibody to an analogous peptide derived from HPV 6. The seroepidemiology of incident SIL appears different from that of cervical HPV infection in the absence of SIL.
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Affiliation(s)
- H D Strickler
- Epidemiology and Biostatistics Program, National Cancer Institute, Bethesda, Maryland, USA
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