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Viguier M, Pérals C, Poirier B, Battistella M, Aubin F, Bachelez H, Prétet JL, Gheit T, Tommasino M, Touzé A, Gougeon ML, Fazilleau N. Human papilloma virus-16-specific CD8+ T-cell expansions characterize different clinical forms of lichen planus and not lichen sclerosus et atrophicus. Exp Dermatol 2023; 32:859-868. [PMID: 36922453 DOI: 10.1111/exd.14788] [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: 11/05/2022] [Revised: 02/22/2023] [Accepted: 02/25/2023] [Indexed: 03/18/2023]
Abstract
Lichen planus (LP) is a cutaneomucosal chronic inflammatory disease characterized by a CD8+ cytotoxic T-lymphocytes (CTL) infiltrate. In erosive oral LP, we found HPV16-specific activated CTL in lesions, supporting a pathogenic contribution of HPV16. Here, we investigated whether a similar scenario occurs in other clinical forms of LP and in lichen sclerosus et atrophicus (LSA), another chronic disease also affecting the mucosa and/or the skin. Blood CTL from LP and LSA patients expressed significant higher levels of granzyme B, perforin and CD107a proteins than healthy donors. Expansions of TCRVß3+ CTL, with presence of TCR clonotypes identical to those previously detected in erosive oral LP, were found both in blood and mucosal/skin lesions of LP, and not of LSA patients. These expansions were enriched with HPV16-specific CD8+ T-cells as shown by their recognition of the E711-20 immunodominant epitope. In LSA patients, the peripheral repertoire of CTL was oligoclonal for TCRVß6+ CTL. Finally, although patients with LP and LSA have developed antibodies against HPV16 capsid L1, antibodies against HPV16 E6 were only observed in patients with LP. Overall, our data collectively suggest an involvement of HPV16-specific CTL in different clinical forms of LP, not only in erosive oral LP, while a different scenario operates in LSA.
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Affiliation(s)
- Manuelle Viguier
- Department of dermatology, Hôpital Robert-Debré, University of Reims Champagne-Ardenne (URCA), EA7509 IRMAIC, Reims, France
| | - Corine Pérals
- Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity), CNRS U5051, INSERM U1291, University Toulouse III, Toulouse, France
| | | | - Maxime Battistella
- Sorbonne Paris Cité, Service d'Anatomo-Pathologie, Hôpital Saint-Louis, Paris, France
| | - François Aubin
- Service de Dermatologie, Centre Hospitalo-Universitaire (CHU) de Besançon, Université de Franche Comté, Besançon, France
| | - Hervé Bachelez
- Laboratory of Genetics of Skin Diseases, Imagine Institute for Human Genetic Diseases, INSERM U1163, Université de Paris, Paris, France
- Department of Dermatology, APHP Hôpital Saint-Louis, Paris, France
| | - Jean-Luc Prétet
- Centre National de Référence Papillomavirus, Laboratoire de Biologie Cellulaire et Moléculaire, CHU de Besançon, Université Bourgogne Franche Comté, Besançon, France
| | | | - Massimo Tommasino
- IARC, Lyon, France
- IRCCS Istituto Tumori Giovanni Paolo II, Bari, Italy
| | | | | | - Nicolas Fazilleau
- Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity), CNRS U5051, INSERM U1291, University Toulouse III, Toulouse, France
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Baddevithana AK, Jayasinghe RD, Tilakaratne WM, Illeperuma RP, Siriwardena BSMS. Expression of Human Papillomavirus and the p16 Gene in Oral Potentially Malignant Disorders (OPMD): a Comparative Study With Oral Squamous Cell Carcinoma. Appl Immunohistochem Mol Morphol 2023; 31:331-338. [PMID: 37036407 DOI: 10.1097/pai.0000000000001124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 03/12/2023] [Indexed: 04/11/2023]
Abstract
BACKGROUND The incidence of oral squamous cell carcinoma (OSCC) of the tongue is increasing in the younger population without traditional risk habits that lead researchers to find other related factors such as diet and viruses, especially human papillomavirus (HPV). It is noteworthy that many OSCCs develop from oral potentially malignant disorders (OPMDs). Correct diagnosis and timely management of OPMDs may help to prevent malignant transformation, and therefore it is worth seeing the involvement of HPV in OPMDs and oral cancers, as the preventive and curative measures in HPV-induced cancer types are different from the conventional types of OPMDs and OSCCs. Therefore, the main objective of this study was to identify a relationship between HPV and p16 in OPMDs and compare it with OSCC. METHODS This study was conducted on 83 cases of known OSCCs and OPMDs (oral submucous fibrosis, leukoplakia, and oral lichen planus). Assays, such as polymerized chain reaction (PCR) and reverse transcription-PCR, were carried out for HPV and p16 . The results were compared with clinical information and with the literature. The results were analyzed using SPSS 16.0 for windows. RESULTS P16 expression was mostly seen in males than in female patients. Out of 21 cases of keratosis with dysplasia, 19% expressed p16 . Of 26 oral lichen planus patients, 29% showed the p16 gene with immunohistochemistry. Interestingly, a high percentage of OSF cases expressed p16 (48.27%). Minimal expression was observed in OSCC (6.25%). HPV DNA was detected in 2.4% of the total sample. Both p16 and HPV were detected in a single case of OSCC. OPMDs expressed a significant amount of the p16 gene by immunohistochemistry and reverse transcription-PCR technique when compared with malignant lesions, suggesting a possible inactivation of the p16 gene. HPV and p16 are mostly negative in our OSCC sample, exhibiting low prevalence. CONCLUSIONS OPMDs expressed a significant amount of the p16 gene when compared with malignant lesions, suggesting a possible inactivation of the p16 gene. Although OSF expressed p16 , HPV was not detected, suggesting that over-expression could be independent of HPV. OSCC shows low HPV prevalence.
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Affiliation(s)
| | - Ruwan D Jayasinghe
- Centre for Research in Oral Cancer
- Departments of Oral Medicine and Periodontology
| | - Wanninayake M Tilakaratne
- Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | - Rasika P Illeperuma
- Centre for Research in Oral Cancer
- Oral Pathology, Faculty of Dental Sciences, University of Peradeniya, Peradeniya, Sri Lanka
| | - Bogahawatte S M S Siriwardena
- Centre for Research in Oral Cancer
- Oral Pathology, Faculty of Dental Sciences, University of Peradeniya, Peradeniya, Sri Lanka
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Mohammadi M, Abbaszadeh H, Mohtasham N, Salehiniya H, Shafaie E. The association between high-risk human papillomavirus and oral lichen planus. Clin Exp Dent Res 2023; 9:93-99. [PMID: 36636987 PMCID: PMC9932238 DOI: 10.1002/cre2.707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 12/07/2022] [Accepted: 12/10/2022] [Indexed: 01/14/2023] Open
Abstract
OBJECTIVES Oral lichen planus (OLP) is a cell-mediated inflammatory mucosal disorder and is classified as an oral potentially malignant disorder. Some research has shown that apoptosis in OLP cells is similar to a viral infection such as human papillomavirus (HPV). So, the aim of this case-control study was to investigate the association of high-risk HPV with OLP. MATERIAL AND METHODS DNA was extracted from 25 formalin-fixed, paraffin-embedded (FFPE) OLP tissues and 25 FFPE normal oral tissues as case and control groups, respectively. The presence of high-risk HPV16 and HPV18 DNA was investigated by polymerase chain reaction (PCR). p-value<.05 was considered significant. RESULTS Twelve samples (48%) of OLPs were positive for HPV16, compared with six samples (24%) of controls; although the difference was not significant, it was borderline (p = .07). Three samples (12%) of OLPs were positive for HPV18 compared with one sample (4%) of controls; the difference was not significant (p = .3). The total frequency of both high-risk HPV were 14 samples (56%) of OLPs and 7 samples (28%) of controls; there was a significant association between the high-risk HPV and OLP (p = .04). High-risk HPVs was more prevalent in erosive-atrophic (EA) form of OLP as compared to non-EA form, although the difference was not significant (p = .13). CONCLUSIONS The results suggest a significant association between high-risk HPVs and OLP.
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Affiliation(s)
- Maryam Mohammadi
- Student Research CommitteeBirjand University of Medical SciencesBirjandIran
| | - Hamid Abbaszadeh
- Department of Oral and Maxillofacial Pathology, Faculty of DentistryBirjand University of Medical SciencesBirjandIran
| | - Nooshin Mohtasham
- Oral and Maxillofacial Disease Research Center, Faculty of DentistryMashhad University of Medical ScienceMashhadIran
| | - Hamid Salehiniya
- Social Determinants of Health Research CenterBirjand University of Medical SciencesBirjandIran
| | - Ebrahim Shafaie
- Infectious Diseases Research CenterBirjand University of Medical SciencesBirjandIran
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Correlation between Oral Lichen Planus and Viral Infections Other Than HCV: A Systematic Review. J Clin Med 2022; 11:jcm11185487. [PMID: 36143134 PMCID: PMC9501453 DOI: 10.3390/jcm11185487] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 09/15/2022] [Accepted: 09/16/2022] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVES This review aimed to evaluate the correlation between viral infections (HPV, EBV, HSV-1, CMV) other than HCV and oral lichen planus to assess if there is sufficient evidence to establish if these viruses can play a role in the etiopathogenesis of the disease. MATERIALS AND METHODS We reviewed the literature using different search engines (PubMed, ISI Web of Science, and the Cochrane Library), employing MeSH terms such as "oral lichen planus" and "OLP" in conjunction with other terms. We utilized the Population, Intervention, Comparison, Outcomes, and Study design (PICOS) method to define our study eligibility criteria. RESULTS A total of 43 articles of the 1219 results initially screened were included in the study. We allocated the 43 selected items into four groups, according to each related virus: HPV, EBV, HSV-1, and CMV. CONCLUSIONS Heterogeneous results neither confirm nor exclude a direct correlation between the investigated viral infections and oral lichen planus etiopathogenesis and its feasible malignant transformation. Many viral agents can cause oral lesions and act as cancerizing agents. Future studies could be desirable to produce comparable statistical analyses and enhance the quantity and quality of the outcomes to promote the translation of research into clinical practice.
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Sahebjamiee M, Sand L, Karimi S, Biettolahi JM, Jabalameli F, Jalouli J. Prevalence of human papillomavirus in oral lichen planus in an Iranian cohort. J Oral Maxillofac Pathol 2015; 19:170-4. [PMID: 26604492 PMCID: PMC4611924 DOI: 10.4103/0973-029x.164528] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2014] [Accepted: 07/29/2015] [Indexed: 11/04/2022] Open
Abstract
CONTEXT Oral lichen planus (OLP) is a chronic inflammatory mucocutaneous disease with female predominance with the potential for malignant transformation. Human papillomavirus (HPV) is associated with both malignant and benign disease in the head and neck region. AIMS The present study assesses the prevalence of high-risk HPV-16 and HPV-18 in tissue and saliva samples from an Iranian population diagnosed with OLP. SUBJECTS AND METHODS Deoxyribonucleic acid was extracted and investigated using polymerase chain reaction from tissue and saliva samples of the same individuals from 40 OLP cases and saliva samples of 40 healthy controls. STATISTICAL ANALYSIS The prevalence of data was compared using the Chi-square test and inter-group differences were analyzed using Fisher's exact test. RESULTS OLP specimens were HPV-positive in 11 of 40 (27.5%) cases compared with three of 40 (7.5%) saliva specimens, representing a statistically significant difference (P = 0.0367). HPV-16 and HPV-18 were positive in eight of 40 (20%) OLP tissues and three of 40 (7.5%) saliva samples. Five of the 40 healthy saliva samples were positive for HPV-16. In the OLP patients with dysplasia, four of seven tissue samples were HPV-positive; threeof these four were HPV-16- positive in comparision with seven of 33 HPV-positive samples from OLP patients without dysplasia. CONCLUSIONS Biopsies were more accurate than saliva analysis for evaluating HPV prevalence in OLP patients. HPV prevalence was higher in dysplastic than nondysplastic OLP lesions in this Iranian cohort.
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Affiliation(s)
- Mahnaz Sahebjamiee
- Department of Medical Sciences, School of Dentistry, Oral Health and Community Dentistry, Tehran University, Tehran, Iran
| | - Lars Sand
- Department of Surgical Sciences, Oral and Maxillofacial Surgery, Uppsala, Sweden
| | - Sharare Karimi
- Department of Medical Sciences, School of Dentistry, Tehran University, Tehran, Iran
| | | | | | - Jamshid Jalouli
- Department of Surgical Sciences, Oral and Maxillofacial Surgery, Uppsala, Sweden
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Peripheral and Local Human Papillomavirus 16–Specific CD8 + T-Cell Expansions Characterize Erosive Oral Lichen Planus. J Invest Dermatol 2015; 135:418-424. [DOI: 10.1038/jid.2014.397] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2014] [Revised: 07/04/2014] [Accepted: 08/16/2014] [Indexed: 12/13/2022]
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Jaiswal R, Pandey M, Shukla M, Kumar M. Condyloma Acuminatum of the Buccal Mucosa. EAR, NOSE & THROAT JOURNAL 2014. [DOI: 10.1177/014556131409300607] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Rashmi Jaiswal
- Department of Surgical Oncology, Institute of Medical
Sciences, Banaras Hindu University, Varanasi, India
| | - Manoj Pandey
- Department of Surgical Oncology, Bhopal Memorial
Hospital and Research Center, Bhopal, India
| | - Mridula Shukla
- SRL Diagnostics, Bhopal. The case described in this
article occurred at Banaras Hindu University
| | - Mohan Kumar
- Department of Pathology, Institute of Medical
Sciences, Banaras Hindu University, Varanasi, India
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Oral lichen planus in thai patients has a low prevalence of human papillomavirus. ISRN DENTISTRY 2013; 2013:362750. [PMID: 23762572 PMCID: PMC3677628 DOI: 10.1155/2013/362750] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/17/2013] [Accepted: 05/08/2013] [Indexed: 01/01/2023]
Abstract
Background. Oral lichen planus (OLP) is a common chronic inflammatory immune-mediated disease, with an etiopathogenesis associated with cell-mediated immunological dysfunction. Viral infection has been hypothesized as a predisposing factor in the pathogenesis of this disease. Viruses may alter host cell function by inducing the abnormal expression of cellular proteins leading to disease development. However, reports on the relationship between human papillomavirus (HPV) and OLP are inconclusive. Objective. To explore the association between HPV and OLP in Thai patients. Materials and Methods. DNA was extracted from thirty-seven fresh-frozen tissue biopsy specimens from OLP lesions, and polymerase chain reaction assay for the L1 and E1 genes covering 32 types of high- and low-risk HPV was performed. Results. HPV DNA was detected in one tissue biopsy from an atrophic-type OLP lesion. All control samples were negative. Genomic sequencing of the E1 gene PCR product demonstrated that the HPV-type 16 found in the lesion is closely related to the East Asian type. Conclusion. Our data indicate a low prevalence of HPV infection in OLP lesions in Thai patients.
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Lodi G, Scully C, Carrozzo M, Griffiths M, Sugerman PB, Thongprasom K. Current controversies in oral lichen planus: Report of an international consensus meeting. Part 1. Viral infections and etiopathogenesis. ACTA ACUST UNITED AC 2005; 100:40-51. [PMID: 15953916 DOI: 10.1016/j.tripleo.2004.06.077] [Citation(s) in RCA: 260] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Despite recent advances in understanding the immunopathogenesis of oral lichen planus (LP), the initial triggers of lesion formation and the essential pathogenic pathways are unknown. It is therefore not surprising that the clinical management of oral LP poses considerable difficulties to the dermatologist and the oral physician. A consensus meeting was held in France in March 2003 to discuss the most controversial aspects of oral LP. Part 1 of the meeting report focuses on (1) the relationship between oral LP and viral infection with special emphasis on hepatitis C virus (HCV), and (2) oral LP pathogenesis, in particular the immune mechanisms resulting in lymphocyte infiltration and keratinocyte apoptosis. Part 2 focuses on patient management and therapeutic approaches and includes discussion on malignant transformation of oral LP.
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Affiliation(s)
- Giovanni Lodi
- Department of Medicine, Surgery, and Dentistry, University of Milan, Italy.
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10
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Miller CS, Johnstone BM. Human papillomavirus as a risk factor for oral squamous cell carcinoma: a meta-analysis, 1982-1997. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 2001; 91:622-35. [PMID: 11402272 DOI: 10.1067/moe.2001.115392] [Citation(s) in RCA: 299] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Human papillomavirus (HPV) infection is a significant risk factor for uterine cervical carcinoma. However, the role of HPV infection in oral squamous cell carcinoma (OSCC) is less well defined. To determine the significance of the relationship of this virus in the progressive development of oral cancer, we estimated the risk of HPV detection in normal oral mucosa, precancerous oral tissue, and oral carcinoma using meta-analysis. STUDY DESIGN Case reports and clinical series published in English-language journals were retrieved by searching MEDLINE (January 1980-August 1998). Review articles were also examined to identify additional studies. Studies that used biochemical, immunologic, microscopic, or molecular analyses to detect HPV in tissue or cells derived from normal oral mucosa (n = 25), benign leukoplakia (n = 21), intraepithelial neoplasia (ie, dysplasia and carcinoma in situ; n = 27), and oral cancer (n = 94) were included in the meta-analysis. Information on sample size, age, sex, method of tissue preservation (ie, fresh, frozen, paraffin-embedded), assay, primer amplification region (early, late), high-risk versus low-risk genotype, and use of tobacco or alcohol was abstracted by one author (C.S.M.). RESULTS Data from 94 reports that analyzed 4680 samples were included in the meta-analysis. Analyses made by means of a random-effects model with and without adjustments for assay sensitivity showed increased probability of HPV detection in tissue with precancerous and cancerous features compared with normal mucosa. The likelihood of detecting HPV in normal oral mucosa (10.0%; 95% confidence interval [CI], 6.1%-14.6%) was significantly less than of detecting benign leukoplakia (22.2%; 95% CI, 15.7%-29.9%), intraepithelial neoplasia (26.2%; 95% CI, 19.6%-33.6%), verrucous carcinoma (29.5%; 95% CI, 23%-36.8%), and OSCC (46.5%; 95% CI, 37.6%-55.5%). Adjustment of findings for differences in assay sensitivity indicated that these estimates may be conservative. Overall, HPV was between 2 and 3 times more likely to be detected in precancerous oral mucosa and 4.7 times more likely to be detected in oral carcinoma than in normal mucosa. The pooled odds ratio for the subset of studies directly comparing the prevalence of HPV in normal mucosa and OSCC was 5.37, confirming the trend observed in the overall sample. The probability of detecting high-risk HPVs in OSCCs was 2.8 times greater than that of low-risk HPVs. CONCLUSION This meta-analysis indicates that HPV is detected with increased frequency in oral dysplastic and carcinomatous epithelium in comparison with normal oral mucosa. The findings provide further quantitative evidence that oral infection with HPV, particularly with high-risk genotypes, is a significant independent risk factor for OSCC.
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Affiliation(s)
- C S Miller
- Department of Oral Health Practice,University of Kentucky College of Dentistry and College of Medicine, Lexington, Ky, USA.
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Affiliation(s)
- C B Fowler
- Oral & Maxillofacial Pathology Services, Wilford Hall Medical Center, Lackland Air Force Base, San Antonio, Texas, USA
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12
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Badaracco G, Venuti A, Di Lonardo A, Scambia G, Mozzetti S, Benedetti Panici P, Mancuso S, Marcante ML. Concurrent HPV infection in oral and genital mucosa. J Oral Pathol Med 1998; 27:130-4. [PMID: 9563805 DOI: 10.1111/j.1600-0714.1998.tb01928.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Screening for human papillomavirus (HPV) types was performed by a PCR-based assay on 29 women (mean age 34.0 years, range 21-48 years). HPV-DNA was demonstrated in 16 women (55.2%), with a detection rate of 37.9% in the oral cavity and 34.5% in the genital tract. HPV-16 was the most prevalent genotype (53.8%), followed by HPV-6, which was present in 34.6% of the positive samples. Other types were more rarely detected. Five subjects showed concurrent genital tract and oral cavity infections but HPV type-specific concordance was detected in only 3 patients. Multiple HPV infections were found in 9 of the 26 positive samples, where HPV-6 appeared frequently associated with the other types. These data confirm the occurrence of mixed HPV infections and the wide diffusion of different types of HPV in the genital mucosa and in the oral cavity; they also stress the need to utilize diagnostic methods with a wide typing capacity.
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Affiliation(s)
- G Badaracco
- Laboratory of Virology, Regina Elena Institute for Cancer Research, Rome, Italy
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Abstract
Lichen Planus is a relatively common inflammatory dermatosis of unknown origin. The present review summarizes the histological and clinical features of lichen planus and variants, including lichenoid drug reactions, are described. Possible mechanisms of pathogenesis of lichen planus are reviewed. The development of malignancy in association with lichen planus and the association with hepatitis are discussed. Treatment options for the more difficult manifestations of lichen planus are proposed.
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Affiliation(s)
- G Marshman
- Department of Medicine, Flinders Medical Centre, Bedford Park, Australia
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Sugerman PB, Shillitoe EJ. The high risk human papillomaviruses and oral cancer: evidence for and against a causal relationship. Oral Dis 1997; 3:130-47. [PMID: 9467355 DOI: 10.1111/j.1601-0825.1997.tb00025.x] [Citation(s) in RCA: 73] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Oncogenic human papillomaviruses (HPVs) have been detected in oral squamous cell carcinoma (SCC). HPV16 is the most frequently detected HPV type in oral SCC and is present in up to 22% of cases, either alone or in combination with other HPV types. HPV18 is present in up to 14% of cases. HPV16 and HPV18 are present together in approximately 6% of cases. However, HPV16 and 18 are also detected in normal oral mucosae (10% and 11% of subjects, respectively). These data suggest that high risk HPV infection may be a co-factor in oral carcinogenesis and that latent HPV infection of the oral mucosa is common. A role for HPV infection in oral carcinogenesis is supported by the ability of high risk HPVs to immortalize oral keratinocytes in vitro. Immortalization may involve (i) deactivation of pre-formed tumor-suppressor proteins by viral oncoproteins, (ii) blocking of tumor-suppressor gene transcription as a result of HPV oncogene insertion or (iii) stimulation of cellular oncogene transcription by the upstream insertion of HPV-derived transcription activating sequences. Hence, infection of oral keratinocytes with high risk HPV may be involved in the pathogenesis of some oral SCCs although the evidence implicating HPV in oral carcinogenesis is, at present, mainly circumstantial.
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Affiliation(s)
- P B Sugerman
- Department of Dermatology, Harvard Medical School, Charlestown, MA, USA
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Chatterjee R, Mukhopadhyay D, Chakraborty RN, Mitra RB. Evaluation of argyrophilic nucleolar organizer regions (AgNORs) in oral carcinomas in relation to human papillomavirus infection and cytokinetics. J Oral Pathol Med 1997; 26:310-4. [PMID: 9250930 DOI: 10.1111/j.1600-0714.1997.tb00221.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The numbers of argyrophilic nucleolar organizer regions (AgNORs) were quantified in oral carcinomas (n = 39) with or without human papillomavirus (HPV) infection. The AgNOR counts of the HPV-positive samples (7.15 +/- 2.13) were not significantly (P = 0.09) higher than those of the HPV-negative ones (6.16 +/- 1.89). Furthermore, the lesions infected with multiple HPV types had greater counts than those with HPV type 16/18 infection alone. Significant differences were observed between the mean counts of the poorly (10.50 +/- 0.54), moderately (7.31 +/- 1.07) and well- (5.12 +/- 0.85) differentiated carcinomas. The mean AgNOR numbers in the oral carcinomas at TNM stages III/IV were found to be significantly (P < 0.01) higher than the numbers in corresponding stage II lesions. Cytokinetics of the lesions assessed by the bromodeoxyuridine (Brdu) labelling index (LI%) showed a linear correlation (r = 0.91; P < 0.0001) with their respective mean AgNOR counts.
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Affiliation(s)
- R Chatterjee
- Department of Tumor Virology, Chittaranjan National Cancer Institute, Calcutta, India
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16
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Coutlée F, Trottier AM, Ghattas G, Leduc R, Toma E, Sanche G, Rodrigues I, Turmel B, Allaire G, Ghadirian P. Risk factors for oral human papillomavirus in adults infected and not infected with human immunodeficiency virus. Sex Transm Dis 1997; 24:23-31. [PMID: 9018780 DOI: 10.1097/00007435-199701000-00006] [Citation(s) in RCA: 81] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND AND OBJECTIVES To investigate in a cross-sectional study the determinants of oral human papillomavirus infection in 287 individuals who are sexually active. GOAL To assess prevalence as well as risk factors for oral human papillomavirus infection. STUDY DESIGN One hundred seventy-eight human immunodeficiency virus-seropositive (158 men and 20 women) and 109 human immunodeficiency virus-negative (73 men and 36 women) individuals were recruited consecutively from sexually transmitted disease-human immunodeficiency virus clinics and gastrointestinal endoscopy clinics. Oral brushings were tested with the L1 consensus polymerase chain reaction assay for human papillomavirus detection. RESULTS Human papillomavirus DNA was detected in 32 (11.2%) of 287 individuals. Associated with oral human papillomavirus infection on univariate analyses were human immunodeficiency virus infection (odds ratio, 6.9; 95% confidence interval, 2.0-23.2), homosexuality (odds ratio, 3.7; 95% confidence interval, 1.5-9.4), unprotected oral sex (odds ratio, 5.5; 95% confidence interval, 1.6-18.4), syphilis (odds ratio, 2.5; 95% confidence interval, 1.1-6.3), gonorrhea (odds ratio, 4.2; 95% confidence interval, 1.9-9.1), Chlamydia trachomatis (odds ratio, 4.4; 95% confidence interval, 1.8-10.6), and genital herpes (odds ratio, 2.9; 95% confidence interval, 1.3-6.5). Human immunodeficiency virus infection and C. trachomatis were independently predictive of human papillomavirus infection in multivariate stepwise logistic regression.
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Affiliation(s)
- F Coutlée
- Département de Microbiologie et Immunologie, Université de Montréal, Québec, Canada
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Miller CS, White DK. Human papillomavirus expression in oral mucosa, premalignant conditions, and squamous cell carcinoma: a retrospective review of the literature. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 1996; 82:57-68. [PMID: 8843455 DOI: 10.1016/s1079-2104(96)80378-7] [Citation(s) in RCA: 168] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVES The literature of human papillomavirus detection in normal oral mucosa and oral lesions associated with the dysplastic progression of epithelium was reviewed to help define the role of this virus in the development of oral squamous cell carcinoma. STUDY DESIGN All available data from published studies were analyzed by chi-square test for association between the human papillomavirus and age, gender, race, DNA type, location, lesional dysplastic progression, method of detection, tissue preservation, and use of tobacco and alcohol. RESULTS Human papillomavirus was identified with increasing frequency in normal oral mucosa (13.5%), benign leukoplakia (14.8%), intraepithelial neoplasia (18.5%), squamous carcinoma (26.2%), and verrucous carcinoma (27%). It was detected in oral squamous cell carcinoma significantly (p < 0.005) more often (37.1%; 122 of 329) in studies that used a high sensitivity assay (polymerase chain reaction) than studies that used moderate sensitivity assays (25.2%; 84 of 334) (e.g., Southern blot hybridization) and low sensitivity assays (16.9%; 61 of 362) (e.g., immunohistochemistry, in situ hybridization). Human papillomavirus DNA was detected significantly more often (p < 0.001) in frozen oral squamous cell carcinoma (51.6%; 115 of 223) than paraffin-embedded tissue (21.7%; 136 of 628). High-risk human papillomaviruses (2, 16, 18) were detected in 81.4% of OSCCs that contained the virus compared with low-risk human papillomavirus genotypes (6, 11) in 17.9% of oral squamous cell carcinoma that contained the human papillomavirus (p < 0.001). In studies that analyzed the use of chemical cofactors, the use of tobacco and alcohol (87.3%) was associated more often with oral squamous cell carcinoma than the presence of human papillomavirus (51.3%), however, the difference was not significant. CONCLUSION High-risk human papillomavirus genotypes have a significant association with oral squamous cell carcinoma. However, the presence of this virus in a high proportion of oral normal mucosa makes the virus alone a poor prognosticator of progression to malignancy.
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Affiliation(s)
- C S Miller
- University of Kentucky College of Dentistry, USA
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Abstract
Human herpesviruses and human papillomaviruses are ubiquitous and may cause an array of oral disease. Herpesviruses are unique because recurrent localized disease occurs after the primary infection. Human papillomaviruses are known for their ability to produce benign epithelial proliferations and increasingly are implicated in the development of oral cancer. This article reviews the pathogenesis of common oral lesions induced by these viruses.
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Affiliation(s)
- C S Miller
- Department of Oral Health Science, University of Kentucky College of Dentistry, Lexington, USA
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Suskind DL, Mirza N, Rosin D, Stanton D, Sachdeva R. Condyloma Acuminatum Presenting as a Base-of-Tongue Mass. Otolaryngol Head Neck Surg 1996; 114:487-90. [PMID: 8649889 DOI: 10.1016/s0194-59989670225-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- D L Suskind
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania School of Medicine, Philadelphia, USA
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Mao EJ. Prevalence of human papillomavirus 16 and nucleolar organizer region counts in oral exfoliated cells from normal and malignant epithelia. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 1995; 80:320-9. [PMID: 7489276 DOI: 10.1016/s1079-2104(05)80390-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
This study was designed to identify the prevalence of human papillomavirus 16 (HPV 16) in oral exfoliated cells from 26 patients with oral cancer and matched healthy volunteers with the use of polymerase chain reaction. In addition, the value of a silver staining technique for nucleolar organizer regions (AgNORs) was also investigated. HPV 16 was detected in 30.8% of the cancer lesions, 26.9% of the unaffected sites, and 15.4% of samples from normal mucosa. AgNOR counts on the same cases were analyzed. Although AgNOR counts are useful in distinguishing between normal and malignant oral exfoliated cells, they provided no additional prognostic information for oral cancer. However, when AgNOR counts were compared with HPV 16-positive and HPV 16-negative counts in cancer lesions, AgNOR counts were higher in HPV-positive lesions. These findings suggest that HPV 16 may play a role in tumor cell proliferation, but it is unlikely to play a significant role alone in the cause of oral cancer. Therefore evidence of HPV 16 infection in oral malignant neoplasms should be cautiously interpreted.
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Affiliation(s)
- E J Mao
- Department of Oral Pathology, School of Clinical Denstistry, Sheffield University, U.K
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Miller CS, Zeuss MS, White DK. Detection of HPV DNA in oral carcinoma using polymerase chain reaction together with in situ hybridization. ORAL SURGERY, ORAL MEDICINE, AND ORAL PATHOLOGY 1994; 77:480-6. [PMID: 8028871 DOI: 10.1016/0030-4220(94)90227-5] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
This study determined the prevalence of human papillomavirus 16/18 DNA in deparaffinized oral carcinoma specimens on slides with the use of the different sensitivities of in situ hybridization and a technique that combines polymerase chain reaction and in situ hybridization. Human papillomavirus DNA was not detected in the 30 biopsy specimens analyzed by in situ hybridization alone using biotinylated DNA probes specific for human papillomavirus 16/18. Twenty of 30 specimens (66.7%) were found to have human papillomavirus DNA (p < 0.001) with the use of the polymerase chain reaction-in situ hybridization technique. Human papillomavirus 16 was detected in 18 of 26 specimens (69.2%), and 7 of 25 carcinomas (28%) were found to contain human papillomavirus 18. Dual infections were present in 5 of 21 (23.8%) specimens. Human papillomavirus DNA was more prevalent in men (75%) than women (57.1%). However, there was no difference in the mean age of patients with oral carcinoma (men, 67.8 years; women, 67.5 years) who had human papillomavirus and those who did not (67.2 years). Carcinomas associated with dual infections occurred at a lower mean age (59.4 years) than those associated with a single human papillomavirus type (p < 0.005). We conclude that the polymerase chain reaction-in situ hybridization technique enhances our ability to demonstrate human papillomavirus types highly associated with oral squamous cell carcinoma.
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Affiliation(s)
- C S Miller
- Department of Oral Health Science, University of Kentucky College of Dentistry, Lexington
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