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Zhu Y, Yin Y, Li F, Ren Z, Dong Y. A review on the oncogenesis of Merkel cell carcinoma: Several subsets arise from different stages of differentiation of stem cell. Medicine (Baltimore) 2023; 102:e33535. [PMID: 37058042 PMCID: PMC10101282 DOI: 10.1097/md.0000000000033535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 03/24/2023] [Indexed: 04/15/2023] Open
Abstract
Merkel cell carcinoma (MCC), a rare primary cutaneous neuroendocrine neoplasm, is extremely aggressive and has a higher mortality rate than melanoma. Based on Merkel cell polyomavirus (MCPyV) status and morphology, MCCs are often divided into several distinct subsets: pure MCPyV-positive, pure MCPyV-negative, and combined MCC. MCPyV-positive MCC develops by the clonal integration of viral DNA, whereas MCPyV-negative MCC is induced by frequent ultraviolet (UV)-mediated mutations, that are characterized by a high mutational burden, UV signature mutations, and many mutations in TP53 and retinoblastoma suppressor gene (RB1). Combined MCC consists of an intimate mix of MCC and other cutaneous tumor populations, and is usually MCPyV-negative, with rare exceptions. Based on the existing subsets of MCC, it is speculated that there are at least 4 stages in the natural history of stem cell differentiation: primitive pluripotent stem cells, divergent differentiated stem cells, unidirectional stem cells, and Merkel cells (or epidermal/adnexal cells). In the first stage, MCPyV may integrate into the genome of primitive pluripotent stem cells, driving oncogenesis in pure MCPyV-positive MCC. If MCPyV integration does not occur, the stem cells enter the second stage and acquire the ability to undergo multidirectional neuroendocrine and epidermal (or adnexal) differentiation. At this stage, accumulated UV-mediated mutations may drive the development of combined MCC. In the third stage, the stem cells differentiate into unidirectional neuroendocrine stem cells, UV-mediated mutations can induce carcinogenesis in pure MCPyV-negative MCC. Therefore, it has been speculated that several subsets of MCCs arise from different stages of differentiation of common stem cells.
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Affiliation(s)
- Yueyang Zhu
- Department of Ophthalmology, The Second Hospital of Jilin University, Changchun, Jilin, China
| | - Yuan Yin
- Department of Ophthalmology, The Second Hospital of Jilin University, Changchun, Jilin, China
| | - Fuqiang Li
- Department of Ophthalmology, The Second Hospital of Jilin University, Changchun, Jilin, China
| | - Zhiyuan Ren
- Department of Mechanical Engineering, University of Illinois Urbana Champaign, Champaign, IL
| | - Yaru Dong
- Department of Ophthalmology, The Second Hospital of Jilin University, Changchun, Jilin, China
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2
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Drexler K, Schwertner B, Haerteis S, Aung T, Berneburg M, Geissler EK, Mycielska ME, Haferkamp S. The Role of Citrate Homeostasis in Merkel Cell Carcinoma Pathogenesis. Cancers (Basel) 2022; 14:cancers14143425. [PMID: 35884486 PMCID: PMC9325124 DOI: 10.3390/cancers14143425] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 06/29/2022] [Accepted: 07/04/2022] [Indexed: 02/06/2023] Open
Abstract
Simple Summary Merkel cell carcinoma (MCC) is a rare but highly aggressive skin cancer. Despite important progress, overall understanding of the events that drive MCC carcinogenesis remains incomplete. We discovered that the plasma membrane citrate transporter (pmCiC) is upregulated in Merkel cell carcinoma cell lines. Cancer cells import extracellular citrate via pmCiC to support their metabolism, which is critical to support proliferation and metastatic spread. In this study, we show that inhibition of pmCiC can decrease the growth rate of Merkel cell carcinoma cell lines. Targeting pmCiC and thereby the tumor metabolism should be considered further as a potential anti-cancer therapy. Abstract Merkel cell carcinoma (MCC) is a rare but highly aggressive tumor of the skin with a poor prognosis. The factors driving this cancer must be better understood in order to discover novel targets for more effective therapies. In the search for targets, we followed our interest in citrate as a central and critical metabolite linked to fatty acid synthesis in cancer development. A key to citrate uptake in cancer cells is the high expression of the plasma membrane citrate transporter (pmCiC), which is upregulated in the different adenocarcinoma types tested so far. In this study, we show that the pmCiC is also highly expressed in Merkel cell carcinoma cell lines by western blot and human tissues by immunohistochemistry staining. In the presence of extracellular citrate, MCC cells show an increased proliferation rate in vitro; a specific pmCiC inhibitor (Na+-gluconate) blocks this citrate-induced proliferation. Furthermore, the 3D in vivo Chick Chorioallantoic Membrane (CAM) model showed that the application of Na+-gluconate also decreases Merkel cell carcinoma growth. Based on our results, we conclude that pmCiC and extracellular citrate uptake should be considered further as a potential novel target for the treatment of Merkel cell carcinoma.
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Affiliation(s)
- Konstantin Drexler
- Department of Dermatology, University Medical Center, 93053 Regensburg, Germany; (B.S.); (M.B.); (S.H.)
- Correspondence: ; Tel.: +49-941-944-9603; Fax: +49-941-944-9525
| | - Barbara Schwertner
- Department of Dermatology, University Medical Center, 93053 Regensburg, Germany; (B.S.); (M.B.); (S.H.)
| | - Silke Haerteis
- Institute for Molecular and Cellular Anatomy, University of Regensburg, 93053 Regensburg, Germany; (S.H.); (T.A.)
| | - Thiha Aung
- Institute for Molecular and Cellular Anatomy, University of Regensburg, 93053 Regensburg, Germany; (S.H.); (T.A.)
- Faculty of Applied Healthcare Science, Deggendorf Institute of Technology, 94469 Deggendorf, Germany
| | - Mark Berneburg
- Department of Dermatology, University Medical Center, 93053 Regensburg, Germany; (B.S.); (M.B.); (S.H.)
| | - Edward K. Geissler
- Department of Surgery, Section of Experimental Surgery, University Hospital Regensburg, 93053 Regensburg, Germany;
| | - Maria E. Mycielska
- Department of Structural Biology, Institute of Biophysics and Physical Biochemistry, University of Regensburg, Universitätsstrasse 31, 93053 Regensburg, Germany;
| | - Sebastian Haferkamp
- Department of Dermatology, University Medical Center, 93053 Regensburg, Germany; (B.S.); (M.B.); (S.H.)
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Yang JF, You J. Merkel cell polyomavirus and associated Merkel cell carcinoma. Tumour Virus Res 2022; 13:200232. [PMID: 34920178 PMCID: PMC8715208 DOI: 10.1016/j.tvr.2021.200232] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 11/08/2021] [Accepted: 12/13/2021] [Indexed: 12/22/2022] Open
Abstract
Merkel cell polyomavirus (MCPyV) is a ubiquitous skin infection that can cause Merkel cell carcinoma (MCC), a highly lethal form of skin cancer with a nearly 50% mortality rate. Since the discovery of MCPyV in 2008, great advances have been made to improve our understanding of how the viral encoded oncoproteins contribute to MCC oncogenesis. However, our knowledge of the MCPyV infectious life cycle and its oncogenic mechanisms are still incomplete. The incidence of MCC has tripled over the past two decades, but effective treatments are lacking. Only recently have there been major victories in combatting metastatic MCC with the application of PD-1 immune checkpoint blockade. Still, these immune-based therapies are not ideal for patients with a medical need to maintain systemic immune suppression. As such, a better understanding of MCPyV's oncogenic mechanisms is needed in order to develop more effective and targeted therapies against virus-associated MCC. In this review, we discuss current areas of interest for MCPyV and MCC research and the progress made in elucidating both the natural host of MCPyV infection and the cell of origin for MCC. We also highlight the remaining gaps in our knowledge on the transcriptional regulation of MCPyV, which may be key to understanding and targeting viral oncogenesis for developing future therapies.
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Affiliation(s)
- June F Yang
- Department of Microbiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104-6076, USA
| | - Jianxin You
- Department of Microbiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104-6076, USA.
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Oss-Ronen L, Cohen I. Epigenetic regulation and signalling pathways in Merkel cell development. Exp Dermatol 2021; 30:1051-1064. [PMID: 34152646 DOI: 10.1111/exd.14415] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 06/15/2021] [Accepted: 06/17/2021] [Indexed: 12/20/2022]
Abstract
Merkel cells are specialized epithelial cells connected to afferent nerve endings responsible for light-touch sensations, formed at specific locations in touch-sensitive regions of the mammalian skin. Although Merkel cells are descendants of the epidermal lineage, little is known about the mechanisms responsible for the development of these unique mechanosensory cells. Recent studies have highlighted that the Polycomb group (PcG) of proteins play a significant role in spatiotemporal regulation of Merkel cell formation. In addition, several of the major signalling pathways involved in skin development have been shown to regulate Merkel cell development as well. Here, we summarize the current understandings of the role of developmental regulators in Merkel cell formation, including the interplay between the epigenetic machinery and key signalling pathways, and the lineage-specific transcription factors involved in the regulation of Merkel cell development.
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Affiliation(s)
- Liat Oss-Ronen
- The Shraga Segal Department of Microbiology, Immunology and Genetics, Faculty of Health Science, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Idan Cohen
- The Shraga Segal Department of Microbiology, Immunology and Genetics, Faculty of Health Science, Ben-Gurion University of the Negev, Beer Sheva, Israel
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Structure of Merkel Cell Polyomavirus Capsid and Interaction with Its Glycosaminoglycan Attachment Receptor. J Virol 2020; 94:JVI.01664-19. [PMID: 32699083 PMCID: PMC7527053 DOI: 10.1128/jvi.01664-19] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 07/07/2020] [Indexed: 11/20/2022] Open
Abstract
The MCPyV genome was found to be clonally integrated in 80% of cases of Merkel cell carcinoma (MCC), a rare but aggressive form of human skin cancer, strongly suggesting that this virus is tumorigenic. In the metastasizing state, the course of the disease is often fatal, especially in immunocompromised individuals, as reflected by the high mortality rate of 33 to 46% and the low 5-year survival rate (<45%). The high seroprevalence of about 60% makes MCPyV a serious health care burden and illustrates the need for targeted treatments. In this study, we present the first high-resolution structural data for this human tumor virus and demonstrate that the full capsid is required for the essential interaction with its GAG receptor(s). Together, these data can be used as a basis for future strategies in drug development. Merkel cell polyomavirus (MCPyV) is a human double-stranded DNA tumor virus. MCPyV cell entry is unique among members of the polyomavirus family as it requires the engagement of two types of glycans, sialylated oligosaccharides and sulfated glycosaminoglycans (GAGs). Here, we present crystallographic and cryo-electron microscopic structures of the icosahedral MCPyV capsid and analysis of its glycan interactions via nuclear magnetic resonance (NMR) spectroscopy. While sialic acid binding is specific for α2-3-linked sialic acid and mediated by the exposed apical loops of the major capsid protein VP1, a broad range of GAG oligosaccharides bind to recessed regions between VP1 capsomers. Individual VP1 capsomers are tethered to one another by an extensive disulfide network that differs in architecture from previously described interactions for other PyVs. An unusual C-terminal extension in MCPyV VP1 projects from the recessed capsid regions. Mutagenesis experiments show that this extension is dispensable for receptor interactions. IMPORTANCE The MCPyV genome was found to be clonally integrated in 80% of cases of Merkel cell carcinoma (MCC), a rare but aggressive form of human skin cancer, strongly suggesting that this virus is tumorigenic. In the metastasizing state, the course of the disease is often fatal, especially in immunocompromised individuals, as reflected by the high mortality rate of 33 to 46% and the low 5-year survival rate (<45%). The high seroprevalence of about 60% makes MCPyV a serious health care burden and illustrates the need for targeted treatments. In this study, we present the first high-resolution structural data for this human tumor virus and demonstrate that the full capsid is required for the essential interaction with its GAG receptor(s). Together, these data can be used as a basis for future strategies in drug development.
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Tessier-Cloutier B, Cochrane DR, Karnezis AN, Colborne S, Magrill J, Talhouk A, Zhang J, Leung S, Hughes CS, Piskorz A, Cheng AS, Greening K, du Bois A, Pfisterer J, Soslow RA, Kommoss S, Brenton JD, Morin GB, Gilks CB, Huntsman DG, Kommoss F. Proteomic analysis of transitional cell carcinoma-like variant of tubo-ovarian high-grade serous carcinoma. Hum Pathol 2020; 101:40-52. [PMID: 32360491 PMCID: PMC8204941 DOI: 10.1016/j.humpath.2020.02.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 02/18/2020] [Accepted: 02/23/2020] [Indexed: 02/06/2023]
Abstract
The current World Health Organization classification does not distinguish transitional cell carcinoma of the ovary (TCC) from conventional tubo-ovarian high-grade serous carcinoma (HGSC), despite evidence suggesting improved prognosis for patients with TCC; instead, it is considered a morphologic variant of HGSC. The immunohistochemical (IHC) markers applied to date do not distinguish between TCC and HGSC. Therefore, we sought to compare the proteomic profiles of TCC and conventional HGSC to identify proteins enriched in TCC. Prognostic biomarkers in HGSC have proven to be elusive, and our aim was to identify biomarkers of TCC as a way of reliably and reproducibly identifying patients with a favorable prognosis and better response to chemotherapy compared with those with conventional HGSC. Quantitative global proteome analysis was performed on archival material of 12 cases of TCC and 16 cases of HGSC using SP3 (single-pot, solid phase-enhanced, sample preparation)-Clinical Tissue Proteomics, a recently described protocol for full-proteome analysis from formalin-fixed paraffin-embedded tissues. We identified 430 proteins that were significantly enriched in TCC over HGSC. Unsupervised co-clustering perfectly distinguished TCC from HGSC based on protein expression. Pathway analysis showed that proteins associated with cell death, necrosis, and apoptosis were highly expressed in TCCs, whereas proteins associated with DNA homologous recombination, cell mitosis, proliferation and survival, and cell cycle progression pathways had reduced expression. From the proteomic analysis, three potential biomarkers for TCC were identified, claudin-4 (CLDN4), ubiquitin carboxyl-terminal esterase L1 (UCHL1), and minichromosome maintenance protein 7 (MCM7), and tested by IHC analysis on tissue microarrays. In agreement with the proteomic analysis, IHC expression of those proteins was stronger in TCC than in HGSC (p < 0.0001). Using global proteomic analysis, we are able to distinguish TCC from conventional HGSC. Follow-up studies will be necessary to confirm that these molecular and morphologic differences are clinically significant.
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Affiliation(s)
- Basile Tessier-Cloutier
- Department of Pathology and Laboratory Medicine, The University of British Columbia, Vancouver, BC, Canada; Department of Molecular Oncology, BC Cancer, Vancouver, BC, Canada; Department of Pathology and Laboratory Medicine, Vancouver General Hospital, Vancouver, BC, Canada
| | - Dawn R Cochrane
- Department of Molecular Oncology, BC Cancer, Vancouver, BC, Canada
| | - Anthony N Karnezis
- Department of Molecular Oncology, BC Cancer, Vancouver, BC, Canada; Department of Pathology and Laboratory Medicine, UC Davis Medical Center, Sacramento, CA, United States
| | - Shane Colborne
- Michael Smith Genome Sciences Centre, BC Cancer, Vancouver, BC, Canada
| | - Jamie Magrill
- Department of Molecular Oncology, BC Cancer, Vancouver, BC, Canada
| | - Aline Talhouk
- Department of Molecular Oncology, BC Cancer, Vancouver, BC, Canada
| | - Jonathan Zhang
- Department of Molecular Oncology, BC Cancer, Vancouver, BC, Canada
| | - Samuel Leung
- Department of Molecular Oncology, BC Cancer, Vancouver, BC, Canada
| | | | - Anna Piskorz
- Cancer Research UK Cambridge Research Institute, Li Ka Shing Centre, Cambridge, UK
| | - Angela S Cheng
- Genetic Pathology Evaluation Centre, The University of British Columbia, Vancouver, Canada
| | - Kendall Greening
- Department of Molecular Oncology, BC Cancer, Vancouver, BC, Canada
| | | | | | - Robert A Soslow
- Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Stefan Kommoss
- Department of Obstetrics and Gynecology, Tübingen University Hospital, Tübingen, Germany
| | - James D Brenton
- Cancer Research UK Cambridge Research Institute, Li Ka Shing Centre, Cambridge, UK
| | - Gregg B Morin
- Michael Smith Genome Sciences Centre, BC Cancer, Vancouver, BC, Canada; Department of Medical Genetics, University of British Columbia, Vancouver, BC, Canada
| | - C Blake Gilks
- Department of Pathology and Laboratory Medicine, Vancouver General Hospital, Vancouver, BC, Canada
| | - David G Huntsman
- Department of Molecular Oncology, BC Cancer, Vancouver, BC, Canada
| | - Friedrich Kommoss
- Institute of Pathology, Medizin Campus Bodensee, Friedrichshafen, Germany.
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Botha AR, Mbodi L, Wadee R. Advanced neuroendocrine carcinoma (Merkel cell carcinoma) of the vulva: a case report and literature review. SOUTHERN AFRICAN JOURNAL OF GYNAECOLOGICAL ONCOLOGY 2020. [DOI: 10.1080/20742835.2020.1740434] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Affiliation(s)
- Adam R Botha
- Department of Anatomical Pathology, School of Pathology, University of the Witwatersrand/National Health Laboratory Service, Johannesburg, South Africa
| | - Langanani Mbodi
- Department of Obstetrics and Gynaecology, Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa
| | - Reubina Wadee
- Department of Anatomical Pathology, School of Pathology, University of the Witwatersrand/National Health Laboratory Service, Johannesburg, South Africa
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Schmerling RA, Casas JG, Cinat G, Ospina FEG, Kassuga LEBP, Tlahuel JLM, Mazzuoccolo LD. Burden of Disease, Early Diagnosis, and Treatment of Merkel Cell Carcinoma in Latin America. J Glob Oncol 2019; 4:1-11. [PMID: 30085832 PMCID: PMC6223512 DOI: 10.1200/jgo.18.00041] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Affiliation(s)
- Rafael A Schmerling
- Rafael A. Schmerling, Beneficiência Portugesa de São Paulo, São Paulo; Luiza E.B.P. Kassuga, National Cancer Institute, Rio de Janeiro, Brazil; Jose G. Casas, Hospital Alemán de Buenos Aires; Gabriela Cinat, University of Buenos Aires; Luis Daniel Mazzuoccolo, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Fabio Ernesto Grosso Ospina, Centro Nacional de Oncología de Colombia, Bogotá, Colombia; and Jorge Luis Martinez Tlahuel, National Cancer Institute, Mexico City, Mexico
| | - Jose G Casas
- Rafael A. Schmerling, Beneficiência Portugesa de São Paulo, São Paulo; Luiza E.B.P. Kassuga, National Cancer Institute, Rio de Janeiro, Brazil; Jose G. Casas, Hospital Alemán de Buenos Aires; Gabriela Cinat, University of Buenos Aires; Luis Daniel Mazzuoccolo, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Fabio Ernesto Grosso Ospina, Centro Nacional de Oncología de Colombia, Bogotá, Colombia; and Jorge Luis Martinez Tlahuel, National Cancer Institute, Mexico City, Mexico
| | - Gabriela Cinat
- Rafael A. Schmerling, Beneficiência Portugesa de São Paulo, São Paulo; Luiza E.B.P. Kassuga, National Cancer Institute, Rio de Janeiro, Brazil; Jose G. Casas, Hospital Alemán de Buenos Aires; Gabriela Cinat, University of Buenos Aires; Luis Daniel Mazzuoccolo, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Fabio Ernesto Grosso Ospina, Centro Nacional de Oncología de Colombia, Bogotá, Colombia; and Jorge Luis Martinez Tlahuel, National Cancer Institute, Mexico City, Mexico
| | - Fabio Ernesto Grosso Ospina
- Rafael A. Schmerling, Beneficiência Portugesa de São Paulo, São Paulo; Luiza E.B.P. Kassuga, National Cancer Institute, Rio de Janeiro, Brazil; Jose G. Casas, Hospital Alemán de Buenos Aires; Gabriela Cinat, University of Buenos Aires; Luis Daniel Mazzuoccolo, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Fabio Ernesto Grosso Ospina, Centro Nacional de Oncología de Colombia, Bogotá, Colombia; and Jorge Luis Martinez Tlahuel, National Cancer Institute, Mexico City, Mexico
| | - Luiza E B P Kassuga
- Rafael A. Schmerling, Beneficiência Portugesa de São Paulo, São Paulo; Luiza E.B.P. Kassuga, National Cancer Institute, Rio de Janeiro, Brazil; Jose G. Casas, Hospital Alemán de Buenos Aires; Gabriela Cinat, University of Buenos Aires; Luis Daniel Mazzuoccolo, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Fabio Ernesto Grosso Ospina, Centro Nacional de Oncología de Colombia, Bogotá, Colombia; and Jorge Luis Martinez Tlahuel, National Cancer Institute, Mexico City, Mexico
| | - Jorge Luis Martinez Tlahuel
- Rafael A. Schmerling, Beneficiência Portugesa de São Paulo, São Paulo; Luiza E.B.P. Kassuga, National Cancer Institute, Rio de Janeiro, Brazil; Jose G. Casas, Hospital Alemán de Buenos Aires; Gabriela Cinat, University of Buenos Aires; Luis Daniel Mazzuoccolo, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Fabio Ernesto Grosso Ospina, Centro Nacional de Oncología de Colombia, Bogotá, Colombia; and Jorge Luis Martinez Tlahuel, National Cancer Institute, Mexico City, Mexico
| | - Luis Daniel Mazzuoccolo
- Rafael A. Schmerling, Beneficiência Portugesa de São Paulo, São Paulo; Luiza E.B.P. Kassuga, National Cancer Institute, Rio de Janeiro, Brazil; Jose G. Casas, Hospital Alemán de Buenos Aires; Gabriela Cinat, University of Buenos Aires; Luis Daniel Mazzuoccolo, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Fabio Ernesto Grosso Ospina, Centro Nacional de Oncología de Colombia, Bogotá, Colombia; and Jorge Luis Martinez Tlahuel, National Cancer Institute, Mexico City, Mexico
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Haley CT, Mui UN, Vangipuram R, Rady PL, Tyring SK. Human oncoviruses: Mucocutaneous manifestations, pathogenesis, therapeutics, and prevention: Papillomaviruses and Merkel cell polyomavirus. J Am Acad Dermatol 2018; 81:1-21. [PMID: 30502418 DOI: 10.1016/j.jaad.2018.09.062] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 09/09/2018] [Accepted: 09/10/2018] [Indexed: 12/18/2022]
Abstract
In 1964, the first human oncovirus, Epstein-Barr virus, was identified in Burkitt lymphoma cells. Since then, 6 other human oncoviruses have been identified: human papillomavirus, Merkel cell polyomavirus, hepatitis B and C viruses, human T-cell lymphotropic virus-1, and human herpesvirus-8. These viruses are causally linked to 12% of all cancers, many of which have mucocutaneous manifestations. In addition, oncoviruses are associated with multiple benign mucocutaneous diseases. Research regarding the pathogenic mechanisms of oncoviruses and virus-specific treatment and prevention is rapidly evolving. Preventative vaccines for human papillomavirus and hepatitis B virus are already available. This review discusses the mucocutaneous manifestations, pathogenesis, diagnosis, treatment, and prevention of oncovirus-related diseases. The first article in this continuing medical education series focuses on diseases associated with human papillomavirus and Merkel cell polyomavirus, while the second article in the series focuses on diseases associated with hepatitis B and C viruses, human T-cell lymphotropic virus-1, human herpesvirus-8, and Epstein-Barr virus.
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Affiliation(s)
| | | | - Ramya Vangipuram
- Center for Clinical Studies, Webster, Texas; Department of Dermatology, University of Texas Health Science Center at Houston, Houston, Texas
| | - Peter L Rady
- Department of Dermatology, University of Texas Health Science Center at Houston, Houston, Texas
| | - Stephen K Tyring
- Center for Clinical Studies, Webster, Texas; Department of Dermatology, University of Texas Health Science Center at Houston, Houston, Texas
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Johansson B, Sahi H, Koljonen V, Böhling T. The expression of terminal deoxynucleotidyl transferase and paired box gene 5 in Merkel cell carcinomas and its relation to the presence of Merkel cell polyomavirus DNA. J Cutan Pathol 2018; 46:26-32. [PMID: 30315594 DOI: 10.1111/cup.13372] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 09/22/2018] [Accepted: 10/08/2018] [Indexed: 01/06/2023]
Abstract
BACKGROUND Merkel cell carcinoma (MCC) tumor samples frequently express B-lymphoid lineage markers. However, the reasons for expression of specific B-lymphoid lineage markers are still unclear. We studied the expression of TdT and PAX5 (two B-cell lymphoid lineage markers) in a large pool of MCC tissue microarray samples. METHODS Immunoexpression and staining intensities of TdT and Pax-5 were statistically correlated with patient, tumor, Merkel cell polyomavirus (MCV), and disease-specific parameters. RESULTS In a cohort of 117 MCC patients and their corresponding tumor samples, TdT was expressed in 37 (31.6%) samples and PAX5 in 26 (22.2%). Simultaneous immunostaining for TdT and PAX5 was observed in 13 (11.1%) samples. A statistically significant relationship was observed between MCV virus copy number and positive TdT expression (P = 0.0056). Similarly, a significant relationship was also observed between positive TdT and tumor MCV virus positivity (P = 0.000495). CONCLUSION We observed frequent TdT and PAX5 immunoexpression in MCC tumor samples. However, simultaneous immunoexpression of these markers was scarce. TdT expression was statistically significantly associated with MCV positivity. The absence of a statistically significant association between tumor parameters and disease progression markers undermines the systemic use of these markers in clinical practice.
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Affiliation(s)
- Benjamin Johansson
- Department of Pathology, Helsinki University and HUSLAB, Helsinki, Finland
| | - Helka Sahi
- Department of Dermatology and Allergology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Virve Koljonen
- Department of Plastic Surgery, Helsinki University Hospital, Helsinki, Finland
| | - Tom Böhling
- Department of Pathology, Helsinki University and HUSLAB, Helsinki, Finland
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Neuroendocrine Key Regulator Gene Expression in Merkel Cell Carcinoma. Neoplasia 2018; 20:1227-1235. [PMID: 30414538 PMCID: PMC6226622 DOI: 10.1016/j.neo.2018.10.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 10/07/2018] [Accepted: 10/11/2018] [Indexed: 01/26/2023] Open
Abstract
Merkel cell carcinoma (MCC) is a highly aggressive non-melanoma skin cancer of the elderly which is associated with the Merkel cell polyomavirus (MCPyV). MCC reveals a trilinear differentiation characterized by neuroendocrine, epithelial and pre/pro B-cell lymphocytic gene expression disguising the cellular origin of MCC. Here we investigated the expression of the neuroendocrine key regulators RE1 silencing transcription factor (REST), neurogenic differentiation 1 (NeuroD1) and the Achaete-scute homolog 1 (ASCL1) in MCC. All MCCs were devoid of REST and were positive for NeuroD1 expression. Only one MCC tissue revealed focal ASCL1 expression. This was confirmed in MCPyV-positive MCC cell lines. Of interest, MCPyV-negative cell lines did express REST. The introduction of REST expression in REST-negative, MCPyV-positive MCC cells downregulated the neuroendocrine gene expression. The lack of the neuroendocrine master regulator ASCL1 in almost all tested MCCs points to an important role of the absence of the negative regulator REST towards the MCC neuroendocrine phenotype. This is underlined by the expression of the REST-regulated microRNAs miR-9/9* in REST-negative MCC cell lines. These data might provide the basis for the understanding of neuroendocrine gene expression profile which is expected to help to elucidate the cellular origin of MCC.
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Rastrelli M, Ferrazzi B, Cavallin F, Chiarion Sileni V, Pigozzo J, Fabozzi A, Tropea S, Vecchiato A, Costa A, Parisi A, Rossi CR, Del Fiore P, Alaibac M. Prognostic Factors in Merkel Cell Carcinoma: A Retrospective Single-Center Study in 90 Patients. Cancers (Basel) 2018; 10:cancers10100350. [PMID: 30249978 PMCID: PMC6210570 DOI: 10.3390/cancers10100350] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 09/20/2018] [Accepted: 09/21/2018] [Indexed: 12/21/2022] Open
Abstract
Merkel Cell Carcinoma (MCC) is a rare but highly aggressive neuroendocrine neoplasm of the skin. This study aimed at describing characteristics, treatment, and prognosis of a series of consecutive cases of MCC patients, in order to contribute to the investigation of this rare malignancy and provide better patient care. This is a retrospective cohort study including all 90 patients diagnosed and/or treated for MCC between 1991 and 2018 at the Veneto Institute of Oncology in Padua (Italy). Patient and tumor characteristics, treatment, and immunohistochemical data were extracted from a prospectively collected local database. There were 68 primary (76%) and 22 non-primary (15 occult primary, three metastatic, four recurrence) tumors (24%). CK20 expression was associated with reduced overall (HR 2.92, 95% CI 1.04–8.16) and disease-specific (HR 4.62, 95% CI 1.31–16.28) survival. Immunomodulatory regimens for treatment of other comorbidities were associated with reduced disease-specific ((HR 2.15, 95% CI 1.06–4.36) and recurrence-free (HR 3.08, 95% CI 1.44–6.57) survival. Iatrogenic immunomodulation resulted as the main factor associated with impaired prognosis. Lack of CK20 expression was associated with better survival.
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Affiliation(s)
- Marco Rastrelli
- Surgical Oncology Unit, Veneto Institute of Oncology IOV⁻IRCCS, 35121 Padua, Italy.
| | - Beatrice Ferrazzi
- Dermatology Unit and Pathology Unit, Department of Medicine (DIMED), University of Padua, 35121 Padua, Italy.
| | | | - Vanna Chiarion Sileni
- Melanoma and Esophagus Oncology Unit, Veneto Institute of Oncology IOV-IRCCS, 35121 Padua, Italy.
| | - Jacopo Pigozzo
- Melanoma and Esophagus Oncology Unit, Veneto Institute of Oncology IOV-IRCCS, 35121 Padua, Italy.
| | - Alessio Fabozzi
- Melanoma and Esophagus Oncology Unit, Veneto Institute of Oncology IOV-IRCCS, 35121 Padua, Italy.
| | - Saveria Tropea
- Surgical Oncology Unit, Veneto Institute of Oncology IOV⁻IRCCS, 35121 Padua, Italy.
| | - Antonella Vecchiato
- Surgical Oncology Unit, Veneto Institute of Oncology IOV⁻IRCCS, 35121 Padua, Italy.
| | - Alessandra Costa
- Surgical Oncology Unit, Veneto Institute of Oncology IOV⁻IRCCS, 35121 Padua, Italy.
| | - Alessandro Parisi
- Radiotherapy Unit, Veneto Institute of Oncology, IOV⁻IRCCS, 35121 Padua, Italy.
| | - Carlo Riccardo Rossi
- Surgical Oncology Unit, Veneto Institute of Oncology IOV⁻IRCCS, 35121 Padua, Italy.
- Department of Surgery, Oncology and Gastroenterology, University of Padua, 35121 Padua, Italy.
| | - Paolo Del Fiore
- Surgical Oncology Unit, Veneto Institute of Oncology IOV⁻IRCCS, 35121 Padua, Italy.
| | - Mauro Alaibac
- Dermatology Unit, Department of Medicine (DIMED), University of Padova, 35128 Padua, Italy.
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13
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MicroRNAs as Potential Biomarkers in Merkel Cell Carcinoma. Int J Mol Sci 2018; 19:ijms19071873. [PMID: 29949882 PMCID: PMC6073391 DOI: 10.3390/ijms19071873] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 06/18/2018] [Accepted: 06/22/2018] [Indexed: 12/27/2022] Open
Abstract
Merkel cell carcinoma (MCC) is a rare and aggressive type of skin cancer associated with a poor prognosis. This carcinoma was named after its presumed cell of origin, the Merkel cell, which is a mechanoreceptor cell located in the basal epidermal layer of the skin. Merkel cell polyomavirus seems to be the major causal factor for MCC because approximately 80% of all MCCs are positive for viral DNAs. UV exposure is the predominant etiological factor for virus-negative MCCs. Intracellular microRNA analysis between virus-positive and virus-negative MCC cell lines and tumor samples have identified differentially expressed microRNAs. Comparative microRNA profiling has also been performed between MCCs and other non-MCC tumors, but not between normal Merkel cells and malignant Merkel cells. Finally, Merkel cell polyomavirus encodes one microRNA, but its expression in virus-positive MCCs is low, or non-detectable or absent, jeopardizing its biological relevance in tumorigenesis. Here, we review the results of microRNA studies in MCCs and discuss the potential application of microRNAs as biomarkers for the diagnosis, progression and prognosis, and treatment of MCC.
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Abstract
Merkel cell carcinoma (MCC) is a rare and aggressive skin cancer with a neuroendocrine phenotype. Here, the authors reported a case of MCC, presented as a rapidly growing, asymptomatic, erythematous nodule measuring 3.8 cm × 2.8 cm in diameter on the right cheek of an 85-year-old Caucasian woman. After resection of the nodule, the defect was repaired with cutaneous graft taken from the supraclavicular area and healed uneventfully. Histopathologic examination confirmed the diagnosis of MCC.
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15
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Zanetti I, Coati I, Alaibac M. Interaction between Merkel cell carcinoma and the immune system: Pathogenetic and therapeutic implications. Mol Clin Oncol 2017; 7:729-732. [PMID: 29142746 DOI: 10.3892/mco.2017.1406] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Accepted: 04/11/2017] [Indexed: 12/23/2022] Open
Abstract
Merkel cell carcinoma (MCC) is a rare, aggressive primary cutaneous neuroendocrine carcinoma. It usually appears on the face and neck of elderly Caucasian people as a flesh-colored, erythematous or violaceous dome-shaped, non-tender nodule with a smooth surface. In immunocompromised patients with T-cell dysfunction, such as patients with acquired immunodeficiency syndrome (AIDS) or solid organ transplant recipients, the incidence of this disease is markedly increased. This suggests a link between the development of MCC and the immune system. Merkel cell polyolmavirus (MCPyV) is clonally integrated into the majority of MCCs, suggesting its causative role in the pathogenesis of the majority of these tumors. Despite wide local excision, sentinel lymph node biopsy, and eventually, adjuvant radiation therapy, which remains the first-line treatment for MCC, the identification of MCPyV has opened novel therapeutic insights. Novel therapeutic strategies could be to inhibit MCPyV oncoproteins and to stimulate immune responses against virus-infected tumor cells by immunostimulatory cytokines, including interferons and interleukin-2.
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Affiliation(s)
- Irene Zanetti
- Unit of Dermatology, University of Padua, I-35128 Padua, Italy
| | - Ilaria Coati
- Unit of Dermatology, University of Padua, I-35128 Padua, Italy
| | - Mauro Alaibac
- Unit of Dermatology, University of Padua, I-35128 Padua, Italy
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16
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Müller-Richter UDA, Gesierich A, Kübler AC, Hartmann S, Brands RC. Merkel Cell Carcinoma of the Head and Neck: Recommendations for Diagnostics and Treatment. Ann Surg Oncol 2017; 24:3430-3437. [PMID: 28762116 PMCID: PMC5596053 DOI: 10.1245/s10434-017-5993-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Indexed: 12/14/2022]
Abstract
Background Merkel cell carcinoma (MCC) is a rare, aggressive tumor that often occurs in the head and neck region. Because of these features, the classifications and diagnostic and treatment regimens are frequently modified. Especially in the anatomically complex head and neck region, it is crucial to be aware of the current recommendations for diagnostics and treatment of MCC to ensure appropriate treatment. This overview aims to summarize the currently available literature. Methods The authors reviewed the relevant literature and international guidelines for MCC from 2012 to 2017 with respect to epidemiology and prognosis, diagnostic procedures and imaging, surgery, radiation, systemic treatment, and aftercare. These results were compared with existing guidelines, some of them current, and recommendations were derived. Results Marked developments in imaging have resulted in an increased use of functional imaging. The surgical concepts have changed regarding safety margins and the use of sentinel node biopsies. In systemic treatment, a move from conventional agents toward immuno-oncology can be observed. Conclusions For staging, it is important to be as exact as possible using functional imaging (e.g., positron emission tomography/computed tomography scan), especially in the head and neck area with its complex lymph drainage. This often plays an especially important role in early stages of the tumor, when the resection margin can be reduced to preserve the organ. Aftercare also should include functional imaging. In an advanced, metastatic stage, immuno-oncology (PD-1, PD-L1, CTLA-4) is superior to the previous methods of systemic treatment.
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Affiliation(s)
| | - Anja Gesierich
- Department of Dermatology, Venereology and Allergology, Würzburg University Hospital, Würzburg, Germany
| | | | - Stefan Hartmann
- Department of Oral and Maxillofacial Plastic Surgery, Würzburg University Hospital, Würzburg, Germany.,Interdisciplinary Center for Clinical Research, Würzburg University Hospital, Würzburg, Germany
| | - Roman Camillus Brands
- Department of Oral and Maxillofacial Plastic Surgery, Würzburg University Hospital, Würzburg, Germany.,Comprehensive Cancer Center Mainfranken, Würzburg University Hospital, Würzburg, Germany
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17
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Schadendorf D, Lebbé C, Zur Hausen A, Avril MF, Hariharan S, Bharmal M, Becker JC. Merkel cell carcinoma: Epidemiology, prognosis, therapy and unmet medical needs. Eur J Cancer 2016; 71:53-69. [PMID: 27984768 DOI: 10.1016/j.ejca.2016.10.022] [Citation(s) in RCA: 242] [Impact Index Per Article: 30.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Accepted: 10/22/2016] [Indexed: 01/19/2023]
Abstract
Merkel cell carcinoma (MCC) is a rare skin cancer that is associated with Merkel cell polyomavirus infection in most cases. Incidence rates of MCC have increased in past decades. Risk factors for MCC include ultraviolet light exposure, immunosuppression and advanced age. MCC is an aggressive malignancy with frequent recurrences and a high mortality rate, although patient outcomes are generally more favourable if the patient is referred for treatment at an early stage. Although advances have been made recently in the MCC field, large gaps remain with regard to definitive biomarkers and prognostic indicators. Although MCC is chemosensitive, responses in advanced stages are mostly of short duration, and the associated clinical benefit on overall survival is unclear. Recent nonrandomised phase 2 clinical trials with anti-PD-L1/PD-1 antibodies have demonstrated safety and efficacy; however, there are still no approved treatments for patients with metastatic MCC. Patients with advanced disease are encouraged to participate in clinical trials for treatment, indicating the largely unmet need for durable, safe treatment within this population.
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Affiliation(s)
- Dirk Schadendorf
- Dermatology, Essen University Hospital, Essen, Germany; German Cancer Consortium Partner Site Essen/Düsseldorf, Essen University Hospital, Essen, Germany.
| | - Céleste Lebbé
- APHP, Dermatology and CIC, Hôpital Saint-Louis, INSERM U976, University Paris 7 Diderot, Paris, France.
| | - Axel Zur Hausen
- Department of Pathology, GROW-School for Oncology and Developmental Biology, Maastricht University Medical Centre, The Netherlands.
| | | | | | - Murtuza Bharmal
- Merck KGaA, Global Evidence & Value Development, Darmstadt, Germany.
| | - Jürgen C Becker
- Translational Skin Cancer Research (TSCR), German Cancer Consortium Partner Site Essen/Düsseldorf, Dermatology, Essen University Hospital, Essen, Germany.
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18
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Crall C, Morley KW, Rabinowits G, Schmidt B, Dioun Broyles A, Huang JT. Merkel cell carcinoma in a patient with GATA2 deficiency: a novel association with primary immunodeficiency. Br J Dermatol 2015; 174:169-71. [PMID: 26252413 DOI: 10.1111/bjd.14062] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/21/2015] [Indexed: 02/06/2023]
Abstract
A 55-year-old woman with GATA2 deficiency and neurofibromatosis 1 was diagnosed with Merkel cell carcinoma (MCC). This polyomavirus-associated cutaneous malignancy has previously been associated with immunosuppression and acquired immunodeficiencies such as HIV/AIDS. However, MCC has not been previously reported in the setting of underlying primary or inherited immunodeficiency.
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Affiliation(s)
- C Crall
- Harvard Medical School, Boston, MA, U.S.A
| | - K W Morley
- Harvard Combined Dermatology Program, Boston, MA, U.S.A
| | - G Rabinowits
- Department of Medical Oncology, Dana-Farber Cancer Institute and Brigham and Women's Hospital, Boston, MA, U.S.A
| | - B Schmidt
- Department of Pathology, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, U.S.A
| | - A Dioun Broyles
- Division of Allergy/Immunology, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, U.S.A
| | - J T Huang
- Dermatology Program, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, U.S.A
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19
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Coexpression of cytokeratin and B cell markers—a rare finding with new implications. J Hematop 2015. [DOI: 10.1007/s12308-015-0243-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/29/2022] Open
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20
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Interaction of human tumor viruses with host cell surface receptors and cell entry. Viruses 2015; 7:2592-617. [PMID: 26008702 PMCID: PMC4452921 DOI: 10.3390/v7052592] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Accepted: 05/12/2015] [Indexed: 02/06/2023] Open
Abstract
Currently, seven viruses, namely Epstein-Barr virus (EBV), Kaposi's sarcoma-associated herpes virus (KSHV), high-risk human papillomaviruses (HPVs), Merkel cell polyomavirus (MCPyV), hepatitis B virus (HBV), hepatitis C virus (HCV) and human T cell lymphotropic virus type 1 (HTLV-1), have been described to be consistently associated with different types of human cancer. These oncogenic viruses belong to distinct viral families, display diverse cell tropism and cause different malignancies. A key to their pathogenicity is attachment to the host cell and entry in order to replicate and complete their life cycle. Interaction with the host cell during viral entry is characterized by a sequence of events, involving viral envelope and/or capsid molecules as well as cellular entry factors that are critical in target cell recognition, thereby determining cell tropism. Most oncogenic viruses initially attach to cell surface heparan sulfate proteoglycans, followed by conformational change and transfer of the viral particle to secondary high-affinity cell- and virus-specific receptors. This review summarizes the current knowledge of the host cell surface factors and molecular mechanisms underlying oncogenic virus binding and uptake by their cognate host cell(s) with the aim to provide a concise overview of potential target molecules for prevention and/or treatment of oncogenic virus infection.
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21
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Dohata A, Chambers JK, Uchida K, Nakazono S, Kinoshita Y, Nibe K, Nakayama H. Clinical and Pathologic Study of Feline Merkel Cell Carcinoma With Immunohistochemical Characterization of Normal and Neoplastic Merkel Cells. Vet Pathol 2015; 52:1012-8. [PMID: 25653203 DOI: 10.1177/0300985815570484] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The authors herein describe the morphologic and immunohistochemical features of normal Merkel cells as well as the clinicopathologic findings of Merkel cell carcinoma in cats. Merkel cells were characterized as vacuolated clear cells and were individually located in the epidermal basal layer of all regions examined. Clusters of Merkel cells were often observed adjacent to the sinus hair of the face and carpus. Immunohistochemically, Merkel cells were positive for cytokeratin (CK) 20, CK18, p63, neuron-specific enolase, synaptophysin, and protein gene product 9.5. Merkel cell carcinoma was detected as a solitary cutaneous mass in 3 aged cats (13 to 16 years old). On cytology, large lymphocyte-like cells were observed in all cases. Histologic examinations of surgically resected tumors revealed nests of round cells separated by various amounts of a fibrous stroma. Tumor cells were commonly immunopositive for CK20, CK18, p63, neuron-specific enolase, and synaptophysin, representing the characteristics of normal Merkel cells.
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Affiliation(s)
- A Dohata
- Department of Veterinary Pathology, Graduate School of Agricultural and Life Sciences, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - J K Chambers
- Department of Veterinary Pathology, Graduate School of Agricultural and Life Sciences, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - K Uchida
- Department of Veterinary Pathology, Graduate School of Agricultural and Life Sciences, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | | | - Y Kinoshita
- Iwakuni Health and Welfare Center, Yamaguchi, Japan
| | - K Nibe
- Japan Animal Referral Medical Center, Kanagawa, Japan
| | - H Nakayama
- Department of Veterinary Pathology, Graduate School of Agricultural and Life Sciences, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
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Spurgeon ME, Cheng J, Bronson RT, Lambert PF, DeCaprio JA. Tumorigenic activity of merkel cell polyomavirus T antigens expressed in the stratified epithelium of mice. Cancer Res 2015; 75:1068-79. [PMID: 25596282 DOI: 10.1158/0008-5472.can-14-2425] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Merkel cell polyomavirus (MCPyV) is frequently associated with Merkel cell carcinoma (MCC), a highly aggressive neuroendocrine skin cancer. Most MCC tumors contain integrated copies of the viral genome with persistent expression of the MCPyV large T (LT) and small T (ST) antigen. MCPyV isolated from MCC typically contains wild-type ST but truncated forms of LT that retain the N-terminus but delete the C-terminus and render LT incapable of supporting virus replication. To determine the oncogenic activity of MCC tumor-derived T antigens in vivo, a conditional, tissue-specific mouse model was developed. Keratin 14-mediated Cre recombinase expression induced expression of MCPyV T antigens in stratified squamous epithelial cells and Merkel cells of the skin epidermis. Mice expressing MCPyV T antigens developed hyperplasia, hyperkeratosis, and acanthosis of the skin with additional abnormalities in whisker pads, footpads, and eyes. Nearly half of the mice also developed cutaneous papillomas. Evidence for neoplastic progression within stratified epithelia included increased cellular proliferation, unscheduled DNA synthesis, increased E2F-responsive genes levels, disrupted differentiation, and presence of a DNA damage response. These results indicate that MCPyV T antigens are tumorigenic in vivo, consistent with their suspected etiologic role in human cancer.
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Affiliation(s)
- Megan E Spurgeon
- Department of Oncology, McArdle Laboratory for Cancer Research, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Jingwei Cheng
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts. Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Roderick T Bronson
- Department of Microbiology and Immunobiology, Harvard Medical School, Boston, Massachusetts
| | - Paul F Lambert
- Department of Oncology, McArdle Laboratory for Cancer Research, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - James A DeCaprio
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts. Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
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