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Bray ER, Tosti A, Morrison BW. Update on Squamous Cell Carcinoma of the Nail Unit: An Human Papillomavirus-Associated Condition. Skin Appendage Disord 2024; 10:199-206. [PMID: 38835716 PMCID: PMC11147528 DOI: 10.1159/000537760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 02/08/2024] [Indexed: 06/06/2024] Open
Abstract
Background Squamous cell carcinoma (SCC) and SCC in situ (Bowen's disease) are the most common malignancies of the nail unit. They are frequently seen in men over 50 and most commonly affect the fingers. The role of high-risk human papillomavirus (HPV) infection has been identified as a key contributor to the development of nail unit SCC. Summary In this review, we aimed to summarize the current state of our understanding of how HPV contributes to nail unit SCC, the role of genitodigital transmission of HPV, and the clinical features of HPV-associated nail unit SCC. We also review current advances in the treatment of nail unit SCC, with a focus on the potential role of HPV vaccination in the treatment and prevention of nail unit SCC. Key Messages Nail unit SCC should be recognized as an HPV-associated disease. HPV vaccination may represent a non-surgical modality for the management of these challenging malignancies in the appropriate clinical setting.
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Affiliation(s)
- Eric R Bray
- Philip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Antonella Tosti
- Philip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Brian W Morrison
- Philip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
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2
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Skelin J, Tomaić V. Comparative Analysis of Alpha and Beta HPV E6 Oncoproteins: Insights into Functional Distinctions and Divergent Mechanisms of Pathogenesis. Viruses 2023; 15:2253. [PMID: 38005929 PMCID: PMC10674601 DOI: 10.3390/v15112253] [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: 10/27/2023] [Revised: 11/09/2023] [Accepted: 11/10/2023] [Indexed: 11/26/2023] Open
Abstract
Human papillomaviruses (HPVs) represent a diverse group of DNA viruses that infect epithelial cells of mucosal and cutaneous tissues, leading to a wide spectrum of clinical outcomes. Among various HPVs, alpha (α) and beta (β) types have garnered significant attention due to their associations with human health. α-HPVs are primarily linked to infections of the mucosa, with high-risk subtypes, such as HPV16 and HPV18, being the major etiological agents of cervical and oropharyngeal cancers. In contrast, β-HPVs are predominantly associated with cutaneous infections and are commonly found on healthy skin. However, certain β-types, notably HPV5 and HPV8, have been implicated in the development of non-melanoma skin cancers in immunocompromised individuals, highlighting their potential role in pathogenicity. In this review, we comprehensively analyze the similarities and differences between α- and β-HPV E6 oncoproteins, one of the major drivers of viral replication and cellular transformation, and how these impact viral fitness and the capacity to induce malignancy. In particular, we compare the mechanisms these oncoproteins use to modulate common cellular processes-apoptosis, DNA damage repair, cell differentiation, and the immune response-further shedding light on their shared and distinct features, which enable them to replicate at divergent locations of the human body and cause different types of cancer.
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Affiliation(s)
| | - Vjekoslav Tomaić
- Division of Molecular Medicine, Ruđer Bošković Institute, Bijenička 54, 10000 Zagreb, Croatia;
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3
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Zhao Y, Amorrortu RP, Stewart SC, Ghia KM, Williams VL, Sondak VK, Tsai KY, Pinilla-Ibarz J, Chavez JC, Rollison DE. Melanoma and CLL co-occurrence and survival: role of KC history. BMC Cancer 2023; 23:1084. [PMID: 37946198 PMCID: PMC10636833 DOI: 10.1186/s12885-023-11573-z] [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: 05/12/2023] [Accepted: 10/27/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND Survival following melanoma and chronic lymphocytic leukemia (CLL) have both been individually associated with previous history of non-melanoma skin cancers (specifically keratinocyte carcinomas [KC]). Furthermore, melanoma and CLL have been reported to occur within the same patients. The survival experience of patients with both cancers is understudied, and the role of history of KC is unknown. Additional research is needed to tease apart the independent associations between KC and CLL survival, KC and melanoma survival, and the co-occurrence of all three cancers. METHODS A retrospective cohort study was conducted among patients who were diagnosed with melanoma and/or CLL at a comprehensive cancer center between 2008 and 2020. Multivariable Cox regression models were used to examine the association between history of KC and survival following melanoma and/or CLL with careful consideration of calendar year of diagnosis, treatment regimens and other risk factors. A nested case-control study comparing patients with both CLL and melanoma to those with only CLL or only melanoma was conducted to compare blood parameters across the three groups. RESULTS A time-dependent association was observed between history of KC and favorable melanoma survival within 4 years following diagnosis and poorer survival post 7 years after melanoma diagnosis. History of KC was not significantly associated with survival following the diagnosis of CLL, after adjustment for clinical factors including historical/concurrent melanoma. Patients with co-occurring melanoma and CLL tended to be diagnosed with melanoma first and had elevated blood parameters including white blood cell and lymphocyte counts as compared with patients who were diagnosed with only melanoma. CONCLUSIONS History of KC was an independent predictor of survival following melanoma but not of CLL. Additional studies are needed to determine if blood parameters obtained at the time of melanoma diagnosis could be used as a cost-effective way to identify those at high risk of asymptomatic CLL for the promotion of earlier CLL diagnosis.
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Affiliation(s)
- Yayi Zhao
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL, USA
| | | | - Sandra C Stewart
- Department of Cancer Registry, Moffitt Cancer Center, Tampa, FL, USA
| | - Kavita M Ghia
- Collaborative Data Services Core, Moffitt Cancer Center, Tampa, FL, USA
| | | | - Vernon K Sondak
- Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, FL, USA
| | - Kenneth Y Tsai
- Department of Anatomic Pathology, Moffitt Cancer Center, Tampa, FL, USA
| | | | - Julio C Chavez
- Department of Malignant Hematology, Moffitt Cancer Center, Tampa, FL, USA
| | - Dana E Rollison
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL, USA.
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4
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Granata S, Tessari G, Stallone G, Zaza G. Skin cancer in solid organ transplant recipients: still an open problem. Front Med (Lausanne) 2023; 10:1189680. [PMID: 37153100 PMCID: PMC10160421 DOI: 10.3389/fmed.2023.1189680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Accepted: 04/04/2023] [Indexed: 05/09/2023] Open
Abstract
In the last two decades, the optimization of organ preservation and surgical techniques, and the personalized immunosuppression have reduced the rate of acute rejections and early post-transplant complications. However, long-term graft survival rates have not improved over time, and evidence suggest a role of chronic calcineurin inhibitor toxicity in this failure. Solid organ transplant recipients may develop chronic dysfunction/damage and several comorbidities, including post-transplant malignancies. Skin cancers, mostly non-melanoma skin cancers (squamous cell carcinoma and basal cell carcinoma), are the most common malignancies in Caucasian solid organ transplant recipients. Several factors, together with immunosuppression, may contribute to the susceptibility for skin cancers which, although often treatable, could be associated with a much higher mortality rate than in the general population. The rapid identification and treatment (including reduction of immunosuppression and early surgical treatments) have an important role to avoid an aggressive behavior of these malignancies. Organ transplant recipients with a history of skin cancer should be followed closely for developing new and metastatic lesions. Additionally, patient education on the daily use of sun-protective measures and the recognition of the early signs (self-diagnosis) of coetaneous malignancies are useful preventive measures. Finally, clinicians should make themselves aware of the problem and build, in every clinical follow-up center, collaborative network involving transplant clinicians, dermatologists and surgeons who should work together to easily identify and rapidly treat these complications. In this review, we discuss the current literature regarding the epidemiology, risk factors, diagnosis, preventive strategies and treatments of skin cancer in organ transplantation.
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Affiliation(s)
- Simona Granata
- Renal, Dialysis and Transplantation Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Gianpaolo Tessari
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy
| | - Giovanni Stallone
- Renal, Dialysis and Transplantation Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Gianluigi Zaza
- Renal, Dialysis and Transplantation Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
- *Correspondence: Gianluigi Zaza,
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5
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Borgogna C, Martuscelli L, Olivero C, Lo Cigno I, De Andrea M, Caneparo V, Boldorini R, Patel G, Gariglio M. Enhanced Spontaneous Skin Tumorigenesis and Aberrant Inflammatory Response to UVB Exposure in Immunosuppressed Human Papillomavirus Type 8‒Transgenic Mice. J Invest Dermatol 2022; 143:740-750.e4. [PMID: 36481357 DOI: 10.1016/j.jid.2022.10.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Revised: 10/09/2022] [Accepted: 10/24/2022] [Indexed: 12/12/2022]
Abstract
Human papillomaviruses (HPVs) from the beta genus are commensal viruses of the skin usually associated with asymptomatic infection in the general population. However, in individuals with specific genetic backgrounds, such as patients with epidermodysplasia verruciformis, or those with immune defects, such as organ transplant recipients, they are functionally involved in sunlight-induced skin cancer development, mainly keratinocyte carcinoma. Despite their well-established protumorigenic role, the cooperation between β-HPV infection, impaired host immunosurveillance, and UVB exposure has never been formally shown in animal models. In this study, by crossing skin-specific HPV8-transgenic mice with Rag2-deficient mice, we have generated a preclinical mouse model, named Rag2‒/‒:K14-HPV8. These mice display an unhealthy skin phenotype and spontaneously develop papilloma-like lesions spreading to the entire skin much more rapidly compared with Rag2+/+:K14-HPV8 mice. Exposure to low doses of UVB radiation is sufficient to trigger severe skin inflammation in Rag2‒/‒:K14-HPV8 but not in Rag2+/+:K14-HPV8 mice. Their inflamed skin very much resembled that observed in cutaneous field cancerization in organ transplant recipients, showing high levels of UVB-damaged cells, enhanced production of proinflammatory cytokines, and mast cell recruitment to the dermis. Overall, this immunocompromised HPV8-transgenic mouse model shows that the coexistence of immune defects, β-HPV, and UVB exposure promotes skin cancer development.
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Affiliation(s)
- Cinzia Borgogna
- Virology Unit, Department of Translational Medicine, Novara Medical School, Novara, Italy
| | - Licia Martuscelli
- Virology Unit, Department of Translational Medicine, Novara Medical School, Novara, Italy
| | - Carlotta Olivero
- European Cancer Stem Cell Research Institute, School of Biosciences, Cardiff University, Cardiff, United Kingdom
| | - Irene Lo Cigno
- Virology Unit, Department of Translational Medicine, Novara Medical School, Novara, Italy
| | - Marco De Andrea
- Virology Unit, Department of Public Health and Pediatric Sciences, Turin Medical School, Turin, Italy; Center for Translational Research on Autoimmune and Allergic Disease (CAAD), Novara Medical School, Novara, Italy
| | - Valeria Caneparo
- Virology Unit, Department of Translational Medicine, Novara Medical School, Novara, Italy; Center for Translational Research on Autoimmune and Allergic Disease (CAAD), Novara Medical School, Novara, Italy
| | - Renzo Boldorini
- Pathology Unit, Department of Health Sciences, Novara Medical School, Novara, Italy
| | - Girish Patel
- European Cancer Stem Cell Research Institute, School of Biosciences, Cardiff University, Cardiff, United Kingdom
| | - Marisa Gariglio
- Virology Unit, Department of Translational Medicine, Novara Medical School, Novara, Italy; Center for Translational Research on Autoimmune and Allergic Disease (CAAD), Novara Medical School, Novara, Italy.
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A broadly protective vaccine against cutaneous human papillomaviruses. NPJ Vaccines 2022; 7:116. [PMID: 36216845 PMCID: PMC9550855 DOI: 10.1038/s41541-022-00539-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 09/08/2022] [Indexed: 11/19/2022] Open
Abstract
Skin colonization by human papillomavirus (HPV) is typically related to inconspicuous cutaneous infections without major disease or complications in immunocompetent individuals. However, in immunosuppressed patients, especially organ transplanted recipients, cutaneous HPV infections may cause massive, highly spreading and recurrent skin lesions upon synergism with UV-exposure. Current HPV prophylactic vaccines are not effective against cutaneous HPV types (cHPV). By applying a modular polytope-based approach, in this work, we explored different vaccine candidates based on selected, tandemly arranged cHPV-L2 epitopes fused to thioredoxin (Trx) as a scaffold protein. Upon conversion to heptameric nanoparticles with the use of a genetically fused oligomerization domain, our candidate Trx-L2 vaccines induce broadly neutralizing immune responses against 19 cHPV in guinea pigs. Similar findings were obtained in mice, where protection against virus challenge was also achieved via passive transfer of immune sera. Remarkably, immunization with the candidate cHPV vaccines also induced immune responses against several mucosal low- and high-risk HPV types, including HPV16 and 18. Based on cumulative immunogenicity data but also on ease and yield of production, we identified a lead vaccine candidate bearing 12 different cHPV-L2 epitopes that holds great promise as a scalable and GMP production-compatible lead molecule for the prevention of post-transplantation skin lesions caused by cHPV infection.
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7
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Rollison DE, Amorrortu RP, Zhao Y, Messina JL, Schell MJ, Fenske NA, Cherpelis BS, Giuliano AR, Sondak VK, Pawlita M, McKay-Chopin S, Gheit T, Waterboer T, Tommasino M. Cutaneous Human Papillomaviruses and the Risk of Keratinocyte Carcinomas. Cancer Res 2021; 81:4628-4638. [PMID: 34266893 PMCID: PMC8416805 DOI: 10.1158/0008-5472.can-21-0805] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 06/04/2021] [Accepted: 07/14/2021] [Indexed: 11/16/2022]
Abstract
Cutaneous human papillomavirus (cuHPV) infections may be novel targets for skin cancer prevention and treatment, but critical information regarding the development of virus-positive skin cancers following cuHPV infection has been lacking. In this study, baseline cuHPV infection was measured by serology and viral DNA detection in eyebrow hairs (EBH) and forearm skin swabs (SSW) among 1,008 individuals undergoing routine skin cancer screening exams and followed for incidence of basal cell carcinoma (BCC) and cutaneous squamous cell carcinoma (cuSCC). Baseline β-HPV detection, particularly in SSW, significantly predicted cuSCC (HR = 4.32; 95% confidence interval, 1.00-18.66), whereas serologic evidence of past β-HPV infection was not associated with cuSCC. Less than 5% of baseline β-HPV types detected in SSW were present in subsequent cuSCC tumors, and cuHPV detected in SSW with higher mean fluorescence intensity values were more likely to be present in cuSCC compared with those with lower levels (P < 0.001). β-HPV-positive cuSCC occurred more often in areas of highly sun-damaged skin than did β-HPV-negative cuSCC. Overall, no clear patterns were observed between baseline β-HPV detection and subsequent development of BCC, or between baseline γ-HPV detection and either cuSCC or BCC. Collectively, these results demonstrate that β-HPV detection in SSW is a significant predictor of cuSCC risk, although evidence suggests only a small subset of cuSCC is etiologically linked to β-HPV infection. SIGNIFICANCE: β-HPV positivity may be a useful biomarker for identifying individuals who could benefit from increased screening or novel cutaneous squamous cell carcinoma prevention strategies.
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MESH Headings
- Aged
- Aged, 80 and over
- Alphapapillomavirus
- Biomarkers, Tumor/metabolism
- Carcinoma, Basal Cell/diagnosis
- Carcinoma, Basal Cell/metabolism
- Carcinoma, Basal Cell/virology
- Carcinoma, Squamous Cell/diagnosis
- Carcinoma, Squamous Cell/metabolism
- Carcinoma, Squamous Cell/virology
- DNA, Viral
- Early Detection of Cancer
- Female
- Follow-Up Studies
- Hair/metabolism
- Humans
- Keratinocytes/cytology
- Male
- Middle Aged
- Neoplasms, Basal Cell/diagnosis
- Neoplasms, Basal Cell/metabolism
- Neoplasms, Basal Cell/virology
- Papillomavirus Infections/diagnosis
- Papillomavirus Infections/metabolism
- Prospective Studies
- Risk Factors
- Skin Neoplasms/diagnosis
- Skin Neoplasms/metabolism
- Skin Neoplasms/virology
- Specimen Handling
- Surveys and Questionnaires
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Affiliation(s)
- Dana E Rollison
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida.
| | | | - Yayi Zhao
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida
| | - Jane L Messina
- Department of Anatomic Pathology, Moffitt Cancer Center, Tampa, Florida
- Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, Florida
| | - Michael J Schell
- Biostatistics and Bioinformatics Shared Resource, Moffitt Cancer Center, Tampa, Florida
| | - Neil A Fenske
- Department of Dermatology and Cutaneous Surgery, University of South Florida College of Medicine, Tampa, Florida
| | - Basil S Cherpelis
- Department of Dermatology and Cutaneous Surgery, University of South Florida College of Medicine, Tampa, Florida
| | - Anna R Giuliano
- Center for Immunization and Infection Research in Cancer, Moffitt Cancer Center, Tampa, Florida
| | - Vernon K Sondak
- Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, Florida
| | - Michael Pawlita
- Infections and Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | | | - Tarik Gheit
- International Agency for Research on Cancer, WHO, Lyon, France
| | - Tim Waterboer
- Infections and Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
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8
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Meyer T, Sand M, Schmitz L, Stockfleth E. The Role of Circular RNAs in Keratinocyte Carcinomas. Cancers (Basel) 2021; 13:cancers13164240. [PMID: 34439394 PMCID: PMC8392367 DOI: 10.3390/cancers13164240] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 08/18/2021] [Accepted: 08/18/2021] [Indexed: 12/19/2022] Open
Abstract
Keratinocyte carcinomas (KC) include basal cell carcinomas (BCC) and cutaneous squamous cell carcinomas (cSCC) and represents the most common cancer in Europe and North America. Both entities are characterized by a very high mutational burden, mainly UV signature mutations. Predominately mutated genes in BCC belong to the sonic hedgehog pathway, whereas, in cSCC, TP53, CDKN2A, NOTCH1/2 and others are most frequently mutated. In addition, the dysregulation of factors associated with epithelial to mesenchymal transition (EMT) was shown in invasive cSCC. The expression of factors associated with tumorigenesis can be controlled in several ways and include non-coding RNA molecules, such as micro RNAs (miRNA) long noncoding RNAs (lncRNA) and circular RNAs (circRNA). To update findings on circRNA in KC, we reviewed 13 papers published since 2016, identified in a PubMed search. In both BCC and cSCC, numerous circRNAs were identified that were differently expressed compared to healthy skin. Some of them were shown to target miRNAs that are also dysregulated in KC. Moreover, some studies confirmed the biological functions of individual circRNAs involved in cancer development. Thus, circRNAs may be used as biomarkers of disease and disease progression and represent potential targets of new therapeutic approaches for KC.
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Affiliation(s)
- Thomas Meyer
- Department of Dermatology St. Josef Hospital, Ruhr-University Bochum, Gudrunstr. 56, 44791 Bochum, Germany;
- Correspondence: ; Tel.: +49-234-5096014
| | - Michael Sand
- Department of Plastic and Reconstructive Surgery, St. Josef-Hospital, Heidbergweg 22–24, 45257 Essen, Germany;
| | - Lutz Schmitz
- Institute of Dermatopathology, MVZ Corius DermPath Bonn, GmbH, Trierer Strasse 70–72, 53115 Bonn, Germany;
| | - Eggert Stockfleth
- Department of Dermatology St. Josef Hospital, Ruhr-University Bochum, Gudrunstr. 56, 44791 Bochum, Germany;
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Robinson C, Chanchlani R, Kitchlu A. Malignancies after pediatric solid organ transplantation. Pediatr Nephrol 2021; 36:2279-2291. [PMID: 33057766 DOI: 10.1007/s00467-020-04790-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 07/28/2020] [Accepted: 09/18/2020] [Indexed: 12/19/2022]
Abstract
As life expectancy among pediatric solid organ transplant recipients (SOTRs) improves, the risk of comorbid conditions such as malignancy post-transplantation has also increased. SOTRs are at elevated risks of post-transplantation lymphoproliferative disorders (PTLDs), and skin and solid cancers. PTLDs typically occur early following transplantation, while skin and solid cancers frequently arise in young adulthood (25-40 years). By 30 years following transplantation, 26-41% of pediatric SOTRs have developed cancer. Different risk factors exist for PTLD, and skin and solid cancers, which are modified by cumulative immunosuppression, infections, transplanted organ, and the underlying disease process associated with initial organ failure (e.g., kidney failure). Optimal cancer treatment strategies depend on the specific cancer type, stage, and patient comorbidities. Immunosuppression reduction may be beneficial for certain cancers but must be considered against the risks of acute and chronic rejection and allograft loss. Lifestyle counseling regarding smoking avoidance and sun protection, as well as human papillomavirus vaccination, is an important aspect of cancer prevention. Currently, no cancer screening guidelines exist specifically for pediatric SOTRs. Adult population screening guidelines have not been validated in transplant populations. Therefore, an individualized approach should be taken to cancer screening for pediatric SOTRs, accounting for other cancer risk factors.
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Affiliation(s)
- Cal Robinson
- Division of Paediatric Nephrology, Department of Paediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Rahul Chanchlani
- Division of Pediatric Nephrology, Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- ICES McMaster, Hamilton, Ontario, Canada
| | - Abhijat Kitchlu
- Division of Nephrology, Department of Medicine, University Health Network, University of Toronto, 200 Elizabeth Street, 8 Eaton North, 8 N-842, Toronto, Ontario, M5G 2C4, Canada.
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10
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Zhao Y, Amorrortu RP, Fenske NA, Cherpelis B, Messina JL, Sondak VK, Giuliano AR, Schell MJ, Waterboer T, Pawlita M, McKay‐Chopin S, Gheit T, Tommasino M, Rollison DE. Cutaneous viral infections associated with ultraviolet radiation exposure. Int J Cancer 2021; 148:448-458. [PMID: 32818302 PMCID: PMC7754468 DOI: 10.1002/ijc.33263] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 07/13/2020] [Accepted: 07/28/2020] [Indexed: 01/16/2023]
Abstract
The complex interplay between ultraviolet radiation (UVR) and cutaneous viral infections in the context of cancer etiology is challenging to unravel, given the limited information on the independent association between UVR and cutaneous viral infections. Using multiple biomarkers of infection with 24 types of cutaneous human papillomavirus (HPV) and 4 types of polyomaviruses (HPyV), we investigated cross-sectional associations with recent UVR exposure, using skin pigmentation measured by spectrophotometer. Age- and sex-adjusted associations between UVR and viral seropositivity, viral DNA present in eyebrow hairs (EBH) and skin swabs (SSW) were estimated using logistic regression. Beta-HPV seropositivity was associated with viral DNA positivity in EBH (OR = 1.40, 95% CI = 1.05-1.88) and SSW (OR = 1.86, 95% CI = 1.25-2.74). Similar associations were observed for Merkel cell polyomavirus. Participants in the highest tertile of UVR exposure were more likely to be seropositive for beta-HPV (OR = 1.81, 95% CI = 1.16-2.38), and have beta-HPV DNA in EBH (OR = 1.57, 95% CI = 1.06-2.33) and SSW (OR = 2.22, 95% CI = 1.25-3.96), compared to participants with the lowest tertile of UVR exposure. UVR exposure was positively associated with three different markers of beta-HPV infection. Therefore, future studies of HPV associated KC development should address more directly the role of HPV and UVR exposure as potential co-carcinogens.
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Affiliation(s)
- Yayi Zhao
- Department of Cancer EpidemiologyMoffitt Cancer CenterTampaFloridaUSA
| | | | - Neil A. Fenske
- Department of Dermatology and Cutaneous SurgeryUniversity of South Florida College of MedicineTampaFloridaUSA
| | - Basil Cherpelis
- Department of Dermatology and Cutaneous SurgeryUniversity of South Florida College of MedicineTampaFloridaUSA
| | - Jane L. Messina
- Department of Dermatology and Cutaneous SurgeryUniversity of South Florida College of MedicineTampaFloridaUSA
- Department of Anatomic PathologyMoffitt Cancer CenterTampaFloridaUSA
- Department of Cutaneous OncologyMoffitt Cancer CenterTampaFloridaUSA
| | - Vernon K. Sondak
- Department of Cutaneous OncologyMoffitt Cancer CenterTampaFloridaUSA
| | - Anna R. Giuliano
- Center for Immunization and Infection Research in CancerMoffitt Cancer CenterTampaFloridaUSA
| | - Michael J. Schell
- Biostatistics and Bioinformatics Shared ResourceMoffitt Cancer CenterTampaFloridaUSA
| | - Tim Waterboer
- Infections and Cancer EpidemiologyGerman Cancer Research Center (DKFZ)HeidelbergGermany
| | - Michael Pawlita
- Infections and Cancer EpidemiologyGerman Cancer Research Center (DKFZ)HeidelbergGermany
| | - Sandrine McKay‐Chopin
- Infections and Cancer Biology GroupInternational Agency for Research on Cancer‐World Health OrganizationLyonFrance
| | - Tarik Gheit
- Infections and Cancer Biology GroupInternational Agency for Research on Cancer‐World Health OrganizationLyonFrance
| | - Massimo Tommasino
- Infections and Cancer Biology GroupInternational Agency for Research on Cancer‐World Health OrganizationLyonFrance
| | - Dana E. Rollison
- Department of Cancer EpidemiologyMoffitt Cancer CenterTampaFloridaUSA
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11
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Evidence of BK Polyomavirus Infection in Urothelial but not Renal Tumors from a Single Center Cohort of Kidney Transplant Recipients. Viruses 2021; 13:v13010056. [PMID: 33401589 PMCID: PMC7823775 DOI: 10.3390/v13010056] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 12/22/2020] [Accepted: 12/30/2020] [Indexed: 12/21/2022] Open
Abstract
Emerging evidence indicates that reactivation of BK polyomavirus (BKPyV) in the kidney and urothelial tract of kidney transplant recipients (KTRs) may be associated with cancer in these sites. In this retrospective study of a single center cohort of KTRs (n = 1307), 10 clear cell renal cell carcinomas and 5 urinary bladder carcinomas were analyzed from 15 KTRs for the presence of BKPyV infection through immunohistochemistry and fluorescent in situ hybridization (FISH). Three of these patients had already exhibited biopsy-proven polyomavirus-associated nephropathies (PyVAN). Although the presence of BKPyV large-T antigen was evident in the urothelium from a kidney removed soon after PyVAN diagnosis, it was undetectable in all the formalin-fixed and paraffin-embedded (FFPE) blocks obtained from the 10 kidney tumors. By contrast, large-T antigen (LT) labeling of tumor cells was detected in two out of five bladder carcinomas. Lastly, the proportion of BKPyV DNA-FISH-positive bladder carcinoma nuclei was much lower than that of LT-positive cells. Taken together, our findings further strengthen the association between BKPyV reactivation and cancer development in KTRs, especially bladder carcinoma.
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12
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A Systematic Review and Meta-Analysis: Evaluation of the β-Human Papillomavirus in Immunosuppressed Individuals with Cutaneous Squamous Cell Carcinoma. Biomedicine (Taipei) 2020; 10:1-10. [PMID: 33854928 PMCID: PMC7735980 DOI: 10.37796/2211-8039.1110] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Accepted: 08/18/2020] [Indexed: 11/30/2022] Open
Abstract
Background Some types of beta-human papillomavirus (β-HPV) may be one of the probable causes of squamous cell carcinoma (SCC) in transplant recipients. β-HPVs are linked to SCC in the literature with small number of subjects. Aim Herein, the first meta-analysis was carried out on the association between β-HPVs and cutaneous SCC in immunosuppressed patients. Methods A systematic search was carried out in the PubMed and Scopus databases up to December 2018. The odds ratio (OR) were calculated by RevMan 5.3 software and the event rate (ER) by Comprehensive Meta-Analysis 2.0 software with a 95% confidence interval (CI). Results A total of 1250 records were identified through the two databases, but at last eleven studies were included in the meta-analysis that they were published from 1989 to 2018. The results showed a significantly high prevalence of β-HPVs in cutaneous SCC patients (ER = 69.1%; 95%CI: 58.7%, 77.8%). In addition, the prevalence of overall β-HPVs and β-HPVs of 5, 8, 9, 17, 49, 75, and 76 in immunosuppressed cutaneous SCC patients was significantly higher compared with controls. Conclusions The findings of the present meta-analysis support the hypothesis that β-HPV may play a role in cutaneous SCC development in immunosuppressed individuals.
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13
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Development of a β-HPV vaccine: Updates on an emerging frontier of skin cancer prevention. J Clin Virol 2020; 126:104348. [PMID: 32334327 DOI: 10.1016/j.jcv.2020.104348] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 03/22/2020] [Accepted: 03/29/2020] [Indexed: 12/11/2022]
Abstract
Human papillomaviruses (HPVs) are small, non-enveloped, doublestranded DNA viruses. Over 200 subtypes of HPV have been identified, organized into five major genera. β-HPVs are a group of approximately 50 HPV subtypes that preferentially infect cutaneous sites. While α-HPVs are primarily responsible for genital lesions and mucosal cancers, growing evidence has established an association between β-HPVs and the development of cutaneous squamous cell carcinomas. Given this association, the development of a vaccine against β-HPVs has become an important topic of research; however, currently licensed vaccines only provide coverage for genital HPVs, leaving β-HPV infections and their associated skin cancers unaddressed. In this review, we summarize the current advances in β-HPV vaccine development, including progress made in preclinical testing and limited clinical data. We also discuss novel findings in the viral pathomechanisms involved in β-HPV cutaneous tumorigenesis that may play a large role in future vaccine development. We hope that synthesizing the available data and advances surrounding β- HPV vaccine development will not only lead to increased dedication to vaccine development, but also heightened awareness of a future vaccine among clinicians and the public.
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14
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Tampa M, Mitran CI, Mitran MI, Nicolae I, Dumitru A, Matei C, Manolescu L, Popa GL, Caruntu C, Georgescu SR. The Role of Beta HPV Types and HPV-Associated Inflammatory Processes in Cutaneous Squamous Cell Carcinoma. J Immunol Res 2020; 2020:5701639. [PMID: 32322596 PMCID: PMC7165336 DOI: 10.1155/2020/5701639] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 03/25/2020] [Indexed: 11/21/2022] Open
Abstract
Cutaneous squamous cell carcinoma (cSCC) is a common form of skin cancer with a complex but not fully understood pathogenesis. Recent research suggests the role of beta human papillomavirus (HPV) types and HPV-associated inflammatory processes in cSCC development. Beta HPV types are components of the normal flora; however, under the influence of certain cofactors, the virus may trigger a malignant process. Dysregulation of the immune system (chronic inflammation and immunosuppression), environmental factors (ultraviolet radiation), and genetic factors are the most important cofactors involved in beta HPV-related carcinogenesis. In addition, the oncoproteins E6 and E7 of beta HPV types differ biochemically from their counterparts in the structure of alpha HPV types, resulting in different mechanisms of action in carcinogenesis. The aim of our manuscript is to present an updated point of view on the involvement of beta HPV types in cSCC pathogenesis.
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Affiliation(s)
- Mircea Tampa
- “Carol Davila” University of Medicine and Pharmacy, 37 Dionisie Lupu, 020021 Bucharest, Romania
- “Victor Babes” Clinical Hospital for Infectious Diseases, 281 Mihai Bravu, 030303 Bucharest, Romania
| | - Cristina Iulia Mitran
- “Carol Davila” University of Medicine and Pharmacy, 37 Dionisie Lupu, 020021 Bucharest, Romania
| | - Madalina Irina Mitran
- “Carol Davila” University of Medicine and Pharmacy, 37 Dionisie Lupu, 020021 Bucharest, Romania
| | - Ilinca Nicolae
- “Victor Babes” Clinical Hospital for Infectious Diseases, 281 Mihai Bravu, 030303 Bucharest, Romania
| | - Adrian Dumitru
- “Carol Davila” University of Medicine and Pharmacy, 37 Dionisie Lupu, 020021 Bucharest, Romania
- Emergency University Hospital Bucharest, 169 Splaiul Independenței, 050098 Bucharest, Romania
| | - Clara Matei
- “Carol Davila” University of Medicine and Pharmacy, 37 Dionisie Lupu, 020021 Bucharest, Romania
| | - Loredana Manolescu
- “Carol Davila” University of Medicine and Pharmacy, 37 Dionisie Lupu, 020021 Bucharest, Romania
| | - Gabriela Loredana Popa
- “Carol Davila” University of Medicine and Pharmacy, 37 Dionisie Lupu, 020021 Bucharest, Romania
- Colentina Clinical Hospital, 19-21 Ștefan cel Mare, 020125 Bucharest, Romania
| | - Constantin Caruntu
- “Carol Davila” University of Medicine and Pharmacy, 37 Dionisie Lupu, 020021 Bucharest, Romania
- “Prof. N. Paulescu” National Institute of Diabetes, Nutrition and Metabolic Diseases, 22-24 Gr. Manolescu, Bucharest 011233, Romania
| | - Simona Roxana Georgescu
- “Carol Davila” University of Medicine and Pharmacy, 37 Dionisie Lupu, 020021 Bucharest, Romania
- “Victor Babes” Clinical Hospital for Infectious Diseases, 281 Mihai Bravu, 030303 Bucharest, Romania
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Abstract
Lung transplantation is an established therapeutic option for selected patients with advanced lung diseases. As early outcomes after lung transplantation have improved, chronic medical illnesses have emerged as significant obstacles to long-term survival. Among them is post-transplant malignancy, currently representing the 2nd most common cause of death 5–10 years after transplantation. Chronic immunosuppressive therapy and resulting impairment of anti-tumor immune surveillance is thought to have a central role in cancer development after solid organ transplantation (SOT). Lung transplant recipients receive more immunosuppression than other SOT populations, likely contributing to even higher risk of cancer among this group. The most common cancers in lung transplant recipients are non-melanoma skin cancers, followed by lung cancer and post-transplant lymphoproliferative disorder (PTLD). The purpose of this review is to outline the common malignancies following lung transplant, their risk factors, prognosis and current means for both prevention and treatment.
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Affiliation(s)
- Osnat Shtraichman
- Pulmonary, Allergy and Critical Care Division, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.,Pulmonary Institute, Rabin Medical Center, Affiliated with Sackler School of Medicine Tel Aviv University, Petach Tikva, Israel
| | - Vivek N Ahya
- Pulmonary, Allergy and Critical Care Division, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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16
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Winer RL, Gheit T, Feng Q, Stern JE, Lin J, Cherne S, Tommasino M. Prevalence and Correlates of β- and γ-Human Papillomavirus Detection in Oral Samples From Mid-Adult Women. J Infect Dis 2020; 219:1067-1075. [PMID: 30395247 DOI: 10.1093/infdis/jiy632] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2018] [Accepted: 10/29/2018] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Little is known about the epidemiology of β and γ human papillomaviruses (HPVs) in oral cavities of healthy women. METHODS We performed multiplex polymerase chain reaction analysis for detection of 46 β-HPVs and 51 γ-HPVs in stored oral rinse samples from healthy mid-adult women (age, 30-50 years). A total of 407 women were tested for β-HPVs, and 310 were tested for γ-HPVs. We used log-binomial regression to identify determinants of β-HPV and γ-HPV in separate models. Using paired fingernail data from a subset of 184 women, we also evaluated whether fingernail β-HPV detection was associated with concurrent detection of the same type in the oral cavity. RESULTS Oral HPV prevalence was 20.6% for β-HPV and 10.7% for γ-HPV. In multivariate analysis, oral β-HPV detection was associated with increasing age (adjusted prevalence ratio [aPR] per 5-year difference, 1.37; 95% confidence interval [CI], 1.01-1.86) and a greater lifetime number of oral sex partners (aPR for reporting ≥6 vs 0-5 partners, 2.06; 95% CI, 1.01-4.20). In a separate model, concurrent detection of the same β-HPV type in fingernails was strongly associated with oral β-HPV detection (aPR, 31.44; 95% CI, 19.81-49.49). No significant determinants of γ-HPV detection were identified. CONCLUSIONS Our results suggest a sexual transmission route for β-HPVs and support the hypothesis that fingers may serve as a source of transmission or autoinoculation of β-HPVs to the oral cavity.
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Affiliation(s)
| | - Tarik Gheit
- Department of Pathology, University of Washington
| | - Qinghua Feng
- Department of Global Health, University of Washington
| | - Joshua E Stern
- Infections and Cancer Biology Group, International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - John Lin
- Department of Epidemiology, University of Washington
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17
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Amorrortu RP, Fenske NA, Cherpelis BS, Vijayan L, Zhao Y, Balliu J, Messina JL, Sondak VK, Giuliano AR, Waterboer T, Pawlita M, Gheit T, Tommasino M, Rollison DE. Viruses in Skin Cancer (VIRUSCAN): Study Design and Baseline Characteristics of a Prospective Clinic-Based Cohort Study. Cancer Epidemiol Biomarkers Prev 2020; 29:39-48. [PMID: 31427307 PMCID: PMC6954275 DOI: 10.1158/1055-9965.epi-19-0446] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 06/26/2019] [Accepted: 08/13/2019] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Accumulating evidence suggests that cutaneous viral infections are risk factors for the development of keratinocyte carcinomas. The Viruses in Skin Cancer (VIRUSCAN) Study, a prospective cohort study, was established in 2014 to investigate the risk of keratinocyte carcinoma associated with cutaneous human papillomavirus and polyomavirus infection and the possible interaction with ultraviolet radiation exposure (UVR). METHODS/RESULTS VIRUSCAN incorporates repeated measures of viral infection using multiple markers of infection and quantitative measures of UVR using a spectrophotometer. Participants were recruited between July 14, 2014 and August 31, 2017 at the University of South Florida Dermatology Clinic in Tampa, FL. After excluding 124 individuals with prevalent keratinocyte carcinomas at baseline, 1,179 participants (53.2% women, 46.8% men, all ages 60 years and older) were followed for up to 4 years with routine skin exams occurring every 6 to 12 months. Here, we present the VIRUSCAN Study design, methods, and baseline characteristics, including demographics, sun exposure behavior, quantitative UVR exposure measurements, and cutaneous viral prevalence, for the full study cohort. CONCLUSIONS The VIRUSCAN Study will provide critical temporal evidence needed to assess the causality of the role cutaneous viral infections play in the development of keratinocyte carcinomas, as well as the potential interaction between cutaneous viral infections and UVR exposure. IMPACT Study findings will be valuable in future development of novel keratinocyte carcinoma prevention strategies.
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MESH Headings
- Aged
- Carcinoma, Basal Cell/epidemiology
- Carcinoma, Basal Cell/etiology
- Carcinoma, Basal Cell/pathology
- Carcinoma, Merkel Cell/diagnosis
- Carcinoma, Merkel Cell/epidemiology
- Carcinoma, Merkel Cell/pathology
- Carcinoma, Merkel Cell/virology
- Carcinoma, Squamous Cell/epidemiology
- Carcinoma, Squamous Cell/etiology
- Carcinoma, Squamous Cell/pathology
- Female
- Follow-Up Studies
- Humans
- Keratinocytes/pathology
- Keratinocytes/radiation effects
- Keratinocytes/virology
- Male
- Middle Aged
- Prevalence
- Prospective Studies
- Research Design
- Risk Factors
- Skin/cytology
- Skin/pathology
- Skin/radiation effects
- Skin/virology
- Skin Neoplasms/diagnosis
- Skin Neoplasms/epidemiology
- Skin Neoplasms/etiology
- Skin Neoplasms/pathology
- Spectrophotometry, Ultraviolet
- Ultraviolet Rays/adverse effects
- Warts/diagnosis
- Warts/epidemiology
- Warts/pathology
- Warts/virology
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Affiliation(s)
| | - Neil A Fenske
- Department of Dermatology and Cutaneous Surgery, University of South Florida College of Medicine, Tampa, Florida
| | - Basil S Cherpelis
- Department of Dermatology and Cutaneous Surgery, University of South Florida College of Medicine, Tampa, Florida
| | - Laxmi Vijayan
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida
| | - Yayi Zhao
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida
| | - Juliana Balliu
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida
| | - Jane L Messina
- Department of Dermatology and Cutaneous Surgery, University of South Florida College of Medicine, Tampa, Florida
- Department of Anatomic Pathology, Moffitt Cancer Center, Tampa, Florida
- Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, Florida
| | - Vernon K Sondak
- Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, Florida
| | - Anna R Giuliano
- Center for Immunization and Infection Research in Cancer, Moffitt Cancer Center, Tampa, Florida
| | - Tim Waterboer
- Infections and Cancer Epidemiology Group, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Michael Pawlita
- Infections and Cancer Epidemiology Group, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Tarik Gheit
- Infections and Cancer Biology Group, International Agency for Research on Cancer-World Health Organization, Lyon, France
| | - Massimo Tommasino
- Infections and Cancer Biology Group, International Agency for Research on Cancer-World Health Organization, Lyon, France
| | - Dana E Rollison
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida.
- Center for Immunization and Infection Research in Cancer, Moffitt Cancer Center, Tampa, Florida
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18
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Abstract
Human papillomaviruses (HPVs) infect squamous epithelia and can induce hyperproliferative lesions. More than 220 different HPV types have been characterized and classified into five different genera. While mucosal high-risk HPVs have a well-established causal role in anogenital carcinogenesis, the biology of cutaneous HPVs is less well understood.From patients with the rare genetic disorder epidermodysplasia verruciformis (EV) and animal models, evidence is accumulating that cutaneous PV of genus β synergize with ultraviolet (UV) radiation in the development of cutaneous squamous cell carcinoma (cSCC). In 2009, the International Agency for Research on Cancer (IARC) classified the genus β-HPV types 5 and 8 as "possible carcinogenic" biological agents (group 2B) in EV disease. Epidemiological and biological studies indicate that genus β-PV infection may also play a role in UV-mediated skin carcinogenesis in non-EV patients. However, they rather act at early stages of carcinogenesis and become dispensable for the maintenance of the malignant phenotype, compatible with a "hit-and-run" mechanism.This chapter will give an overview on genus β-PV infections and discuss similarities and differences of cutaneous and genus α mucosal high-risk HPV in epithelial carcinogenesis.
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19
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Rollison DE, Schell MJ, Fenske NA, Cherpelis B, Messina JL, Giuliano AR, Epling-Burnette PK, Hampras SS, Amorrortu RP, Balliu J, Vijayan L, Naqvi SMH, Zhao Y, Parab K, McKay-Chopin S, Gheit T, Tommasino M. Cutaneous Viral Infections Across 2 Anatomic Sites Among a Cohort of Patients Undergoing Skin Cancer Screening. J Infect Dis 2019; 219:711-722. [PMID: 30260406 DOI: 10.1093/infdis/jiy577] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Accepted: 09/21/2018] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Findings from previous studies of cutaneous human papillomavirus (cuHPV) infection and keratinocyte carcinomas have varied due to several factors, including use of different sample types for cuHPV DNA detection. Elucidating the relationship between cuHPV infection in eyebrow hairs (EBHs) and skin swabs (SSWs) is critical for advancing the design of future studies. METHODS DNA corresponding to 46 β-HPV and 52 γ-HPV types was measured in EBHs and SSWs obtained from 370 individuals undergoing routine skin cancer screening examinations. RESULTS Prevalence of β-HPV/γ-HPV was 92%/84% and 73%/43% in SSWs and EBHs, respectively, with 71%/39% of patients testing positive for β-HPV/γ-HPV in both sample types. Number of cuHPV types detected and degree of infection were correlated across SSWs and EBHs. When the EBH was positive for a given β-HPV/γ-HPV type, the SSW was positive for that same type 81%/72% of the time. CONCLUSIONS Testing SSWs captures more cuHPV infection than EBHs, with EBH infections usually representing a subset of SSW infections. The importance of optimizing sensitivity of cuHPV infection detection using SSWs vs specificity using EBHs (or a combination of the 2) will be ascertained in an ongoing cohort study investigating cuHPV associations with subsequent keratinocyte carcinomas.
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Affiliation(s)
- Dana E Rollison
- Department of Cancer Epidemiology, Tampa, Florida.,Center for Immunization and Infection Research in Cancer, Tampa, Florida
| | - Michael J Schell
- Department of Biostatistics and Bioinformatics, Moffitt Cancer Center, Tampa, Florida
| | - Neil A Fenske
- Department of Dermatology and Cutaneous Surgery, University of South Florida College of Medicine, Tampa, Florida
| | - Basil Cherpelis
- Department of Dermatology and Cutaneous Surgery, University of South Florida College of Medicine, Tampa, Florida
| | - Jane L Messina
- Department of Dermatology and Cutaneous Surgery, University of South Florida College of Medicine, Tampa, Florida.,Department of Anatomic Pathology, Tampa, Florida.,Department of Cutaneous Oncology, Tampa, Florida
| | - Anna R Giuliano
- Center for Immunization and Infection Research in Cancer, Tampa, Florida
| | | | | | | | | | | | | | - Yayi Zhao
- Department of Cancer Epidemiology, Tampa, Florida
| | | | - Sandrine McKay-Chopin
- Infections and Cancer Biology Group, International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Tarik Gheit
- Infections and Cancer Biology Group, International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Massimo Tommasino
- Infections and Cancer Biology Group, International Agency for Research on Cancer, World Health Organization, Lyon, France
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20
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Wareham NE, Li Q, Sengeløv H, Da Cunha-Bang C, Gustafsson F, Heilmann C, Perch M, Rasmussen A, Sørensen SS, Mocroft A, Lundgren JD. "Risk of de novo or secondary cancer after solid organ or allogeneic haematopoietic stem cell transplantation". J Cancer Res Clin Oncol 2019; 145:3125-3135. [PMID: 31587105 DOI: 10.1007/s00432-019-03039-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 09/25/2019] [Indexed: 12/14/2022]
Abstract
PURPOSE Solid organ (SOT) and allogeneic haematopoietic stem cell (HSCT) transplant recipients have elevated risks of de novo or secondary cancer. We explored risk factors hereof. METHODS Among SOT and HSCT between January 2004 and December 2014, standardised incidence ratio (SIR) of de novo/secondary cancer compared with the Danish population was determined and risk factors were identified using Poisson regression. RESULTS During a median of 3.4 (IQR 1.3-6.4) and 2.6 (0.8-5.4) person-years (PY) after SOT and HSCT, a total of 212/1656 (13%) and 75/992 (8%) persons developed cancer; SIR 3.61 (3.0-4.3) and 2.2 (1.6-3.0), resp.). SIR correlated with younger age and was highest for skin and haematological cancers for both types of transplantation. Within the cohort, cancer was associated with older age (adjusted incidence rate ratio > 50 vs ≤ 19 years, among SOT and HSCT: 9.4 (3.4-25.7) and 25.4 (5.1-126.0), resp.) and current elevated C-reactive protein (CRP) (≥ 10 vs < 10 mg/L: 2.5 (1.8-3.4) and 2.3 (1.4-3.9), resp.), but neither with prior cancer nor type of immunosuppressants. CONCLUSION Rates of de novo or secondary cancers are elevated in both SOT and HSCT compared with the general population and mainly for skin and haematological cancers. Among transplant recipients, older age and current elevated CRP are risk factors.
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Affiliation(s)
- Neval E Wareham
- CHIP, Department of Infectious Diseases, Centre for Cardiac, Pulmonary and Infectious Diseases Vascular, University of Copenhagen, Rigshospitalet, Section 2100, Blegdamsvej 9, 2100 Copenhagen, Copenhagen Ø, Denmark.
| | - Qiuju Li
- Centre for Clinical Research, Epidemiology, Modelling and Evaluation (CREME), University College London, London, UK
| | - Henrik Sengeløv
- Department of Haematology, Rigshospitalet, Copenhagen, Denmark
| | | | - Finn Gustafsson
- Department of Cardiology, Rigshospitalet, Copenhagen, Denmark
| | | | - Michael Perch
- Department of Cardiology, Rigshospitalet, Copenhagen, Denmark
| | - Allan Rasmussen
- Department of Surgical Gastroenterology, Rigshospitalet, Copenhagen, Denmark
| | | | - Amanda Mocroft
- Centre for Clinical Research, Epidemiology, Modelling and Evaluation (CREME), University College London, London, UK
| | - Jens D Lundgren
- CHIP, Department of Infectious Diseases, Centre for Cardiac, Pulmonary and Infectious Diseases Vascular, University of Copenhagen, Rigshospitalet, Section 2100, Blegdamsvej 9, 2100 Copenhagen, Copenhagen Ø, Denmark
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21
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Chin-Hong PV, Reid GE. Human papillomavirus infection in solid organ transplant recipients: Guidelines from the American Society of Transplantation Infectious Diseases Community of Practice. Clin Transplant 2019; 33:e13590. [PMID: 31077438 DOI: 10.1111/ctr.13590] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Accepted: 05/06/2019] [Indexed: 02/06/2023]
Abstract
These guidelines from the American Society of Transplantation Infectious Diseases Community of Practice update the epidemiology and management of human papillomavirus (HPV) infections in organ transplant recipients. HPV is one of the most common sexually transmitted infections and is associated with cancers of the anogenital region. Increasing evidence suggests an association with head and neck cancers as well. Solid organ transplant recipients have a higher risk of HPV infection than the general population. Infection manifests as premalignant lesions, warts, or cancer of the cervix, penis, vulva, scrotum, and anal canal. Most are asymptomatic initially, so diagnosis can be difficult without screening. A vaccine is available though not effective in preventing all cancer-causing strains. Organ transplant recipients should be screened for HPV-associated cancers and appropriate therapy initiated in a timely manner. Further studies are warranted to delineate the most effective screening methods and therapeutic modalities, including whether changes in immunosuppression are effective in attenuating disease.
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Affiliation(s)
- Peter V Chin-Hong
- Division of Infectious Diseases, University of California at San Francisco, San Francisco, California
| | - Gail E Reid
- Division of Infectious Diseases, Loyola University Medical Center, Maywood, Illinois
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22
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Venuti A, Lohse S, Tommasino M, Smola S. Cross-talk of cutaneous beta human papillomaviruses and the immune system: determinants of disease penetrance. Philos Trans R Soc Lond B Biol Sci 2019; 374:20180287. [PMID: 30955489 PMCID: PMC6501898 DOI: 10.1098/rstb.2018.0287] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/23/2019] [Indexed: 12/19/2022] Open
Abstract
Human papillomaviruses (HPVs) infect the epithelia of skin or mucosa, where they can induce hyperproliferative lesions. More than 220 different HPV types have been characterized and classified into five different genera. Mucosal high-risk HPVs are causative for cancers of the anogenital region and oropharynx. Clinical data from patients with the rare genetic disorder epidermodysplasia verruciformis (EV) indicate that genus beta-HPVs cooperate with ultraviolet (UV) radiation in the development of cutaneous squamous cell carcinoma. In addition, epidemiological and biological findings indicate that beta-HPV types play a role in UV-mediated skin carcinogenesis also in non-EV individuals. However, the mechanisms used by these cutaneous viruses to promote epithelial carcinogenesis differ significantly from those of mucosal HPVs. Recent studies point to a delicate cross-talk of beta-HPVs with the cell-autonomous immunity of the host keratinocytes and the local immune microenvironment that eventually determines the fate of cutaneous HPV infection and the penetrance of disease. This review gives an overview of the critical interactions of genus beta-HPVs with the local immune system that allow the virus to complete its life cycle, to escape from extrinsic immunity, and eventually to cause chronic inflammation contributing to skin carcinogenesis. This article is part of the theme issue 'Silent cancer agents: multi-disciplinary modelling of human DNA oncoviruses'.
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Affiliation(s)
- Assunta Venuti
- 1 Infections and Cancer Biology Group, International Agency for Research on Cancer , 150 Cours Albert Thomas, Lyon 69008 , France
| | - Stefan Lohse
- 2 Institute of Virology, Saarland University Medical Center , Kirrbergerstr. Building 47, 66421 Homburg/Saar , Germany
| | - Massimo Tommasino
- 1 Infections and Cancer Biology Group, International Agency for Research on Cancer , 150 Cours Albert Thomas, Lyon 69008 , France
| | - Sigrun Smola
- 2 Institute of Virology, Saarland University Medical Center , Kirrbergerstr. Building 47, 66421 Homburg/Saar , Germany
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23
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Rollison DE, Viarisio D, Amorrortu RP, Gheit T, Tommasino M. An Emerging Issue in Oncogenic Virology: the Role of Beta Human Papillomavirus Types in the Development of Cutaneous Squamous Cell Carcinoma. J Virol 2019; 93:e01003-18. [PMID: 30700603 PMCID: PMC6430537 DOI: 10.1128/jvi.01003-18] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Evidence suggests that beta human papillomaviruses (HPVs), together with ultraviolet radiation, contribute to the development of cutaneous squamous cell carcinoma. Beta HPVs appear to be not the main drivers of carcinogenesis but rather facilitators of the accumulation of ultraviolet-induced DNA mutations. Beta HPVs are promoters of skin carcinogenesis, although they are dispensable for the maintenance of the malignant phenotype. Therefore, beta HPV represents a target for skin cancer prevention, especially in high-risk populations.
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Affiliation(s)
- Dana E Rollison
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida, USA
| | - Daniele Viarisio
- Infection and Cancer Epidemiology, Deutsches Krebsforschungszentrum, Heidelberg, Germany
| | | | - Tarik Gheit
- Infections and Cancer Biology Group, International Agency for Research on Cancer (IARC), Lyon, France
| | - Massimo Tommasino
- Infections and Cancer Biology Group, International Agency for Research on Cancer (IARC), Lyon, France
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24
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Risk Factors for Developing Nonmelanoma Skin Cancer after Lung Transplantation. J Skin Cancer 2019; 2019:7089482. [PMID: 30984427 PMCID: PMC6431522 DOI: 10.1155/2019/7089482] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 12/24/2018] [Accepted: 02/12/2019] [Indexed: 01/25/2023] Open
Abstract
Background Nonmelanoma skin cancer (NSMC) is the most common malignancy after organ transplantation. Lung transplant recipients (LTRs) are particularly prone to develop NMSC as compared to renal or hepatic transplant recipients due to higher dosages of immunosuppression needed. Everolimus, an immunosuppressant used in organ transplant recipients, is thought to inherit a lower risk for NMSC than calcineurin inhibitors, especially in renal transplant recipients. It is currently unknown whether this also applies to LTRs. Objectives To determine risk factors for NMSC and precancerous lesions after lung transplantation (LTx) and to characterize the effect of everolimus-based regimens regarding this risk. Materials and Methods 90 LTRs and former participants of the interventional trial “Immunosuppressive Therapy with Everolimus after Lung Transplantation”, who were randomized to receive either an everolimus- or mycophenolate mofetil- (MMF-) based regimen, were enrolled and screened in this retrospective, single-center cohort study. Results After a median follow-up of 101 months, we observed a prevalence of 38% for NMSC or precancerous lesions. 33% of the patients continuously receiving everolimus from LTx to dermatologic examination compared to 39% of all other patients, predominantly receiving an MMF-based regimen, were diagnosed with at least one NMSC or precancerous lesion (P=.66). Independent risk factors for NMSC or precancerous lesions after LTx were male sex and duration of voriconazole therapy. Conclusion NMSC or precancerous lesions were very common after LTx, and risk factors were similar to previous reports on LTRs. Everolimus did not decrease this risk under the given circumstances of this study. Patients should be counseled regarding their risk, perform vigorous sunscreen, and undergo regular dermatological controls, regardless of their immunosuppressive regimen.
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Sichero L, Rollison DE, Amorrortu RP, Tommasino M. Beta Human Papillomavirus and Associated Diseases. Acta Cytol 2019; 63:100-108. [PMID: 30673666 DOI: 10.1159/000492659] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Accepted: 08/06/2018] [Indexed: 12/12/2022]
Abstract
The cutaneous human papillomavirus (HPV), mostly from β- and γ-HPV genus, is ubiquitously distributed throughout the human body and may be part of the commensal flora. The association of β-HPVs and cutaneous squamous cell carcinoma (cSCC) development was initially reported in patients with the rare genetic disorder Epidermodysplasia verruciformis. Likewise, immunosuppressed organ transplant recipients have an increased susceptibility to β-HPV infections in the skin as well as to cSCC development. Although ultraviolet radiation (UVR) is the main risk factor of cSCC, experimental data points toward β-HPVs as co-carcinogens, which appear to be required solely at early stages of skin carcinogenesis by facilitating the accumulation of UVR-induced DNA mutations. Several epidemiological studies relying on different biomarkers of β-HPV infections have also been conducted in immunocompetent individuals to access their association with cSCC development. Additionally, in vivo and in vitro studies are presenting cumulative evidence that E6 and E7 proteins from specific β-HPVs exhibit transforming activities and may collaborate with different environmental factors in promoting carcinogenesis. Nevertheless, further research is crucial to better understand the pathological implications of the broad distribution of these HPVs.
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Affiliation(s)
- Laura Sichero
- Center for Translational Research in Oncology, Instituto do Cancer do Estado de Sao Paulo, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, São Paulo, Brazil,
| | - Dana E Rollison
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida, USA
| | | | - Massimo Tommasino
- Infections and Cancer Biology Group, International Agency for Research on Cancer, World Health Organization, Lyon, France
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Bolatti EM, Hošnjak L, Chouhy D, Re-Louhau MF, Casal PE, Bottai H, Kocjan BJ, Stella EJ, Gorosito MD, Sanchez A, Bussy RF, Poljak M, Giri AA. High prevalence of Gammapapillomaviruses (Gamma-PVs) in pre-malignant cutaneous lesions of immunocompetent individuals using a new broad-spectrum primer system, and identification of HPV210, a novel Gamma-PV type. Virology 2018; 525:182-191. [PMID: 30292127 DOI: 10.1016/j.virol.2018.09.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 09/05/2018] [Accepted: 09/07/2018] [Indexed: 12/13/2022]
Abstract
Genus Gammapapillomavirus (Gamma-PV) is the most diverse and largest clade within the Papillomaviridae family. A novel set of degenerate primers targeting the E1 gene was designed and further used in combination with the well-known CUT PCR assay to assess HPV prevalence and genus distribution in a variety of cutaneous samples from 448 immunocompetent individuals. General HPV, Gamma-PV and mixed infections prevalence were significantly higher in actinic keratosis with respect to benign and malignant neoplasms, respectively (p = 0.0047, p = 0.0172, p = 0.00001). Gamma-PVs were significantly more common in actinic keratosis biopsies than Beta- and Alpha-PVs (p = 0.002). The full-length genome sequence of a novel putative Gamma-PV type was amplified by 'hanging droplet' long-range PCR and cloned. The novel virus, designated HPV210, clustered within species Gamma-12. This study provides an additional tool enabling detection of HPV infections in skin and adds new insights about possible early roles of Gamma-PVs in the development of cutaneous malignant lesions.
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Affiliation(s)
- Elisa M Bolatti
- Grupo Virología Humana, Instituto de Biología Molecular y Celular de Rosario (CONICET), Suipacha 590, 2000 Rosario, Argentina; Área Virología, Facultad de Ciencias Bioquímicas y Farmacéuticas, Universidad Nacional de Rosario, Suipacha 531, 2000 Rosario, Argentina
| | - Lea Hošnjak
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Zaloška 4, 1000 Ljubljana, Slovenia
| | - Diego Chouhy
- Grupo Virología Humana, Instituto de Biología Molecular y Celular de Rosario (CONICET), Suipacha 590, 2000 Rosario, Argentina; Área Virología, Facultad de Ciencias Bioquímicas y Farmacéuticas, Universidad Nacional de Rosario, Suipacha 531, 2000 Rosario, Argentina
| | - Maria F Re-Louhau
- Grupo Virología Humana, Instituto de Biología Molecular y Celular de Rosario (CONICET), Suipacha 590, 2000 Rosario, Argentina
| | - Pablo E Casal
- Área Virología, Facultad de Ciencias Bioquímicas y Farmacéuticas, Universidad Nacional de Rosario, Suipacha 531, 2000 Rosario, Argentina
| | - Hebe Bottai
- Área Estadística y Procesamiento de Datos, Facultad de Ciencias Bioquímicas y Farmacéuticas, Universidad Nacional de Rosario, Suipacha 531, 2000 Rosario, Argentina
| | - Boštjan J Kocjan
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Zaloška 4, 1000 Ljubljana, Slovenia
| | - Emma J Stella
- Grupo Virología Humana, Instituto de Biología Molecular y Celular de Rosario (CONICET), Suipacha 590, 2000 Rosario, Argentina
| | - Mario D Gorosito
- División de Anatomía Patológica, Facultad de Ciencias Médicas, Universidad Nacional de Rosario, Santa Fe 3100, 2000 Rosario, Argentina
| | - Adriana Sanchez
- División de Dermatología, Facultad de Ciencias Médicas, Universidad Nacional de Rosario, Santa Fe 3100, 2000 Rosario, Argentina
| | - Ramón Fernandez Bussy
- División de Dermatología, Facultad de Ciencias Médicas, Universidad Nacional de Rosario, Santa Fe 3100, 2000 Rosario, Argentina
| | - Mario Poljak
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Zaloška 4, 1000 Ljubljana, Slovenia.
| | - Adriana A Giri
- Grupo Virología Humana, Instituto de Biología Molecular y Celular de Rosario (CONICET), Suipacha 590, 2000 Rosario, Argentina; Área Virología, Facultad de Ciencias Bioquímicas y Farmacéuticas, Universidad Nacional de Rosario, Suipacha 531, 2000 Rosario, Argentina.
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Nunes EM, Talpe-Nunes V, Sichero L. Epidemiology and biology of cutaneous human papillomavirus. Clinics (Sao Paulo) 2018; 73:e489s. [PMID: 30133564 PMCID: PMC6097087 DOI: 10.6061/clinics/2018/e489s] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Accepted: 02/06/2018] [Indexed: 01/16/2023] Open
Abstract
Cutaneous human papillomaviruses (HPVs) include β- and γ-HPVs, in addition to a small fraction of α-HPVs. β-HPVs were first isolated from patients with the rare genetic disorder Epidermodysplasia verruciformis, and they are associated with the development of nonmelanoma skin cancer at sun-exposed skin sites in these individuals. Organ transplant recipients also have greater susceptibility to β-HPV infection of the skin and an increased risk of developing nonmelanoma skin cancer. In both immunosuppressed and immunocompromised individuals, cutaneous HPVs are ubiquitously disseminated throughout healthy skin and may be an intrinsic part of the commensal flora. Functional analysis of E6 and E7 proteins of specific cutaneous HPVs has provided a mechanistic comprehension of how these viruses may induce carcinogenesis. Nevertheless, additional research is crucial to better understand the pathological implications of the broad distribution of these HPVs.
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Affiliation(s)
- Emily M Nunes
- Centro de Investigação Translacional em Oncologia, Instituto do Cancer do Estado de Sao Paulo (ICESP), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
- *Corresponding author. E-mail:
| | - Valéria Talpe-Nunes
- Centro de Investigação Translacional em Oncologia, Instituto do Cancer do Estado de Sao Paulo (ICESP), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Laura Sichero
- Centro de Investigação Translacional em Oncologia, Instituto do Cancer do Estado de Sao Paulo (ICESP), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR
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Purdie KJ, Proby CM, Rizvi H, Griffin H, Doorbar J, Sommerlad M, Feltkamp MC, der Meijden EV, Inman GJ, South AP, Leigh IM, Harwood CA. The Role of Human Papillomaviruses and Polyomaviruses in BRAF-Inhibitor Induced Cutaneous Squamous Cell Carcinoma and Benign Squamoproliferative Lesions. Front Microbiol 2018; 9:1806. [PMID: 30154763 PMCID: PMC6102365 DOI: 10.3389/fmicb.2018.01806] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Accepted: 07/18/2018] [Indexed: 12/19/2022] Open
Abstract
Background: Human papillomavirus (HPV) has long been proposed as a cofactor in the pathogenesis of cutaneous squamous cell carcinoma (cSCC). More recently, the striking clinico-pathological features of cSCCs that complicate treatment of metastatic melanoma with inhibitors targeting BRAF mutations (BRAFi) has prompted speculation concerning a pathogenic role for oncogenic viruses. Here, we investigate HPV and human polyomaviruses (HPyV) and correlate with clinical, histologic, and genetic features in BRAFi-associated cSCC. Materials and Methods: Patients receiving BRAFi treatment were recruited at Barts Health NHS Trust. HPV DNA was detected in microdissected frozen samples using reverse line probe technology and degenerate and nested PCR. HPV immunohistochemistry was performed in a subset of samples. Quantitative PCR was performed to determine the presence and viral load of HPyVs with affinity for the skin (HPyV6, HPyV7, HPyV9, MCPyV, and TSPyV). These data were correlated with previous genetic mutational analysis of H, K and NRAS, NOTCH1/2, TP53, CDKN2A, CARD11, CREBBP, TGFBR1/2. Chromosomal aberrations were profiled using single nucleotide polymorphism (SNP) arrays. Results: Forty-five skin lesions from seven patients treated with single agent vemurafenib in 2012–2013 were analyzed: 12 cSCC, 19 viral warts (VW), 2 actinic keratosis (AK), 5 verrucous keratosis/other squamoproliferative (VK/SP) lesions, one melanocytic lesion and 6 normal skin samples. Significant histologic features of viral infection were seen in 10/12 (83%) cSCC. HPV DNA was detected in 18/19 (95%) VW/SP, 9/12 (75%) cSCC, 4/5 (80%) SP, and 3/6 (50%) normal skin samples and in 1/12 cases assessed by immunohistochemistry. HPyV was co-detected in 22/30 (73%) of samples, usually at low viral load, with MCPyV and HPyV7 the most common. SNP arrays confirmed low levels of chromosomal abnormality and there was no significant correlation between HPV or HPyV detection and individual gene mutations or overall mutational burden. Conclusion: Despite supportive clinicopathologic evidence, the role for HPV and HPyV infection in the pathogenesis of BRAFi-induced squamoproliferative lesions remains uncertain. Synergistic oncogenic mechanisms are plausible although speculative. Nonetheless, with the prospect of a significant increase in the adjuvant use of these drugs, further research is justified and may provide insight into the pathogenesis of other BRAFi-associated malignancies.
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Affiliation(s)
- Karin J Purdie
- Centre for Cell Biology and Cutaneous Research, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Charlotte M Proby
- Division of Cancer Research, School of Medicine, University of Dundee, Dundee, United Kingdom
| | - Hasan Rizvi
- Department of Pathology, Barts Health NHS Trust, London, United Kingdom
| | - Heather Griffin
- Division of Virology, Department of Pathology, University of Cambridge, Cambridge, United Kingdom
| | - John Doorbar
- Division of Virology, Department of Pathology, University of Cambridge, Cambridge, United Kingdom
| | - Mary Sommerlad
- Department of Dermatology, Barts Health NHS Trust, London, United Kingdom
| | - Mariet C Feltkamp
- Department of Medical Microbiology, Leiden University Medical Center, Leiden, Netherlands
| | - Els Van der Meijden
- Department of Medical Microbiology, Leiden University Medical Center, Leiden, Netherlands
| | - Gareth J Inman
- Division of Cancer Research, School of Medicine, University of Dundee, Dundee, United Kingdom
| | - Andrew P South
- Department of Dermatology and Cutaneous Biology, Thomas Jefferson University, Philadelphia, PA, United States
| | - Irene M Leigh
- Institute of Dentistry, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Catherine A Harwood
- Centre for Cell Biology and Cutaneous Research, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom.,Department of Dermatology, Barts Health NHS Trust, London, United Kingdom
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Infusino SD, Loi C, Ravaioli GM, Piraccini BM, Bardazzi F, Patrizi A. Cutaneous complications of immunosuppression in 812 transplant recipients: a 40-year single center experience. GIORN ITAL DERMAT V 2018; 155:662-668. [PMID: 30014685 DOI: 10.23736/s0392-0488.18.06091-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND As a consequence of the improvement in survival after solid organ transplantation, to visit transplant recipients with neoplastic and non-neoplastic skin disorders due to immunosuppressive treatment has become common for dermatologists. METHODS Our endpoints were: 1) to investigate the most common skin diseases in a population of transplant recipients; 2) their associations with the type of immunosuppressant or transplant received; and 3) to compare our single center 40-year experience with the literature data. We retrospectively analyzed the clinical details of the adult patients transplanted in the years 1974-2014, visited for consultation at the Unit of Dermatology of our hospital. RESULTS Pathologic conditions were observed in more than 3/4 of 812 adults during the follow-up (mean 12.1 years): nonmelanoma skin cancers or actinic keratoses were seen in 44.0% (N.=357) of patients, non-neoplastic events in 55.2% (N.=448). Heart transplant had the statistically significant highest rate of NMSC and AK (52.6%, P=0.0352). Patients receiving cyclosporine A developed at least one non-melanoma skin cancer or actinic keratosis in 57.7% of cases (P=0.0001), while tacrolimus showed a lower risk (33%, P=0.0001). CONCLUSIONS As transplant recipients are susceptible to skin changes, especially after immunosuppressant treatments, a dermatological follow-up should be scheduled for each patient.
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Affiliation(s)
- Salvatore D Infusino
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Camilla Loi
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Giulia M Ravaioli
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy -
| | - Bianca M Piraccini
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Federico Bardazzi
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Annalisa Patrizi
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
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Dantal J, Morelon E, Rostaing L, Goffin E, Brocard A, Tromme I, Broeders N, Del Marmol V, Chatelet V, Dompmartin A, Kessler M, Serra A, Hofbauer GFL, Kamar N, Pouteil-Noble C, Kanitakis J, Roux A, Decullier E, Euvrard S. Sirolimus for Secondary Prevention of Skin Cancer in Kidney Transplant Recipients: 5-Year Results. J Clin Oncol 2018; 36:2612-2620. [PMID: 30016177 DOI: 10.1200/jco.2017.76.6691] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Purpose Transplant recipients who develop cutaneous squamous cell carcinomas are at high risk for multiple subsequent skin cancers. Sirolimus has been shown to reduce the occurrence of secondary skin cancers, but no study included a follow-up exceeding 2 years. We extended at 5 years the TUMORAPA randomized trial of sirolimus-based immunosuppressive regimen versus calcineurin inhibitor-based immunosuppression. Methods Kidney transplant recipients receiving calcineurin inhibitors who had at least one cutaneous squamous cell carcinoma were randomly assigned to receive sirolimus as a substitute for calcineurin inhibitors (n = 64) or to maintain their initial treatment (n = 56). The primary end point was survival free of squamous cell carcinoma at 5 years. Secondary end points included the occurrence of other skin cancers, renal function, patient and graft survival, and treatment tolerance. Results Survival free of cutaneous squamous cell carcinoma was significantly longer in the sirolimus group than in the calcineurin inhibitor group ( P = .007). In the sirolimus group, the number of patients with new skin cancers was significantly lower compared with the calcineurin inhibitor group: 22% versus 59% for squamous cell carcinomas ( P < .001), 34% versus 66% for other skin cancers ( P < .001), and 20% versus 37.5% for basal cell carcinomas ( P < .05). Kidney graft function, patients, and graft survival were similar in both groups. In the sirolimus group, the mean number of serious adverse effects per patient decreased from 1.16 during the first 2 years, to 0.83 between years 2 and 5. Conclusion In kidney transplant recipients with previous cutaneous squamous cell carcinomas, the antitumoral effect of conversion from calcineurin inhibitors to sirolimus was maintained at 5 years, and sirolimus tolerance was satisfactory.
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Affiliation(s)
- Jacques Dantal
- Jacques Dantal and Anabelle Brocard, Nantes University Hospital, Nantes; Emmanuel Morelon, Claire Pouteil-Noble, Jean Kanitakis, and Sylvie Euvrard, Hospices Civils de Lyon, Edouard Herriot Hospital Group; Adeline Roux and Evelyne Decullier, Hospices Civils de Lyon, Unité de Recherche Clinique, Lyon; Lionel Rostaing and Nassim Kamar, Toulouse University Hospital, Toulouse; Valérie Chatelet and Anne Dompmartin, University Hospital of Caen, Caen; Michèle Kessler, University Hospital of Nancy, Vandœuvre-lès-Nancy, France; Eric Goffin and Isabelle Tromme, St Luc University Hospital, Woluwe-Saint-Lambert; Nilufer Broeders and Véronique del Marmol, Université Libre de Bruxelles, Bruxelles, Belgium; and Andreas Serra and Günther F.L. Hofbauer, Zürich University Hospital, Zürich, Switzerland
| | - Emmanuel Morelon
- Jacques Dantal and Anabelle Brocard, Nantes University Hospital, Nantes; Emmanuel Morelon, Claire Pouteil-Noble, Jean Kanitakis, and Sylvie Euvrard, Hospices Civils de Lyon, Edouard Herriot Hospital Group; Adeline Roux and Evelyne Decullier, Hospices Civils de Lyon, Unité de Recherche Clinique, Lyon; Lionel Rostaing and Nassim Kamar, Toulouse University Hospital, Toulouse; Valérie Chatelet and Anne Dompmartin, University Hospital of Caen, Caen; Michèle Kessler, University Hospital of Nancy, Vandœuvre-lès-Nancy, France; Eric Goffin and Isabelle Tromme, St Luc University Hospital, Woluwe-Saint-Lambert; Nilufer Broeders and Véronique del Marmol, Université Libre de Bruxelles, Bruxelles, Belgium; and Andreas Serra and Günther F.L. Hofbauer, Zürich University Hospital, Zürich, Switzerland
| | - Lionel Rostaing
- Jacques Dantal and Anabelle Brocard, Nantes University Hospital, Nantes; Emmanuel Morelon, Claire Pouteil-Noble, Jean Kanitakis, and Sylvie Euvrard, Hospices Civils de Lyon, Edouard Herriot Hospital Group; Adeline Roux and Evelyne Decullier, Hospices Civils de Lyon, Unité de Recherche Clinique, Lyon; Lionel Rostaing and Nassim Kamar, Toulouse University Hospital, Toulouse; Valérie Chatelet and Anne Dompmartin, University Hospital of Caen, Caen; Michèle Kessler, University Hospital of Nancy, Vandœuvre-lès-Nancy, France; Eric Goffin and Isabelle Tromme, St Luc University Hospital, Woluwe-Saint-Lambert; Nilufer Broeders and Véronique del Marmol, Université Libre de Bruxelles, Bruxelles, Belgium; and Andreas Serra and Günther F.L. Hofbauer, Zürich University Hospital, Zürich, Switzerland
| | - Eric Goffin
- Jacques Dantal and Anabelle Brocard, Nantes University Hospital, Nantes; Emmanuel Morelon, Claire Pouteil-Noble, Jean Kanitakis, and Sylvie Euvrard, Hospices Civils de Lyon, Edouard Herriot Hospital Group; Adeline Roux and Evelyne Decullier, Hospices Civils de Lyon, Unité de Recherche Clinique, Lyon; Lionel Rostaing and Nassim Kamar, Toulouse University Hospital, Toulouse; Valérie Chatelet and Anne Dompmartin, University Hospital of Caen, Caen; Michèle Kessler, University Hospital of Nancy, Vandœuvre-lès-Nancy, France; Eric Goffin and Isabelle Tromme, St Luc University Hospital, Woluwe-Saint-Lambert; Nilufer Broeders and Véronique del Marmol, Université Libre de Bruxelles, Bruxelles, Belgium; and Andreas Serra and Günther F.L. Hofbauer, Zürich University Hospital, Zürich, Switzerland
| | - Anabelle Brocard
- Jacques Dantal and Anabelle Brocard, Nantes University Hospital, Nantes; Emmanuel Morelon, Claire Pouteil-Noble, Jean Kanitakis, and Sylvie Euvrard, Hospices Civils de Lyon, Edouard Herriot Hospital Group; Adeline Roux and Evelyne Decullier, Hospices Civils de Lyon, Unité de Recherche Clinique, Lyon; Lionel Rostaing and Nassim Kamar, Toulouse University Hospital, Toulouse; Valérie Chatelet and Anne Dompmartin, University Hospital of Caen, Caen; Michèle Kessler, University Hospital of Nancy, Vandœuvre-lès-Nancy, France; Eric Goffin and Isabelle Tromme, St Luc University Hospital, Woluwe-Saint-Lambert; Nilufer Broeders and Véronique del Marmol, Université Libre de Bruxelles, Bruxelles, Belgium; and Andreas Serra and Günther F.L. Hofbauer, Zürich University Hospital, Zürich, Switzerland
| | - Isabelle Tromme
- Jacques Dantal and Anabelle Brocard, Nantes University Hospital, Nantes; Emmanuel Morelon, Claire Pouteil-Noble, Jean Kanitakis, and Sylvie Euvrard, Hospices Civils de Lyon, Edouard Herriot Hospital Group; Adeline Roux and Evelyne Decullier, Hospices Civils de Lyon, Unité de Recherche Clinique, Lyon; Lionel Rostaing and Nassim Kamar, Toulouse University Hospital, Toulouse; Valérie Chatelet and Anne Dompmartin, University Hospital of Caen, Caen; Michèle Kessler, University Hospital of Nancy, Vandœuvre-lès-Nancy, France; Eric Goffin and Isabelle Tromme, St Luc University Hospital, Woluwe-Saint-Lambert; Nilufer Broeders and Véronique del Marmol, Université Libre de Bruxelles, Bruxelles, Belgium; and Andreas Serra and Günther F.L. Hofbauer, Zürich University Hospital, Zürich, Switzerland
| | - Nilufer Broeders
- Jacques Dantal and Anabelle Brocard, Nantes University Hospital, Nantes; Emmanuel Morelon, Claire Pouteil-Noble, Jean Kanitakis, and Sylvie Euvrard, Hospices Civils de Lyon, Edouard Herriot Hospital Group; Adeline Roux and Evelyne Decullier, Hospices Civils de Lyon, Unité de Recherche Clinique, Lyon; Lionel Rostaing and Nassim Kamar, Toulouse University Hospital, Toulouse; Valérie Chatelet and Anne Dompmartin, University Hospital of Caen, Caen; Michèle Kessler, University Hospital of Nancy, Vandœuvre-lès-Nancy, France; Eric Goffin and Isabelle Tromme, St Luc University Hospital, Woluwe-Saint-Lambert; Nilufer Broeders and Véronique del Marmol, Université Libre de Bruxelles, Bruxelles, Belgium; and Andreas Serra and Günther F.L. Hofbauer, Zürich University Hospital, Zürich, Switzerland
| | - Véronique Del Marmol
- Jacques Dantal and Anabelle Brocard, Nantes University Hospital, Nantes; Emmanuel Morelon, Claire Pouteil-Noble, Jean Kanitakis, and Sylvie Euvrard, Hospices Civils de Lyon, Edouard Herriot Hospital Group; Adeline Roux and Evelyne Decullier, Hospices Civils de Lyon, Unité de Recherche Clinique, Lyon; Lionel Rostaing and Nassim Kamar, Toulouse University Hospital, Toulouse; Valérie Chatelet and Anne Dompmartin, University Hospital of Caen, Caen; Michèle Kessler, University Hospital of Nancy, Vandœuvre-lès-Nancy, France; Eric Goffin and Isabelle Tromme, St Luc University Hospital, Woluwe-Saint-Lambert; Nilufer Broeders and Véronique del Marmol, Université Libre de Bruxelles, Bruxelles, Belgium; and Andreas Serra and Günther F.L. Hofbauer, Zürich University Hospital, Zürich, Switzerland
| | - Valérie Chatelet
- Jacques Dantal and Anabelle Brocard, Nantes University Hospital, Nantes; Emmanuel Morelon, Claire Pouteil-Noble, Jean Kanitakis, and Sylvie Euvrard, Hospices Civils de Lyon, Edouard Herriot Hospital Group; Adeline Roux and Evelyne Decullier, Hospices Civils de Lyon, Unité de Recherche Clinique, Lyon; Lionel Rostaing and Nassim Kamar, Toulouse University Hospital, Toulouse; Valérie Chatelet and Anne Dompmartin, University Hospital of Caen, Caen; Michèle Kessler, University Hospital of Nancy, Vandœuvre-lès-Nancy, France; Eric Goffin and Isabelle Tromme, St Luc University Hospital, Woluwe-Saint-Lambert; Nilufer Broeders and Véronique del Marmol, Université Libre de Bruxelles, Bruxelles, Belgium; and Andreas Serra and Günther F.L. Hofbauer, Zürich University Hospital, Zürich, Switzerland
| | - Anne Dompmartin
- Jacques Dantal and Anabelle Brocard, Nantes University Hospital, Nantes; Emmanuel Morelon, Claire Pouteil-Noble, Jean Kanitakis, and Sylvie Euvrard, Hospices Civils de Lyon, Edouard Herriot Hospital Group; Adeline Roux and Evelyne Decullier, Hospices Civils de Lyon, Unité de Recherche Clinique, Lyon; Lionel Rostaing and Nassim Kamar, Toulouse University Hospital, Toulouse; Valérie Chatelet and Anne Dompmartin, University Hospital of Caen, Caen; Michèle Kessler, University Hospital of Nancy, Vandœuvre-lès-Nancy, France; Eric Goffin and Isabelle Tromme, St Luc University Hospital, Woluwe-Saint-Lambert; Nilufer Broeders and Véronique del Marmol, Université Libre de Bruxelles, Bruxelles, Belgium; and Andreas Serra and Günther F.L. Hofbauer, Zürich University Hospital, Zürich, Switzerland
| | - Michèle Kessler
- Jacques Dantal and Anabelle Brocard, Nantes University Hospital, Nantes; Emmanuel Morelon, Claire Pouteil-Noble, Jean Kanitakis, and Sylvie Euvrard, Hospices Civils de Lyon, Edouard Herriot Hospital Group; Adeline Roux and Evelyne Decullier, Hospices Civils de Lyon, Unité de Recherche Clinique, Lyon; Lionel Rostaing and Nassim Kamar, Toulouse University Hospital, Toulouse; Valérie Chatelet and Anne Dompmartin, University Hospital of Caen, Caen; Michèle Kessler, University Hospital of Nancy, Vandœuvre-lès-Nancy, France; Eric Goffin and Isabelle Tromme, St Luc University Hospital, Woluwe-Saint-Lambert; Nilufer Broeders and Véronique del Marmol, Université Libre de Bruxelles, Bruxelles, Belgium; and Andreas Serra and Günther F.L. Hofbauer, Zürich University Hospital, Zürich, Switzerland
| | - Andreas Serra
- Jacques Dantal and Anabelle Brocard, Nantes University Hospital, Nantes; Emmanuel Morelon, Claire Pouteil-Noble, Jean Kanitakis, and Sylvie Euvrard, Hospices Civils de Lyon, Edouard Herriot Hospital Group; Adeline Roux and Evelyne Decullier, Hospices Civils de Lyon, Unité de Recherche Clinique, Lyon; Lionel Rostaing and Nassim Kamar, Toulouse University Hospital, Toulouse; Valérie Chatelet and Anne Dompmartin, University Hospital of Caen, Caen; Michèle Kessler, University Hospital of Nancy, Vandœuvre-lès-Nancy, France; Eric Goffin and Isabelle Tromme, St Luc University Hospital, Woluwe-Saint-Lambert; Nilufer Broeders and Véronique del Marmol, Université Libre de Bruxelles, Bruxelles, Belgium; and Andreas Serra and Günther F.L. Hofbauer, Zürich University Hospital, Zürich, Switzerland
| | - Günther F L Hofbauer
- Jacques Dantal and Anabelle Brocard, Nantes University Hospital, Nantes; Emmanuel Morelon, Claire Pouteil-Noble, Jean Kanitakis, and Sylvie Euvrard, Hospices Civils de Lyon, Edouard Herriot Hospital Group; Adeline Roux and Evelyne Decullier, Hospices Civils de Lyon, Unité de Recherche Clinique, Lyon; Lionel Rostaing and Nassim Kamar, Toulouse University Hospital, Toulouse; Valérie Chatelet and Anne Dompmartin, University Hospital of Caen, Caen; Michèle Kessler, University Hospital of Nancy, Vandœuvre-lès-Nancy, France; Eric Goffin and Isabelle Tromme, St Luc University Hospital, Woluwe-Saint-Lambert; Nilufer Broeders and Véronique del Marmol, Université Libre de Bruxelles, Bruxelles, Belgium; and Andreas Serra and Günther F.L. Hofbauer, Zürich University Hospital, Zürich, Switzerland
| | - Nassim Kamar
- Jacques Dantal and Anabelle Brocard, Nantes University Hospital, Nantes; Emmanuel Morelon, Claire Pouteil-Noble, Jean Kanitakis, and Sylvie Euvrard, Hospices Civils de Lyon, Edouard Herriot Hospital Group; Adeline Roux and Evelyne Decullier, Hospices Civils de Lyon, Unité de Recherche Clinique, Lyon; Lionel Rostaing and Nassim Kamar, Toulouse University Hospital, Toulouse; Valérie Chatelet and Anne Dompmartin, University Hospital of Caen, Caen; Michèle Kessler, University Hospital of Nancy, Vandœuvre-lès-Nancy, France; Eric Goffin and Isabelle Tromme, St Luc University Hospital, Woluwe-Saint-Lambert; Nilufer Broeders and Véronique del Marmol, Université Libre de Bruxelles, Bruxelles, Belgium; and Andreas Serra and Günther F.L. Hofbauer, Zürich University Hospital, Zürich, Switzerland
| | - Claire Pouteil-Noble
- Jacques Dantal and Anabelle Brocard, Nantes University Hospital, Nantes; Emmanuel Morelon, Claire Pouteil-Noble, Jean Kanitakis, and Sylvie Euvrard, Hospices Civils de Lyon, Edouard Herriot Hospital Group; Adeline Roux and Evelyne Decullier, Hospices Civils de Lyon, Unité de Recherche Clinique, Lyon; Lionel Rostaing and Nassim Kamar, Toulouse University Hospital, Toulouse; Valérie Chatelet and Anne Dompmartin, University Hospital of Caen, Caen; Michèle Kessler, University Hospital of Nancy, Vandœuvre-lès-Nancy, France; Eric Goffin and Isabelle Tromme, St Luc University Hospital, Woluwe-Saint-Lambert; Nilufer Broeders and Véronique del Marmol, Université Libre de Bruxelles, Bruxelles, Belgium; and Andreas Serra and Günther F.L. Hofbauer, Zürich University Hospital, Zürich, Switzerland
| | - Jean Kanitakis
- Jacques Dantal and Anabelle Brocard, Nantes University Hospital, Nantes; Emmanuel Morelon, Claire Pouteil-Noble, Jean Kanitakis, and Sylvie Euvrard, Hospices Civils de Lyon, Edouard Herriot Hospital Group; Adeline Roux and Evelyne Decullier, Hospices Civils de Lyon, Unité de Recherche Clinique, Lyon; Lionel Rostaing and Nassim Kamar, Toulouse University Hospital, Toulouse; Valérie Chatelet and Anne Dompmartin, University Hospital of Caen, Caen; Michèle Kessler, University Hospital of Nancy, Vandœuvre-lès-Nancy, France; Eric Goffin and Isabelle Tromme, St Luc University Hospital, Woluwe-Saint-Lambert; Nilufer Broeders and Véronique del Marmol, Université Libre de Bruxelles, Bruxelles, Belgium; and Andreas Serra and Günther F.L. Hofbauer, Zürich University Hospital, Zürich, Switzerland
| | - Adeline Roux
- Jacques Dantal and Anabelle Brocard, Nantes University Hospital, Nantes; Emmanuel Morelon, Claire Pouteil-Noble, Jean Kanitakis, and Sylvie Euvrard, Hospices Civils de Lyon, Edouard Herriot Hospital Group; Adeline Roux and Evelyne Decullier, Hospices Civils de Lyon, Unité de Recherche Clinique, Lyon; Lionel Rostaing and Nassim Kamar, Toulouse University Hospital, Toulouse; Valérie Chatelet and Anne Dompmartin, University Hospital of Caen, Caen; Michèle Kessler, University Hospital of Nancy, Vandœuvre-lès-Nancy, France; Eric Goffin and Isabelle Tromme, St Luc University Hospital, Woluwe-Saint-Lambert; Nilufer Broeders and Véronique del Marmol, Université Libre de Bruxelles, Bruxelles, Belgium; and Andreas Serra and Günther F.L. Hofbauer, Zürich University Hospital, Zürich, Switzerland
| | - Evelyne Decullier
- Jacques Dantal and Anabelle Brocard, Nantes University Hospital, Nantes; Emmanuel Morelon, Claire Pouteil-Noble, Jean Kanitakis, and Sylvie Euvrard, Hospices Civils de Lyon, Edouard Herriot Hospital Group; Adeline Roux and Evelyne Decullier, Hospices Civils de Lyon, Unité de Recherche Clinique, Lyon; Lionel Rostaing and Nassim Kamar, Toulouse University Hospital, Toulouse; Valérie Chatelet and Anne Dompmartin, University Hospital of Caen, Caen; Michèle Kessler, University Hospital of Nancy, Vandœuvre-lès-Nancy, France; Eric Goffin and Isabelle Tromme, St Luc University Hospital, Woluwe-Saint-Lambert; Nilufer Broeders and Véronique del Marmol, Université Libre de Bruxelles, Bruxelles, Belgium; and Andreas Serra and Günther F.L. Hofbauer, Zürich University Hospital, Zürich, Switzerland
| | - Sylvie Euvrard
- Jacques Dantal and Anabelle Brocard, Nantes University Hospital, Nantes; Emmanuel Morelon, Claire Pouteil-Noble, Jean Kanitakis, and Sylvie Euvrard, Hospices Civils de Lyon, Edouard Herriot Hospital Group; Adeline Roux and Evelyne Decullier, Hospices Civils de Lyon, Unité de Recherche Clinique, Lyon; Lionel Rostaing and Nassim Kamar, Toulouse University Hospital, Toulouse; Valérie Chatelet and Anne Dompmartin, University Hospital of Caen, Caen; Michèle Kessler, University Hospital of Nancy, Vandœuvre-lès-Nancy, France; Eric Goffin and Isabelle Tromme, St Luc University Hospital, Woluwe-Saint-Lambert; Nilufer Broeders and Véronique del Marmol, Université Libre de Bruxelles, Bruxelles, Belgium; and Andreas Serra and Günther F.L. Hofbauer, Zürich University Hospital, Zürich, Switzerland
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31
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Stiebing BN, Rosado FG, Vos JA. Human Papillomavirus-Related Malignancies in the Setting of Posttransplantation Immunosuppression. Arch Pathol Lab Med 2018; 142:711-714. [PMID: 29848025 DOI: 10.5858/arpa.2017-0586-ra] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
CONTEXT - The use of immunosuppression to avoid allograft rejection within the host creates the opportunity for unchecked development of malignancy in the posttransplantation setting. These malignancies frequently show association with human papillomavirus. Within this specific patient population, understanding the oncogenic role of this virus is vital for prompt recognition and treatment of malignancy and precursor lesions as well as the institution of appropriate preventive measures. OBJECTIVE - To review the role of human papillomavirus in the development of malignancies and their precursor lesions in the posttransplantation setting. DATA SOURCES - The study comprised a review of the literature. CONCLUSIONS - The development of human papillomavirus-related malignancies in transplantation patients is dependent on several factors, such as virus subtype, length of immunosuppression, and type of immunosuppressive therapy. Malignancies within these patients differ from those in the general population in terms of pathogenesis, frequency, and recurrence rate, and therefore require further understanding to allow for optimal surveillance and clinical management.
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Affiliation(s)
| | | | - Jeffrey A Vos
- From the West Virginia University School of Medicine, Morgantown (Ms Stiebing); the Department of Pathology, University of Texas Southwestern BioCenter, Dallas (Dr Rosado); and the Department of Pathology, West Virginia University School of Medicine, Morgantown (Dr Vos)
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32
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Winer RL, Gheit T, Cherne S, Lin J, Stern JE, Poljak M, Feng Q, Tommasino M. Prevalence and correlates of beta human papillomavirus detection in fingernail samples from mid-adult women. PAPILLOMAVIRUS RESEARCH 2018; 5:1-5. [PMID: 29807613 PMCID: PMC5886955 DOI: 10.1016/j.pvr.2017.11.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Revised: 09/20/2017] [Accepted: 11/07/2017] [Indexed: 01/05/2023]
Abstract
Cutaneous human papillomaviruses (HPVs) have not been evaluated in fingernails from healthy individuals. To determine prevalence and correlates of β-HPVs in fingernails from healthy mid-adult women, we tested archived samples collected from 2011 to 2012 using a multiplex PCR combined with Luminex technology for 46 β-HPV genotypes. One hundred thirteen (61.1%) of 185 fingernail samples were positive for β-HPV, and the median number of types detected in positive samples was 2 (interquartile range: 1–4). The most common genotypes detected were HPV-23 (β−2) (13.5%), HPV-38 (β−2) (13.0%), HPV-5 (β−1) (9.2%), HPV-107 (β−2) (8.7%), and HPV-120 (β−2) (8.7%). In multivariate analysis, β-HPV detection was associated with age (prevalence ratio [PR] for women 40–51 years versus 30–39 years = 1.30, 95% CI: 1.05–1.62) and race (PR for non-white versus white race = 0.65, 95% CI: 0.45–0.94). The prevalence of β-HPV in fingernail samples from healthy mid-adult women was similar to the prevalence of β-HPV reported at other cutaneous sites in prior studies. We did not identify any significant health or sexual behavior predictors of β-HPV detection in fingernails. Our results support the hypothesis that fingers may serve as a source of transmission or autoinoculation of cutaneous HPVs to other anatomic sites.
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Affiliation(s)
- Rachel L Winer
- Department of Epidemiology, University of Washington, Seattle, WA, USA.
| | - Tarik Gheit
- Infections and Cancer Biology Group, International Agency for Research on Cancer-World Health Organization, Lyon, France.
| | - Stephen Cherne
- Department of Pathology, University of Washington, Seattle, WA, USA.
| | - John Lin
- Department of Pathology, University of Washington, Seattle, WA, USA.
| | - Joshua E Stern
- Department of Global Health, University of Washington, Seattle, WA, USA.
| | - Mario Poljak
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
| | | | - Massimo Tommasino
- Infections and Cancer Biology Group, International Agency for Research on Cancer-World Health Organization, Lyon, France.
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33
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Beta and gamma human papillomaviruses in anal and genital sites among men: prevalence and determinants. Sci Rep 2018; 8:8241. [PMID: 29844517 PMCID: PMC5974254 DOI: 10.1038/s41598-018-26589-w] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Accepted: 04/05/2018] [Indexed: 02/08/2023] Open
Abstract
Data regarding the anogenital distribution of and type-specific concordance for cutaneous β- and γ-HPV types in men who have sex with women is limited and geographically narrow. Knowledge of determinants of anogenital detection of cutaneous HPV types in different regions is needed for better understanding of the natural history and transmission dynamics of HPV, and its potential role in the development of anogenital diseases. Genital and anal canal samples obtained from 554 Russian men were screened for 43 β-HPVs and 29 γ-HPVs, using a multiplex PCR combined with Luminex technology. Both β- and γ-HPVs were more prevalent in the anal (22.8% and 14.1%) samples than in the genital (16.8% and 12.3%) samples. Low overall and type-specific concordance for β-HPVs (3.5% and 1.1%) and γ-HPVs (1.3% and 0.6%) were observed between genital and anal samples. HIV-positive men had higher anal β- (crude OR = 12.2, 95% CI: 5.3–28.1) and γ-HPV (crude OR = 7.2, 95% CI: 3.3–15.4) prevalence than HIV-negative men. Due to the lack of genital samples from the HIV-positive men, no comparison was possible for HIV status in genital samples. The lack of type-specific positive concordance between genital and anal sites for cutaneous β- and γ-HPV types in heterosexual men posits the needs for further studies on transmission routes to discriminate between contamination and true HPV infection. HIV-positive status may favor the anal acquisition or modify the natural history of cutaneous HPV types.
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34
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Bouwes Bavinck JN, Feltkamp MCW, Green AC, Fiocco M, Euvrard S, Harwood CA, Nasir S, Thomson J, Proby CM, Naldi L, Diphoorn JCD, Venturuzzo A, Tessari G, Nindl I, Sampogna F, Abeni D, Neale RE, Goeman JJ, Quint KD, Halk AB, Sneek C, Genders RE, de Koning MNC, Quint WGV, Wieland U, Weissenborn S, Waterboer T, Pawlita M, Pfister H. Human papillomavirus and posttransplantation cutaneous squamous cell carcinoma: A multicenter, prospective cohort study. Am J Transplant 2018; 18:1220-1230. [PMID: 29024374 PMCID: PMC5947129 DOI: 10.1111/ajt.14537] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Revised: 09/20/2017] [Accepted: 10/03/2017] [Indexed: 01/25/2023]
Abstract
Organ transplant recipients (OTRs) have a 100-fold increased risk of cutaneous squamous cell carcinoma (cSCC). We prospectively evaluated the association between β genus human papillomaviruses (βPV) and keratinocyte carcinoma in OTRs. Two OTR cohorts without cSCC were assembled: cohort 1 was transplanted in 2003-2006 (n = 274) and cohort 2 was transplanted in 1986-2002 (n = 352). Participants were followed until death or cessation of follow-up in 2016. βPV infection was assessed in eyebrow hair by using polymerase chain reaction-based methods. βPV IgG seroresponses were determined with multiplex serology. A competing risk model with delayed entry was used to estimate cumulative incidence of histologically proven cSCC and the effect of βPV by using a multivariable Cox regression model. Results are reported as adjusted hazard ratios (HRs). OTRs with 5 or more different βPV types in eyebrow hair had 1.7 times the risk of cSCC vs OTRs with 0 to 4 different types (HR 1.7, 95% confidence interval 1.1-2.6). A similar risk was seen with high βPV loads (HR 1.8, 95% confidence interval 1.2-2.8). No significant associations were seen between serum antibodies and cSCC or between βPV and basal cell carcinoma. The diversity and load of βPV types in eyebrow hair are associated with cSCC risk in OTRs, providing evidence that βPV is associated with cSCC carcinogenesis and may present a target for future preventive strategies.
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Affiliation(s)
| | - Mariet C. W. Feltkamp
- Department of Medical MicrobiologyLeiden University Medical CenterLeidenThe Netherlands
| | - Adele C. Green
- QIMR Berghofer Medical Research InstituteBrisbaneAustralia
| | - Marta Fiocco
- Department of Medical Statistics and BioinformaticsLeiden University Medical CenterLeidenThe Netherlands,Institute of MathematicsLeiden UniversityLeidenThe Netherlands
| | - Sylvie Euvrard
- Department of DermatologyEdouard Herriot HospitalHospices Civils de LyonLyonFrance
| | - Catherine A. Harwood
- Centre for Cell Biology and Cutaneous ResearchBlizard Institute, Barts and The London School of Medicine and DentistryQueen Mary University of LondonUK
| | - Shaaira Nasir
- Centre for Cell Biology and Cutaneous ResearchBlizard Institute, Barts and The London School of Medicine and DentistryQueen Mary University of LondonUK
| | - Jason Thomson
- Centre for Cell Biology and Cutaneous ResearchBlizard Institute, Barts and The London School of Medicine and DentistryQueen Mary University of LondonUK
| | - Charlotte M. Proby
- Division of Cancer ResearchUniversity of DundeeNinewells Hospital and Medical SchoolDundeeUK
| | - Luigi Naldi
- Department of DermatologyAzienda Ospedaliera papa Giovanni XXIII, and GISED Study CenterBergamoItaly
| | - Janouk C. D. Diphoorn
- Department of DermatologyAzienda Ospedaliera papa Giovanni XXIII, and GISED Study CenterBergamoItaly
| | - Anna Venturuzzo
- Department of DermatologyAzienda Ospedaliera papa Giovanni XXIII, and GISED Study CenterBergamoItaly
| | - Gianpaolo Tessari
- Department of MedicineSection of DermatologyUniversity of Veronac/o Ospedale Civile MaggioreVeronaItaly
| | - Ingo Nindl
- Department of DermatologyUniversity Hospital CharitéSkin Cancer Center CharitéBerlinGermany
| | | | | | | | - Jelle J. Goeman
- Department of Medical Statistics and BioinformaticsLeiden University Medical CenterLeidenThe Netherlands
| | - Koen D. Quint
- Department of DermatologyLeiden University Medical CenterLeidenThe Netherlands
| | - Anne B. Halk
- Department of DermatologyLeiden University Medical CenterLeidenThe Netherlands
| | - Carmen Sneek
- Department of DermatologyLeiden University Medical CenterLeidenThe Netherlands
| | - Roel E. Genders
- Department of DermatologyLeiden University Medical CenterLeidenThe Netherlands
| | | | | | - Ulrike Wieland
- Institute of VirologyUniversity of CologneCologneGermany
| | | | - Tim Waterboer
- German Cancer Research Center (DKFZ)HeidelbergGermany
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35
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Fallahian F, Molway D, Jadeja S, Clark R, Marty FM, Riella LV, Chandraker A, Talbot SG. Eponychial lesions following bilateral upper extremity vascular composite allotransplantation: a case report. CASE REPORTS IN PLASTIC SURGERY AND HAND SURGERY 2018; 5:14-17. [PMID: 29441355 PMCID: PMC5804719 DOI: 10.1080/23320885.2018.1431047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Accepted: 01/12/2018] [Indexed: 11/29/2022]
Abstract
Vascularized composite allotransplantation represents a useful addition to reconstructive options available to the plastic surgeon. Though the procedure provides beneficial functional outcomes, there remain complications, often associated with the immunosuppression necessary to maintain an allograft. We report a case of eponychial fold lesions following successful bilateral upper extremity allotransplantation.
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Affiliation(s)
- Fedra Fallahian
- School of Medicine, University of Missouri-Kansas CityKansas CityMOUSA
| | - David Molway
- Department of Medicine, Brigham and Women's HospitalBostonMAUSA
| | - Saagar Jadeja
- Department of Pathology, Brigham and Women's HospitalBostonMAUSA
| | - Rachael Clark
- Department of Dermatology, Brigham and Women's HospitalBostonMAUSA
| | | | | | - Anil Chandraker
- Department of Medicine, Brigham and Women's HospitalBostonMAUSA
| | - Simon G Talbot
- Department of Medicine, Brigham and Women's HospitalBostonMAUSA
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36
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Bacik LC, Chung C. Human papillomavirus-associated cutaneous disease burden in human immunodeficiency virus (HIV)-positive patients: the role of human papillomavirus vaccination and a review of the literature. Int J Dermatol 2017; 57:627-634. [PMID: 29152727 DOI: 10.1111/ijd.13819] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2017] [Revised: 09/21/2017] [Accepted: 09/26/2017] [Indexed: 11/30/2022]
Abstract
Human papillomavirus (HPV) infection is related to the development of cutaneous squamous cell carcinoma, oropharyngeal carcinoma, and anogenital malignancies. Patients infected with human immunodeficiency virus (HIV) have impaired cell-mediated immunity, placing them at risk for more prolonged infection with a greater likelihood of disease expression. This presents important implications for screening and treatment of HPV in the HIV patient population. The use of prophylactic vaccines directed against HPV has been a promising clinical development, though the immunogenicity of these vaccines in the immunocompromised host and in patients with previously established HPV infections has not been well established. In this review, we describe the pathogenesis and epidemiology of HPV-related cutaneous malignancies in patients with HIV. We outline the current guidelines and recent advances in the field of HPV vaccination. It is our hope that increasing awareness of the HPV-related HIV comorbidities will lead to developments in preventative medicine capable of reducing the burden of these diseases. We recognize the importance of prevention as a primary defense against disease and hope that this article organizes and disseminates recent findings in the field of HPV-associated comorbidities in the HIV population.
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Affiliation(s)
- Lindsay C Bacik
- Department of Dermatology, Penn State Hershey Medical Center, Hershey, PA, USA
| | - Catherine Chung
- Department of Dermatology, Ohio State University, Columbus, OH, USA
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37
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Harwood CA, Toland AE, Proby CM, Euvrard S, Hofbauer GFL, Tommasino M, Bouwes Bavinck JN. The pathogenesis of cutaneous squamous cell carcinoma in organ transplant recipients. Br J Dermatol 2017; 177:1217-1224. [PMID: 29086420 DOI: 10.1111/bjd.15956] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/14/2017] [Indexed: 12/14/2022]
Abstract
The pathogenesis of keratinocyte carcinoma following organ transplantation is multifactorial, and recent evidence suggests a complex and often synergistic interplay between the carcinogenic effects of ultraviolet radiation, compromised immune surveillance, direct pro- and anticarcinogenic effects of drugs, oncogenic viruses (in particular, beta-genus human papillomaviruses) and host genetic susceptibility factors. We present an overview of those factors for which there is currently the most convincing evidence and highlight important gaps in our knowledge. In particular, a clear understanding of the interdependence and relative contributions of these co-factors is currently lacking, yet has important implications for rational development of clinically relevant biomarkers and targeted strategies for treatment and prevention of post-transplant keratinocyte cancers.
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Affiliation(s)
- C A Harwood
- Centre for Cell Biology and Cutaneous Research, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, U.K
| | - A E Toland
- Cancer Biology and Genetics, The Ohio State University, Columbus, OH, U.S.A
| | - C M Proby
- Division of Cancer Research, School of Medicine, University of Dundee, Dundee, U.K
| | - S Euvrard
- Hospices Civils de Lyon, Department of Dermatology, Edouard Herriot Hospital, Lyon, France
| | - G F L Hofbauer
- Department of Dermatology, University of Zurich, Zurich, Switzerland
| | - M Tommasino
- Infections and Cancer Biology Group, International Agency for Research on Cancer, Lyon, France
| | - J N Bouwes Bavinck
- Department of Dermatology, Leiden University Medical Centre, Leiden, The Netherlands
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38
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Hasche D, Stephan S, Braspenning-Wesch I, Mikulec J, Niebler M, Gröne HJ, Flechtenmacher C, Akgül B, Rösl F, Vinzón SE. The interplay of UV and cutaneous papillomavirus infection in skin cancer development. PLoS Pathog 2017; 13:e1006723. [PMID: 29190285 PMCID: PMC5708609 DOI: 10.1371/journal.ppat.1006723] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Accepted: 10/30/2017] [Indexed: 12/11/2022] Open
Abstract
Cutaneous human papillomaviruses (HPVs) are considered as cofactors for non-melanoma skin cancer (NMSC) development, especially in association with UVB. Extensively studied transgenic mouse models failed to mimic all aspects of virus-host interactions starting from primary infection to the appearance of a tumor. Using the natural model Mastomys coucha, which reflects the human situation in many aspects, we provide the first evidence that only UVB and Mastomys natalensis papillomavirus (MnPV) infection strongly promote NMSC formation. Using UVB exposures that correspond to UV indices of different geographical regions, irradiated animals developed either well-differentiated keratinizing squamous cell carcinomas (SCCs), still supporting productive infections with high viral loads and transcriptional activity, or poorly differentiated non-keratinizing SCCs almost lacking MnPV DNA and in turn, early and late viral transcription. Intriguingly, animals with the latter phenotype, however, still showed strong seropositivity, clearly verifying a preceding MnPV infection. Of note, the mere presence of MnPV could induce γH2AX foci, indicating that viral infection without prior UVB exposure can already perturb genome stability of the host cell. Moreover, as shown both under in vitro and in vivo conditions, MnPV E6/E7 expression also attenuates the excision repair of cyclobutane pyrimidine dimers upon UVB irradiation, suggesting a viral impact on the DNA damage response. While mutations of Ras family members (e.g. Hras, Kras, and Nras) were absent, the majority of SCCs harbored-like in humans-Trp53 mutations especially at two hot-spots in the DNA-binding domain, resulting in a loss of function that favored tumor dedifferentiation, counter-selective for viral maintenance. Such a constellation provides a reasonable explanation for making continuous viral presence dispensable during skin carcinogenesis as observed in patients with NMSC.
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Affiliation(s)
- Daniel Hasche
- Division of Viral Transformation Mechanisms, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Sonja Stephan
- Division of Viral Transformation Mechanisms, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Ilona Braspenning-Wesch
- Division of Viral Transformation Mechanisms, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Julita Mikulec
- Division of Viral Transformation Mechanisms, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Division of Virus-associated Carcinogenesis, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Martina Niebler
- Division of Viral Transformation Mechanisms, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Hermann-Josef Gröne
- Division of Cellular and Molecular Pathology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | | | - Baki Akgül
- Institute of Virology, University of Cologne, Cologne, Germany
| | - Frank Rösl
- Division of Viral Transformation Mechanisms, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Sabrina E. Vinzón
- Division of Viral Transformation Mechanisms, German Cancer Research Center (DKFZ), Heidelberg, Germany
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Madeleine M, Patel N, Plasmeijer E, Engels E, Bouwes Bavinck J, Toland A, Green A. Epidemiology of keratinocyte carcinomas after organ transplantation. Br J Dermatol 2017; 177:1208-1216. [DOI: 10.1111/bjd.15931] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2017] [Indexed: 12/14/2022]
Affiliation(s)
| | - N.S. Patel
- University of South Florida Tampa FL U.S.A
| | - E.I. Plasmeijer
- QIMR Berghofer Medical Research Institute Queensland Australia
| | | | | | - A.E. Toland
- The Ohio State University Medical Center Columbus OH U.S.A
| | - A.C. Green
- QIMR Berghofer Medical Research Institute Queensland Australia
- CRUK Manchester Institute and University of Manchester Manchester Academic Health Sciences Centre Manchester U.K
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Smola S. Immunopathogenesis of HPV-Associated Cancers and Prospects for Immunotherapy. Viruses 2017; 9:E254. [PMID: 28895886 PMCID: PMC5618020 DOI: 10.3390/v9090254] [Citation(s) in RCA: 80] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Revised: 09/07/2017] [Accepted: 09/08/2017] [Indexed: 02/06/2023] Open
Abstract
Human papillomavirus (HPV) infection is a causative factor for various cancers of the anogenital region and oropharynx, and is supposed to play an important cofactor role for skin carcinogenesis. Evasion from immunosurveillance favors viral persistence. However, there is evidence that the mere presence of oncogenic HPV is not sufficient for malignant progression and that additional tumor-promoting steps are required. Recent studies have demonstrated that HPV-transformed cells actively promote chronic stromal inflammation and conspire with cells in the local microenvironment to promote carcinogenesis. This review highlights the complex interplay between HPV-infected cells and the local immune microenvironment during oncogenic HPV infection, persistence, and malignant progression, and discusses new prospects for diagnosis and immunotherapy of HPV-associated cancers.
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Affiliation(s)
- Sigrun Smola
- Institute of Virology, Saarland University Medical Center, 66421 Homburg/Saar, Germany.
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Abstract
Malignancy is the second most common single cause of death observed in organ transplant recipients. The excess cancer risk is related to intensity and duration of immunosuppressive therapy and inversely to recipient age. Immunodeficiency and (chronic/oncogenic) viral infections together constitute a major risk. Nonmelanoma skin cancer, Kaposi sarcoma, and posttransplant lymphoproliferative disease have standardized incidence ratios exceeding 10- or 50-fold. The mammalian target of rapamycin (mTOR) inhibitors, sirolimus and everolimus, are increasingly used after organ transplantation with potential advantages in virus-associated posttransplant malignancies as well as anti-cancer properties. Despite a seemingly clear mechanism of action and solid rationale for their use in cancer therapy, mTORis have met only modest success rates in clinical trials with advanced malignancies except for specific tumors, such as Kaposi sarcoma and mantle cell lymphoma. Because mTORis are primarily cytostatic, not cytotoxic, the observed clinical efficacy is a reflection of disease stabilization rather than tumor regression. Nonmelanoma skin cancers, in particular cutaneous squamous cell carcinoma, have the highest standardized incidence ratios in transplant recipients. Recent meta-analyses and randomized trials on secondary prevention of squamous cell carcinoma observed a reduction in cumulative tumor load, suggesting most benefit to be gained by early conversion to an mTOR inhibitor-based maintenance regime. There is ongoing debate on the mechanisms involved including withdrawal of the carcinogenic effects of calcineurin inhibitors and/or their impact on chronic (oncogenic) viral infections. At present, there is, however, insufficient evidence for the primary use of mTORis as protective agents against most other cancer types.
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Smelov V, Hanisch R, McKay-Chopin S, Sokolova O, Eklund C, Komyakov B, Gheit T, Tommasino M. Prevalence of cutaneous beta and gamma human papillomaviruses in the anal canal of men who have sex with women. PAPILLOMAVIRUS RESEARCH 2017; 3:66-72. [PMID: 28720458 PMCID: PMC5883282 DOI: 10.1016/j.pvr.2017.02.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Revised: 12/19/2016] [Accepted: 02/13/2017] [Indexed: 12/15/2022]
Abstract
Background Data regarding anal cutaneous HPV detection among HIV-positive and HIV-negative persons largely relies on studies among men who have sex with men in limited geographical settings. Understanding the distribution, determinants, and potential human health effects of anal cutaneous HPV types among men who have sex with women (MSW) is important. Methods Anal canal swab samples from 415 Russian MSW (384 HIV-negative and 31 HIV-positive) were tested for 43 β-HPVs and 29 γ-HPVs, using a multiplex PCR combined with Luminex technology. Results β-HPV was detected in 24.4% and γ-HPV in 15.9% of anal samples of all Russian MSW. In total, 34 β-HPV and 19 γ-HPV types were detected, with the most commonly detected β-HPV types being 110, 22 and 124 and the most common γ-HPV types being 95, 132 and 50. For both genera, being HIV-positive at the time of testing was a significant determinant of detection (74.2% for β-HPVs and 48.4% for γ-HPVs compared to 20.1% and 12.5% in HIV-negative MSW, respectively). Conclusions A wide spectrum and moderate prevalence of anal β-HPV and γ-HPV types was found in our MSW study sample, suggesting that routes other than penile-anal intercourse may be important in cutaneous HPV transmission. β and γ HPV types commonly colonize the anal canal of MSW, but their geographical variation in prevalence could be wide. HIV-positive men were more likely to have both genera of HPV types detected. Routes other than penile-anal intercourse may be important in cutaneous HPV transmission.
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Affiliation(s)
- Vitaly Smelov
- Infections and Cancer Biology Group, International Agency for Research on Cancer, World Health Organization, Lyon, France; Screening Group, International Agency for Research on Cancer, World Health Organization, Lyon, France; Department of Urology, North-Western State Medical University named after I.I. Mechnikov, St. Petersburg, Russia; Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden.
| | - Rachel Hanisch
- Section of Environment and Radiation, International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Sandrine McKay-Chopin
- Infections and Cancer Biology Group, International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Olga Sokolova
- Faculty of Medicine, St. Petersburg State University, St. Petersburg, Russia; Clinical Infectious Diseases Hospital named after S.P. Botkin,, St. Petersburg, Russia
| | - Carina Eklund
- Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Boris Komyakov
- Department of Urology, North-Western State Medical University named after I.I. Mechnikov, St. Petersburg, Russia
| | - Tarik Gheit
- Infections and Cancer Biology Group, International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Massimo Tommasino
- Infections and Cancer Biology Group, International Agency for Research on Cancer, World Health Organization, Lyon, France
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Rahman S, Rollison DE, Pierce Campbell CM, Waterboer T, Michel A, Pawlita M, Villa LL, Lazcano Ponce E, Wang W, Borenstein AR, Giuliano AR. Seroprevalence of Cutaneous Human Papillomaviruses and the Risk of External Genital Lesions in Men: A Nested Case-Control Study. PLoS One 2016; 11:e0167174. [PMID: 27893841 PMCID: PMC5125700 DOI: 10.1371/journal.pone.0167174] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Accepted: 11/09/2016] [Indexed: 12/11/2022] Open
Abstract
Background A variety of cutaneous human papillomaviruses (HPV) are detectable in genital epithelial lesions in men and non-melanoma skin cancer patients. It remains unclear whether these viruses are associated causally with skin lesions. To date, no study has prospectively examined the association between cutaneous HPV seropositivity and development of external genital lesions (EGLs) in men. Objectives To examine the association between seropositivity to cutaneous HPV types and the risk of subsequent development of EGLs. Methods A nested case-control study including 163 incident EGL cases and 352 EGL-free controls in the HPV Infection in Men (HIM) Study cohort was conducted. Cases were ascertained at each of up to 10 biannual clinical visits and verified through biopsy and pathological diagnoses. EGLs were categorized as condyloma, suggestive of condyloma, penile intraepithelial neoplasia (PeIN), and other EGLs. Archived serum specimens collected at baseline were tested for antibodies against 14 cutaneous HPV types (β types (5, 8, 12, 14, 17, 22, 23, 24, 38, and 47), α type 27, γ type 4, μ type 1, and ν type 41) using a GST L1-based multiplex serology assay. Socio-demographic and sexual behavior data were collected through a questionnaire. Using logistic regression, adjusted odds ratios (AOR) and 95% confidence intervals (CI) were estimated. Results Overall, seropositivity to ≥1 cutaneous HPV type (any-HPV) and ≥1 β types (any-β) was 58.3% and 37.5% among other EGL cases, 71.6% and 46.8% among condyloma, 66.8% and 50.0% among PeIN, and 71.9% and 38.4% among controls, respectively. Type-specific seropositivity was most common for ɤ-HPV 4, μ-HPV 1, and β-HPV 8. No statistically significant association was observed between any-HPV, any-β, and type-specific HPV seropositivity and subsequent development of EGLs across all pathological diagnoses. Conclusions Overall, seropositivity to cutaneous HPV was common among men; however, it appears that cutaneous HPV is not associated with the development of genital lesions in men.
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Affiliation(s)
- Shams Rahman
- Center for Infection Research in Cancer, Moffitt Cancer Center, Tampa, United States
- Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, Tampa, United States
| | - Dana E. Rollison
- Center for Infection Research in Cancer, Moffitt Cancer Center, Tampa, United States
| | | | - Tim Waterboer
- Infection, Inflammation and Cancer Research Program, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Angelika Michel
- Infection, Inflammation and Cancer Research Program, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Michael Pawlita
- Infection, Inflammation and Cancer Research Program, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Luisa L. Villa
- School of Medicine, University of São Paulo, São Paulo, Brazil
| | | | - Wei Wang
- Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, Tampa, United States
| | - Amy R. Borenstein
- Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, Tampa, United States
| | - Anna R. Giuliano
- Center for Infection Research in Cancer, Moffitt Cancer Center, Tampa, United States
- * E-mail:
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Hampras SS, Reed RA, Bezalel S, Cameron M, Cherpelis B, Fenske N, Sondak VK, Messina J, Tommasino M, Gheit T, Rollison DE. Cutaneous Human Papillomavirus Infection and Development of Subsequent Squamous Cell Carcinoma of the Skin. J Skin Cancer 2016; 2016:1368103. [PMID: 27891253 PMCID: PMC5116506 DOI: 10.1155/2016/1368103] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Revised: 10/05/2016] [Accepted: 10/16/2016] [Indexed: 12/17/2022] Open
Abstract
The role of cutaneous human papillomavirus (HPV) infection in the development of subsequent cutaneous squamous cell carcinoma (SCC) is unknown. Pathologically confirmed cases of SCC (n = 150) enrolled in a previously conducted case-control study were included in a retrospective cohort study to examine the association of cutaneous HPV at the time of SCC diagnosis with the risk of subsequent SCC development. Data on HPV seropositivity, HPV DNA in eyebrow hairs (EB) and SCC tumors were available from the parent study. Incidence of subsequent SCC was estimated using person-years of follow up. Cox Proportional Hazards ratios were estimated to evaluate the associations of both, HPV seropositivity and HPV DNA positivity with subsequent SCC. The five year cumulative incidence of subsequent SCC was 72%. Seropositivity to cutaneous HPV was not associated with the risk of subsequent SCC (HR = 0.83, 95% CI = 0.41-1.67). Any beta HPV infection in EB was associated with reduced risk (HR = 0.30, 95% CI = 0.11-0.78) of subsequent SCC among cases who were positive for beta HPV DNA in tumor tissue. Infection with beta HPV type 2 (HR = 0.32, 95% CI = 0.12-0.86) in EB was associated with reduced risk of subsequent SCC among HPV DNA positive SCCs. In conclusion, beta HPV infection was inversely associated with the risk of subsequent SCC.
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Affiliation(s)
- Shalaka S. Hampras
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida, USA
| | - Rhianna A. Reed
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida, USA
| | - Spencer Bezalel
- University of South Florida, Morsani College of Medicine, Tampa, Florida, USA
| | - Michael Cameron
- University of South Florida, Morsani College of Medicine, Tampa, Florida, USA
| | - Basil Cherpelis
- Department of Dermatology, University of South Florida, College of Medicine, Tampa, FL, USA
- Department of Cutaneous Surgery, University of South Florida, College of Medicine, Tampa, FL, USA
| | - Neil Fenske
- Department of Dermatology, University of South Florida, College of Medicine, Tampa, FL, USA
- Department of Cutaneous Surgery, University of South Florida, College of Medicine, Tampa, FL, USA
| | - Vernon K. Sondak
- Cutaneous Oncology Program, Moffitt Cancer Center, Tampa, Florida, USA
| | - Jane Messina
- Department of Dermatology, University of South Florida, College of Medicine, Tampa, FL, USA
- Cutaneous Oncology Program, Moffitt Cancer Center, Tampa, Florida, USA
- Departments of Pathology and Cell Biology, University of South Florida, College of Medicine, Tampa, FL, USA
| | - Massimo Tommasino
- Infections and Cancer Biology Group, International Agency for Research on Cancer-World Health Organization, Lyon 69372, France
| | - Tarik Gheit
- Infections and Cancer Biology Group, International Agency for Research on Cancer-World Health Organization, Lyon 69372, France
| | - Dana E. Rollison
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida, USA
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Human Papillomavirus Infection and p16 Expression in Extragenital/Extraungual Bowen Disease in Immunocompromised Patients. Am J Dermatopathol 2016; 38:751-7. [DOI: 10.1097/dad.0000000000000530] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Balakirski G, Dueckers G, Niehues T, Megahed M. A non-healing lesion in a 14-year old boy with primary immunodeficiency: a rare case of actinic keratosis affecting a child. J Eur Acad Dermatol Venereol 2016; 30:1408-9. [DOI: 10.1111/jdv.13255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- G. Balakirski
- Department of Dermatology and Allergology; Universitiy Hospital of Aachen; Pauwelsstr. 30 52074 Aachen Germany
| | - G. Dueckers
- Center for Child and Adolescent Medicine; Helios-Clinic; Krefeld Germany
| | - T. Niehues
- Center for Child and Adolescent Medicine; Helios-Clinic; Krefeld Germany
| | - M. Megahed
- Department of Dermatology and Allergology; Universitiy Hospital of Aachen; Pauwelsstr. 30 52074 Aachen Germany
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Švajdler M, Mezencev R, Kašpírková J, Kacerovská D, Kazakov DV, Ondič O, Michal M. Human papillomavirus infection and p16 expression in the immunocompetent patients with extragenital/extraungual Bowen's disease. Diagn Pathol 2016; 11:53. [PMID: 27342647 PMCID: PMC4919835 DOI: 10.1186/s13000-016-0505-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2016] [Accepted: 06/15/2016] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND The role of human papillomaviruses (HPV) in the development of squamous cell carcinoma (SCC) has been established for anogenital lesions but still remains controversial for carcinomas in other sites. The aim of this study was to determine the α-HPV and β-HPV prevalence and their association with p16 expression, sun exposure, and clinicopathological findings in patients with Bowen's disease (BD). METHODS One hundred sixty nine skin biopsy specimens from 157 immunocompetent patients with extragenital/extraungual BD were examined for HPV status and p16 expression. The presence of koilocyte-like changes, solar elastosis and papillomatosis was recorded for each specimen. RESULTS BD was diagnosed more often in potentially sun-exposed sites with prevalence 73.6 % and a remarkable predilection for the head and neck region. High risk α-HPV or β-HPV were detected in 34.7 % of lesions and β-HPV infections dominated over α-HPV. Higher prevalence of koilocyte-like changes and papillomatosis was found in HPV-positive specimens but it was not statistically significant. The expression of p16 was detected in 79.8 % of lesions and displayed no correlation with the HPV status. HPV-positivity tended to be detected more often in sun-protected sites. Dual infections by α-HPV/β-HPV genera and mixed α-HPV infections were not detected, while 37.5 % of β-HPV positive specimens were infected by two or more β-HPV genotypes. HPV 9 was significantly associated with mixed β-HPV infections. CONCLUSIONS HPV may play an etiological role at least in some SCC in situ arising in extragenital sites. Sunprotected sites may be more dependent on HPV-mediated co-carcinogenesis than sun exposed areas. The presence of the p16-expression, papillomatosis or koilocyte-like change is not a reliable marker of HPV infection in SCC in situ.
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Affiliation(s)
- Marián Švajdler
- />Šikl’s Department of Pathology, Charles University in Prague, The Faculty of Medicine and Faculty Hospital in Pilsen, Pilsen, Czech Republic
- />Bioptická laboratoř, s.r.o., Mikulášske nám. 4, 326 00 Pilsen, Czech Republic
| | - Roman Mezencev
- />Integrated Cancer Research Center, School of Biology and Parker H. Petit Institute of Bioengineering and Biosciences, Georgia Institute of Technology, Atlanta, GA USA
| | - Jana Kašpírková
- />Bioptická laboratoř, s.r.o., Mikulášske nám. 4, 326 00 Pilsen, Czech Republic
| | - Denisa Kacerovská
- />Šikl’s Department of Pathology, Charles University in Prague, The Faculty of Medicine and Faculty Hospital in Pilsen, Pilsen, Czech Republic
- />Bioptická laboratoř, s.r.o., Mikulášske nám. 4, 326 00 Pilsen, Czech Republic
| | - Dmitry V. Kazakov
- />Šikl’s Department of Pathology, Charles University in Prague, The Faculty of Medicine and Faculty Hospital in Pilsen, Pilsen, Czech Republic
- />Bioptická laboratoř, s.r.o., Mikulášske nám. 4, 326 00 Pilsen, Czech Republic
| | - Ondrej Ondič
- />Šikl’s Department of Pathology, Charles University in Prague, The Faculty of Medicine and Faculty Hospital in Pilsen, Pilsen, Czech Republic
- />Bioptická laboratoř, s.r.o., Mikulášske nám. 4, 326 00 Pilsen, Czech Republic
| | - Michal Michal
- />Šikl’s Department of Pathology, Charles University in Prague, The Faculty of Medicine and Faculty Hospital in Pilsen, Pilsen, Czech Republic
- />Bioptická laboratoř, s.r.o., Mikulášske nám. 4, 326 00 Pilsen, Czech Republic
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Prevalence and Associated Risk Factors of Human Papillomavirus in Healthy Skin Specimens Collected from Rural Anyang, China, 2006-2008. J Invest Dermatol 2016; 136:1191-1198. [PMID: 26916390 DOI: 10.1016/j.jid.2016.02.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2015] [Revised: 02/02/2016] [Accepted: 02/05/2016] [Indexed: 12/20/2022]
Abstract
Skin infections with cutaneous human papillomavirus (HPV) have been linked to the development of non-melanoma skin cancer, in which mucosal HPV may also play a crucial role. However, systematic investigations of the distribution and associated factors of HPV infection in healthy skin of the general population are scarce. HPV DNA from palmar exfoliated cells of 2,087 individuals was detected by FAP6085/64 and SPF1/GP6+ primers followed by sequencing. A total of 338 papillomavirus types were detected, with HPV-3, HPV-57, and HPV-49 being the most dominant types. The overall prevalence for HPV DNA on skin was 79.92% and for alpha-, beta-, and gamma-HPV were 27.07%, 38.76%, and 29.56%, respectively. Having multiple lifetime sexual partners (adjusted odds ratio 1.60), being a migrant worker (adjusted odds ratio 2.05, reference: farmers), and frequent bathing (Ptrend = 0.001) were associated with alpha-HPV DNA presence. Advancing age increased the detection risk of beta-HPV (Ptrend = 0.001). Higher education (Ptrend = 0.017) and frequent bathing (Ptrend = 0.001) were positively related to gamma-HPV positivity. This study demonstrates that alpha-HPV commonly exists on healthy skin of the general population in rural China, and alpha- and gamma-HPV infections are related to certain behaviors, different from beta-HPV infection. These findings are crucial to better understanding the biology of HPV infection and may be suggestive of the potential transmission of these viruses.
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Tufaro AP, Azoury SC, Crompton JG, Straughan DM, Reddy S, Prasad NB, Shi G, Fischer AC. Rising incidence and aggressive nature of cutaneous malignancies after transplantation: An update on epidemiology, risk factors, management and surveillance. Surg Oncol 2015; 24:345-52. [DOI: 10.1016/j.suronc.2015.09.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Revised: 09/16/2015] [Accepted: 09/30/2015] [Indexed: 02/06/2023]
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50
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Díaz-Corpas T, Morales-Suárez-Varela M, Rausell Fontestad N, Fuertes Prósper A, Marquina-Vila A, Jordá-Cuevas E. Squamous Cell Carcinoma: Clinical and Pathological Features and Associated Risk Factors in an Observational Study of 118 Patients. ACTAS DERMO-SIFILIOGRAFICAS 2015. [DOI: 10.1016/j.adengl.2015.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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