Soluble membrane antigens of lip and cervical carcinomas: reactivity with antibody for herpesvirus nonvirion antigens

Herpes Simplex Virus Tumor-Associated Antigens in Cancer Patients

Data are reported on the HSV nonstructural antigens detected in GPK and RK cells after infection with the same strain of virus. Both the HSV types 1 and 2 NV antigens consist of more than one component for which the immunized guinea pigs produce distinct antibodies. It was possible to separate by PAGE, HSV-induced markers not only from cells undergoing lytic infection by the virus but also from viable cells from squamous cell carcinoma of the head and neck and the urogenital tract. These fractions were tested with sera from cancer patients, and the percentages of their CF reactivity are reported. The specificity of the antibody to the antigen from the cancer cells was less high than that of the antibody to the antigen from HSV-infected cells. It is suggested that the use of these PAGE separate antigens would eliminate the need for removal of the virion antibody from the cancer sera prior to testing them for the NV-specific antibody.

Characterization of a Herpes Simplex Virus Isolated from a Lip Tumor Developing after Recurrent Herpes

A spindle-cell carcinoma developed on the lower lip of 53-year-old patient who had suffered from recurrent local herpes. From a tumor biopsy a human herpesvirus 1 (Type 1 Herpes Simplex Virus) was isolated (strain n. 466). Infected cells contain eosinophilic intranuclear inclusions (fig. 3); the agent's cpe is abolished by anti-HSV antiserum and by chloroform; the agent produces typical plaques (fig. 4), grows at 38 °C, and its DNA has a density of approximately 1.726 g per cm3, equal to that of DNA of « F » prototype of human herpesvirus 1 (text-fig. 1). However, its immunological structure (text-fig. 2) and its protein electrophoretic pattern (fig. 5) slightly differentiate this virus from homotypic strains including some local isolates. At the time the virus was isolated from the tumor no HSV was recovered from the surrounding skin of the patient. After surgical removal of the tumor, the patient suffered no more of herpetic recurrences. As far as the significance of the isolation is concerned, UV-inactivated strains possess a transforming activity in vitro and human herpesvirus 2 is known to be associated to cervical carcinoma in some human populations, but no direct oncogenicity has been shown in HSV. In our case, HSV may have been implicated through the association of the irritant effect of repeated recurrences and a possible abortive type of infection with cigarette smoking.

Oncogenes, tumor suppressors and viruses in oral squamous carcinoma

The pathogenesis of oral squamous cell carcinoma involves recognised carcinogens in tobacco and/or alcohol but other factors, including viruses, may also have a role. This paper reviews the gene changes revealed in oral carcinoma, the evidence implicating viruses, and mechanisms whereby viruses may affect gene function.

Viruses in the aetiology of oral carcinoma? Examination of the evidence

This paper examines the evidence for an aetiological role for viruses in the development of oral carcinoma. Several viruses have been sought in oral cancer and evidence found for some, particularly herpes simplex and human papillomavirus. However, the evidence also suggests that these viruses are ubiquitous agents and a number of criteria must be met before these potentially oncogenic agents can reliably be implicated in human carcinogenesis. In contrast, there is no evidence that viruses such as adenovirus, Epstein-Barr virus, and retroviruses play any role in oral carcinogenesis.

Viruses and chronic disorders involving the human oral mucosa

Viruses have been implicated in the etiology of several chronic disorders of the oral mucosa. Most of these associations have been with DNA viruses, particularly certain herpesviruses, which are associated, for example, with some cases of erythema multiforme and with hairy leukoplakia. Papillomaviruses are associated with various papillomatous lesions, focal epithelial hyperplasia, and possibly with some carcinomas. Viruses may possibly be associated with recurrent aphthae, Behçet's syndrome, and some dermatoses. The literature concerning these possible associations is reviewed. However, much more research needs to be done before the full story of viral associations with oral mucosal disorders can be written.

Suppression of immune responses by herpes virus type 2-transformed murine tumor cells

Work done in our laboratories, using a murine model, indicates that suppression of host immune responses might be due to secretion of soluble factors by tumor cells. The H238 cells (BALB/c embryonic fibroblasts transformed by UV-inactivated herpes simplex virus Type 2) exhibit progressive tumor growth with subsequent decrease in lymphoproliferation. To further study the suppressive effects of a tumor, H238 conditioned medium (CM) was tested for its ability to block murine and human mitogenic and allogeneic lymphocyte responses. PHA, Con A and LPS were used as mitogens. Lymphoproliferation, in the presence of increasing amounts of H238 CM, resulted in a greater degree of suppression of [3H]thymidine ([3H]Tdr) uptake, in both human and mouse systems. The kinetics of proliferation in the presence of concentrated H238 CM (cCM) showed that depression was evident regardless of the time of cCM addition, thereby affecting it at any stage of the cell cycle. Treatment of H238 cCM using acid (pH 2.3), base (pH 9.6), trypsin (100 micrograms/ml), heat (56 degrees C, 100 degrees C) and freeze-thawing, restored PHA-stimulated lymphoproliferation. Dialysis of H238 cCM showed that the molecular weight of the suppressor lies between 15 and 25 kDa. Northern blot analysis demonstrated the presence of a TGF-beta transcript in H238 cells. Neutralization of the H238 cCM with monoclonal antibody to TGF-beta resulted in complete abrogation of suppressive activity in spleen cell lymphoblastogenesis. These results suggest that TGF-beta appears to be the main inhibitor of immune responses found in this HSV-2-induced murine tumor cell line. Such tumor-induced modulations may contribute to the outcome of immunotherapy in the tumor-bearing host.

Monoclonal antibodies to HSV-infection-related antigens cross-react with tumor cell lines and tumor tissue sections

The purpose of our study was to evaluate a possible association between herpes simplex virus (HSV) and various tumors, including oral squamous cell carcinoma (SCC). To this end, we tested the binding of appropriate monoclonal antibodies to a panel of cell lines and tumor sections. The 25 monoclonal antibodies were reactive with HSV-infected cells but not with uninfected cells. Of these antibodies, three bound to several SCC cell lines and to one non-SCC cell line (K562). One of these three antibodies also reacted with sections of oral SCC tumors, the adjacent mucosa, and normal esophageal epithelium. In contrast, it did not bind to sections of kidney, spleen, esophageal smooth muscle, and skin. To evaluate whether the observed antibody binding could reflect an actual infection by HSV, hybridization experiments between K562 DNA and HSV DNA were performed. HSV DNA sequences were found in K562 DNA at a ratio of 0.1 genome-equivalents/cell. Although these data do not characterize the nature of the relationship, they clearly confirm the postulated association of HSV with some tumors (in particular oral SCC).

Oncogenic potential of sexually transmitted viruses with special reference to oral cancer

Recent changes in social mores have been accompanied by a noted increase in the frequency of sexually transmitted diseases. Viruses that have been identified as causative agents for a large proportion of these diseases have also been associated with various malignant states. Concomitantly, the number of cases of oral cancer (considered to occur usually around or after the fifth decade of life) reportedly has been increasing among young adults. The oncogenic potential of several sexually transmitted viruses (HSV, HPV, CMV, and LAV/HTLV III) and their possible role in the development of malignant conditions, in particular oral cancer, are discussed in this review.

The oncogenic potential of herpes simplex viruses: evidence for a 'hit-and-run' mechanism

Experiments to determine the mechanism of transformation of herpes simplex virus (HSV) have identified fragments of viral DNA which are able to initiate transformation. No set of viral genes seems to be consistently retained or expressed in the transformed cells or in human cervical tumours, suggesting that viral DNA is not needed to maintain the transformed phenotype. In fact there is no conclusive evidence that initiation of neoplasia is mediated by a viral protein. Here we revisit the 'hit-and-run' hypothesis and its implications for HSV-induced tumorigenicity.

Lactosylsphingosine-reactive antibody and CEA in patients with colorectal cancer

The sera of 71 patients with colorectal cancer were examined for lactosylsphingosine-reactive antibody and CEA. Fifteen of those patients were studied repeatedly over extensive periods of time. The antibody was determined by the semiquantitative radioimmunoabsorption technique using lactosylsphingosine-polyacrylamide conjugate and [125I]-labelled anti-human IgG. Excessive antibody levels were invariably found In serum samples of all 39-patients who were examined before or within 2 months after surgery. Serum samples of certain patients became negative for the presence of high antibody levels usually between 3 and 6 months after surgery. This occurred in 13 out of 41 operated patients. The follow-up study revealed that 11 such patients have been free of any signs of cancer relapse up until the time of the follow-Up examination, i.e. for 12-28 months, mean 19 months. In contrast, only 4 out of 28 patients who remained positive for the excessive antibody longer than 2 months after surgery are at present free of the disease. The high antibody levels which persist more than 6 months after surgery are almost always associated with cancer recurrences or metastases. This was true for 21 out of 22 such patients. The high levels of the antibody preceded other signs of cancer relapse, including increased concentrations of CEA in about 40% of the operated patients.

Herpesvirus-specific RNA and protein in carcinoma of the uterine cervix

Cloned probes of herpes simplex virus type 2 DNA were used in cytological hybridization experiments to detect herpesvirus RNA transcripts in the neoplastic cells of tumors of the uterine cervix. Virus-specific RNA was shown to represent transcription of limited regions of the genome, of which one is known to code for a DNA-binding protein that can be found by immunoperoxidase staining in the neoplastic cells of these tumors and has also been detected in cells transformed in vitro by this virus.

Risk factors for cervical cancer

Despite a long history of research into the epidemiology and biology of cervical carcinoma, a definitive statement about its probable causes still remains elusive. This review recognizes the population based data on high and low risk groups and summarizes the findings from numerous case-control studies which have explored the marital, sexual and reproductive factors associated with cervical cancer. Although vigorously pursued, an increased risk from oral contraceptives has not been convincingly demonstrated. A variety of venereally transmitted organisms appear to be frequent cohabitants with cervical neoplastic cells. Herpesvirus type 2 still remains the prime suspect in the complex pathogenesis of cervical neoplasia. Clinical findings, biological characteristics of the virus, serological studies and interactions of host cells and viral particles continue to stimulate the most intensive investigative efforts.

The antigenicity and immunology of human cervical squamous cell carcinoma: a review

Numerous studies have demonstrated an altered antigenicity in the carcinomatous cervix. Whether the neoplasia-associated antigens are of viral origin, are actually normal antigens expressed in elevated levels, or are true tumor-associated antigens has not been precisely determined, since evidence has been presented for all of these possibilities. These antigens associated with cervical squamous cell carcinoma have been demonstrated not only biochemically and by raising antisera to the tumors in animals but also by studies of the humoral and cell-mediated immune responses of cervical cancer patients. Immunodiagnosis of cervical cancer with the use of these antigens has, to date, not been feasible, although several of the assays appear potentially useful.

Purification of herpes simplex virus tumor associated antigen from human kidney carcinoma

In the present study, we attempted to purify herpes simplex virus (HSV) tumor associated antigen(s) (TAA) extracted from human kidney carcinoma. Trypsinized human tumor cells were sonicated for 9 minutes and clarified at 100,000 x g for 1 hour; the supernate yielded 70% of detectable TAA as determined by means of quantitative absorption with specific antisera. The supernate used as source of soluble HSV-TAA was concentrated and the pellet was resuspended in 0.02 M tris, pH 7.2, and purified by means of filtration on Sephadex G-100 followed by chromatography on DEAE Sephadex A-50 and then affinity chromatography on concanavalin A (Con A) sepharose. The TAA bound to Con A sepharose was eluted by 0.5 M of alpha-CH3D-mannoside (alpha-MM) and behaved as a glycoprotein. The molecular weight determined on SDS-PAGE was about 70,000 daltons in relation to standard marker proteins. This antigen reacted in complement fixing tests with hyperimmune guinea pig sera as well as with certain human squamous cancer sera. As a control we used a human kidney carcinoma which showed no complement fixing activity in any of the procedural steps, and as control sera, guinea pig sera prepared by inoculation of uninfected guinea pig cells.

Soluble immune complexes in sera from head and neck cancer patients: a preliminary report

With the recent demonstration of circulating immune complexes in a variety of malignant and nonmalignant diseases, we have examined the sera of head and neck cancer patients for evidence of soluble immune compleses. Using the Raji, cell test, we have shown that immune complexes are present in over 80% of the cancer sera examined as compared to less than 10% of normal control sera, and that these complexes persist following treatment of the patients by surgery or radiation therapy. These complexes may be acting as blocking factors which would account for the anergic state of these patients.

Complement-dependent cytotoxic antibodies in the course of cervical carcinoma

Complement-dependent cytotoxic antibodies to three cervical carcinoma cell lines (Me-180, SW-732 and HeLa) and to Herpes simplex virus type 2 (HSV-2)-infected cells were determined in a long-term study of women with cervical carcinoma. Cytolysis of surface antigens differed significantly between the cervical carcinoma cell lines and HSV-2. Regression of the tumor during treatment was accompanied by decreasing cytolysis in the cervical carcinoma lines, while tumor bearers and patients who became severely ill had high or increasing cytotoxic antibodies, The opposite was noted for the antibody response to HSV-2 infected cells: patients with less advanced cancer had significantly higher cytolytic activity than those who were severely ill or had advanced cancer; long-term survivors demonstrated high, stable lysis of HSV-2 infected cells. As a control of the cervical carcinoma cell lines, cytolytic activity was tested also on a lung carcinoma cell line, A-549. No significant differences were found between the patients with cervical cancer and the control women. Tumor bearers and patients treated for advanced cervical cancer showed a slight but non-significant increase in cytolytic activity on the A-549 line.

Cyclic adenosine monophosphate-phosphodiesterase (cAMP-PDE) in lymphocytes from patients with stage III and IV squamous cell carcinoma of the head and neck

In vivo skin tests using multiple recall and primary antigens such as dinitrochlorobenzine (DNCB) have established that there is decreased cellular-mediated immune response in patients with squamous cell carcinomas of the head and neck. In vitro testing of lymphocytes using blastogenic mitogens as a measure of lymphocyte function has not always shown a statistical difference between patients and controls.cAMP-PDE was assayed in lymphocytes from normal controls-patients with benign conditions in various age groups. No significant difference was found in the specific activity (Vmax) or affinity (Km) in these groups. The mean average was used as a normal control value. In lymphocytes from untreated patients with Stage III and IV squamous cell carcinomas of the head and neck, the Vmax and Km of cAMP-PDE were higher than the controls. This difference was statistically significant. Postoperative values were also determined byt were not statistically different. There were no differences found in blastogenesis in these two groups.

Serum antibodies to herpesvirus early antigens in patients with cervical carcinoma determined by anticomplement immunofluorescence technique

Sera from patients with carcinoma of the uterine cervix were used with the anticomplement immunofluorescence (ACIF) technique to develop a simple procedure for detection of antibodies to herpes simplex virus type 2 (HSV-2) early antigens. Test cells used in the ACIF assay were HEp-2 cells infected with HSV-2 sequentially treated with inhibitors of protein and of DNA SYNTHESIS. The cells were first treated for 7 h with cycloheximide (100 mug/ml) and then for 3 h with hydroxyurea (150 mug/ml). In this assay serum titers giving more than 21.5% ACIF-positive cells correlated to invasive carcinoma of the cervix. Using these criteria 18 out of 43 patients with invasive carcinoma, none of 8 patients with carcinoma in situ, and only 1 of 43 controls, were diagnosed as positive. Thus an elevated titer of antibodies against HSV-2 antigens correlated to cervical carcinoma.

Viral-specific humoral immunity to herpes simplex-induced antigens in patients with squamous carcinoma of the head and neck

Serum antibodies to herpes simplex virus-induced antigens (HSVIA) were quantitated in 122 patients with head and neck squamous carcinoma, 93 patients tumor-free after treatment for these malignant lesions, 27 patients with nonsquamous malignant lesions, 30 heavy smokers, and 36 nonsmokers. Serum IgA anti-HSVIA antibodies were detected in a greater percentage of sera of patients with squamous carcinoma (61 per cent), patients previously treated for these malignant lesions (56 per cent), and heavy smokers (57 per cent) than in patients with nonsquamous malignant lesions (11 per cent) or nonsmokers (8 per cent). Furthermore, titers of these antibodies were higher in patients with squamous carcinoma than in smokers. In patients tumor-free more than three years after treatment, the percentage of positive sera was significantly lower than that in untreated patients and in patients three years or less after treatment. This study demonstrates for the first time a high frequency of antibodies to HSV-induced antigens confined to subjects at high risk of developing head and neck squamous carcinoma and in patients with these malignancies as well as a correlation between the levels of these antibodies and clinical course after treatment.

Humoral immunity to herpes simplex viral-induced antigens in smokers

Antibodies to herpes simplex viral-induced antigens (HSVIA) were assayed by an indirect immunofluorescent technique in 93 regular cigarette smokers, 75 of whom also imbibed alcoholic beverages. Controls were 94 nonsmoking, nondrinking volunteers matched with the smoker for age and sex. IgA antibodies to HSVIA were detected six times more frequently in the sera of smokers than in nonsmoking controls, p less than .0005. IgG and IgM anti-HSVIA were detected with comparable frequencies in both groups, but the antibody titers were significantly higher in the smoking group than in controls, p less than .05. IgA anti-HSVIA was detected more frequently in smokers with 10 or more pack-years of cigarette exposure than in smokers with 10 or more pack-years of smoking (p less than .05) or in matched nonsmokers (p less than .02). IgA antibody titers to HSVIA were significantly higher in cigarette smokers who drank alcoholic beverages than in smokers who did not drink, p less than .025. This study demonstrates that cigarette smoking and the use of alcoholic beverages are associated with heightened humoral immunity to HSV-induced antigens in a population at high risk for development of squamous cell carcinomas of the head and neck region.

The effect of radiation-induced xerostomia on saliva and serum lysozyme and immunoglobulin levels

Saliva and serum lysozyme, immunoglobulin, albumin, and total protein levels were monitored in thirty patients with cancer of the head or neck before, during, and after radiotherapy and compared with those of a group of non-irradiated noncancer control subjects. The mean volume-based saliva lysozyme and total protein concentrations were significantly higher in the cancer patients before radiotherapy than in the control group. During radiotherapy, the mean volume-based concentrations of all protein components assayed increased as the saliva flow rate decreased. Protein-based ratios of saliva albumin, IgG, and lysozyme and the ratio of IgG/IgA increased as the xerostomia intensified. Ratios of saliva total protein and IgA to flow rate paralleled the flow rate decrease. Such increased concentrations in saliva immunoproteins were offset, however, by a greater than 93 per cent reduction in total saliva output. This reduced saliva output, therefore, resulted in an immunoprotein deficit. There were no significant differences between the mean serum lysozyme levels of the cancer and control groups at any point of comparison. The mean serum immunoglobulin concentrations in the cancer patients before radiotherapy were significantly higher than those in the control group. During radiotherapy, there was a decrease in the mean serum total protein, albumin, and immunoglobulin levels which reverted toward the pretreatment values during the postirradiation period.

Immunologic approaches to the diagnosis of cancer

A variety of immunologic approaches can be applied to the diagnosis of human cancer, and these have the potential advantages of specificity and sensitivity. Many tumor distinctive markers have been detected in the circulation of cancer patients. Cancer patients frequently have detectably depressed immune competence, but also have cell-mediated and humoral immune reactivity against tumor-associated antigens. Radiolabeling of specific antibodies may allow localization in vivo of tumors. With each of these potential immunodiagnostic approaches, it is necessary to systematically evaluate the assays and determine their value for specific clinical applications.

Correlation of tumor burden with in vitro lymphocyte reactivity and antibodies to herpesvirus tumor-associated antigens in head and neck squamous carcinoma

In 94 patients with squamous carcinoma of the head and neck region, the clinical extent of tumor was correlated with in vitro lymphocyte reactivity (LR) to phytohemagglutinin (PHA) and serum complement-fixing antibodies to herpes simplex virus (HSV)-induced tumor-associated antigen (TAA). Forty-six patients were tumor-bearing and 48 were considered cured. Controls were 41 age-matched normals with histories of similar cigarette consumption. In 15 patients with Stage I carcinomas of the larynx, among whom the tumor diameter was 5 mm or less, mean LR or PHA did not differ from controls and 7 of 11 tested (63%) had antibodies to HSV-TAA. In 83 patients with more extensive tumors, LR to PHA was significantly lower than controls and 42 of 44 tested (95%) had antibodies to HSV-TAA. In both groups, LR to PHA was similar among tumor-bearing and cured patients. The study delineates a clinical tumor burden associated with impaired LR to PHA and a high incidence of antibodies to HSV-TAA in patients with squamous carcinomas of the head and neck region, and shows a correlation between the immune defects in clinically cured patients and tumor extent prior to treatment.

Antibodies to herpesvirus nonvirion antigens in squamous carcinomas

Serums from tumor-bearing patients, cured patients, and normal subjects were examined for antibodies to the separated complement-fixing reactive components of nonvirion antigens of herpesvirus type 1 and type 2. The occurrence of antibodies to the antigens was similar in serums from tumor-bearing patients and cured patients. Antibodies to the antigens were observed among 21 of 24 (87 percent) cervical cancer cases, 44 of 49 (90 percent) laryngeal cancer cases, 15 of 24 (62 percent) cases of squamous cell carcinomas of the head and neck excluding the larynx, 2 of 24 (8 percent) nonsquamous cell cancer cases, and 3 of 51 (6 percent) normal subjects. By contrast, no differences were found in the titers of neutralizing antibodies to the virus in serums from laryngeal cancer patients and controls. The observations support an etiologic role of herpesviruses in cervical cancer and in laryngeal cancer, and possibly other squamous cell cancers of the head and neck.

Herpes simplex and herpes genitalis viruses in etiology of some human cancers

The results of complement fixation tests on 202 sera from people without cancer and from patients with cancer in 29 different areas of the body indicated that only those with nine varieties of advanced cancer (lip, mouth, oropharynx, nasopharynx, kidney, urinary bladder, prostate, cervix uteri, and vulva-all of 56 tested) gave positive specific reactions with nonvirion antigens induced by the DNA herpes simplex (HSV 1) and herpes genitalis (HSV 2) viruses. None of 57 people without cancer (including 10 with current and 18 with recurrent HSV 1 or HSV 2 infections), none of 81 patients with 20 other varieties of advanced cancer (gum, tongue, tonsil, salivary gland, accessory sinus, epiglottis, lung-bronchus, stomach, colon, breast, corpus uteri, ovary, testis, liver, thyroid, Wilms' embryonal kidney, melanoma, Hodgkin's disease, acute lymphocytic leukemia, and acute myelocytic leukemia), and none of four women with early malignant changes in the cervix uteri gave positive results. The seven patients with advanced cancer of the lip or oropharynx gave positive reactions with HSV 1 but not with HSV 2 nonvirion antigens (compatible with involvement of only HSV 1), all of the 13 women with advanced cancer of the cervix uteri and the one woman with advanced cancer of the vulva gave positive reactions with both HSV 1 and HSV 2 nonvirion antigens (compatible with involvement of only HSV 2), while among the 35 other positive patients only two (one with cancer of the kidney and one with cancer of the bladder) reacted with HSV 1 and not at all with HSV 2 nonvirion antigens. Positive sera failed to react with cells harvested at different times after high-multiplicity infection with the DNA vaccinia virus. Massive absorption of positive sera with trypsinized, uninfected human embryonic kidney cells failed to remove, or lower the titer of, the HSV 1 and HSV 2 nonvirion antibodies. All of these data taken together are interpreted as indicating that HSV 1 and HSV 2 play an etiologic role in certain human cancers, because they provide the kind of evidence by which virus-free experimental cancers can be proved to have been originally induced by such DNA viruses as polyoma, Simian Virus 40, or certain types of adenovirus.

Antibody to HSV-2 induced tumor specific antigens in serums from patients with cervical carcinoma

Antibody distinct from that involved in neutralization and directed to an antigen (AG-4) induced in HEp-2 cells by infection with herpesvirus type 2 was identified in serums from patients with cervical carcinoma by means of a quantitative micro complement fixation test. The presence of antibody to AG-4 correlates well with the extent of the tumor; antibody is virtually absent in matched control women and in women with therapy and without recurrent neoplasia. Reactivity is not observed with control antigen consisting of a cell extract prepared from uninfected HEp-2 cells. The possible prognostic significance of this antibody and its implications are discussed.