Contributions of viral oncogenes of HPV-18 and hypoxia to oxidative stress and genetic damage in human keratinocytes

Infection with high-risk human papillomaviruses like HPV-16 and HPV-18 is highly associated with the development of cervical and other cancers. Malignant transformation requires viral oncoproteins E5, E6 and E7, which promote cell proliferation and increase DNA damage. Oxidative stress and hypoxia are also key factors in cervical malignant transformation. Increased levels of reactive species of oxygen (ROS) and nitrogen (RNS) are found in the hypoxic tumor microenvironment, promoting genetic instability and invasiveness. In this work, we studied the combined effect of E5, E6 and E7 and hypoxia in increasing oxidative stress and promoting DNA damage and nuclear architecture alterations. HaCaT cells containing HPV-18 viral oncogenes (HaCaT E5/E6/E7-18) showed higher ROS levels in normoxia and higher levels of RNS in hypoxia compared to HaCaT parental cells, as well as higher genetic damage in hypoxia as measured by γH2AX and comet assays. In hypoxia, HaCaT E5/E6/E7-18 increased its nuclear dry mass and both cell types displayed marked heterogeneity in nuclear dry mass distribution and increased nuclear foci. Our results show contributions of both viral oncogenes and hypoxia to oxidative stress, DNA damage and altered nuclear architecture, exemplifying how an altered microenvironment combines with oncogenic transformation to promote tumor progression.

Artificial Intelligence for Image Analysis in Oral Squamous Cell Carcinoma: A Review

Head and neck tumor differential diagnosis and prognosis have always been a challenge for oral pathologists due to their similarities and complexity. Artificial intelligence novel applications can function as an auxiliary tool for the objective interpretation of histomorphological digital slides. In this review, we present digital histopathological image analysis applications in oral squamous cell carcinoma. A literature search was performed in PubMed MEDLINE with the following keywords: "artificial intelligence" OR "deep learning" OR "machine learning" AND "oral squamous cell carcinoma". Artificial intelligence has proven to be a helpful tool in histopathological image analysis of tumors and other lesions, even though it is necessary to continue researching in this area, mainly for clinical validation.

Mechanical profile of human keratinocytes expressing HPV-18 oncogenes

During tumorigenesis, the mechanical properties of cancer cells change markedly, with decreased stiffness often accompanying a more invasive phenotype. Less is known about the changes in mechanical parameters at intermediate stages in the process of malignant transformation. We have recently developed a pre-tumoral cell model by stably transducing the immortalized but non-tumorigenic human keratinocyte cell line HaCaT with the E5, E6 and E7 oncogenes from HPV-18, one of the leading causes of cervical cancer and other types of cancer worldwide. We have used atomic force microscopy (AFM) to measure cell stiffness and to obtain mechanical maps of parental HaCaT and HaCaT E5/E6/E7-18 cell lines. We observed a significant decrease in Young's modulus in HaCaT E5/E6/E7-18 cells measured by nanoindentation in the central region, as well as decreased cell rigidity in regions of cell-cell contact measured by Peakforce Quantitative Nanomechanical Mapping (PF-QNM). As a morphological correlate, HaCaT E5/E6/E7-18 cells displayed a significantly rounder cell shape than parental HaCaT cells. Our results therefore show that decreased stiffness with concomitant perturbations in cell shape are early mechanical and morphological changes during the process of malignant transformation.

Human papillomavirus type 18 E5 oncoprotein cooperates with E6 and E7 in promoting cell viability and invasion and in modulating the cellular redox state

BACKGROUND

High-risk human papillomaviruses (HR-HPVs) are the etiological agents of cervical cancer. Among them, types 16 and 18 are the most prevalent worldwide. The HPV genome encodes three oncoproteins (E5, E6, and E7) that possess a high transformation potential in culture cells when transduced simultaneously. In the present study, we analysed how these oncoproteins cooperate to boost key cancer cell features such as uncontrolled cell proliferation, invasion potential, and cellular redox state imbalance. Oxidative stress is known to contribute to the carcinogenic process, as reactive oxygen species (ROS) constitute a potentially harmful by-product of many cellular reactions, and an efficient clearance mechanism is therefore required. Cells infected with HR-HPVs can adapt to oxidative stress conditions by upregulating the formation of endogenous antioxidants such as catalase, glutathione (GSH), and peroxiredoxin (PRX).

OBJECTIVES

The primary aim of this work was to study how these oncoproteins cooperate to promote the development of certain cancer cell features such as uncontrolled cell proliferation, invasion potential, and oxidative stress that are known to aid in the carcinogenic process.

METHODS

To perform this study, we generated three different HaCaT cell lines using retroviral transduction that stably expressed combinations of HPV-18 oncogenes that included HaCaT E5-18, HaCaT E6/E7-18, and HaCaT E5/E6/E7-18.

FINDINGS

Our results revealed a statistically significant increment in cell viability as measured by MTT assay, cell proliferation, and invasion assays in the cell line containing the three viral oncogenes. Additionally, we observed that cells expressing HPV-18 E5/E6/E7 exhibited a decrease in catalase activity and a significant augmentation of GSH and PRX1 levels relative to those of E5, E6/E7, and HaCaT cells.

MAIN CONCLUSIONS

This study demonstrates for the first time that HPV-18 E5, E6, and E7 oncoproteins can cooperate to enhance malignant transformation.

The Asian-American variant of human papillomavirus type 16 exhibits higher activation of MAPK and PI3K/AKT signaling pathways, transformation, migration and invasion of primary human keratinocytes

Asian-American (AA) HPV-16 variants are associated with higher risk of cancer. Abnormal activation of intracellular signaling play a critical role in cancer development and progression. Our aim was to elucidate mechanisms underlying the higher oncogenic potential attributed to AA variant. We evaluated activation of MAPK and PI3K/AKT pathways in primary human keratinocytes (PHKs) transduced with E6/E7 of three HPV-16 variants: E-P, AA, E-350G. Phenotypes examined included migration, anchorage independent growth and invasion. AA PHKs presented the highest levels of active proteins involved in all cascades analyzed: MAPK-ERK, MAPK-p38 and PI3K-AKT. AA PHKs were more efficient in promoting anchorage independent growth, and in stimulating cell migration and invasion. MEK1 inhibition decreased migration. The mesenchymal phenotype marker vimentin was increased in AA PHKs. Our results suggest that MEK1, ERK2, AKT2 hyperactivation influence cellular behavior by means of GSK-3b inactivation and EMT induction prompting AA immortalized PHKs to more efficiently surpass carcinogenesis steps.

Effect of genetic ancestry on leukocyte global DNA methylation in cancer patients

BACKGROUND

The study of genetic variants alone is not enough to explain a complex disease like cancer. Alterations in DNA methylation patterns have been associated with different types of tumor. In order to detect markers of susceptibility for the development of cutaneous melanoma and breast cancer in the Uruguayan population, we integrated genetic and epigenetic information of patients and controls.

METHODS

We performed two case-control studies that included 49 individuals with sporadic cutaneous melanoma and 73 unaffected controls, and 179 women with sporadic breast cancer and 209 women controls. We determined the level of global leukocyte DNA methylation using relative quantification of 5mdC by HPLC, and we compared methylation levels between cases and controls with nonparametric statistical tests. Since the Uruguayan population is admixed and both melanoma and breast cancer have very high incidences in Uruguay compared to other populations, we examined whether individual ancestry influences global leucocyte DNA methylation status. We carried out a correlation analysis between the percentage of African, European and Native American individual ancestries, determined using 59 ancestry informative markers, and global DNA methylation in all participants.

RESULTS

We detected global DNA hypomethylation in leukocytes of melanoma and breast cancer patients compared with healthy controls (p < 0.001). Additionally, we found a negative correlation between African ancestry and global DNA methylation in cancer patients (p <0.005).

CONCLUSIONS

These results support the potential use of global DNA methylation as a biomarker for cancer risk. In addition, our findings suggest that the ancestral genome structure generated by the admixture process influences DNA methylation patterns, and underscore the importance of considering genetic ancestry as a modifying factor in epigenetic association studies in admixed populations such as Latino ones.

[Demonstration of the effect of estrogen and progesterone receptors on survival in breast cancer without cytostatic and hormonal treatment in a small set of patients]

BACKGROUND

With respect to diagnostic and therapeutic progress, it may occur that the statistical sets of patients evaluated and treated with uniform methods are small. As a consequence, it is meaningful to check a greater number of statistical approaches. It is suitable to verify whether, for instance, the differences between the results (+) and (++) for estrogen and progesterone receptors (ER and PR) in breast cancer have an effect on the length of survival. This question could be answered with the use of several Kaplan-Meier survival curves. However, it is also profitable to judge the simple graph of survival in dependence on receptor concentration. Nevertheless, traditional regression brings too great an error to this method of assessment. Therefore, the use of orthogonal regression is much more precise. Since it can be assumed that no non-revealable micro-metastases were present at the time of operation in some patients with N0, it is possible to achieve healing ad integrum of them using only simple surgery. Consequently, we concluded that it was necessary to exclude from the evaluation the group of patients in N0 surviving 10 years (in the search for evidence of the post-operative impact of age-based reduction of blood estrogen on survival).

DESIGN AND SUBJECTS

We verified these considerations when monitoring the ER and PR influence on overall survival. We performed this analysis in an approximately 2-year sample of 74 female patients who received the described treatment in Pardubice hospital. At the time of operation, 56 were postmenopausal and 21 of these postmenopausal patients were in stage N1.

METHODS AND RESULTS

ER and PR in breast tumours were examined in the cytosol of operational biopsies. Adjuvant radiological treatment was used in addition to the surgical treatment of primary tumours and their original and post-operative metastases. In the case of premenopausal patients with ER, (+) therapeutic sterilization was performed. The finding of higher ER in postmenopausal surviving patients (in comparison to dead ones) was below the boundary of statistical significance. Also, longer survival in cases of higher ER concentrations in the group of dead N1 patients was below the boundary of statistical significance in the use of traditional regression. Therefore, we put together evidence from the group of surviving patients with evidence from the group of dead patients. In the case of N1 patients surviving 10 years, we rounded their survival period to 15 years for inclusion in the graph of survival dependence on ER. In the case of the combined (premenopausal with postmenopausal) group, statistical reliability appeared for longer survival of higher ER already in traditional regression. However, for the postmenopausal alone, the difference was statistically insignificant. Nevertheless, if we used orthogonal regression (similar to Deming regression) instead of traditional regression, then the reliability of the dependence of the length of survival on ER increased (in the last cited graph) to such a degree that it was statistically highly significant (at the level of 0.001) even in case of just postmenopausal patients. The same level of statistical reliability was achieved in the Kaplan-Meier analysis. Also in the case of PR--the higher concentrations of this receptor in survivors compared to dead patients were not statistically significant. But (in contrast to ER) in the case of PR, we observed a statistically significant increase in survival time depending on the receptor concentration within the group of only the dead patients--hence without putting them together with the surviving patients).

CONCLUSIONS

The graph of the Kaplan-Meier analysis is more frequently used when solving these problems but the graph of simple dependence of survival on receptor concentration should not be neglected either because, for example, it better shows the difference in survival between ER(+) and (++). Nevertheless, it is necessary to use orthogonal regression in it. The greater suitability of PR and ER for short-term and long-term prognosis, respectively, which we identified in our statistical set, is in concordance with the literature.

What happens to children with PDD when they grow up? Prospective follow-up of 219 children from preschool age to mid-childhood

OBJECTIVE

To describe the psychological development of children with pervasive developmental disorders over a period of 3 years and to identify the factors linked to their developmental paths.

METHOD

The study was a collaborative and prospective follow-up study of 219 preschoolers. Retrospective data and enrollment data were collected at the beginning of the study and 3 years later.

RESULTS

We observed high variability in the short-term outcomes of preschoolers. In line with previous research, our results showed that intellectual, linguistic and adaptive functioning were useful for predicting outcome. The severity of a child's autistic symptoms appears to be related to his or her future development. These variables can therefore be used as predictors of outcome for preschoolers with autism.

CONCLUSION

Developmental and symptom changes in young children with autism should not be overlooked and need to be assessed regularly in view of choosing suitable servicing programs.

Ratio of concentrations of estrogen receptors to progesterone receptors (ER/PR) in the cytosol of breast cancers (stratification by forming of groups differing in PR)

The ratio of cytosol concentrations of estrogen receptors to progesterone receptors (ER/PR) can help at the diagnosis of the excessive production of estrogens or (on the contrary) of the lowered function of ER or of the too small expression of the PR gene. We divided the statistical set into the groups with the approximately same concentrations of PR for stronger judgement of this ratio because PR is nearly not changing due to the age (in contrast to the age unstable ER). We used this stratification into the PR-limited groups at the radio-receptor analysis of 147 patients. 1) The ER/PR quotient was higher in the older patients but predominantly it was approximately 10-times lower in case of the high PR than in case of the low PR. This is why the more than 10-fould error can arise at uncorrected judgement whether ER of some patient is inadequately high or low in the comparison with her PR. It implies that e.g. in case of any one patient it is possible to infer the excessive production of ER from the comparison of her ER/PR--best only in the range of her PR-limited group (and in the addition taking account of the age). It can be important for therapy and prognosis. 2) The interpersonal differences of ER and ER/PR were approximately 10-times smaller in PR-limited groups than in the whole statistical set. This is why e.g. the correlation coefficients of the age increase of ER and ER/PR in the PR-limited groups were more favourable than in the whole non-stratified statistical set. In case if PR decreases in the higher age in case of some authors, it is necessary to create the PR-limited groups by another manner. For instance, 20 % of the tumors with the highest PR from each age group will be in the same PR-limited group (despite the fact that they differ in PR). The impact of the age will be then more marked in case of ER/PR than in case of ER only because the numerator elevates and denominator decreases. The impact of the ovarian cycle might be detected more sensitively on the same principle. It is possible to analyse by this manner the possibility to transform the receptor results to the average age or to the optimal phase of the ovulation cycle to prevent e.g. the false negativity of ER. The principles of this mathematical approach might be exploited even for a judgement of the prognosis and therapy on the basis of the mutual ratio of different isotypes of receptors for one hormone only (ERalpha / ERbeta or PRA / PRB). It concerns not only the breast cancers but also the cancers of the uterus.

[Paul Girard and the left-handed]

Paul Girard's original theory of left handedness and of its relationship with stuttering, writer's cramp, and obsessive compulsive disorders is described and connected with its historical background.

[René Allendy and the medicine of the imponderables]

René Allendy was one of the first French psychoanalysts. He was also a homeopath. A text by him on the "medicine of the imponderables" demonstrates his proximity to esoteric theories. The objective of this article is to illustrate a cultural misunderstanding at the time of the introduction of psychoanalysis in France, when it met up with a Gnostic and Illuminist heritage that was still very much alive. This initial confusion between the Freudian approach, which was in keeping with the thinking of the Lumières, and a certain obscurantism, explains perhaps some of the resistance as well as some of the subsequent deviations of psychoanalysis in France.

Social behaviour in pervasive developmental disorders: effects of informant, group and "theory-of-mind"

Theory of mind skills and a range of social behaviour in everyday life were assessed in a sample of 21 children with pervasive developmental disorders and 22 normally-developing preschoolers. Parents, teachers and therapists were interviewed using the Vineland Adaptive Behaviour Scales and a new supplementary scale, the "Echelle d'Adaptation Sociale pour Enfants" (EASE). Teachers and therapists were able to differentiate subtle forms of social problems in everyday life between subgroups of children diagnosed later to have either autism (n = 13) or PDDNOS (n = 8), according to DSM-III-R (1) criteria. This study offers a (small) cross-cultural replication of recent work suggesting that differences in the mentalising skills of children with autism are reflected in the everyday social behaviour of this group. A significant effect of informant was found for the PDD group, and this effect was particularly pronounced when children with autism were considered separately. The implications of informant differences are discussed.

[Institutional treatment of schizophrenics today.]

This article suggests that the solution to treating schizophrenia can only be found in an institution. The author reaches this conclusion after pointing out the disastrous effects on patients of a poorly-understood liberating theory and the misguided emphasis on social skills and readaptation at the expense of patient care. The author uses his vast knowledge acquired in clinical work to discuss his argument and lay out the conditions needed to make institutional treatments possible.

[Community psychiatry. Evaluation and research perspectives]

The author deals with 3 possible types of epidemiological studies in community mental health services: studies on the efficiency measuring the difference between the objectives of each team and the results; studies on the distribution between the teams and within each team, institutionalised models and implicit defensive modalities elaborated by the staff against the fear of the insane; studies on the populations considered at risk by psychoanalytical theories en vogue (depressive mothers, relationship anomalies). These studies would have the advantage to limit the "etiopathogenic pretentions" in psychiatry and avoid the "realistic slide" of imaginary constructions (myths or fiction of origin) which the community health service psychiatrist needs to work with but which has only an uncertain relationship with historical truth.

[Fear of the mad.]

The author shows us that, apart from a physical fear that we may experience at times, there exists a more subtle and destructive fear of the insane which determined - and still determines in many circumstances - the attitudes and even the policies which we advocate in regard to the mentally ill. The fear of being overcome, of being consumed by the avidity, the hate, and the projective identification which exist in the psychotic. In the face of this fear we have developed a series of rather inadequate and inefficient defense mechanisms which range from the denial of insanity to institutiona-lization and include all forms of activism and intolerance. In the end, however, this fear must not create in us a state of helplessness nor an oppressive reaction of omnipotence. Perhaps all that is necessary is simply to continue to listen to oneself and others?

[Elements of a theory of psychiatric care]

According to traditional psychiatric care, hospitalisation is indicated as soon as a schizophrenic patient presents an acute episode. If one, on the contrary, tries to apply psychiatric crisis intervention in the home of the patient, it seems very useful, in order to make people aware of the family's dynamics, to observe the psychological transactions related to the medication.