Improved detection reveals active β-papillomavirus infection in skin lesions from kidney transplant recipients

Mod Pathol. 2014 Aug;27(8):1101-15. doi: 10.1038/modpathol.2013.240. Epub 2014 Jan 3.

Abstract

The aim of this study was to determine whether detection of β-HPV gene products, as defined in epidermodysplasia verruciformis skin cancer, could also be observed in lesions from kidney transplant recipients alongside the viral DNA. A total of 111 samples, corresponding to 79 skin lesions abscised from 17 kidney transplant recipients, have been analyzed. The initial PCR analysis demonstrated that β-HPV-DNA was highly present in our tumor series (85%). Using a combination of antibodies raised against the E4 and L1 proteins of the β-genotypes, we were able to visualize productive infection in 4 out of 19 actinic keratoses, and in the pathological borders of 1 out of 14 squamous cell carcinomas and 1 out of 31 basal cell carcinomas. Increased expression of the cellular proliferation marker minichromosome maintenance protein 7 (MCM7), that extended into the upper epithelial layers, was a common feature of all the E4-positive areas, indicating that cells were driven into the cell cycle in areas of productive viral infections. Although the present study does not directly demonstrate a causal role of these viruses, the detection of E4 and L1 positivity in actinic keratosis and the adjacent pathological epithelium of skin cancer, clearly shows that β-HPV are actively replicating in the intraepidermal precursor lesions of kidney transplant recipients and can therefore cooperate with other carcinogenic agents, such as UVB, favoring skin cancer promotion.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Betapapillomavirus / chemistry
  • Betapapillomavirus / genetics
  • Betapapillomavirus / growth & development
  • Betapapillomavirus / isolation & purification*
  • Biomarkers, Tumor / analysis
  • Capsid Proteins / analysis
  • Carcinoma, Basal Cell / chemistry
  • Carcinoma, Basal Cell / pathology
  • Carcinoma, Basal Cell / virology*
  • Carcinoma, Squamous Cell / chemistry
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / virology*
  • DNA, Viral / isolation & purification*
  • Female
  • Hospitals, University
  • Human Papillomavirus DNA Tests*
  • Humans
  • Immunohistochemistry
  • Italy
  • Keratosis, Actinic / metabolism
  • Keratosis, Actinic / pathology
  • Keratosis, Actinic / virology*
  • Kidney Transplantation / adverse effects*
  • Male
  • Middle Aged
  • Minichromosome Maintenance Complex Component 7 / analysis
  • Oncogene Proteins, Viral / analysis
  • Papillomavirus Infections / pathology
  • Papillomavirus Infections / virology*
  • Polymerase Chain Reaction
  • Predictive Value of Tests
  • Risk Factors
  • Skin Neoplasms / chemistry
  • Skin Neoplasms / pathology
  • Skin Neoplasms / virology*
  • Virus Replication

Substances

  • Biomarkers, Tumor
  • Capsid Proteins
  • DNA, Viral
  • HPV L1 protein, Human papillomavirus
  • Oncogene Proteins, Viral
  • MCM7 protein, human
  • Minichromosome Maintenance Complex Component 7