Estandarización de PCR en tiempo real para detección y cuantificación de los oncogenes E7 de seis Virus del Papiloma Humano de Alto Riesgo

El cáncer de cuello uterino es causado por la infección persistente del epitelio cervical con los genotipos de alto riesgo del Virus del Papiloma Humano. Para su detección se realizan pruebas moleculares que detectan el gen L1 del VPH. Este gen puede perderse hasta en el 11 % de los casos durante la integración del ADN viral en el genoma del hospedero originando falsos negativos. Por otra parte, el oncogén E7 se expresa durante todas las etapas de progresión de la enfermedad. El objetivo de este trabajo fue estandarizar una PCR en tiempo real del oncogén E7 (E7-qPCR) para genotipificación y cuantificación de 6 VPH-AR. Los resultados muestran que la E7- qPCR amplificó VPH-16, -18, -31, -33, -35 y -45 con una alta sensibilidad con límites de detección desde 102 copias, eficiencias entre 90 y 110 %, valores R2 > 0,97 y análisis de curva de fusión que revelan productos específicos.

Cervical cancer is caused by persistent infection of the cervical epithelium with the high-risk genotypes of the Human Papilloma Virus (HR-HPV). For its detection, molecular tests are carried out that detect the L1 gene of HPV. This gene can be lost in up to 11 % of cases during the integration of viral DNA into the host genome, causing false negatives. On the other hand, the E7 oncogene is expressed during all stages of disease progression. The aim of this work was to standardize a real-time PCR of the E7 oncogene (E7-qPCR) for genotyping and quantification of 6 HR-HPV. The results show that the E7-qPCR amplified HPV-16, -18, -31, -33, -35 and -45 with high sensitivity with detection limits from 102 copies, efficiencies between 90 and 110 %, R2 values >0,97 and melting curve analysis revealing specific products.

Assessment of the diagnostic value and prognosis of different detection markers in endocervical adenocarcinoma / 中华肿瘤杂志

Objective: To study the diagnostic value of different detection markers in histological categories of endocervical adenocarcinoma (ECA), and their assessment of patient prognosis. Methods: A retrospective study of 54 patients with ECA in the Cancer Hospital, Chinese Academy of Medical Sciences from 2005-2010 were performed. The cases of ECA were classified into two categories, namely human papillomavirus-associated adenocarcinoma (HPVA) and non-human papillomavirus-associated adenocarcinoma (NHPVA), based on the 2018 international endocervical adenocarcinoma criteria and classification (IECC). To detect HR-HPV DNA and HR-HPV E6/E7 mRNA in all patients, we used whole tissue section PCR (WTS-PCR) and HPV E6/E7 mRNA in situ hybridization (ISH) techniques, respectively. Additionally, we performed Laser microdissection PCR (LCM-PCR) on 15 randomly selected HR-HPV DNA-positive cases to confirm the accuracy of the above two assays in identifying ECA lesions. Receiver operating characteristic (ROC) curves were used to analyze the efficacy of markers to identify HPVA and NHPVA. Univariate and multifactorial Cox proportional risk model regression analyses were performed for factors influencing ECA patients' prognoses. Results: Of the 54 patients with ECA, 30 were HPVA and 24 were NHPVA. A total of 96.7% (29/30) of HPVA patients were positive for HR-HPV DNA and 63.3% (19/30) for HR-HPV E6/E7 mRNA, and 33.3% (8/24) of NHPVA patients were positive for HR-HPV DNA and HR-HPV E6/E7 mRNA was not detected (0/24), and the differences were statistically significant (P<0.001). LCM-PCR showed that five patients were positive for HR-HPV DNA in the area of glandular epithelial lesions and others were negative, which was in good agreement with the E6/E7 mRNA ISH assay (Kappa=0.842, P=0.001). Analysis of the ROC results showed that the AUC of HR-HPV DNA, HR-HPV E6/E7 mRNA, and p16 to identify HPVA and NHPVA were 0.817, 0.817, and 0.692, respectively, with sensitivities of 96.7%, 63.3%, and 80.0% and specificities of 66.7%, 100.0%, and 58.3%, respectively. HR-HPV DNA identified HPVA and NHPVA with higher AUC than p16 (P=0.044). The difference in survival rates between HR-HPV DNA (WTS-PCR assay) positive and negative patients was not statistically significant (P=0.156), while the difference in survival rates between HR-HPV E6/E7 mRNA positive and negative patients, and p16 positive and negative patients were statistically significant (both P<0.05). Multifactorial Cox regression analysis showed that International Federation of Obstetrics and Gynecology (FIGO) staging (HR=19.875, 95% CI: 1.526-258.833) and parametrial involvement (HR=14.032, 95% CI: 1.281-153.761) were independent factors influencing the prognosis of patients with ECA. Conclusions: HR-HPV E6/E7 mRNA is more reflective of HPV infection in ECA tissue. The efficacy of HR-HPV E6/E7 mRNA and HR-HPV DNA (WTS-PCR assay) in identifying HPVA and NHPVA is similar, with higher sensitivity of HR-HPV DNA and higher specificity of HR-HPV E6/E7 mRNA. HR-HPV DNA is more effective than p16 in identifying HPVA and NHPVA. HPV E6/E7 mRNA and p16 positive ECA patients have better survival rates than negative.

Establishment and identification of human immortalized keratinocytes stably expressing human papillomavirus type 16 E6/E7 gene / 中华皮肤科杂志

Objective:To construct human immortalized keratinocytes stably expressing human papillomavirus type 16 (HPV16) E6/E7 gene, and provide a cell model for studying mechanisms underlying HPV16 E6/E7-induced cell immortalization and malignant transformation.Methods:Primary human foreskin keratinocytes (HFKs) were isolated by sequential two-step enzymatic digestion. Cultured HFKs were stably transfected with a HPV16 E6/E7 gene-overexpressing lentiviral vector LV5-HPV16 E6/E7, and consecutively cultured for more than 30 passages. Then, immortalized keratinocytes were screened out and divided into 3 groups: (1) blank control group: second-passage primary HFKs; (2) experimental group: HFKs transfected with LV5-HPV16 E6/E7 at different passages, and the second-passage primary HFKs transfected with LV5-HPV16 E6/E7 were referred to as A0 cells, thereafter, the transfected HFKs were named according to their passage number, such as A1, A2, ... A30; (3) positive control group: the HPV16-positive cervical cancer cell line SiHa. Real-time fluorescence-based quantitative PCR (qRT-PCR) and Western blot analysis were performed to determine the mRNA expression of HPV16 E6/E7 and protein expression of HPV16 E6/E7 and CK14, respectively, in the blank control group, experimental group and positive control group. Cell counting kit-8 (CCK8) assay and Transwell insert invasion assay were conducted to assess the cellular proliferative and invasive activity. In vivo tumor formation experiment in nude mice was conducted to investigate the tumorigenicity of A30 cells in the experimental group and SiHa cells in the positive control group. Results:Primary HFKs were successfully isolated. After the primary HFKs were transfected with the recombinant plasmid LV5-HPV16 E6/E7, the blank control group showed no fluorescence in the cells, but showed senescent phenotypes after serial passages, while in the experimental group, the volume and morphology of A30 cells were similar to those of the primary HFKs with the proportion of fluorescence-positive cells being 100%. Compared with the blank control group, the experimental group showed significantly increased mRNA expression levels of HPV16 E6 and E7 in A1, A10, A20 and A30 cells (HPV16 E6: t = 7.12, 8.07, 6.53, 5.66, P < 0.001, < 0.001, = 0.001, = 0.005, respectively; HPV16 E7: t = 3.20, 4.29, 3.75, 4.22; P = 0.024, 0.008, 0.013, 0.014, respectively) . The protein expression of HPV16 E6/E7 was absent in the blank control group, but was observed in A30 and SiHa cells. CCK8 assay showed that the proliferative activity of A10, A20 and A30 cells was significantly higher than that of the blank control group ( t = 6.49, 7.55, 9.43, P = 0.003, 0.002, 0.001, respectively) , while there was no significant difference in the proliferative activity between A1 cells and the blank control group ( t = 2.40, P = 0.074) . Transwell insert invasion assay showed that A30 cells could not cross the basement membrane, but SiHa cells could pass through the basement membrane and were stained blue. Two months after the inoculation with A30 cells in the nude mice, no visible tumors were found, which was confirmed by a histological study. Subcutaneous tumors were formed in the nude mice after the inoculation with SiHa cells. Conclusion:Human immortalized keratinocytes were successfully established by lentivirus-mediated transfection with HPV16 E6/E7 gene, and can serve as an ideal cell model for HPV-related research.

Clinical analysis on the application value of human papillomavirus E6/E7 mRNA testing for screening under 30 years old / 中国医师进修杂志

Objective:To evaluate the clinical value of human papillomavirus (HPV) E6/E7 mRNA testing in cervical cancer screening under 30 years old.Methods:The clinical data of 330 young women (less than 30 years old) with minor abnormalities of thinprep cytologic test (TCT) screening for in Dalian Women′s and Children′s Medical Center (Group) Chunliu Region from January 2020 to June 2021 were retrospectively analyzed. Among them, 165 patients underwent HPV DNA typing test (DNA group), and 165 patients underwent HPV E6/E7 mRNA typing test (mRNA group). The positive rate of cervical intraepithelial neoplasia (CIN) Ⅱ and above (CIN Ⅱ +) was compared between two groups, and the positive rates of CIN Ⅱ + in different high risk HPV types. Results:The positive rate of high risk HPV types in mRNA group was significantly lower than that in DNA group: 32.7% (54/165) vs. 47.9% (79/165), and there was statistical difference ( χ2 = 7.87, P<0.05). There was no statistical difference in the incidence of CIN Ⅱ + of patients with positive of high risk HPV types between DNA group and mRNA: 45.6% (36/79) and 59.3% (32/54), P>0.05. There was no statistical difference in the incidence of CIN Ⅱ + of patients with HPV 16, 18 or 45 positive between DNA group and mRNA group: 38.5% (10/26) and 6/10, P>0.05. The incidence of CIN Ⅱ + of patients without HPV 16, 18 or 45 positive in mRNA group was significantly higher than that in DNA group: 60.9% (28/46) vs. 41.3% (26/63), and there was statistical difference ( P<0.05). Conclusions:Without increasing the rate of missed diagnosis, HPV E6/E7 mRNA testing plays an important shunt role in women under 30 years old, and the predicted value of CIN Ⅱ + is higher for patients who are not infected with HPV16/18/45 with HPV E6/E7 mRNA testing.

Presença do papilomavirus humano tipo 16 e expressão gênica da proteína p16ink4a e oncoproteína e7 no carcinoma colorretal / Hpv16 and expression of protein p16ink4a and e7 oncoprotein in colorectal carcinoma

RESUMO - INTRODUÇÃO: O papilomavírus humano (HPV) é agente das doenças sexualmente transmissíveis de maior prevalência no mundo que estão associadas ao câncer do colo do útero e canal anal. A ação do HPV na carcinogênese colorretal não está ainda estabelecida. OBJETIVO: Estudar a eventual correlação entre a presença do HPV tipo 16 e a expressão gênica da proteína p16INK4a e da oncoproteína E7 de HPV e de seus níveis no tecido do carcinoma colorretal. METODOS: Estudo retrospectivo caso-controle de 79 doentes com carcinoma colorretal divididos em dois grupos: HPV presente e HPV ausente. Foi realizada reação em cadeia da polimerase (PCR), além da hibridização do tipo dot blot para o HPV 16 e o HPV 18 Amostras do tecido colorretal também foram submetidas ao estudo imuno-histoquimico para avaliar o nível tecidual das proteínas E7 e p16INK4a. RESULTADOS: O HPV foi identificado em 36 (45,6%) casos. Não houve diferença significante entre os grupos quanto ao sexo (p=0,056), idade (p=0,1), localização cólica e/ou retal (0,098) e presença do HPV. A expressão gênica da oncoproteína E7 de HPV estava presente em 3,12% dos casos (p=0,9) e a expressão da proteína p16INK4a foi observada em 46,3% (p=0,27) dos indivíduos com detecção do HPV. CONCLUSÃO: A expressão gênica e os níveis teciduais da oncoproteína E7 e da proteína p16INK4a encontrados nos pacientes positivos para o HPV sugerem a ausência de atividade oncogênica do HPV tipo 16 no carcinoma colorretal.

ABSTRACT - BACKGROUND: Human papillomavirus (HPV) is the agent of the most prevalent sexually transmitted diseases in the world associated with cervix and anal canal cancer. The action of HPV on colorectal carcinogenesis is not yet established. OBJECTIVE: This research aimed to study the possible correlation between the presence of HPV16 and the gene expression of p16INK4a protein and HPV E7 oncoprotein and their levels in colorectal carcinoma tissue. METHODS: A retrospective case-control study of 79 patients with colorectal carcinoma was divided into two groups: HPV-positive and HPV-negative. The polymerase chain reaction was performed, in addition to dot-blot hybridization for HPV16 and HPV18. Colorectal tissue samples were also subjected to immunohistochemical study to assess the tissue level of E7 and p16INK4a proteins. RESULTS: HPV was identified in 36 (45.6%) cases. There was no significant difference between groups regarding gender (p=0.056), age (p=0.1), colic and/or rectal location (0.098), and presence of HPV. Gene expression of HPV E7 oncoprotein was present in 3.12% of cases (p=0.9), and p16INK4a protein expression was observed in 46.3% (p=0.27) of those selected with HPV detection. CONCLUSION: Gene expression and tissue levels of E7 oncoprotein and p16INK4a protein found in HPV-positive patients suggest the absence of HPV16 oncogenic activity in colorectal carcinoma.

Diagnostic value of serum miRNA-9-5p, miRNA-21-5p and miRNA-3923 in cervical cancer / 肿瘤研究与临床

Objective:To investigate the diagnostic value of serum miRNA-9-5p (miR-9-5p), miRNA-21-5p (miR-21-5p) and miRNA-3923 (miR-3923) in patients with cervical cancer.Methods:The data of 100 cervical cancer patients in Shanxi Provincial Cancer Hospital from July 2016 to June 2018 (the experimental group) and 100 healthy subjects (the healthy control group) during the same period were collected. The real-time fluorescent quantitative polymerase chain reaction (qRT-PCR) combined with probe hybridization was used to detect the expression levels of human papillomavirus (HPV) E6/E7 mRNA in paraffin-embedded tissues of patients with cervical cancer and in cervical exfoliated cells of the healthy control people. Ct value ≤ 40 cycles was considered as HPV E6/E7 positive. Serum samples from 3 patients with cervical cancer and 3 healthy people were taken out; microRNA (miRNA) Array was used to detect the expression level of 384 miRNA; the differential expression of miRNA was screened out and cluster analysis was performed, and then the screened miRNAs was verified by using qRT-PCR. Finally, the receiver operation characteristics (ROC) curves of screened miRNAs alone and HPV E6/E7 alone or the combination of three miRNAs and HPV E6/E7 in the diagnosis of cervical cancer were drawn to make comparison of diagnostic efficacy.Results:Among the paraffin-embedded tissues from 100 patients with cervical cancer, there were 65 cases (65%) HPV E6/E7 positive; in the healthy control group, HPV E6/E7 in cervical exfoliated cells of 100 people was negative. A total of 248 differentially expressed miRNAs were detected from the serum samples in 3 patients with cervical cancer and 3 healthy people. The cluster analysis finally identified 16 abnormally regulated miRNAs. qRT-PCR verification confirmed that differences in the expression levels of miR-9-5p, miR-21-5p and miR-3923 in the healthy control group and cervical cancer group were statistically significant (all P < 0.01), and then the three were selected to make diagnosis of cervical cancer. The expression levels of miR-9-5p, miR-21-5p and miR-3923 in HPV E6/E7 positive cervical cancer group were higher than those in the healthy control group (all P < 0.05), expression levels of miR-21-5p and miR-3923 in HPV E6/E7 negative cervical cancer group were increased ( P = 0.008, P = 0.038); expression levels of the three miRNAs in HPV E6/E7 positive group were higher than those in HPV E6/E7 negative group (all P < 0.05). ROC curve analysis showed that the area under the curve (AUC) of miR-3923 was the biggest (0.843), the specificity was the highest (82%, the cut-off value was 2.88) and the sensitivity of miR-21-5p was the highest (85%, the cut-off value was 4.08) when miR-9-5p, miR-21-5p and miR-3923 were respectively applied to diagnose the cervical cancer; AUC (0.924), the sensitivity and the specificity (85%, 94%; the cut-off value was 4.04) of the combination of the three indicators were higher than those of the single indicator in the diagnosis of cervical cancer. AUC was 0.766 when HPV E6/E7 was kused alone to diagnose. The diagnostic efficacy of HPV E6/E7 combined with miR-9-5p, miR-21-5p, miR-3923 respectively was further improved, the corresponding AUC was 0.914, 0.848, 0.932, respectively; the diagnostic efficacy of the combination of the four indicators was the highest (AUC was 0.942). Conclusion:miR-9-5p, miR-21-5p and miR-3923 may be helpful in the diagnosis of cervical cancer.

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.

Early Mitotic Inhibitor 1 Regulates DNA Re-replication Mediated by Human Papillomavirus Subtype 16 E7 in Response to DNA Damage / 中国医学科学院学报

To explore the molecular mechanism of human papillomavirus subtype 16(HPV-16)E7 oncogene-induced DNA re-replication in response to DNA damage. Flow cytometry was performed to examine the cell cycle changes in RPE1 E7 cells stably expressing HPV-16 E7 and its control cell RPE1 Vector after DNA damage.Immunoblotting assay was used to evaluate the early mitotic inhibitor 1(Emi1)expression in RPE1 E7 and RPE1 Vector cells with or without DNA damage.The changes of the proportion of polyploidy was detected by flow cytometry in DNA-damaged RPE1 E7 cells interfered by Emi1 small interfering RNA. Compared with the control cells,the proportion of polyploids in RPE1 E7 cells was significantly increased in response to DNA damage(=6.397,=0.0031).Emi1 protein expression was significantly increased in DNA damaged RPE1 E7 cells(=8.241,=0.0012).The polyploid ratio of RPE1 E7 cells was significantly reduced after Emi1 was interfered by two independent small interfering RNAs(=2.916,=0.0434;=3.452,=0.0260). In response to DNA damage,Emi1 promoted DNA re-replication caused by HPV-16 E7.

A new lignan from Gleditsiae spina / 药学学报

The chemical constituents from ethyl acetate extract of Gleditsiae spina were isolated and purified by various chromatographic methods such as MCI gel CHP-20, ODS, Sephadex LH-20, silica gel and semi-preparative HPLC. Seven lignans were isolated and identified by spectroscopic data analyses as (7R,8S,7'E,7''S,8''R)-buddlenol P (1), (+)-syringaresinol (2), (+)-isolariciresinol (3), (7S,8R)-cedrusin (4), (7S,8R)-4,9,9'-trihydroxy-3,3'-dimethoxy-7,8-dihydrobenzofuran-1'-propylneolignan (5), 3',4-O-dimethylcedrusin (6), balanophonin (7). Among them, compound 1 is a new lignan, compounds 2-7 are isolated from the Gleditsia L. for the first time. MTT method was used to investigate the effect of compounds 2-7 on LPS-induced injury of NRK-52e cells. As a result, compounds 2, 3 and 7 exhibit protective effects against LPS-induced damage to NRK-52e cells.

Prueba de concepto de una pcr multiplex de primera generación (cualitativa) para detección del oncogén e7 de vphs de alto riesgo

Introducción: Infección persistente con el virus de papiloma humano de alto riesgo (VPH-AR) causa cáncer de cuello uterino (CCU). Existen ensayos moleculares para la detección y la genotipificación del gen L1 de VPH, sin embargo, L1 puede perderse durante la integración viral. La expresión e integración del oncogén E7 es fundamental para el desarrollo de CCU. Objetivo: Estandarizar una PCR multiplex (mPCR) del oncogén E7 (E7-mPCR) para genotipificación de los VPH-AR de mayor frecuencia en CCU (VPH-16, -18, -31, -33, -45 y -52). Métodos: Se obtuvieron cepillados cervicales de voluntarias y se analizaron amplificando por PCR el gen L1 con subsecuente hibridación reversa. Posteriormente, se escogieron 59 muestras positivas para VPH-AR y se analizaron por E7-mPCR. Resultados: Se evidenció una elevada concordancia entre los resultados del ensayo E7- mPCR y los de la PCR de L1 (concordancia observada de 95,1%, Kappa de Cohen = 0,88), encontrándose mayor número de infecciones por VPH- AR en el 15,8% con E7-mPCR. Conclusión: E7-mPCR es una herramienta diagnóstica con alta concordancia y económica que puede adaptarse a una plataforma de mayor complejidad para procesar y detectar mayor cantidad de muestras y genotipos de VPH-AR.

Introduction: The persistent infection of the high-risk Human Papiloma Virus (VPH-AR in Spanish) causes uterine cervix cancer (CCU in Spanish). There are molecular essays for detection and genotyping of gen L1 of VPH. However, L1 may get lost during the viral integration. The expression and integration of oncogene E7 is fundamental for the development of CCU. Objective: To standardize a multiplex PCR (mPCR) of oncogene E7 (E7-mPCR) for genotyping the VPH- AR of highest frequency in CCU (VPH-16, -18, -31, -33, -45 y -52). Method: We obtained cervix brushing simples from volunteers and we analyzed them by amplifying the L1 gene through PCR with a subsequent reverse hybridization. After that, we chose 59 positive VPH- AR samples and we analyzed them for E7-mPCR. Results: We found out a high concordance between the results of the essay E7-mPCR and those of L1 PC (Observed concordance was of 95.1%, Cohen's Kappa = 0.88), and we revealed a higher number of infections for VPH-AR in a 15.8% with E7-mPCR. Conclusion: E7-mPCR is an economic diagnostic tool with high concordance which can be adapted to a platform with more complexity to process and detect a higher number of samples and VPH-AR genotypes.

Introdução: a infecção persistente com o virus de papiloma humano de alto risco (HPV-AR) causa cáncer de colo do útero (CCU). Existem ensaios moleculares para detecção e para a genotipificação do gene L1 de HPV; contudo, L1 pode ser perdido durante a integrado viral. A expressão e integração do oncogênese E7 é fundamental para o desenvolvimento do CCU. Objetivo: padronizar uma PCR multiplex (mPCR) do oncogênese E7 (E7-mPCR) para genotipificação dos HPV-AR de maior frequência no CCU (HPV-16, -18, -31, -33, -45 e -52). Métodos: foram realizadas raspagens com escova cervical rodada em voluntárias e foram analisadas a partir da amplificação do gene L1 por PCR com subsequente hibridação inversa. Em seguida, foram escolhidas 59 amostras positivas para HPV-AR, as quais foram analisadas por E7-mPCR. Resultados: foi evidenciada elevada concordância entre os resultados do ensaio E7-mPCR e os da PCR de L1 (concordância observada de 95,1%, Kappa de Cohen = 0,88), encontrando-se maior número de infecções por HPV-AR em 15,8% com E7-mPCR. Conclusão: E7-mPCR é uma ferramenta diagnóstica com alta concordância e económica que pode ser adaptada a uma plataforma de maior complexidade para processar e detectar maior quantidade de amostras e genótipos de HPV-AR.

A phase 1/2a, dose-escalation, safety and preliminary efficacy study of oral therapeutic vaccine in subjects with cervical intraepithelial neoplasia 3 / 부인종양

OBJECTIVE: Persistent infection of HPV increases the chance of carcinoma in situ of cervix through stages of cervical intraepithelial neoplasia (CIN) 1, 2, and 3, and finally progresses into cervical cancer. We aimed to explore the safety and efficacy of BLS-M07 which is orally administered agent expressing human papillomavirus (HPV) 16 E7 antigen on the surface of Lactobacillus casei in patients with CIN 3. METHODS: Patients with CIN 3 were recruited in our clinical trial. Reid Colposcopic Index (RCI) grading and serum HPV16 E7 specific antibody production were used to evaluate efficacy of BLS-M07. In phase 1, BLS-M07 was administered orally, 5 times a week, on weeks 1, 2, 4, and 8 with dosages of 500 mg, 1,000 mg, and 1,500 mg. In phase 2a, patients were treated with 1,000 mg. The primary endpoints were the safety and the pathologic regression on colposcopic biopsy. RESULTS: Nineteen patients were enrolled in the CIN 3 cohort. In phase 1, no patients experienced dose limiting toxicity. No grade 3 or 4 treatment-related adverse events or deaths were observed. At 16 weeks after treatment, RCI grading was improved and serum HPV16 E7 specific antibody production increased (p<0.05). Six of 8 (75%) patients with CIN 3 were cured in phase 2a. CONCLUSIONS: Oral immunization with BLS-M07 increases production of serum HPV16 E7 specific antibody which induces protective humoral immunity. The safety of this oral vaccine was proved and could be a competitive non-surgical therapeutic agent of CIN 3. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02195089

Application of AHPV and Its Genotyping in Low-grade Squamous Intraepithelial Lesions / 实用妇产科杂志

Objective:To investigate the application of Aptima high-risk human papillomavirus (HR-HPV) E6/E7 mRNA (AHPV) and its genotyping (GT) in the risk assessment of low-grade squamous intraepithelial lesions (LSIL).Methods:The AHPV and its genotype (AHPV-GT) incervical exfoliated cells were detectedin 529 women with LSIL.The DNA-Based Hybrid Capture 2 HPV Test (HC2-HPV), colposcopy and cervical biopsy were performedsimultaneously.Results:① In 529 patients with LSIL, the positive rate of HC2-HPV in the group of ＜30 years old was significantly higher than that in the group of ≥30 years old (92.2％ vs 83.6％, P=0.026).There was no significant difference in AHPV positive rate among different age groups (82.5％ vs 77.7％, P=0.284).No significant difference of the genotyping (AHPV-GT) was detected between the two groups, either.In the 529 cases, 83 cases of HSIL+were confirmed by histology.81 cases (97.6％) were AHPV positive in the patients with HSIL+;② Compared with other 11 positive types of HR-HPV, the incidence of HSIL+in GT+ women increased significantly (P＜0.05).In the group ≥30 years old, the OR value of HSIL+exposure risk of AHPV16 positive women was the highest (141.00), which was significantly higher than that of 18/45+, GT +, AHPV + (P=0.005, 0.000, 0.000).However, in the group of ＜30 years old, the OR value of HSIL+exposure risk of AHPV16 positive women was 8.50, which showed no significant difference from that of 18/45+ and AHPV-(P=1.000, 0.070).③ In group over 30 years old, the specificity of detecting HSIL+by AHPV was higher than that by HC2-HPV (P＜0.05).There was no significant difference in detection specificity between AHPV and HC2-HPV in women under 30 years old.Conclusions:AHPV and its GT detection are reliable methods for colposcopic screening and risk stratification in women aged over 30 years old with LSIL, more attention should be focused on AHPV16 positive.Better biological markers should be explored for younger women.

Diagnostic value of flow cytometry in detecting human papillomavirus E6／E7 mRNA in cervical lesions / 中国综合临床

Objective To explore the diagnostic value of flow cytometry in detecting HPV E6／E7 mRNA of human papilloma virus (HPV) in the diagnosis of cervical lesions. Methods From January 2017 to September 2018,119 women with suspected cervical lesions in the department of gynecology and obstetrics of Shanxi Maternal and Child Health Hospital were selected. Flow cytometry was used to detect HPV E6 ／ E7 mRNA in cervical exfoliated cells of women,and the DNA of HPV was detected by the method of hybrid capture 2 (HC2). Results 31. 09%(37／119) HPV E6／E7 mRNA and 57. 14%(68 ／ 119) HPV DNA were positive in 119 cases. The positive rate of HPV E6／E7 mRNA in cervical intraepithelial neoplasia ( CIN)2+ group was 77. 78%(28／36),which was statistically significant compared with 20. 00%(4／20) in CIN1 group (χ2＝15. 246,P＜0. 01),and was statistically significant compared with 7. 94%(5／63) in nilm group (χ2＝50. 286,P＜0. 01) . In nilm group,HPV E6 ／ E7 mRNA positive rate was 7. 94%(5／63) and HPV DNA positive rate was 30. 16%(19 ／ 63),which was statistically significant (χ2＝10. 088,P＝0. 001) . In cin1 group,HPV E6／ E7 mRNA positive rate was 20. 00%(4 ／ 20) and HPV DNA positive rate was

Application and clinical significance of human papilloma virus E6/E7 mRNA detection in cervical atypical glandular cells / 中国医师进修杂志

Objective To investigate the application and clinical significance of human papilloma virus (HPV) E6/E7 mRNA detection in cervical atypical glandular cells (AGC). Methods Four hundred and forty-five cervical AGC patients diagnosed by thin-layer liquid-based cytology in the Maternity Affiliated Hospital of Dalian Medical University from January 2014 to March 2018 were collected. Histological follow-up data and HPV E6/E7 mRNA detection results were analyzed, and histological differences in HPV E6/E7 mRNA positive and negative patients were compared. Results The histological result of 445 patients with cervical AGC showed that negative was in 306 cases (68.76%), and clinical significant lesion was in 129 cases (28.99%). In 445 patients with cervical AGC, HPV E6/E7 mRNA result was positive in 121 cases (27.19%), among whom the positive rate of HPV 16 and 18/45 type was 54.55% (66/121); HPV E6/E7 mRNA result was negative in 324 cases (72.81% ), including 13 non-cervical lesions. The negative rate of histological results in HPV E6/E7 mRNA negative patients was significantly higher than that in HPV E6/E7 mRNA positive patients: 91.05% (295/324) vs. 9.09% (11/121), and there was statistical difference (P＜0.01); the rates of adenocarcinoma in situ (AIS), high-grade squamous intraepithelial lesion (HSIL) and cervical adenocarcinoma of histological result in HPV E6/E7 mRNA positive patients were significantly higher than those in HPV E6/E7 mRNA negative patients: 40.50% (49/121) vs. 1.23% (4/324), 44.63% (54/121) vs. 1.23% (4/324), 3.31% (4/121) vs. 0.31% (1/324), and there were statistical differences (P＜0.01). The sensitivity of HPV E6/E7 mRNA in detecting clinical significant lesion of cervical AGC patients was 82.95% (107/129), the specificity was 95.57% (302/316), positive predictive value was 88.43% (107/121), and negative predictive value was 93.21% (302/324). Conclusions The histological result of cervical AGC shows that the amount of negative patients is significantly higher than clinical significant lesion. For cervical AGC patients with HPV E6/E7 mRNA negative results, conservative follow-up can be adopted after excluding extracervical lesions and fully assessing the risk of cervical lesions. However, the cervical AGC patients with HPV E6/E7 mRNA positive results need further examination to detect lesion and choose treatment earlier.

Human papillomavirus and genome instability: from productive infection to cancer

Infection with high oncogenic risk human papillomavirus types is the etiological factor of cervical cancer and a major cause of other epithelial malignancies, including vulvar, vaginal, anal, penile and head and neck carcinomas. These agents affect epithelial homeostasis through the expression of specific proteins that deregulate important cellular signaling pathways to achieve efficient viral replication. Among the major targets of viral proteins are components of the DNA damage detection and repair machinery. The activation of many of these cellular factors is critical to process viral genome replication intermediates and, consequently, to sustain faithful viral progeny production. In addition to the important role of cellular DNA repair machinery in the infective human papillomavirus cycle, alterations in the expression and activity of many of its components are observed in human papillomavirus-related tumors. Several studies from different laboratories have reported the impact of the expression of human papillomavirus oncogenes, mainly E6 and E7, on proteins in almost all the main cellular DNA repair mechanisms. This has direct consequences on cellular transformation since it causes the accumulation of point mutations, insertions and deletions of short nucleotide stretches, as well as numerical and structural chromosomal alterations characteristic of tumor cells. On the other hand, it is clear that human papillomavirus-transformed cells depend on the preservation of a basal cellular DNA repair activity level to maintain tumor cell viability. In this review, we summarize the data concerning the effect of human papillomavirus infection on DNA repair mechanisms. In addition, we discuss the potential of exploiting human papillomavirus-transformed cell dependency on DNA repair pathways as effective antitumoral therapies.

Analysis of the value of HPV E6/E7 mRNA detection in screening lesions at grade CIN 2 and above / 国际检验医学杂志

Objective To explore the clinical value of HPV E6/E7 mRNA in screening lesions at grade CIN2 and above.Methods A total of 120 cases with CIN and suspected cervical cancer treated in our hospital from January 2014 to September 2016 were selected.According to the results of pathological examination,60 patients with CIN2,CIN3 and invasive cancer were selected as the research group.60 patients with normal CIN1 and CIN1 were selected as control group.The results of TCT,HPV DNA and HPV E6/E7 mRNA were detected and analyzed.Results In 120 patients,the total positive rate of TCT was 55%,the total positive rate of HPV DNA was 87.5%,the total positive rate of HPV E6/E7 mRNA 60.8% HPV E6/E7;control group mRNA positive rate of 78.3% was significantly higher than the positive rate of HPV DNA 36.7%(P<0.05),HPV in the study group were E6/E7 mRNA positive rate of 85.0% was significantly lower than the positive rate of HPV DNA(96.7%);HPV E6/E7 mRNA CIN1,quantitative CIN2,CIN3 and invasive carci-noma were(4 867.31 ± 694.84),(8 943.51 ± 986.23),(28 243.10 ± 10 963.21),(3 610.84 ± 412.64)copies/mL;HPV E6/E7 mRNA quantitative CIN3 values were significantly higher than that of CIN 2,CIN1 and infil-tration of cancer and the control group(P<0.05),E6/E7 mRNA CIN2 quantitative HPV the value of CIN1 was significantly higher than that of control group(P< 0.05).Two methods of detecting HPV DNA and HPV E6/E7 mRNA in the screening of CIN2 and above lesions,the sensitivity of 84.5% DNA 93.8% HPV sensitivity was higher than that of HPV E6/E7 mRNA(P<0.05)HPV E6/E7 21.6%;specificity the speci-ficity of mRNA was 53.6% higher than that of HPV DNA(P<0.05),HPV DNA.HPV ROC curve E6/E7 mRNA were 0.581 and 0.681,the difference was statistically significant(P<0.05).Conclusion The specific-ity and accuracy of HPV,E6/E7 and mRNA in detecting cervical lesions over CIN2 and above are higher than those of HPV and DNA.It is of certain diagnostic value for screening cervical lesions over CIN 2 and above.

Preliminary study on the role of protein HPC2 in the regulation of HPV16 infected cervical cancer cells / 重庆医学

Objective To study the effect of human homologue of polycomb 2 (HPC2) on the growth of cervical cancer cells siha and the regulation of E7 gene.Methods HPC2 and E7 genes of siha cells were silenced by siRNAs respectively.Detected the expression of HPC2 gene and protein in siha cell lines after E7 gene silencing,cell proliferation activity and the rate of cell apoptosis.Results The expressions of HPC2 mRNA and protein were decreased in siha cells with E7 gene silencing,cell proliferation was inhibited,and apoptosis was increased,which was similar to HPC2 gene silencing.Conclusion HPC2 may be involved in the regulation of cell proliferation and apoptosis,and its expression may be closely related to E7 gene in SiHa cells.

O papel da autofagia no estresse oncogênico promovido por HRASG12V em queratinócitos humanos imortalizados por E6E7 / The role of autophagy in the face of the oncogenic stress triggered by HRASG12V in human keratinocytes immortalized by E6E7

RAS é a oncoproteína mutada mais encontrada em tumores sólidos, o que mostra seu grande potencial transformador. Não obstante, células que carregam essa mutação apresentam estresse oncogênico gerado por excessiva sinalização mitogênica, o que direciona preferencialmente as células portadoras para a morte em detrimento da transformação maligna. Basicamente a transformação direcionadapela proteína RAS mutada age sinergicamente com deficiência em supressores de tumor para evitar o destino celular preferencial frente ao estresse oncogênico. Este é o caso da interação observada entre HRASG12V e E6E7 de HPV, sendo que a infecção pelo vírus aparentemente é condição necessária em cânceres cervicais e muito presente em cânceres de cabeça e pescoço. A sinergia entre HRASG12V e queratinócitos imortalizados por E6E7 desequilibra o balanço homeostático entre subsistemas pró-morte, devido ao estresse oncogênico, ou pró-sobrevivência, que garante viabilidade por meio de novos padrões de robustez celular. Em ambos os casos, o processo que gera uma célula transformada, ou as elimina pelo caminho, apresenta pistas de vulnerabilidades às quais os queratinócitos são expostos uma vez que carreguem tal combinação de fatores. Apresentamos nesse trabalho os principais atores que compõem o estresse oncogênico deletério desencadeado pela atividade de HRASG12V: estresse mitogênico, replicativo e oxidativo; todos eles são responsáveis por provocar dano no DNA, que por sua vez promove parada no ciclo celular até que as células não possam mais suportar tamanha injúria, o que acaba levando-as maciçamente a morte. Mostramos que a alta intensidade mitogênica gerada pela atividade de HRASG12V provoca um desequilíbrio metabólico que leva ao aumento de espécies oxidantes e ao estresse replicativo. Todavia, um tratamento exógeno com o antioxidante NAC restaurou parcialmente a proliferação celular assim como a sobrevivência, agindo como um amenizador do dano no DNA gerado pelas espécies oxidantes. Já uma suplementação com nucleosídeos exógenos restaurou fortemente a sobrevivência celular, sugerindo que o desequilíbrio metabólico pode estar agindo no pool de nucleotídeos, o que poderia ser uma das causas do estresse replicativo. Como mecanismo intrínseco de sobrevivência, a autofagia se intensifica em resposta ao desequilíbrio sistêmico desencadeado pela atividade de HRASG12V. Por meio de sublinhagens defectivas para autofagia, mostramos que o processo retarda o aparecimento de espécies oxidantes, além de evitar sua elevação a níveis ainda mais drásticos, o que consequentemente ameniza o dano no DNA observado. Além disso, hipotetizamos que o processo poderia também estar contribuindo fortemente para a reciclagem de substratos básicos tais como nucleotídeos, assim acarretando em menor estresse replicativo. Na literatura atual, debate-se a noção de que, dependendo do contexto celular, a autofagia poderia promover tanto morte celular como transformação maligna. Entretanto, nesta tese mostramos que, na interação entre queratinócitos, E6E7 e HRASG12V, a autofagia é um mecanismo pró-sobrevivência: se por um lado a demanda autofágica é recrutada além de sua capacidade de processamento, fazendo com que seu fluxo seja bloqueado, por outro a eliminação do sistema se torna demasiadamente deletério, direcionando as células expostas ao estresse oncogênico causado pela atividade de HRASG12V necessariamente à morte.

Mutated RAS is the oncoprotein most found in solid tumors, which shows its huge tumorogenic potential. Despite of that, mutated RAS triggers a strong oncogenic stress, which very often drives cells to death instead of malignant transformation. Basically, the success of the Ras malignant transformation driving activity depends on a synergy between that mutated protein and inhibition of tumor suppression genes. This is the case of the interaction between HRASG12V and E6E7 proteins of HPV: It seems that HPV infection is an initial necessary condition for cervical cancer development and is also very frequent in head and neck carcinomas. The synergy between HRASG12V and E6E7, in pre-malignant keratinocytes, imbalances the homeostasis between pro-death subsystems, due oncogenic stress, and pro-survival subsystems that ensure new patterns of cellular robustness. In both cases, the process responsible for generating a malignant transformed cell or, more frequently, eliminating those cells carrying the combined characteristics, exposes the keratinocytes vulnerabilities. We showed in this work that the main actors of deleterious oncogenic stress triggered by HRASG12V activity are: Mitogenic, replicative and oxidative stresses; all of them induce DNA damage, hence cell cycle arrests until the cell cannot resist such injury any further, which leads to massive cell death. The intense mitogenic activity triggered by HRASG12Vcauses metabolic imbalance, which is responsible for an increase of oxidative species and replicative stress levels; the exogenous treatment with antioxidant NAC partially restored cell growth and cell survival, acting as a softener of the DNA damage caused by oxidative species. On the other hand, nucleoside supplementation strongly restored cell survival, suggesting that the aforementioned metabolic imbalance might be acting in the pool of nucleotides, hence it might be a possible cause of replicative stress. As an intrinsic survival mechanism, the autophagy is intensified in response to systemic imbalance triggered by HRASG12V activity. Through the autophagy defective subline, we showed that that mechanism both delays the increase of oxidative species and avoids their elevation to catastrophic highlevels. Furthermore, autophagy could strongly contribute to the recycling of basic substrates such as nucleotides, which might be mitigating the replicative stress. Nowadays, there is a debate on the role of autophagy promoting either malignant transformation or cell death depending on metabolic context. In this work, we showed an instance of the interaction between E6E7 and HRASG12V triggering autophagy pro-survival mechanisms and hence increasing general cell viability

Expression of E7 protein in the cervical tissues from patients with persistent infection with HPV16 variant / 实用医学杂志

Objective To explore the differences and similarities of the cervical lesions and mechanism between Asian variant E6 T178G and European variant E6 T350G, A442C and other variants. Methods We selected 300 clinic or hospitalized patients in our hospital during the period of May 2011 to October 2012. Cervical exfoliated cells were harvested by Thinprep cytologic test (TCT). A PCR sequencing assay was performed to detect HPV16 E2, E6 and E7 gene variants. One year later, the test was repeated. The patients with persistent infection underwent cervical biopsy by colposcopy for pathological examination. SP immunohistochemical method was applied to detect E7 protein expression level in all the patients. Results After one year, of 292 patients who were successfully sequenced, 259 were chronic cervicitis, 32 were cervical intraepithelial neoplasia grade I (CINI), and one was cervical intraepithelial neoplasia grade II (CINII). E7 protein expressed in each variant. But the expression of E7 protein in patients with different variant infection had no significant difference from each other. Conclusions E7 protein may be play a role in the early stages of HPV16?induced cervical lesions. But E7 protein may not be a reference index of the different carcinogenic mechanism between different HPV16 variants.