ABSTRACT
The aim of this study was to identify recurrent respiratory papillomatosis patients who may benefit from interferon (IFN)-alpha treatment and to determine the means of IFN-alpha action. The presence of human papillomavirus (HPV) and viral load and proliferation rate in pre-, ongoing and post-treatment respiratory papillomatosis biopsies were examined retrospectively in 25 patients, 18 of whom were IFN-alpha treated and seven of whom were IFN-alpha non-treated. Using PCR, HPV was found to be present in 20/25 respiratory papillomatosis patients and HPV type was determined for 18/25 patients (12 HPV6 and six HPV11). Eighteen of the patients were treated with IFN-alpha, 14 of whom were HPV positive (eight HPV6, five HPV11 and one undefined HPV). Response to IFN-alpha therapy was observed in 12 patients (7/8 HPV6, 3/5 HPV11, 1/1 undefined HPV and 1/4 HPV negative), while six patients (1/8 HPV6, 2/5 HPV11 and 3/4 HPV negative) did not respond to therapy. Viral load, determined by quantitative real-time PCR (between 0.03 and 533 HPV copies per cell), and proliferation rate, determined as the percentage of Ki-67-positive cells (between 8 and 54 %), were similar in IFN-alpha-treated and non-treated patients and were generally unaffected by IFN-alpha treatment. In summary, most (12/18) IFN-alpha-treated patients responded to therapy. Moreover, there was a tendency for patients with HPV6-positive (7/8) respiratory papillomatosis to respond more frequently to IFN-alpha therapy than patients with HPV11 (3/5) or HPV-negative (1/4) respiratory papillomatosis. Finally, the presence of HPV and viral load and proliferation in respiratory papillomatosis biopsies was similar in patients treated or not with IFN-alpha and were in general unaffected by IFN-alpha treatment.
Subject(s)
Antiviral Agents/therapeutic use , Interferon-alpha/therapeutic use , Neoplasm Recurrence, Local/drug therapy , Papillomaviridae/isolation & purification , Papillomavirus Infections/drug therapy , Respiratory Tract Neoplasms/drug therapy , Adolescent , Adult , Aged , Biopsy , Child , Child, Preschool , DNA, Viral/analysis , Female , Finland , Humans , Infant , Male , Middle Aged , Neoplasm Recurrence, Local/virology , Papillomaviridae/genetics , Papillomavirus Infections/virology , Respiratory Tract Neoplasms/virology , Retrospective Studies , Sweden , Viral LoadABSTRACT
One prominent activity of Interferons (IFNs) is their ability to induce cell cycle arrest, and this effect has furthermore been proposed to be of major importance in mediating the clinical antitumor activity of IFNs. In several IFN sensitive established cell lines, a rapid upregulation of the cyclin dependent kinase inhibitor p21 occurs following IFN-alpha treatment, and is thought to play a major role as an effector for this phenomenon by triggering further events. The aim of this study was to investigate how these previous findings in established cells lines correlate with clinical material. We therefore, analyzed how IFN-alpha influences the cell cycle distribution, by analysis of cellular DNA content, and the level of various cell cycle regulatory proteins by Western blot analysis, in primary leukemic cells. In 5 of 10 examined acute myeloid leukemia samples and in 1 of 6 chronic lymphocytic leukemia sample a clear increase in p21 protein levels was detected following treatment with IFN-alpha, while p21 protein levels were unaffected by IFN treatment in any of the examined acute lymphoblastic leukemia samples. In our total material consisting of 21 patient samples all other cell cycle regulatory proteins studied (p27, Cyclin E, Cdk2), were largely unaffected by IFN treatment. These results confirm that IFN-alpha can act as a potent regulator of Cdk-inhibitor expression, and that the induction of p21 seems to be a primary event in IFN-alpha mediated cell cycle regulation.
