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Case Study on
Human
Papillomavirus
Teresa Dominguez
LaTasha Hardy
Francisca Mata
Case Study Overview
25-five-year-old carpenter
Several hyperkeratotic papules (warts) on
Palm inside of index finger
Do not change size
Cause only minimal discomfort
Spontaneously disappear after a year
What are Warts?
Non-cancerous skin growths in the epidermis
Caused mostly by HPV-1, 2 and 4
Usually skin-colored and feel rough to the
touch
Several types:
Common warts
Foot (planar) warts
Flat warts
Fig. 1 HPV infecting the
epidermis
Fig. 2 More extreme case of
common warts.
Question I
Will this virus infection spread to
other body parts?
Transmission via contact
Infection of basal cells of epidermis
Breach in the skin predisposing factor
There is a possibility of spreading warts to other
parts of your body through breaks in the skin.
Question II
After its disappearance, is the infection
likely to be completely resolved
or persist in the host?
Immunocompetent persons:
Once infected with a specific HPV type,
it is unlikely
Immunosuppressed persons:
Can present with numerous treatment
resistant warts
Recurrent infections with same HPV
type
Question III
What viral, cellular, and host conditions regulate
the replication of this virus and other HPV’s?
• The Virus
– icosahedral particle, 72
capsomers
– Closed, circular dsDNA
computer colorized EM
image of Papillomavirus
capsid
Genomic organization of HPV-16
– Replicates and assembles in the nucleus
– Dependent on:
DNA Replication
• transcription is tightly regulated by the differentiation state
of the infected epithelial cell
DNA Replication
QIV:
How would the papilloma type causing this
infection be identified?
What is known
Disease
HPV type
Common warts
2, 7
Plantar warts
1, 2, 4
Flat cutaneous warts
3, 10
Anogenital warts
6, 11, 42, 43, 44, 55 and
others
Genital malignancies
16, 18, 31, 33, 35, 39,
45, 51
Epidermodysplasia
verruciformis
more than 15 types
Focal epithelial
hyperplasia (oral)
Oral papillomas
13, 32
6, 7, 11, 16, 32
Detection Methods
•
•
•
•
Clinical Recognition
PCR and RT-PCR
PCR Cloning and Sequencing
Standard enzyme linked immunosorbent
assay (ELISA)
• Histological Analysis
QV:
Is it likely that this type of HPV is
associated with human cancer?
• This type of HPV is not associated
with human cancer
• HPV-2 (hand warts)
• Common skin wart
• Does not cause genital warts
• Not associated with development of
cancer
Which types of HPV are
associated with cancer?
15 classified as “high-risk”
HPV Strains:
o 16,18,31,33,35,39,45,51,52,56,58,59,68,73,
&82
o 16 & 18 cause 70% of cervical cancers
o 2 types of cervical cancer (squamous
cell cancer and adenocarcinoma)
HPV and Cancer
oAnal cancer, vulvar cancer, penile
cancer, and throat cancer
o3 classified as probable high-risk
(HPV-26,53, &66)
o12 classified as “low-risk” (HPV6,11,40,42,43,44,54,61,70,72,81,
&CP6108)
HPV- Induced Cancers
http://HPV_tree_1.png
References
Antonsson, A, et.al. The Ubiquity and Impressive Genomic Diversity of Human Skin Papillomaviruses
Suggest a Commensalic Nature of These Viruses. J. Virol. 2000. Vol. (74)
Centers for Disease Control and Prevention. 2007 Human Papillomavirus: HPV Information for Clinicians
(Brochure). Washington, DC. April 2007
Desante, C., and Demeret, C. Control of papillomavirus DNA replication and transcription. Seminars in Cancer
Biology, 1996: (51): 339–347
Kari, I. et. al. Antisense RNA directed to the human papillomavirus type 16 E7 mRNA from herpes simplex
virus type 1 derived vectors is expressed in CaSki cells and downregulates E7 mRNA. J. Virol.
2007, 4:47
Kingsley K, Johnson D, O’Malley, S. Transfection of oral squamous cell carcinoma with human
papillomavirus-16 induces proliferative and morphological changes in vitro. Cancer Cell Int. 2006
May 22;6:14
Lambert, P. Papillomavirus Replication. J. Virol. 1991, (65):3417-3420.
Lehtinen, M. Serologically diagnosed infection with human papillomavirus type 16 and risk for subsequent
development of cervical carcinoma: nested case-control study. BMJ 1996;(312):537-539
McBride AA, Romanczuk H, Howley PM. The Papillomavirus E2 Regulatory Proteins. J Biol Chem 1991 Oct.
266(28); 18411-18414
Mino T, Mori T, Aoyama Y, Sera T. Development of protein-based antiviral drugs for human papillomaviruses.
Nucleic Acids Symp Ser (Oxf). 2007; (51):427-8
Reddout, N. et. al. High Risk HPV types 18 and 16 are potent modulators of oral squamous cell carcinoma
phenotypes in vitro. Infect Agent Cancer. 2007 Nov. 14;2(1):21
Stanley, MA. et. al. HPV: From infection to cancer. Biochem Soc Trans. 2007 Dec;35(Pt 6): 1456-60.
Walboomers, JM, Jacobs MV, Manos MM, et. al. Human papillomavirus is a necessary cause of invasive cervical
cancer worldwide. J Pathology. 1999 Oct. 189(1):12-9
Werness BA, Levine AJ, Howley PM. Association of human papillomavirus types 16
and 18 E6 proteins with p53. Science 1990 Apr 6; 248(4951):76-9.
http://en.wikipedia.org/wiki/Human_papillomavirus
http://www.gsbs.utmb.edu/microbook/ch066.htm
http://www.healthscout.com/ency/68/384/main.html
http://www.medicinenet.com/genital_warts_in_women/article.htm
http://www.oncolink.upenn.edu/types/article.cfm?c=6&s=17&ss=131&id=9531
http://www.oralcancerfoundation.org/facts/humanpapillomavirus.htm
THANK YOU!