Immunology of HPV infection and HPV-associated tumors

Based on neurobiological and development-psychological findings psychodynamic concepts for understanding compulsive disorders are supplemented and extended. A stimulus barrier impaired during development which in the early mother-child system normally develops into an autonomous and self-regulating ability has the consequence in compulsive disorders that the ability of drawing limits between reality and phantasy has only poor success. Based on case examples the function of the situation triggering the compulsive symptoms and the foreseeable relationship quality are examined on the different levels of development. Then it becomes clear how complex the originating conditions for compulsive disorders are, and under which conditions a primary object fails as original external psycho-neurobiological regulator in the development of autonomous self-regulation.     

Immunology and prevention of infection in feedlot cattle

This article reviews the basic types of immunity, the factors relevant to feedlot cattle that have been shown to suppress immune function, and what is known about the basis of protective acquired immunity against the common bovine respiratory pathogens. The characteristics and efficacy of vaccines for respiratory disease pathogens are also reviewed. Recommendations for optimizing vaccination are presented.     

Persistent papillomavirus infection in a cat

The purpose of this study was to further define the cellular response to titanium and polymethylmethacrylate (PMMA) particles in aseptic loosening, and to determine if the use of pamidronate may be effective in inhibiting bone resorption associated with this response. Macrophages and osteoblasts were cocultured to simulate the environment around an aseptically loose prosthesis. Macrophages were plated on the bottom of six well plates and osteoblasts were plated on culture dish inserts, and placed into the wells with the macrophages. Incubation of macrophages with PMMA in this system led to release of prostaglandin E (PGE2), granulocyte macrophage-colony stimulating factor (GM-CSF), and interleukin-6 (IL-6). Incubation with titanium led to release of tumor necrosis factor (TNF) and IL-6. Exposure of calvaria to media from cells exposed to either PMMA or titanium led to release of calcium 45. Incubation of calvaria with pamidronate was able to inhibit release of calcium 45 associated with exposure to the macrophage/osteoblast/particle conditioned medium. Bone resorption at the interface between implant and bone is a consistent feature leading to loosening of orthopedic implants. By inhibiting bone resorption associated with the inflammatory response to implant particulates, pamidronate or other bisphosphonates may have clinical utility in the treatment or prevention or aseptic loosening.     

Detection of human papillomavirus DNA and clinicopathological study of vulvar human papillomavirus infection

We studied 217 vulvar HPV infection patients by clinically, pathologically, and virologically. From 90.6% of the cauliflower-like vulvar lesions and 29.7% of the papillomatous and finger-like lesions, we detected HPV 6/11 DNA by dot blotting hybridization. The patients in 90.0% of the cauliflower-like group and 9.8% of the papillomatous and finger-like group had a high risk factor to intercourse with different sex partners (P < 0.0001). The pathological characteristics, nature history, and response to treatment were different. According to clinical, pathological, and virological findings divided three types: vulvar HPV infection type 1 (or condylomata acuminata), vulvar HPV infection type 2, and vulvar HPV infection type 3.     

Humoral immune response to human papillomavirus infection

Nematodes are known to be a useful system for studies of comparative development. Here we perform a molecular phylogenetic analysis to allow for the independent interpretation of the developmental and morphological changes observed among a selected set of nematode species. Our molecular phylogenetic analysis is based on coding regions of the genes for RNA polymerase II, the small subunit rRNA and an expansion segment of the large subunit rRNA. Sequences were compared from five species in the family (Rhabditidae) that includes the developmental model organism Caenorhabditis elegans and from an outgroup taxon Aduncospiculum halicti (Diplogasterina). The phylogenetic analysis does not support the monophyly of the subfamily Mesorhabditinae and identifies the unnamed strain PS1010 as a sister taxon of C. elegans despite its morphologically divergent buccal capsule. On the basis of the inferred framework, we can begin to interpret the evolution of vulval development and of morphological differences among these nematode species.     

Effect of HIV infection on the natural history of anal human papillomavirus infection

OBJECTIVE: To identify risk factors for the detection of prevalent and incident anal human papillomavirus (HPV) infection, and HPV persistence among HIV-seropositive and seronegative homosexual men. DESIGN: Longitudinal study of 287 HIV-seronegative and 322 HIV-seropositive men attending a community-based clinic. METHODS: Subjects underwent an interview and examination; specimens were collected for HIV serology and assessment of anal HPV and HIV DNA. RESULTS: Anal HPV DNA was detected at study entry in 91.6% of HIV-infected men, and 65.9% of men not infected with HIV. HPV detection was associated with lifetime number of sexual partners and recent receptive anal intercourse (HIV-seronegative men), decreased CD4+ lymphocyte count (HIV-seropositive men), and anal warts (all men). Among men negative for HPV at study entry, subsequent detection of HPV was associated with HIV, unprotected receptive anal intercourse, and any sexual contact since the last visit. Among men positive for HPV at study entry, subsequent detection of additional HPV types was more common among HIV-seropositive men. Becoming HPV negative during follow-up was less common among men with HIV or high HPV levels at study entry. Among those with HIV, HPV persistence was associated with presence of anal HIV DNA, but not with CD4+ lymphocyte count. CONCLUSIONS: Risk of anal HPV infection appears to increase with sexual exposure, epithelial trauma, HIV infection and immune deficiency. Incident infection may result from recent sexual exposure or reactivation of latent infection. Further studies are needed to elucidate the mechanism by which HIV DNA in the anal canal increases the risk of HPV persistence.     

Molecular methods for the detection of human papillomavirus infection

HPVs are small DNA tumor viruses with an icosahedral virion structure. All members of the genus cause diverse benign lesions, and some members promote the development of carcinoma. The viruses do not replicate in culture without extraordinary measures, and virtually all studies to date have used molecular methods to elucidate their biology and natural history. Tests of choice for detecting HPV from clinical specimens are based on nucleic acid probe technology. Until recently, most epidemiologic and molecular studies employed Southern blot (SB), dot blot (DB), and in situ hybridization (ISH). With the exception of ISH, which continues to have many uses and a strong following in the pathology community, SB and DB have been essentially replaced by polymerase chain reaction (PCR) and the Hybrid Capture System (HCS). These newer in vitro probe tests have proven to be accurate and robust workhorses for epidemiologic and clinical use. Automation promises to revolutionize HPV testing in the near future and will allow cost-effective mass screening worldwide.     

Anogenital papillomavirus infection and neoplasia in immunodeficient women

This article reviews the impact of infection with human immunodeficiency virus (HIV) on HPV infections and HPV-associated lesions of the female anogenital tract. Studies investigating HPV infections in HIV-seropositive women are presented as well as the possibility that HIV can influence HPV expression directly through molecular interactions between viral genes and indirectly through immunosuppression. Studies linking HIV infection to invasive cervical cancer and cervical intraepithelial neoplasia are reviewed; recommended protocols for cervical cancer screening in HIV-seropositive women for cervical disease also are presented.     

Immunohistochemical study on human papillomavirus infection of the vulva

Two hundred and sixteen cases of human papillomavirus infection of the vulva from 1984 to 1991 in the Affiliated Hospital of Qingdao Medical College were reviewed, and were immunohistochemically studied by ABC method to detect HPV-Ag. The results showed that the demonstration of diagnostic koilocytes is very important in diagnosis of HPV infection in routine tissue slides examination. But in cases of atypical morphological changes; when diagnostic koilocytes were not formed in early stage, the demonstration of brown color granules in the nuclei of prickle cells is very diagnostic for positive HPV infection. In occasional cases, the diagnostic koilocytes do not demonstrate brown color granules in their nuclei. The explanation is that HPV-Ag was exhausted during metabolism. Besides, the cell membrane of basal cells are stained with brown color granules, while the morphological changes of upper layers of squamous epithelium have not appeared yet, therefore, there were no HPV-Ag positive reactive cells. It is probably showed that the HPV-Ag is primarily formed and appeared in the cell membrane of basal cells.     

Perinatal transmission and maternal risks of human papillomavirus infection

We conducted a prospective study to investigate whether human papillomavirus (HPV) could be vertically transmitted to neonates. Pregnant women (N = 203) were tested for HPV DNA infection during the third trimester and again during labor prior to delivery. Their newborns (N = 203) were tested 1 to 3 days after delivery. Among the mothers, 12.3% (N = 25/203) typed HPV positive at either or both maternal specimen collection periods, whereas only 1.0% of the neonates (N = 2/203) typed positive. This low transmission rate may be due in part to the fact that 65% of mothers who were HPV positive during the third trimester tested HPV negative by labor/delivery. The higher frequency of risks associated with maternal HPV infection were similar to those found in studies of cervical dysplasia and cancer: younger age at first intercourse and first pregnancy, number of sexual partners, and longer duration in use of oral contraceptives. In addition, those who were past smokers and had a shorter recency and latency period in smoking were more likely to be detected with HPV.     

Psychological aspects of genital human papillomavirus infection: a preliminary report

Genital human papillomavirus (HPV) infection can lead to self-inflicted blame and hypochondriac fears as well as to problems with sexuality. The aim of this study was to assess the psychological and psychodynamic aspects of patients with widespread genital HPV infection entering into a clinical trial in which they were randomly assigned to three treatment groups: CO2 laser ablation, intramuscular interferon-alpha, CO2 laser ablation plus intramuscular interferon-alpha. Fifty-one patients were studied. Patients were asked to take a series of questionnaires which included a self-rating questionnaire for gathering information on sexuality, emotional relationship with the partner and social life. A visual analog scale was used to rate intensity of pain during sexual intercourse. Each patient went also through an in-depth interview with a clinical psychologist and filled out two personality tests to measure depression (CDQ = IPAT depression test) and anxiety (ASQ = IPAT anxiety test). Results indicated a high percentage of sexual impairments after therapy (28 cases), presence of fear of cancer (14 cases) and worsenings in the emotional relationship with the partner. No difference was found among groups of treatment.     

Morphologic manifestations of human papillomavirus infection in the vulvar and anogenital region

Out of 235 patients discharged from the Department of Thoracic Surgery, Silesian Medical Academy, after treatment of primary spontaneous pneumothorax between 1981 and 1993, 232 (98.7%) answered our questionnaire and so were included in the study. Mean follow-up time was 10.4 years. No recurrence of the disease was reported by any of 79 patients who had been treated by surgical procedure/thoracotomy plus pleurectomy/, but 21 (14.3%) out of 147 treated by paracentesis reported a recurrence of pneumothorax. In 17 patients the recurrence was the first-time case, in 3 the second-time, in 1 the third-time. Out of 232 patients, 10 (4.3%) had a recurrence of pneumothorax on the opposite side. Achieving expansion of the lung, 80% of the patients reported no problems at all. Only 6 (2.6%) of the whole group stated they could no longer work in their profession because of the pneumothorax they had suffered in the past.     

Prevalence of human papillomavirus infection and HPV DNA among male partners of Israeli women with genital premalignant and human papillomavirus lesions

The role of the males who are sexual partners of females with genital human papillomavirus (HPV) infection and premalignant lesions is explored in the present study. Within a period of 3 years, 391 females with genital premalignant and HPV-associated lesions were examined and treated at the Cervical Pathology Unit of the Tel Aviv Medical Center. The male partners of all the women were asked to attend this unit, and 322 of them responded. All participants underwent colposcopic examination of the anogenital area followed by colposcopically guided biopsies from the most representative lesions, when present, part of which included in situ hybridization (ISH) of HPV DNA sequences 6/11 and 16/18. The histological prevalence of HPV among the male partners was 86.6% (185 of 213 biopsies). Of the 48 couples who had ISH evaluations, the ISH could not identify any copy of HPV DNA in 58.3% of the males (28 cases) and 41.6% of the females (20 cases). Among the males, HPV 6/11 and 16/18 were found in 17 (35.4%) and 3 cases (6.2%), respectively, and among the females there were 23 (48.0%) and 5 cases (10.4%), respectively. Correlation of HPV DNA sequences 6/11 and 16/18 between the couples was found in six (12.5%) and in one (2.0%), respectively. These data do not support a direct contamination by the current male partner. The question of treating the male partner of a woman with genital HPV and premalignant lesions remains to be evaluated.     

Human papillomavirus infection in women. Special aspects of infectious diseases in women

These studies assess the quantity and morphology of the emitted aerosolized dose of irregularly shaped disodium cromoglycate particles in the fine particle fraction using in vitro methods. Disodium cromoglycate was treated with a homologous series of saturated fatty acids, between C8 and C18, in a range of concentrations. The products of these treatments were powders with a variety of particle size, shape, and aggregation characteristics. Samples of these powders were loaded in gelatin capsules, generated as aerosols from a Rotahaler and collected in a two-stage liquid impinger or eight-stage inertial impactor. Particles were examined directly by scanning electron microscopy and subsequently the images were analyzed to define morphology. The aerodynamic fine-particle fraction determined by the two-stage impinger increased approximately twofold with lauric acid treatment (0.0317 g/g, 6.7%) and threefold with stearic acid treatment (0.58 g/g; 9.7%) compared with disodium cromoglycate alone (0 g/g, 3.56%). The lauric acid formulation appeared to alter deposition primarily by changing particle morphology. Stearic acid altered particle shape to some extent and the increase in the fine-particle fraction appeared to be attributable to improved particle dispersion properties. The uncontrolled presence of irregular-shaped particles can introduce dosing errors due to effects on dispersion and aerodynamic behavior. Conversely, controlled particle morphology and size may be employed to optimize the dose delivered to the lungs particularly if particle-particle and particle-surface interactions can be minimized.     

Human papillomavirus infection and its relationship to recent and distant sexual partners

OBJECTIVE: To determine the relation between the detection of genital human papillomavirus (HPV) DNA and the number of new sexual partners in the last year, 1-5 years, and 5-10 years. METHODS: In a cross-sectional study, 298 women collected tampon specimens and completed self-answer questionnaires on the known risk factors for HPV infection, including the number of sexual partners during the last 1, 5, and 10 years. The tampons were analyzed for the presence of HPV DNA by polymerase chain reaction using L1 consensus primers. RESULTS: Ninety-two (30.9%) tampons were positive for HPV DNA. In univariate analysis, the presence of HPV DNA was associated with a younger age, single marital status, a previously abnormal or currently abnormal Papanicolaou smear, and one or more new sexual partners in the last year, 1-5 years, and 5-10 years. The presence of HPV DNA was not associated with education level, past pregnancy, current or past oral contraceptive use, or the age at first intercourse. In multivariate analysis, only the number of sexual partners during the last year and 1-5 years, and a previously abnormal Papanicolaou smear were associated with HPV. CONCLUSION: The presence of HPV DNA is best predicted by the number of new sexual partners in the last 5 years. Transiently detectable HPV DNA is one possible explanation for this observation.     

Immunology of malignant melanoma

Traditionally a homograft valve is used as a pulmonary replacement device for the Ross operation. Right ventricular outflow tract reconstruction during aortic valve replacement with an autograft was performed with stentless xenograft valves in nine patients. Hemodynamic performance is satisfying, but, long term evaluation is needed.     

Cervical intraepithelial neoplasia (CIN) and human papillomavirus (HPV) infection

Many studies have shown a strong correlation between CIN and HPV infection. Molecular biology has allowed identification of types of HPV which seem to be connected, more frequently than others, to dysplastic lesions. Physical state of HPV-genome seems to play an important role in the development of cervical cancer. In this study the HPV-genome has been searched in tissue specimens obtained from 34 women affected by CIN II and III. All patients underwent laser conization. Immediately before treatment, colposcopically directed biopsies of the cervical lesion and of the areas with no colposcopically apparent disease were taken and on these samples, HPV-DNA has been searched, isolated and analysed for HPV types and physical state. Histologic examination on cones showed 6 cases of CIN II (3 with HPV), 24 cases of CIN III (14 with HPV), 1 microinvasive carcinoma and 3 with no residual lesion. Southern blot analysis detected HPV-DNA in 4 cases of CIN II (16.7%) and in 20 cases of CIN III (70.6%). In 50% of CIN II and 85% of CIN III HPV 16 DNA has been found and in the remaining 50% of CIN II and 15% of CIN III HPV 31 DNA has been detected. All CIN II and 14 cases of CIN III showed episomal HPV-DNA. Integrated HPV-DNA has been found in 3 cases of CIN III and the other 3 cases of CIN III showed both integrated and episomal HPV-genome. Integrated form has been noticed only for HPV 16 type. In no case of colposcopically normal tissue has HPV-DNA been found. These data seem to confirm the strong correlation between HPV 16 type, which often has integrated form, and CIN III strengthening the hypothesis of its potential oncogenic action.