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Dual detection of human herpesvirus-6 and human papillomavirus type 16 and 18 in cervical carcinoma

Yadav M, Padmanathan A, Arivananthan M

J Obstet Gynaecol, 1997 Jan;17(1):86-7.
PMID: 15511780

Introduction It is widely accepted that certain 'high risk' human papillomavirus (HPV) genotypes, particularly HPV 16 and 18 are aetiological agents in the development of neoplasia of the uterine cervix. The long latent period between initial HPV infection and emergence of carcinoma suggests that HPV alone is insufficient for malignant transformation and additional factors are required for the progression of HPV infected cells to a neoplastic phenotype. Cells with integrated HPV express viral E6 and E7 oncoproteins which are crucial for immortalisation of epithelial cells via their action on host p53 protein. It is therefore of particular interest to elucidate the molecular mechanisms that alter the expression of E6/E7 proteins during HPV-associated tumorigenesis. Recently, human herpesvirus-6 (HHV-6) has been shown to infect a HPV-immortalised cervical epithelial cell line and transactivate HPV 18 promoters, upregulating gene expression of E6 and E7 HPV oncoproteins (Chen et al., 1994; DiPaolo et al., 1994). HHV-6, first isolated from peripheral blood mononuclear cells of patients with AIDS and lymphoproliferative disorders, is the causative agent of exanthem subitum, heterophile-negative infectious mononucleosis and other febrile illnesses. HHV-6 has recently been detected in oral carcinomas (Yadav et al., 1994). HHV-6 also contains DNA sequences which can transform epithelial cells in culture.
HHV-6 antigen and viral DNA detected in cervical cells from archived tissue using histochemical staining and hybridization

Yadav M, Arivananthan M, Kumar S

Clin Diagn Virol, 1996 Oct;7(1):23-33.
PMID: 9077427

BACKGROUND: Human herpesvirus type 6 (HHV-6), an ubiquitous virus, is the causative agent for exanthem subitum. The virus is frequently associated with lymphoproliferative disorders and other diseases. Recently, we have reported the frequent presence of HHV-6 in oral carcinoma and the present study extends the observation to cervical carcinoma.
OBJECTIVE: To examine the presence of HHV-6 in cervical carcinoma.
STUDY DESIGN: Formalin-fixed, paraffin-embedded cervical carcinoma tissues were examined for the presence of HHV-6 by immunohistochemistry using two monoclonal antibodies that react to HHV-6-encoded p41/38 and gp116/64/54. In situ hybridization with variant-specific probes were used to type the HHV-6 DNA sequences present.
RESULTS: A total of 14/26 (53.9%) carcinoma tissue specimens and 5/8 (62.5%) normal tissue specimens were positive for viral antigens. In situ hybridization studies revealed the presence of HHV-6 DNA sequences in 10/26 (38.5%) carcinoma tissue specimens and 1/8 (12.5%) normal tissue specimens. In the normal tissue, the HHV-6 was present in the endocervical ciliated columnar-epithelial cells and some cells in the subepithelial mucosa but in the carcinoma, the transformed cells were positive for the virus.
CONCLUSIONS: HHV-6 viral proteins and DNA were found in more than one third of the cervical tissue examined suggesting possible viral expression in these tumours. The significance of the distribution and role of the HHV-6 in cervical tissue remains unclear. Since HHV-6 has an oncogenic potential, the virus may cooperate with other transforming agents for the progression of the disease.
Detection of HHV-6 genotypes by in situ hybridization with variant-specific oligonucleotide probes

Arivananthan M, Yadav M, Kumar S

J Virol Methods, 1997 Jun;66(1):5-14.
PMID: 9220385

Human herpesvirus-6 exists in two forms, HHV-6A which has not been clearly associated with any disease, and HHV-6B, the causative agent of exanthem subitum. The two variants have been distinguished by techniques such as dot blotting and restriction fragment length polymorphism of PCR products. This study aims to establish the prevalence of HHV-6A and HHV-6B in carcinoma tissues using variant-specific oligonucleotide probes. A total of 73 archived carcinoma biopsies from the oral, salivary gland, larynx, breast and cervix were obtained with seven histologically normal controls. In situ hybridization was carried out with nonradioactively labelled variant-specific probes. Samples that hybridized with both variant A and B probes were subjected further to nested PCR and digested with HindIII to distinguish the variants. A hybridization signal was observed in 76.2% of oral carcinoma tissue and 75.0% of salivary gland carcinoma tissue. In contrast, only 33.3% of cervical carcinoma tissue were positive for HHV-6 DNA. A hybridization signal was noted in all 4 laryngeal carcinoma tissues studied. However, the 10 breast carcinoma tissues studied were negative, as was the histologically normal tissue. The virus possesses tumourigenic potential and demonstrates virus transactivating properties. The frequency of HHV-6 variants in certain tumours suggest a cofactorial role in multistep carcinogenesis. While PCR amplifies selectively the predominant variant in a sample, this was not seen by in situ hybridization. The in situ hybridization technique allowed the localization of both HHV-6A and HHV-6B in the nuclei of transformed regions.
Human herpesvirus-6 (HHV-6) DNA and virus-encoded antigen in oral lesions

Yadav M, Arivananthan M, Chandrashekran A, Tan BS, Hashim BY

J Oral Pathol Med, 1997 Oct;26(9):393-401.
PMID: 9385576

Archival oral tissues comprising 51 squamous cell carcinomas, 18 non-malignant lesions and 7 normal mucosa samples were investigated for human herpesvirus-6 (HHV-6)-encoded antigens and HHV-6 DNA. The virus-specific antigens were detected by an immunohistochemical method using monoclonal antibodies. Two further techniques used for HHV-6 DNA detection included the polymerase chain reaction (PCR) with virus-specific primers and in situ hybridization using digoxigenin-labelled oligonucleotides specific for HHV-6A and HHV-6B genotypes. A high proportion (79-80%) of the squamous cell carcinomas were positive for HHV-6 with the various detection methods. In cases of lichen planus and leukoplakia a high prevalence rate (67-100%) was noted with in situ hybridization and immunohistochemical techniques but a lower proportion (22-33%) was detected with the PCR method. All 7 normal tissues tested were negative for HHV-6. The HHV-6 variant B was found in 60% of the oral carcinoma tissues analysed. The study demonstrates the frequent presence of HHV-6 in neoplastic and non-malignant lesions of the oral cavity. While the role of HHV-6 in oral mucosal tissues remains to be determined, the in vitro tumorigenic potential of the virus suggests a possible role in the etiopathogenesis of oral lesions.