Human papillomavirus infection and skin cancer risk in organ transplant recipients
Human papillomavirus infection and skin cancer risk in organ transplant recipients
复制标题
DOI：
10.1046/j.0022-202x.2001.00048.x
复制
发表时间：
2001-12-01
影响因子：
--
通讯作者：
ter Schegget, J
中科院分区：
文献类型：
--
作者：
Bavinck, JNB;Feltkamp, M;ter Schegget, J
疣和鳞状细胞癌是器官移植受者的重要皮肤并发症。人乳头瘤病毒（HPV）感染在皮肤鳞状细胞癌发生中的作用尚不清楚。在器官移植受者的良性、癌前病变和恶性皮肤病变中可以检测到一组极其多样化的HPV类型，主要包括疣状流行病学发育不良（EV）相关的HPV类型。通常，在单一皮肤活检中存在多种HPV类型。通常，移植后病毒性疣的患病率稳步上升，HPV诱导的疣的数量与皮肤癌的发展之间存在强烈的关联。从移植到疣的发展之间的间隔明显短于从移植到诊断出第一次皮肤癌的间隔。然而，对有和无皮肤癌的移植受者的比较显示，两组患者角化性皮肤病变中EV-HPV DNA的患病率同样高，角化过度性乳头状瘤、光化性角化病和鳞状细胞癌中HPV感染的检出率和谱也相似。HPV DNA经常可以在患有过度增殖性疾病如银屑病的患者中检测到，而在具有再生皮肤的患者中检测到针对HPV的抗体（例如，大面积二度烧伤后）。EV-HPV的潜伏感染似乎很普遍。毛囊区可能是EV-HPV的储存库。来自一系列皮肤HPV类型的E6蛋白有效地抑制响应于UV光诱导的损伤的细胞凋亡。因此，可以想象，感染EV-HPV的个体发生光化性角化病和鳞状细胞癌的风险增加，这可能是由于长期阻止UV光诱导的细胞凋亡。
Warts and squamous cell carcinomas are important cutaneous complications in organ transplant recipients. The role of infection with human papillomaviruses (HPV) in the development of cutaneous squamous cell carcinoma is stiff unclear. An extremely diverse group of HPV types, mainly consisting of epidemiodysplasia-verruciformis (EV)-associated HPV types, can be detected in benign, premalignant, and malignant skin lesions of organ transplant recipients. Frequently, there are multiple HPV types present in single skin biopsies. Typically, the prevalence of viral warts rises steadily after transplantation and a strong association exists between the number of HPV-induced warts and the development of skin cancer. The interval between the transplantation to the development of warts is clearly shorter than the interval from transplantation to the diagnosis of the first skin cancer. A comparison of transplant recipients with and without skin cancer, however, showed an equally high prevalence of EV-HPV DNA in keratotic skin lesions in both groups of patients and the detection rate and spectrum of HPV infection in hyperkeratotic papillomas, actinic keratoses, and squamous cell carcinomas was also similar. HPV DNA can frequently be detected in patients with hyperproliferative disorders like psoriasis and antibodies against HPV in patients with regenerating skin (e.g., after extensive second degree burns). Latent infection with EV-HPV seems to be widespread. The hair follicle region might be the reservoir of EV-HPV. The E6 protein from a range of cutaneous HPV types effectively inhibits apoptosis in response to UV-light induced damage. It is therefore conceivable that individuals who are infected by EV-HPV are at an increased risk of developing actinic keratoses and squamous cell carcinomas, possibly by chronically preventing UV-light induced apoptosis.