Detection of HPV infection in the oral cavity of Hispanics with and without periodontal disease

描述（由申请人提供）：美国（US）和全球HPV阳性口咽癌的发病率不断上升，是一个重大的公共卫生问题。在美国，估计47%（约6500万）的30岁以上成年人患有牙周病。这是令人担忧的，因为研究表明，慢性牙周炎与全身健康状况有关，包括口腔癌。评估局部口腔因素对口腔HPV自然史的作用的研究缺乏制定有效预防策略的关键信息。鉴于缺乏研究评估慢性口腔炎症对口腔HPV感染自然史的作用，评估一般人群中口腔HPV感染的患病率，基因型和相关性是更好地了解这种感染的负担及其与口腔恶性肿瘤的潜在作用的一步。目前的横截面 这项研究将利用超重成人纵向研究（SOALS）已经建立的基础设施，这是一项由NIH资助的正在进行的队列研究，共有1，214名年龄在40-65岁之间的西班牙裔成年人居住在波多黎各的圣胡安大都市区，旨在设计和实施一项横断面研究，以开始解决所描述的差距。具体而言，我们建议选择600名参加SOALS的非机构成年人的随机子样本，以评估口腔HPV感染的患病率和类型分布（总体，高风险和并发多种类型），并评估HPV感染与牙周病严重程度之间的关联。对于目前的研究，牙周病和口腔HPV检测的评估将使用经验证的NHANES方法进行。口腔HPV感染的危险因素的措施将收集使用音频计算机辅助自我访问（ACASI）的方法，收集敏感的风险行为数据的有用工具。将从母研究中获得牙科评估、选定的社会人口学特征、体重指数、生活方式、病史和牙科史以及生化检测的数据。对于HPV分型，将使用38种类型特异性探针和两种单独的混合物（包括致癌和非致癌HPV类型）通过斑点杂交对PCR产物进行分型。据我们所知，这是第一项研究，将评估口腔HPV感染的频率在西班牙裔成年人牙周病和没有。选定的研究人群将为我们提供一个独特的高危人群，牙周病和口腔HPV感染都将更高。因此，我们可以以合理的成本高效率地研究这种联系。如果在无癌症个体中的纵向研究证实牙周病增加了口腔HPV感染的风险，则可以制定预防性公共卫生策略，因为牙周病筛查可以识别口腔HPV感染和口腔癌风险增加的个体，特别是在口腔健康差异普遍存在的少数民族，低收入和服务不足的人群中。

DESCRIPTION (provided by applicant): The rising rates of HPV-positive oropharyngeal cancers in the United States (US) and worldwide are a significant public health concern. In the US, it is estimated that 47% (~65 million) of adults aged e30 years have periodontal disease. This is of concern as studies suggest that chronic periodontitis is associated with systemic health conditions, including oral cancers. Research evaluating the role of local oral factors on natural history of oral HPV is lacking, critical information to develop effective prevention strategies. Given the scarcity of research evaluating the role of chronic oral inflammation on the natural history of oral HPV infection, assessment of the prevalence, genotypes, and correlates of oral HPV infection in the general population is a step toward a better understanding of the burden of this infection and its potential role with oral malignancies. The present cross-sectional study will capitalize on the already established infrastructure of the Study of Overweight Adults Longitudinal Study (SOALS), an ongoing NIH-funded cohort of 1,214 Hispanic adults aged 40-65 years living in the San Juan metropolitan area of Puerto Rico, to design and implement a cross-sectional study to start addressing the gaps described. Specifically, we propose to select a random subsample of 600 non-institutionalized adults who participate in SOALS to assess the prevalence and type distribution of oral HPV infection (overall, high-risk and concurrent multiple-type) in adults with and without periodontal disease, and to assess the association between HPV infection and periodontal disease severity. For the current study, assessment of both periodontal disease and oral HPV testing will be performed using validated NHANES methodology. Measures of risk factors for oral HPV infection will be collected using the audio computer-assisted self-interview (ACASI) methodology, a useful tool for collecting sensitive risk behavioral data. Data on dental assessment, selected sociodemographic characteristics, body mass index, lifestyles, medical and dental histories, and biochemical testing will be obtained from the parent study. For HPV typing, PCR products will be typed by dot-blot hybridization using 38 type-specific probes and two separate mixtures, including oncogenic and non-oncogenic HPV types. To our knowledge, this is the first study that will assess the frequency of oral HPV infection in Hispanic adults with and without periodontal disease. The selected study population will provide us with a unique high-risk group where both periodontal disease and oral HPV infection would be higher. Hence, we can study this association with high efficiency and at a reasonable cost. If longitudinal studies in cancer-free individuals confirm that periodontal disease increases the risk of oral HPV infection, preventive public health strategies could be developed, as periodontal disease screening could identify individuals at increased risk of oral HPV infection and oral cancer, particularly among minority, low-income, and underserved populations where oral health disparities are prevalent.