Invasive cervical cancer (ICC) remains a significant cause of morbidity and mortality in France. Since human papillomavirus (HPV) is the necessary cause of ICC, the aim of this study was to assess the type-specific prevalence of HPV in ICC in France in order to locally evaluate the potential benefit of an HPV 16/18 L1 virus-like particles (VLP) vaccination. A total of 516 histological specimens collected in 15 centers were analyzed. Among them, 86% had a diagnosis of squamous cell carcinoma (SCC) whereas 14% were adenocarcinomas (ADC). HPV genotyping was performed using the INNO-LiPA assay allowing the specific detection of 24 HPV genotypes both high risk (HR) and low risk (LR). The overall HPV prevalence in ICC was 97%. The most prevalent genotypes were HPV 16 (73%) and HPV 18 (19%) followed by HPV 31 (7%), 33, 68, 45, 52 and 58 (4.1-2.3%). HPV 16 and/or 18 were associated with 82% of ICC, 10% being HPV 16 and 18 coinfections. While HPV 16 was the most prevalent type in both SCC (74%) and ADC (64%), HPV 18 was by far more prevalent in ADC (37%) compared to SCC (16%; p < 0.001). Multiple infections with at least two different HR HPV genotypes were observed in 22% of ICC. Given the high HPV 16/18 prevalence and taking into account possible production of crossneutralizing antibodies against other HPV types, HPV 16/18 L1 VLP vaccination would be expected to significantly reduce the burden of ICC in France. ' 2007 Wiley-Liss, Inc.Key words: human papillomavirus; invasive cervical cancer; prevalence; genotype Despite widespread screening, invasive cervical cancer (ICC) remains a significant cause of morbidity and mortality and represents the second most common cancer among women worldwide. 1In France, this cancer accounts for 3,400 new cases and about 1,000 deaths annually. 2,3 It is universally accepted that human papillomavirus (HPV) is the necessary cause of ICC with more than 99% of ICC containing the DNA of the virus. 4 HPV is sexually transmitted and the majority of infections occurs in adolescents or young adults with the highest prevalence observed in the 15 to 19-year-old group.5 After infection, spontaneous viral clearance is observed in most cases within a year and time to clearance is likely to depend on HPV genotype. It has been observed, for example, that HPV 16 persisted longer than other genotypes.6 HPV persistence represents the major risk factor for cervical cancer.6-8 After established infection, mild cervical abnormalities may appear. These abnormalities spontaneously resolve if HPV is eliminated, but may progress to low and high grade cervical intraepithelial neoplasia (CIN 1 and CIN 2/3, respectively) and ICC in case of viral persistence. About 40 different HPV types are known to infect the genital tract of which 15, known as ''high risk'' (HR) types, have been associated with ICC.10 Among these HR types, HPV types 16 and 18 are responsible for about 70% of ICC worldwide 11 and 60-70% of high grade lesions according to geographical area considered.12 Prophylactic vaccines based on HPV 16/18 L1 ...

The mitochondrial localization of p53 is an important event in p53-dependent apoptosis. Some p53 mutants defective for transcription also facilitate apoptosis through changes of the mitochondria. Here, apoptosis of HeLa and CaSki cells (p53(wt)), C33A and HaCat cells (p53(mt)) and SaOs-2 cells (p53 deficient) was induced by 300 nM staurosporine. We showed that wild-type p53, as well as p53 mutants, were transiently located to the mitochondria with changes in the mitochondrial membrane potential (Delta Psi m). However, in C33A cells harboring a p53 mutated on its DNA binding domain, Delta Psi m collapse and Sub-G1 DNA content were reduced compared to p53(wt) cells, whereas no significant difference was observed in HaCat cells with a p53 mutated on UV hot spots. In addition, inhibition of the mitochondrial permeability transition pores by cyclosporine A significantly reduced the Delta Psi m loss and the sub-G1 DNA content in p53 positive cells. These results indicate that Delta Psi m collapse is an early and necessary event, which plays an important role in apoptosis of immortal mammalian cells.

We recently argued for a major role of p53 in staurosporine(ST)-induced apoptosis of immortalized epithelial cells, depending on their p53 status. Here, we studied the effects of PRIMA-1 (p53 reactivation and induction of massive apoptosis) and Pifithrin-alpha (p fifty-three inhibitor) in combination with ST to reinforce our previous results by respectively restoring or inhibiting the p53 transcriptional activity in different cell lines.PRIMA-1 does modify neither expression of apoptosis-related proteins nor the percentage of wild-type p53 HeLa and CaSki cells with [symbol: see text]delta psi m and DNA cleavage, whilst it increases by 45% Bax expression and apoptosis of mutated p53 C33A cells. Pifithrin-alpha, does modify neither Bax expression nor apoptosis level of C33A cells, but readily inhibits both [symbol: see text]delta psi m and DNA fragmentation of p53wt cells with decreasing Bax expression. These data support the evidence that PRIMA-1 could be a good candidate, as an anti-cancer drug targeting mutant p53, in order to increase ST efficiency. Moreover, Pifithrin-alpha could be used in combination with ST and PRIMA-1 to prevent side effects of anti-tumor therapies in cells expressing mutant P53.

We have recently shown that staurosporine (ST) can trigger apoptosis of CaSki and HeLa cervical tumor cells from G2/M checkpoint, though the mechanism remains elusive. In this study, we reported that ST induced the inhibition of E6 and E7 viral oncogene and MDM2 expression, while it led to increased levels of p53, which was transiently located to mitochondria. Additionally, the proteins of the p53-regulated genes, p21 WAF1 and Bax, were increased with a similar time, while Bcl-2 and Bcl-X L expression was lowered. Upon ST treatment, the cytochrome c was released into the cytosol and, then, activation of caspases-9 and -3 led to Poly(ADP)RibosePolymerase (PARP) cleavage. Finally, characteristic morphological signs confirmed the apoptosis execution. Thus, taken together, all these observations suggest that apoptosis can be reactivated in HPV-positive human carcinoma cells and highlight that ST could be used as a potently chemotherapy agent to enhance the sensitivity of tumor cells to apoptosis.

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