Oral HPV infection is strongly associated with oropharyngeal cancer among subjects with or without the established risk factors of tobacco and alcohol use.

HPV-16-positive HNSCCs and HPV-16-negative HNSCCs have different risk factor profiles, indicating that they should be considered to be distinct cancers.

HPV appears to play an etiologic role in many cancers of the oropharynx and possibly a small subgroup of cancers of the oral cavity. The most common HPV type in genital cancers (HPV16) was also the most common in these tumors. The mechanism of transmission of HPV to the oral cavity warrants further investigation.

The prevalence and risk factors for oral human papillomavirus (HPV) infection are unknown, despite evidence for an etiological role for HPV in oral cancers. Oral samples from human immunodeficiency virus (HIV)-seronegative (n=396) and HIV-seropositive (n=190) adults were tested for HPV DNA. High-risk HPV infections were present in 2.1% of tonsil and 6.3% of oral-rinse specimens. The prevalence of oral high-risk HPV infection was greater in HIV-seropositive individuals (13.7% vs. 4.5%; P<.001). In multiple logistic regression, odds of oral HPV infection increased with age, male sex, and herpes simplex virus (HSV)-2 seropositivity in HIV-seronegative individuals and with CD4 cell count <200 cells/mL, HSV-2 seropositivity, oral mucosal abnormalities, and >1 oral sex partner during the previous year (odds ratio, 12.8; 95% confidence interval, 3.1-52.7) among HIV-seropositive individuals. HPV type 16, which is present in most HPV-associated tonsillar cancers, was the most prevalent high-risk oral HPV infection.

The presentation of antigenic peptides by major histocompatibility complex (MHC) class II molecules to CD4+ T cells is critical to the function of the immune system. In this study, we have utilized the sorting signal of the lysosomal-associated membrane protein LAMP-1 to target a model antigen, human papillomavirus 16 E7 (HPV-16 E7), into the endosomal and lysosomal compartments. The LAMP-1 sorting signal reroutes the antigen into the MHC class II processing pathway, resulting in enhanced presentation to CD4+ cells in vitro. In vivo immunization experiments in mice demonstrated that vaccinia containing the chimeric E7/LAMP-1 gene generated greater E7-specific lymphoproliferative activity, antibody titers, and cytotoxic T-lymphocyte activities than vaccinia containing the wild-type HPV-16 E7 gene. These results suggest that specific targeting of an antigen to the endosomal and lysosomal compartments enhances MHC class II presentation and vaccine potency.The presentation of antigenic peptides by major histocompatibility complex (MHC) class II molecules to CD4+ T cells is critical to the function of the immune system. CD4+ T cells are the major helper T-cell phenotype whose predominant function is to generate cytokines that regulate essentially all other functions of the immune response. CD4+ MHC class II restricted cells have also been shown to have cytotoxic capacity in a number of systems, including a response to fragments of the human immunodeficiency virus gpl20 protein (1). CD4+ cells have also been shown to be of great importance in immune responses against several different murine (2, 3) and human (4) solid malignancies. Several mouse tumors that were transfected with syngeneic MHC class II genes have become very effective vaccines against subsequent challenge with wild-type (wt) class II negative tumors (5). For these reasons, there has been increased interest in developing strategies that will most effectively activate CD4+ MHC class II restricted cells against a given specific antigen (6).Two major pathways by which antigens enter endosomal and lysosomal compartments for MHC class II presentation to CD4+ T cells have been described. The traditional pathway involves the phagocytosis or endocytosis of exogenous proteins into antigen-presenting cells (APCs), followed by degradation by acid proteases in the endosomal or lysosome-like compartments (7-9). A second pathway involves the processing of membrane proteins endogenously synthesized by APCs (1, 10). These membrane proteins are believed to enter endosomal and lysosomal compartments by internalization from the cell surface. In certain experimental systems, cytoplasmic proteins may also enter this endogenous MHC class II pathway (11, 12), but normally these antigens are preferentially routed for MHC class I presentation. In general, cytoplasmic or nuclear proThe publication costs of this article were defrayed in part by page charge payment. This article must therefore be hereby marked "advertisement" in accordance with 18 U.S.C. §1734 solely to in...

Objectives The vaginal microbiota help protect the female genital tract from disease. We sought to describe the composition of the vaginal microbiota between pre-, peri- and postmenopausal women and to explore the association between the microbiota and vulvovaginal atrophy (VVA). Methods 87 women (age 35–60) were classified as premenopausal (n=30), perimenopausal (n=29) or postmenopausal (n=28) according to STRAW guidelines. Mid-vagina bacterial community composition was characterized by 16S rRNA gene analysis. Results Bacterial communities clustered into six community state types (CSTs), of which four were dominated by Lactobacillus crispatus, L. gasseri, L. iners, or L. jensenii; and two (CST-IV-A and IV-B) had low relative abundance of Lactobacillus. CST IV-A was characterized by Streptococcus and Prevotella, whereas CST IV-B by Atopobium. There was a significant association between menopause stage and CST (p-value=0.004) and VVA and CST (p-value=0.002). Perimenopausal women were more likely to be classified as CST IV-A or the L. gasseri CST, whereas postmenopausal women were mostly CST IV-A. CSTs dominated by L. crispatus and L. iners were more prevalent in premenopausal women. Nineteen participants had signs of mild or moderate VVA. Compared to women with no VVA, the vaginal microbiota of women with mild or moderate atrophy had 25-fold greater odds of being classified as CST IV-A vs. L. crispatus CST (aOR: 25.89, 95% Credible Interval:2.98-406.79). Conclusions A distinct bacterial community state (CST IV-A) with low relative abundance of Lactobacillus was associated with VVA. Future studies recruiting a larger number of women are needed to replicate the findings. This study provides an impetus for future longitudinal studies designed to manage, modulate and restore vaginal microbiota homeostasis which would provide stronger evidence for a causal relationship with VVA and ultimately improve treatment and prevention of atrophic vaginitis in menopause.

Purpose: To evaluate the safety and immunogenicity of a therapeutic human papillomavirus (HPV)16 DNA vaccine administered to women with HPV16+cervical intraepithelial neoplasia (CIN)2/3. Experimental Design:This phase I trial incorporated the standard ¶3+3 00 dose-escalation design with an additional 6 patients allocated to the maximally tolerated dose. Healthy adult women with colposcopically directed, biopsy-proven HPV16+ CIN2/3 received 3 i.m. vaccinations (0.5, 1, or 3 mg) of a plasmid expressing a Sig-E7(detox)-heat shock protein 70 fusion protein on days 0, 28, and 56, and underwent standard therapeutic resection of the cervical squamocolumnar junction at day 105 (week 15). The safety and immunogenicity of the vaccine and histologic outcome based on resection at week 15 were assessed. Results: Fifteen patients were evaluable (3 each at 0.5 and 1mg, 9 at 3 mg).The vaccine was well tolerated: most adverse events were mild, transient injection-site discomfort; no dose-limiting toxicities were observed. Although HPVE7-specificT-cell responses to E7 detected by enzymelinked immunospot assays (IFN-g) were of low frequency and magnitude, detectable increases in response subsequent to vaccination were identified in subjects in the second and third cohorts. Complete histologic regression occurred in 3 of 9 (33%; 7-70% confidence interval) individuals in the highest-dose cohort. Although the difference is not significant, it is slightly higher than would be expected in an unvaccinated cohort (25%). Conclusions:This HPV16 DNA vaccine was safe and well tolerated.Whereas it seems possible to elicit HPV-specific T-cell responses in patients with established dysplastic lesions, other factors are likely to play a role in lesion regression.

We produced capsids of Merkel cell polyomavirus (MCPyV) in a baculovirus expression system and developed a virus-like particle (VLP) enzyme-linked immunosorbent assay (ELISA). To determine age-specific seroprevalence, serum samples were collected from 947 individuals attending hospital outpatient clinics and ranging in age from 1 to 93 years. To evaluate the association between exposure to MCPyV and Merkel cell cancer (MCC), plasma samples were obtained from 33 MCC patients and 37 controls. MCPyV seroprevalence was 45% in children under 10 years of age, increased to 60% in the next decade of life, and peaked at 81% among those 60 to 69 years of age. Levels of MCPyV capsid antibodies were positively correlated with age (P ‫؍‬ 0.007). Virus specificity of MCPyV seroreactivity was supported by competitive inhibition of reactivity by MCPyV VLPs and not by BK polyomavirus (BKPyV) VLPs. MCPyV seroprevalence was greater among MCC patients (91%) than controls (68%; age-adjusted P value, 0.32); the mean level of MCPyV antibodies was also greater (P ‫؍‬ 0.04). The age-specific seroprevalence of MCPyV shares with previously known polyomaviruses, BKPyV and JC polyomavirus (JCPyV), evidence of widespread exposure in human populations beginning early in life. MCPyV age-specific seroprevalence also has unique features. Seroprevalence among children is higher than that of JCPyV but lower than that of BKPyV. Among older adults, MCPyV seroprevalence remains high, while that of BKPyV declines and that of JCPyV continues to rise. In agreement with results from other studies, we found an association between MCPyV seropositivity and MCC, and higher levels of serum MCPyV capsid antibodies in MCC patients than in controls.Merkel cell polyomavirus (MCPyV), a new human polyomavirus, was recently discovered by molecular techniques in Merkel cell carcinoma (MCC) (11), a rare and aggressive skin tumor (20,22). Studies from North America and Europe have detected MCPyV DNA by PCR in 69 to 100% of MCC tumors (1,9,11,13,14,17,25). The virus has also been detected in rare instances and in low copy numbers in cutaneous, gastrointestinal, and respiratory tract samples from healthy individuals (2,11,15). Little is known about the natural history of MCPyV infection in human populations. Serological assays can reveal the extent of past exposure to a virus and provide insights into its epidemiology. We and others have developed virus-like particle (VLP)-based enzyme-linked immunosorbent assays (ELISAs) to measure antibodies to various human and animal polyomaviruses (10, 27, 31). Polyomavirus VLPs are empty viral capsids produced by expression of the gene for the major capsid protein, VP1, in a eukaryotic expression system. VLPs resemble native virions morphologically and retain their immunological properties, including the ability to bind antiviral capsid antibodies. We now report the development of a VLP-based ELISA to detect antibodies to MCPyV and its application for comparison of the age-specific seroprevalence of MCPyV to those of two other huma...