Association of human papilloma virus with pterygia and ocular-surface squamous neoplasia

Abstract

There are more microorganisms that colonize the human body than resident cells; some are commensal whereas others are pathogenic. Pathogenic microorganisms are sensed by the innate or adaptive immune system, an immune response is initiated, and the infection is often cleared. Some microorganisms have developed strategies to evade immune defenses, ensuring their long-term survival with potentially devastating consequences for the host. Approximately 18% of all cancers can be attributed to infective agents; the most common being Helicobacter pylori, Human papilloma virus (HPV) and Hepatitis B and C virus in causing stomach, cervical and liver carcinoma, respectively. This review focuses on whether HPV infection is necessary for initiating pterygia, a common benign condition and ocular-surface squamous neoplasia (OSSN), a rare disease with metastatic potential. The search engine PubMed was used to identify articles from the literature related to HPV and pterygium or conjunctival neoplasia. From 34 investigations that studied HPV in pterygia and OSSN, a prevalence rate of 18.6% (136/731) and 33.8% (144/426), respectively, was recorded. The variation in HPV prevalence (0-100%) for both disease groups may have arisen from study-design faults and the techniques used to identify the virus. Overall, the data suggest that HPV is not necessary for initiating either condition but may be a co-factor in susceptible hosts. Currently, over 60 million people worldwide have been immunized with HPV vaccines, but any effect on pterygium and OSSN development may not be known for some time as these lesions can evolve over decades or occur in older individuals.

A 10-Year Survey: Prevalence of Ocular Surface Squamous Neoplasia in Clinically Benign Pterygium Specimens

“…6 Pterygium and OSSN share potential common risk factors such as exposure to UVB, chronic ocular surface irritation, or HPV infection. [7][8][9][10] Pterygium and OSSN can coexist. 11 In several studies, it has been suggested that pterygium is a stem cell disorder with premalignant features.…”

Carcinome conjonctival épidermoïde invasif révélé après exérèse d’une lésion simulant un ptérygion

“…Par conséquent, il existerait un risque moins important de développer une néoplasie dans les zones peu exposées à ces rayonnements [7][8][9][10]. Outre cette exposition, le ptérygion et les néoplasies malpighiennes de la surface oculaire partageraient d'autres facteurs de risque comme l'infection par le HPV [4,5]. Certains facteurs de risque de ces tumeurs sont retrouvés dans notre observation : l'âge supérieur à 60 ans [1], l'origine du patient, l'exposition aux rayonnements ultraviolets [2], la récidive précoce après chirurgie et le caractère rapidement extensif de la tumeur.…”

“…Les néoplasies malpighiennes de la surface oculaire sont la cause la plus fréquente de tumeurs conjonctivolimbiques malignes et affectent principalement les sujets de plus de 60 ans [1], exposés à des facteurs de risque particuliers dont les principaux sont les rayonnements ultraviolets [2], le virus de l'immunodéficience humaine (VIH) [3], et le human papilloma virus (HPV) [4,5]. Ces tumeurs restent cependant rares [6] et se caractérisent par un important polymorphisme clinique (allant de la lésion asymptomatique jusqu'au tableau de panophtalmie) mimant parfois des lésions bénignes telles qu'un ptérygion.…”

Human Papillomavirus Infection and Human Cancer

“…Ocular surface squamous neoplasia, that is conjunctival squamous neoplasia, is a highly intersting tumour which is evaluated by Scott et al [2002], Biswas et al [2010], Aktas et al [2012], Chauhan et al [2012], Di Girolamo [2012 as well as by Kao et al [2012].…”