Week 3 Flashcards
Characteristics of viruses
Enormous variety of structure and complexity
Comprise: genetic material (DNA or RNA) protein capsid and membrane envelope
Cannot reproduce independently of host cell, obligate parasites
Host cell functions required for:
-translation of viral mRNA (all viruses)
-genome transcription. —— depending on complexity of virus
-genome replication
Virus replication normally results in cell death
Cancer cell transformation is not a normal stage/phase of the virus life cycle
Cancer accumulation of genetic mutations
Contributions from:
Genetics, virus, diet, chemical exposure
Normal cells have a strong balance of expression of proto oncogenes and tumour suppressor genes
In cancer this balance becomes dysregulated such that oncogenes become inappropriately activated and tumour suppressor genes become inactive
Viruses that cause cancer drive this process
Biological agents classified as carcinogenic to humans
IARC: international agency for research on cancer, WHO foundation
Viruses: Epstein Barr virus, kaposi sarcoma associated herpes virus, hepatitis c, hepatitis b, human T cell lymphotrophic virus type 1, high risk human papilloma virus types hpv16, hpv18, Merkel cell polyomavirus, hiv-1
Bacteria: helicobacter pylori
Liver flukes: schistosoma haematobium, opisthorchis viverrini, clonorchis sinensis
Cancer causing viruses- diverse tumour types
Epstein Barr virus: Nasopharyngealcarcinoma,Burkitt’slymphoma, immune‐suppressionrelatednon‐Hodgkin
lymphoma,extranodalNK/Tcelllymphoma, Hodgkin’slymphoma,gastriccarcinoma
Kaposi sarcoma associated herpes virus: Kaposisarcoma,primaryeffusionlymphoma
Hepatitis b and c: hepatocellular carcinoma
HumanT‐celllymphotrophicvirus type 1: AdultT‐cellleukaemiaandlymphoma
High‐riskHumanpapillomavirustypes hpv16,18,31: Anogenitalcancers‐cervix,vulva,vagina,
penis,anus, Oropharyngealtract–tonsil,baseoftongue
Merkel cell polyomavirus: Merkel cell carcinoma (skin)
HIV1: non Hodgkin lymphoma, Hodgkin lymphoma, cervical and anal cancers, conjunctiva
Direct vs indirect carcinogens
Direct: viral oncogenes directly contribute to cancer cell transformation eg HPV, EBV, KSHV
Indirect: viruses that cause cancer through chronic infections, inflammation, and immunosuppresion- lead to carcinogenic mutations in the host eg HIV1 and immune surppression. Beta-hpv types and non melanoma skin cancer- block apoptosis of UV damaged skin cells
Some viruses difficult to place in either group: HCV, HBV, HTLV1
HIV1 and cancer
Indirect carcinogen
Profound immunosuppression in HIV 1 infected patients
Opportunistic infections-persistence of infectious agents including the cancer causing viruses
Persistent immune activation by HIV1 may lead to chronic tissue damage
HIV 1 may also contribute to cell cycle deregulation or alter the microenvironment
In HIV1 infected individuals there’s an increased incidence of cancers caused by other infectious agents including viruses
Kochs postulates
For identifying an infectious agent as the cause of a specific disease
-the infectious agent is regularly found in the lesions of the disease
-the infectious agent can be isolated in cultures from fluids or tissues of an organism with the disease
-inoculation of this culture into a susceptible host produces the same disease
-the disease can be indefinitely transmitted by the recovered infectious agent
These fail when applied to infectious agents and cancer
Causality
This is difficult to establish because virus associated human cancers:
-long latency period between primary infection and tumour development
-only small % of virus infected individuals develop the tumour
-complex multi step pathogenesis: cofactors, viral genome can be disrupted in the cancer
Virus infection is one link in a chain
No experimental animal models for the human cancer
Common persistent infections
Herpes virus Epstein Barr virus EBV:
-usually asymptomatic infection during childhood (infectious mononucleosis)
-lifelong silent (latent) infection
-95% of worldwide population infected
-only small % infected individuals develop cancer, Burkitt lymphoma
-infection alone is not sufficient for cancer development
Other factors involved- Multifactorial:
-Burkitt lymphoma- malaria, MYC oncogene chromosome translocation to IgG enhancer- c-MYC deregulation
-nasopharyngeal cancer- eating salted fish (nitrosamines); genetic changes
Epidemiology- kaposi sarcoma
Classic KS (rare)- elderly Mediterranean men
In HIV infection kaposi sarcoma is:
-20000x more common than in general population
-300x more common than in other immunosuppressed groups
Patrick Moore and Yuan Chang 1994 isolated HHV8/KSHV viral sequences from AIDs-related kaposi sarcoma tumours
-representational difference analysis RDA- sequences present in tumours and not in normal tissue
Disease association HPV
HPV is a necessary cause of cervical cancer- 99.7%
Cancer causing types: HPV 16, HPV 18, >75% of cervical cancer, >50% vaginal and vulvar cancer
Non cancer causing types: HPV 6, HPV 11, >90% anogenital warts
Cervical cancer is not hereditary
Human papillomavirus HPV and cancer
Skin cancer
Cervical cancer
Head and neck cancer on the increase in boys
HPV is a direct carcinogen: viral oncogenes contribute directly to cancer cell transformation: -E6 and E7 are viral oncoproteins
HPV- a small DNA virus dependent on the host cell for replication of the viral DNA
HPV life cycle is tightly linked to epithelial differentiation
Productive phase in suprabasal layer: vision assembly, capsid expression, viral DNA, amplification
Infect basal cells, HPV infects mitotically active cells in basal layer but undergoes productive replication in mitotically inactive suprabasal cells
HPV is dependent on the host for provision of replication factors
HPV orchestrates the host cell to induce proliferation and promote cell survival
E7 and E6 expressed by HPV virus
E7 binds and inactivates Rb causes cell proliferation, RB very important in preventing cell cycle entry and E7 gets rid of it
This would normally result in lots stress on cells this would activate P53 which would induce apoptosis in those cells
But E6 binds and degrades p53 so cells divide more rapidly
G1/S checkpoint
Several growth factors can activate cyclin D CDK4,6 complex
Which then phosphorylates Rb which results in release of TF family called E2F which drives cell cycle entry
Positive growth signals activate cyclin D/CDK4,6, complex this prevents Rb binding to E2F releasing them to activate transcription specific genes
Active E2F enhances transcription genes required for S phase progression
If cell is stressed or experiencing negative growth signals p16, p21 are activated with inhibit cyclin D/CDK4,6 complex to prevent Rb phosphorylation and arrest cell at the G1 restriction point
E7 bypasses arrest and stimulates G1/S progression, Rb pocket region- LXCXE CR2 motif, conserved in oncoproteins E1A, SV40 large T antigen
E6 blocks apoptosis
Through degradation p53
In a normal cell p53 activated by phosphorylation following DNA damage
E6AP ubiquitin E3 ligase- proteasome
Cells continue to proliferate
Hepatitis B virus vaccine
HBV endemic in china, Indonesia, Nigeria, Taiwan, and also high in rest of Asia and Africa- similar to distribution of HCC
HBV vaccine constitutes purified hepatitis B virus surface antigen HBsAg licensed in US in 1979
In US successful at reducing HBV infection once at risk population targeted
Introduced into Taiwan in 1984 all new born babies vaccinated (mother to child transmission)
NHS cervical screening programme
Cervical cytology initiated in 1940s
1988 saw emergence of a “true” programme
Commences at 25 years every 3 years until 50, 5 years until 64
Registration in central computer database known as the ‘Exeter’ system
Interlinked “failsafe” processes
HPV DNA testing now an important part of the screening programme
HPV and cervical screening programme
Cytological abnormalities in the cervix monitored by the “cervical smear” or PAP test
Squamocolumnar junction epithelium changes here so very vulnerable to HPV, epithelium thin and easy to damage
Prophylactic HPV vaccine
Virus like particles formed by HPV L1 protein
72 capsomeres L1 major capsid protein
HPV16 L1 protein expressed in insect cells (early 1990s)
-assembled into empty particles
-virus like particles VLP
-basis for the HPV vaccine- induces neutralising antibodies
How do the vaccines work- block infection (prophylactic)
Given before people become sexually active
HPV vaccines stimulate production of neutralising antibodies
Produces IgH in mucosa bind to virus before it gets to basal cells