Thukral Himanshu et al. Journal of Biological & Scientific Opinion · Volume 2 (6).

2014

Available online through

www.jbsoweb.com
ISSN 2321 - 6328

Review Article
HUMAN-PAPILLOMA VIRUS IN ORAL MUCOSA: AN OVERVIEW
Thukral Himanshu1*, Vohra Jayati1, Sarkar Aparna2
1
PG Scholar, Medical Physiology, Amity Institute of Physiology and Allied Sciences, Amity University, Noida,
Uttar Pradesh, India
2
Associate Professor and Coordinator, Amity Institute of Physiology and Allied Sciences, Amity University, Noida,
Uttar Pradesh, India
*Corresponding Author Email: [email protected]

Article Received on: 02/07/14 Accepted on: 04/08/14

DOI: 10.7897/2321-6328.02676

ABSTRACT
Since 20 years there been an ever-increasing interest in human papillomaviruses HPV for the reason that of their impending character in the
pathogenesis of malignant tumors. HPV was undeniably confirmed as an independent risk factor which leads to oral carcinoma. Up to now, totally
more than 200 different strains and 170 types of HPV have been identified with their genomes and of them generally very less leads to the cancerous
stage. As in HPV type 16 is the most prevalent type in oral carcinomas. The benign oral lesions, related with HPV infection, include Oropharyngeal
squamous cell carcinoma, verrucca vulgaris and focal epithelial hyperplasia (FEH) and benign warts (genital, plantar and flat warts). These Oral
benign HPV lesions are mostly asymptomatic as they may persist or regress spontaneously.
Keywords: Human papilloma viruses, malignant tumors, oral carcinoma, HPV infection

INTRODUCTION Various scientists have identified that there are two major
Human papillomavirus (HPV) is a DNA virus from variants of HPV16, European HPV16-E and Non-
the papillomavirus family that is capable of infecting European HPV16-NE11. The casual link between human
humans1-2. The first visualization of papillomavirus papillomavirus HPV infection and the growth of head and
particles in human warts by electron microscopy was neck carcinomas (HNCs) particularly in the oropharynx
reported in 19493. The structure of papillomavirus are becoming more firmly established12-14. Still there are
genomes was unraveled by Crawford and Crawford in number of unanswered questions remain. Unlike cervical
1963. The unavailability of tissue culture systems and the cancer, with high risk HPVs in HNC are neither an
apparent benign nature of human warts led to few obligatory nor an adequate cause of cancer and only of
additional experimental approaches in subsequent years. these 20 % malignancies are associated with the
Gradually interest in papillomaviruses evolved in second transmission12. There is a need to conclude whether a test
part of the 1970s, evidenced by the first papillomavirus based on oral exfoliated cells can be used to provide a
workshops, commonly attended at that time by 15 to 30 sensitive method for predicting oncogenic mucosal HPV
participants. This developed in part from the hypothesis types in head and neck tissues15. This review tries to
that papillomavirus may play significant role in etiology summarize our present understanding of papillomavirus
of cancer of the cervix4,5. Meisels and Fortin proposed a infections by emphasizing their role in human cancers.
papillomavirus origin of koilocytotic atypias, separating
them from ‘true’ pre-neoplastic lesions. In the 1980s the The current review was conducted by means of a search
situation changed almost abruptly; the isolation of new of various articles and various websites associated with
HPV types HPV 6 and 11 from genital warts67 and the HPV. The search terms used were: ‘History
subsequently directly from cervical cancer biopsies HPV Associated with HPV,” ‘Structure of Human
type 16 and 188 resulted in a rapid expansion of Papillomavirus,’ ‘Types of HPV Has Been Identified Up
experimental work and also in early epidemiological to The Date,’ ‘Physiological Basis Of Human
approaches. HPVs establish productive infections only Papillomavirus,’ ‘Preventive Measures Associate With
in keratinocytes of the skin or mucous membranes. There Human Papillomavirus.’ Based on these review and
are two types of sexually transmitted HPV infections: considering only published information, this article is
1. Low risk viruses that can cause skin warts like constructed.
Condylomata acuminata
2. High risk or cancer producing viruses are Type 16 and Structure of Viral Particles
18. HPV 16 and 18 infections are a cause of a unique The diameter of HPV particles amounts to approx 55 nm.
type of oropharyngeal throat cancer 9,10. Full particles contain the double-stranded closed circular
DNA genome. The viral DNA is associated with histone-

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like proteins16,17 and encapsulated by 72 capsomeres18. of these proteins in recombinant vectors19,20. Obviously
The major capsid protein is coded by the L1 open reading the L1 protein suffices for this particle formation. This
frame seems to contain reactive epitopes for type-specific protein has a molecular weight of approx 55000 and is
neutralization. The L2 open reading frame codes for an highly conserved among different papillomavirus types.
additional structural component of the viral capsid. The second structural protein, L2 is less conserved and
Antigenic domains of this protein appear to be responsible possesses a molecular weight of about 75000. The non-
for a group-specific reactivity of antisera. Virus like enveloped structure renders papillomaviruses relatively
particles containing the structural components of various resistant to heating and to organic solvents21.
types of HPV can however be obtained by the expression

Table 1: Characterized HPV types from

HPV TYPES GENOMES

HPV-1 Mu papillomavirus 1
HPV-2,27,57 Alpha papillomavirus 4
HPV-3,10,28,29,77,78,94,117,125,160 Alpha papillomavirus 2
HPV-41 Nu papillomavirus 1
HPV-5,8,12,14,19,20,21,24,25,36,47,93,98,99,105,118,124,143 Beta papillomavirus 1
HPV-6,11,13,44,55,74 Alpha papillomavirus 10
HPV-7,40,43,91 Alpha papillomavirus 8
HPV-9,15,17,22,23,37,38,80,100,104,107,110,111,113,120,122,145,151 Beta papillomavirus 2
HPV-16,31,33,35,52,58,67 Alpha papillomavirus 9
HPV-18,39,45,59,68,70,85,97 Alpha papillomavirus 7
HPV-26,51,69,82 Alpha papillomavirus 5
HPV-30,53,56,66 Alpha papillomavirus 6
HPV-32,42 Alpha papillomavirus 1
HPV-34,73 Alpha papillomavirus 11
HPV-96,150 Beta papillomavirus 5
HPV-46 Subtype of HPV 20
HPV-49,75,76,115 Beta papillomavirus 3
HPV-91 Alpha papillomavirus 8
HPV-64 Subtype of HPV 34
HPV-92 Beta papillomavirus 4
HPV-61,62,72,81,83,84,86,87,89,102,114 Alpha papillomavirus 3
HPV-63 Mu papillomavirus 2
HPV-54 Alpha papillomavirus 13
HPV-71,90,106 Alpha papillomavirus 14
HPV-79,152,157,158,167,168 Not known
HPV-4,65,95 Gamma papillomavirus 1
HPV-48 Gamma papillomavirus 2
HPV-50 Gamma papillomavirus 3
HPV-60 Gamma papillomavirus 4
HPV-88 Gamma papillomavirus 5
HPV-101,103,108 Gamma papillomavirus 6
HPV-109,123,134,149,155 Gamma papillomavirus 7
HPV-112,119 Gamma papillomavirus 8
HPV-116,129 Gamma papillomavirus 9
HPV-121,130,133 Gamma papillomavirus 10
HPV-126,136,140,141 Gamma papillomavirus 11
HPV-127,132,148 Gamma papillomavirus 12
HPV-128,153 Gamma papillomavirus 13
HPV131 Gamma papillomavirus 14
HPV-135 Gamma papillomavirus 15
HPV-137 Gamma papillomavirus 16
HPV-144 Gamma papillomavirus 17
HPV-138,139,142,146,147,154,156,161,162,163,164,165,166,169,170 Gamma papillomavirus
HPV-159 Beta papillomavirus22-24

Patho-physiology shows that virus can survive without host for long26.
HPV infects the basal cells of stratified squamous Studies have showed that HPV is a small DNA virus with
epithelium tissue, where they replicate25. They infect a genome of approximately 8000 base pairs27. The
epithelial tissues through expose segments (abrasions or development and history of the various strains of HPV
trauma) of the basement membrane or during human usually shows the relocation patterns of modern humans
sexual behavior25. The infection is having slow course of (Homo sapiens) and suggested that HPV may have
action, takes around 12–24 hours for initiation of become more varied among humans. It has been showed
transcription process. HPV lesions and infections arise in many studies that HPV evolved along the five major
from the proliferation of cells in the epidermis (Infected branches that would be a sign of the civilization of human
basal keratinocyte). HPVs are released as a result of hosts, and varied along with the human population28.
deterioration of desquamating cells. Individuals with
plantar warts spread virus by walking barefoot which

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Symptoms and Lesions associated CONCLUSION

Oral HPV is mostly asymptomatic and may persist or In this study we detailed about types of HPV, its
relapse spontaneously. The similarity of the morphologic physiology and various preventive measure. It is seen that
features of genital and oral HPV- associated lesions was younger age cases with cancers of oral cavity/oropharynx
one of the early findings that suggested HPV might be may have higher prevalence of HPV in tumors because of
involved in oral and laryngeal squamous cell carcinomas behaviors linked to sexually transmitted diseases. The
SCCs29. DNA HPV has been found in 25-30 % of the observation is consistent with data on cancers of the
cases of oral carcinomas. HPV-related cancers arise cervix and anogenital areas that involve viral transmission
mainly from the tonsils and base of the tongue, gingivae, through direct physical contact34. Although much
cheek, palate and floor of the mouth30-31. HPV-related speculation has been made about sexual transmission of
diseases are increased in oral cavity of immune- the virus in HPV-HR HNC, few large scale investigations
suppressant individuals, such as that of HIV. Studies have have been conducted. A study by Schwartz et al, found a
demonstrated an increase in the incidence of oral warts higher odds of HPV-16 in oral cancer patients with 15 or
related to HPV infection since the advent of antiretroviral more sex partners adjusted OR-2.5; 95 % CI- 1.1-5.6, but
therapy. Smoke contains several carcinogenic pyrolitic the data were not presented by age group. The risk of
products that bind to DNA and cause genetic mutations. HPV-HR was greater among men whose female partners
had a history of either an abnormal pap smear or a
Diagnostic measures cervical dysplasia, is consistent with data from a large
These studies used a variety of detection techniques, Swedish cancer databases.
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04.004 Cite this article as:
26. Greer CE, Wheeler CM, Ladner MB, Beutner K, Coyne MY, Liang Thukral Himanshu, Vohra Jayati, Sarkar Aparna. Human-papilloma
H, Langenberg A, Yen TS, Ralston R. Human papillomavirus HPV virus in oral mucosa: An overview. J Biol Sci Opin 2014;2(6): 335-338
type distribution and serological response to HPV type 6 virus-like http://dx.doi.org/10.7897/2321-6328.02676

Source of support: Nil; Conflict of interest: None Declared

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