Bladder carcinogenesis via viral infection
Abstract number: 1734_205
Badawi H., Ahmed H., Ismail A., El-Khafif N., Helmy A., Badawy A., Mansy S., Saber M.
Objectives: To investigate the role of human papillomaviruses (HPV16, 18), cytomegalovirus (CMV), Epstein-Barr virus (EBV), and herpes simplex virus (HSV-2) in the etiopathogenesis of cancer bladder, using polymerase chain reaction (PCR) and Electron Microscopic Studies (EMS). It is also a trial to highlight the possible correlation of such infections with the apoptosis of buffy coat cells and serologic responses using Enzyme Linked Immunosorbent Assay (ELISA).
Methods: This study was conducted on 80 patients, Urosurgery Department, Theodor Bilharz Research Institute (TBRI), who were identified as three groups, cancer bladder (group I, 20), cystitis (group II, 20), cancer bladder with cystitis (group III, 20), and a fourth group of 20 normal healthy subjects as controls. They were all subjected to the following: Detection of viral genomic sequences by PCR and EMS on bladder tissue biopsies, buffy coat cells, serum and urine samples, serological detection by ELISA of HPV IgG using Baculovirus recombinant HPV virus-like particles and IgG & IgM of EBV, HSV-2 and CMV and detection of CMV antigen (pp65) in PMNL by monoclonal antibody.
Results: Among all Patients 56.6% were virally infected with different viruses under the study. HPV16 was detected in 53% cases, HPV18 in 24%, CMV in 48%, EBV in 41% and HSV-2 in 48%. Infection with multiple viruses (74%) was significantly associated with either cancer or cystitis than single infection (26%) (P < 0.01). EMS of the examined cases showed remarkable apoptotic changes in lymphocytes and neutrophils of 75% of either cystitis or cancer cases and were absolutely associated with virally infected cases. IgG antibodies to HPV16 VLPs were detected in 66.7% and 11.4% of HPV16 DNA positive and negative patients respectively and in none of healthy controls.
Conclusion: Our study confirms significant association of mixed viral infection with bladder cancer in Egyptian patients which suggests the interesting hypothesis of a viral synergistic action in bladder carcinogenesis. The sensitivity and accuracy of PCR could be increased by adding EMS. PCR on serum or urine samples proved to be non-sensitive. ELISA for detection of anti-HPV16 VLPs could be used in conjunction with HPV DNA detection techniques for accurate clinical diagnosis and epidemiological studies. Detailed investigations on the different apoptotic pathways in general and on the viral manipulations of these pathways are necessary so as to open up new strategies for therapy.
|Session name:||European Society of Clinical Microbiology and Infectious Diseases|
|Location:||ICC, Munich, Germany|
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