O carcinoma oral de células escamosas (OSCC Oral Squamous Cell Carcinoma) é o câncer de cabeça e pescoço mais comum. Somente no Brasil, foram estimados 14.160 novos diagnósticos para o ano de 2009. O HPV está associado com o aumento no risco do câncer oral, mas seu papel na carcinogênese ainda é controverso. A BubR1, uma proteína importante para o checkpoint de fuso mitótico (SAC Spindle Assembly Checkpoint), tem sido associada com algumas proteínas codificadas por espécies virais e com o câncer. O objetivo do presente estudo foi avaliar a expressão de BubR1 em lesões orais benignas e amostras de OSCC com e sem metástase associadas com infecção pelo HPV. Nós realizamos imunoistoquímica para BubR1 em 16 biópsias de lesão oral benigna e em 70 biópsias de OSCC divididas em três grupos (tumores in situ, tumores invasivos sem metástase e tumores invasivos com metástase), com os respectivos linfonodos das amostras com metástase. A técnica de Nested PCR foi realizada com finalidade de detectar DNA do HPV. Nas lesões malignas, foi observada uma significante superexpressão de BubR1 associada com menor sobrevida (p = 0.0479). Houve também correlação significante (r = 1.000) de BubR1 entre as lesões com metástase e seus respectivos linfonodos. Noventa por cento dos OSCC e 100% das lesões benignas foram HPV positivos. HPV 16 e HPV 18 foram detectados em, respectivamente, 13% e 24% das amostras com OSCC HPV-positivas. O HPV teve maior prevalência (76%) nas amostras com alta expressão de BubR1 e a ausência de DNA viral não influenciou no padrão de expressão de BubR1. Esses resultados sugerem uma provável associação do HPV com a superexpressão de BubR1 em OSCC, o que não se aplica para lesões orais benignas. / Oral squamous cell carcinoma (OSCC) is the most common head and neck cancer. Only in Brazil, the estimate is that 14,160 new diagnoses will be made in 2009. HPV is associated with increasing risk of oral cancer, but its role in carcinogenesis is still controversial. BubR1, an important protein in the mitotic Spindle Assembly Checkpoint (SAC), has been associated with some virus-encoded proteins and cancer. The aim of the present study was to evaluate the expression of BubR1 in non-malignant oral lesions and OSCC with and without metastasis associated with HPV infection. We performed immunohistochemistry for BubR1 in 16 non-malignant oral lesion biopsies and in 70 OSCC biopsies divided into three groups (in situ tumors, invasive tumors without metastasis and invasive tumors with metastasis) with their respective lymph nodes from samples with metastasis. Nested PCR was performed in order to detect HPV DNA. Significantly higher BubR1 expression associated with shorter survival (p = 0.0479) was observed in malignant lesions. There was also a significant correlation (r = 1.000) with BubR1 expression in lesions with metastasis and their lymph nodes. Ninety percent of OSCC and 100% of benign lesions were HPV positive. HPV 16 and HPV 18 were present in 13% and 24% of HPV-positive OSCC samples, respectively. HPV was more prevalent (76%) in samples with high BubR1 expression and the absence of viral DNA had no influence on BubR1 expression. These findings suggest that HPV could be associated with overexpression of BubR1 in OSCC, but not in benign oral lesions.

Introdução: A infecção pelo Papiloma Virus Humano (HPV) vem sendo reportada como uma das doenças sexualmente transmissíveis com maior incidência na atualidade, porém a sua prevalência não é bem esclarecida em homens, principalmente devido a baixa presença de sintomas. Além disso, poucos estudos foram realizados nesta população até o momento para verificar a resposta imune pós-vacinação. As hipóteses testadas serão fundamentais para aprofundar o conhecimento da imunopatogênese, da resposta vacinal em pacientes infectados pelo HIV e colaborar no desenho e estratégias de vacinação anti-HPV na população infectada pelo HIV Objetivos: Analisar a resposta específica aos antígenos da vacina anti-HPV em homens infectados pelo HIV. Métodos: Um total de 24 pacientes infectados pelo HIV que preencheram os critérios de inclusão durante o período de coleta foram vacinados pela vacina anti-HPV bivalente em três doses nos períodos: zero, dois e seis meses. Os grupos foram divididos em: Grupo Controle (Cinco indivíduos sadios, com sorologia negativa para HIV); Grupo A (Nove pacientes com CD4 <500 celulas mm³); Grupo B (10 pacientes com CD4 >=500 celulas mm³). Foram realizados ELISA para a detecção de anticorpos Anti-HPV nos momentos pré e pós-vacinação nos grupos estudados; posteriormente realizamos nos mesmos o ensaio de cultura celular para detecção de citocinas (IFN?, IL17, TNF, IL6 e IL10) pela técnica de CBA . Resultados: Obtivemos soroconversão da primeira dose da vacina para o grupo A 55,6%, grupo B 30%, grupo controle 60%; na segunda dose obtivemos para o grupo A 88,8%, grupo B 80%, grupo controle 80%, e por final a terceira dose no grupo A 88,8%, grupo B 90%, grupo controle 100%. A citocina IL 6 (perfil TH2) demonstrou níveis mais elevados, comparados entre os grupos A, B e grupo controle (p<0.001). A partir da 3° dose da vacinação observamos baixos níveis de INF-? (perfil TH1) A e B (p<0.0006). O grupo controle apresentou produção de INF- ? quando comparado com grupos A e B (p<0.001). Conclusão: Os pacientes soropositivos e grupo controle foram respondedores a vacinação anti-HPV. Foi demonstrada uma elevada produção das citocinas entre os grupos sugerindo uma imunomodulação do grupo HIV+. Esse trabalho apresenta informações relevantes que estimulam a realização de novos estudos nessa população, avaliações de reações cruzada da vacina que pode resultar em proteção a outros tipos de HPV não presentes na vacina, além de analisar por mais tempo as titulações no soro desses pacientes. Os dados do nosso estudo podem corroborar para a vacinação nessa população, diminuindo assim o risco de uma infecção, mortalidade e morbidade das doenças causadas pelo HPV em homens. / Introduction: Infection with Human Papilloma Virus (HPV) has been reported as one of the sexually transmitted diseases with a higher incidence nowadys, but its prevalence must be clarified in men, mainly due to low presence of symptoms. Moreover, few studies have been performed in this population until now to verify the immune response post-vaccination. The hypothesis here suggested will be the key for better understanding of the immunopathogenesis, the vaccine´s response in HIV-infected patients and collaborate in the design and strategies of vaccination against HPV in HIV-infected population. Objectives: Analyze the specific response to antigens of HPV vaccine in HIV-infected men. Methods: A total of 24 HIV-infected patients who were in accordance with the inclusion criteria during the data collection period were vaccinated with anti-HPV bivalent vaccine in three period doses: zero, two and six months. The groups were distributed in: Control group (five healthy subjects with negative serology against HIV); Group A (nine subjects with CD4 <500 cells/mm³; Group B (10 subjects with CD4 >500 cells/mm³). ELISA was performed to detect the level of antibodies anti-HPV before and after vaccination in the studied cohort. Postenarly, cells of these groups were submitted in culture to verify citokynes production (IFN?, IL17, TNF, IL6 and IL10) using CBA methodology. Results: We obtained seroconversion after the first dose of anti-HPV vaccine: control group 60%, group A 55,6% and group B 30%. In the second dose: control group 80%, group A 88,8% and Group B 80%. And at last, the third dose: Control Group 100%, Group A 88,8% and group B 90%. IL 6 citokyne (TH2 response) was detected in higher level when compared Control, A and B groups (p<0.001). IFN? citokyne (TH1 response) was detect in low level only after the third dose of vaccination, showing relevance between A and B groups (p<0.0006). Additionally, higher IFN? production was detected when compared the control with A and B groups (p<0.001). Conclusion: HIV patients and controls (HIV-) were responders to anti-HPV vaccination. It was clear that an elevated cytokine production was detected between groups, suggesting immunomodulation of HIV + group. This work suggests relevant information that challenge: new studies in this population, verification of cross-reactions of the vaccine resulting in protection of other HPV types not present in this vaccine, and analyze for longer period the titers of anti-HPV antibodies in these patients. All together, our data can corroborate for vaccination in this population, thus decreasing the risk of infection, mortality and morbidity of the disease caused by HPV in men.

O carcinoma oral de células escamosas (OSCC Oral Squamous Cell Carcinoma) é o câncer de cabeça e pescoço mais comum. Somente no Brasil, foram estimados 14.160 novos diagnósticos para o ano de 2009. O HPV está associado com o aumento no risco do câncer oral, mas seu papel na carcinogênese ainda é controverso. A BubR1, uma proteína importante para o checkpoint de fuso mitótico (SAC Spindle Assembly Checkpoint), tem sido associada com algumas proteínas codificadas por espécies virais e com o câncer. O objetivo do presente estudo foi avaliar a expressão de BubR1 em lesões orais benignas e amostras de OSCC com e sem metástase associadas com infecção pelo HPV. Nós realizamos imunoistoquímica para BubR1 em 16 biópsias de lesão oral benigna e em 70 biópsias de OSCC divididas em três grupos (tumores in situ, tumores invasivos sem metástase e tumores invasivos com metástase), com os respectivos linfonodos das amostras com metástase. A técnica de Nested PCR foi realizada com finalidade de detectar DNA do HPV. Nas lesões malignas, foi observada uma significante superexpressão de BubR1 associada com menor sobrevida (p = 0.0479). Houve também correlação significante (r = 1.000) de BubR1 entre as lesões com metástase e seus respectivos linfonodos. Noventa por cento dos OSCC e 100% das lesões benignas foram HPV positivos. HPV 16 e HPV 18 foram detectados em, respectivamente, 13% e 24% das amostras com OSCC HPV-positivas. O HPV teve maior prevalência (76%) nas amostras com alta expressão de BubR1 e a ausência de DNA viral não influenciou no padrão de expressão de BubR1. Esses resultados sugerem uma provável associação do HPV com a superexpressão de BubR1 em OSCC, o que não se aplica para lesões orais benignas. / Oral squamous cell carcinoma (OSCC) is the most common head and neck cancer. Only in Brazil, the estimate is that 14,160 new diagnoses will be made in 2009. HPV is associated with increasing risk of oral cancer, but its role in carcinogenesis is still controversial. BubR1, an important protein in the mitotic Spindle Assembly Checkpoint (SAC), has been associated with some virus-encoded proteins and cancer. The aim of the present study was to evaluate the expression of BubR1 in non-malignant oral lesions and OSCC with and without metastasis associated with HPV infection. We performed immunohistochemistry for BubR1 in 16 non-malignant oral lesion biopsies and in 70 OSCC biopsies divided into three groups (in situ tumors, invasive tumors without metastasis and invasive tumors with metastasis) with their respective lymph nodes from samples with metastasis. Nested PCR was performed in order to detect HPV DNA. Significantly higher BubR1 expression associated with shorter survival (p = 0.0479) was observed in malignant lesions. There was also a significant correlation (r = 1.000) with BubR1 expression in lesions with metastasis and their lymph nodes. Ninety percent of OSCC and 100% of benign lesions were HPV positive. HPV 16 and HPV 18 were present in 13% and 24% of HPV-positive OSCC samples, respectively. HPV was more prevalent (76%) in samples with high BubR1 expression and the absence of viral DNA had no influence on BubR1 expression. These findings suggest that HPV could be associated with overexpression of BubR1 in OSCC, but not in benign oral lesions.

Philosophiae Doctor - PhD / PURPOSE: High risk human papillomavirus (HR-HPV) is well established as a causative agent of squamous cell carcinoma (SCC) of the orophaynx. HR-HPV has also been reported in periocular cancers and precancers, but controversy exists about its overall incidence and clinicopathologic profile. The purpose of this study is to evaluate the role of HR-HPV infection in periocular cancers and precancers, using multiple methods of detection. DESIGN: Retrospective observational case series with laboratory investigations. METHODS: Sequential surgical samples of 87 carcinomas (invasive SCC, SCC in situ and sebaceous carcinoma) from three different periocular sites (conjunctiva, lacrimal sac and the eyelid) diagnosed over a 15-year period (2000-2015) were selected for evaluation. Unstained paraffin sections of 87 cases of periocular carcinomas were analyzed with immunohistochemistry (IHC) for p16 as a screening test. p16 positive conjunctival- and lacrimal sac SCC were further evaluated for HR-HPV using DNA in situ hybridization (DNA ISH), and a subset was also analyzed by DNA Polymerase Chain Reaction (DNA PCR). p16 positive periocular sebaceous carcinomas (SC) were analyzed with PCR, and a subset of 18cases was further studied with a novel method of mRNA ISH, an advanced technique with an enhanced sensitivity and specificity. Relevant patient clinical information was obtained from review of the electronic medical records.

O presente estudo teve como principal objetivo aprimorar os efeitos antitumorais de uma nova estratégia imunoterapêutica para controle de tumores induzidos pelo vírus do papiloma humano tipo 16 (HPV-16). Para tal finalidade foi utilizado um novo conceito de imunoterapia ativa, baseada em uma vacina de DNA recombinante, desenvolvida no Laboratório de Desenvolvimento de Vacinas da USP (pgDE7h) e diferentes abordagens experimentais delineadas com a finalidade de aumentar a eficácia terapêutica do tratamento. Desta forma, o presente trabalho focou no desenvolvimento de novos sistemas de entrega para a vacina de DNA empregando três nanocarregadores distintos, de natureza lipídica, proteica ou peptídica, e a avaliação da eficácia terapêutica desses frente a tumores pré-estabelecidos. O presente trabalho também avaliou a combinação da imunoterapia, baseada no vetor pgDE7h, com a quimioterapia, empregando o composto cisplatina, de forma a permitir o tratamento de tumores em estágios mais avançados de crescimento. Os resultados demonstram que a associação do plasmídeo vacinal com vesículas peptídicas mostrou-se capaz de ativar células dendríticas murinas in vitro e promover aumento na sobrevivência de animais frente ao modelo de tumores subcutâneos, sem induzir toxicidade. Quando combinada ao tratamento com cisplatina, a vacina, principalmente associada à eletroporação, demonstrou um efeito sinérgico, promovendo regressão total de tumores, aumento expressivo na ativação de linfócitos T CD8 E7-específicos, indução de resposta de memória efetora e memória residente e controle de populações imunossupressoras de forma sistêmica e no microambiente tumoral. Em resumo, a pesquisa ampliou os conhecimentos sobre a ação da imunoterapia ativa contra tumores induzidos por HPV e abriu perspectivas importantes para sua utilização em condições clínicas. / The present study aimed to improve the antitumor effects of a new immunotherapeutic strategy for the control of tumors induced by human papillomavirus type 16 (HPV-16). For this purpose, a new concept of active immunotherapy based on a recombinant DNA vaccine developed at the Laboratory of Vaccine Development at USP (pgDE7h) was used, and different experimental approaches were designed to increase the therapeutic efficacy of the treatment. Thus, the present work focused on the development of new delivery systems for the DNA vaccine using three distinct nanocarregadores, of a lipid, protein or peptidic nature, and the evaluation of the therapeutic efficacy of these in front of pre-established tumors. The present study also evaluated the combination of pgDE7h-based immunotherapy with chemotherapy using the cisplatin compound to allow the treatment of tumors in more advanced stages of growth. The results demonstrate that the association of the peptide-vesicle vaccine plasmid was shown to activate murine dendritic cells in vitro and promote increased survival of animals against the subcutaneous tumor model without inducing toxicity. When combined with cisplatin treatment, the vaccine, mainly associated with electroporation, demonstrated a synergistic effect, promoting total tumor regression, expressive increase in the activation of CD8 E7-specific T lymphocytes, induction of effector and resident memory response and control of immunosuppressive populations in a systemic way and in the tumor microenvironment. In summary, the research expanded knowledge about the action of active immunotherapy against HPV-induced tumors and opened important perspectives for its use under clinical conditions.

Os Papilomavírus Humanos (HPV) são vírus de DNA, não envelopados que infectam as células epiteliais. A infecção persistente por alguns tipos de HPV é o principal fator de risco para o desenvolvimento do câncer cervical. A maquinaria de reparo de DNA desempenha um papel essencial em várias fases do ciclo de vida do HPV e é crucial para a sobrevivência de células tumorais. Durante a transformação maligna, as oncoproteínas E6 e E7 de HPV são capazes de induzir alterações cromossômicas e numéricas, além de modular a resposta de danos ao DNA. Estas observações sugerem que a maquinaria celular de reparo de dano ao DNA podem desempenhar um papel duplo na biologia do HPV e na sua patogênese. No presente estudo, procurou-se investigar o papel das proteínas de reparo de DNA na biologia das células derivadas de câncer cervical. A fim de alcançar este objetivo, a expressão de 189 genes foi silenciada em células HeLa (HPV 18) e em células SiHa (HPV16), bem como em queratinócitos humanos primários (QHP), utilizando vetores lentivirais que expressam shRNAs específicos. O efeito do silenciamento gênico foi determinado por ensaios de viabilidade celular, análise de proliferação celular, ensaio clonogênico e de formação de colônias em soft ágar. Observamos que o silenciamento dos genes ATM, BRCA1, CHEK2 e HMGB1 reduziu a taxa de crescimento celular, o potencial de crescimento em colônia e a capacidade de crescimento independente de ancoragem das linhagens celulares derivadas de câncer cervical transformadas por HPV, sem afetar QHP. O tratamento das linhagens celulares com fármacos capazes de inibir a atividade das proteínas ATM e CHEK2 revelou uma maior sensibilidade das células tumorais à inibição destas proteínas quando comparadas a QHP. Além disso, mostramos que QHP que expressavam E6E7 ou somente E6 de HPV16 foram mais sensíveis a estes inibidores, quando comparados ao controle QHP ou QHP expressando apenas E7. Além disso, QHP que expressavam mutantes de E6 de HPV16, defectivos para a degradação de p53, foram menos sensíveis do que QHP, que expressavam HPV16 E6 selvagem. Desta forma, estes resultados indicam que estes genes são necessários para a sobrevivência de células transformadas por HPV. Além disso, os nossos resultados sugerem que este efeito está relacionado com a expressão oncoproteína de HPV16 E6 e a sua capacidade para degradar p53. / Human Papillomaviruses (HPV) are non-enveloped DNA viruses that infect epithelial cells. Persistent infection with some HPV types is the main risk factor for the development of cervical cancer. DNA repair machinery plays an essential role in several stages of the HPV life cycle and is crucial for tumor cells survival. During malignant transformation, HPV E6 and E7 oncoproteins induce structural and numerical chromosome alterations and modulate DNA damage response. These observations suggest that cellular DNA repair machinery may play a dual role in both HPV biology and pathogenesis. In the present study, we sought to investigate the role of DNA repair proteins in cervical cancer derived cells biology. In order to achieve this goal, the expression of 189 genes was silenced in HeLa (HPV18) and SiHa (HPV16) cells as well as in primary human keratinocytes (PHK) using lentiviral vectors expressing specific shRNA. The effect of gene silencing was determined by cell viability assay, cell growth analysis, clonogenic and soft agar colony formation test. We observed that ATM, BRCA1, CHEK2 and HMGB1 down-regulation decreased growth rate, clonogenic potential and cellular anchorage-independent growth of HPV-transformed cervical cancer-derived cell lines with no effect in normal keratinocytes. Treatment of cells with drugs that inhibit ATM and CHEK2 activity showed that tumor cells are more sensitive to the inhibition of these proteins than PHK. Besides, we show that PHK expressing HPV16 E6 alone or along with HPV16 E7 were more sensitive to these inhibitors than control PHK or PHK expressing only E7. Moreover, PHK expressing E6 mutants defective for p53 degradation were less sensitive than PHK expressing E6wt. Moreover, to potentiate the effect observed by the ATM and CHEK2 inhibition, we treated cells lines with Doxorubicin and Cisplantin. We observed that tumor cells lines and PHK expressing HPV16 E6 or HPV16 E6/E7 were more sensitive to DNA damage induction. Altogether, these results indicated that these genes are required for HPV-transformed cells survival. Besides, our results suggest that this effect is related to HPV16 E6 oncoprotein expression and its capacity to degrade p53.

In Canada, parental acceptance and uptake of the HPV vaccine has been low. There is a need for more effective HPV vaccination health messages for parents. Whether a message is framed in terms of the benefits of engaging in the behaviour (gain frame), the costs of failing to engage in the behaviour (loss frame) or both the benefits and the costs (mixed frame) has potential to impact parents’ decision making. The appropriate frame of a message may depend on the recipient’s sex and involvement with the health issue. The purpose of this study was to investigate the persuasiveness of gain-, loss- and mixed-framed messages on mothers’ and fathers’ intentions to have their young son or daughter vaccinated against HPV. The study used a 3 Frame x 2 Sex of Parent x 2 Sex of Child design. We randomly assigned participants (n=367) to read a framed message and then complete a 29-item questionnaire assessing theoretical determinants of parental consent for vaccination. ANCOVAs revealed a three-way interaction for intentions to speak to a doctor about the HPV vaccine, F(2, 342)=3.66, p =.03, perceived severity of HPV, F(2, 347) = 3.10, p = .05, and for anxiety about their child contracting HPV, F(2, 342)=3.58, p=.02. Effect size comparisons revealed that gain-framed messages seem to persuade parents who are the opposite sex to the child for whom they are considering the vaccine. In turn, loss- and mixed-framed messages may persuade parents who are the same sex as the child for whom they are considering the vaccine. Perceived severity of HPV and anxiety about HPV mediated the relationship between message frame and intentions for some parent-child dyads. Findings have implications for constructing effective messages encouraging parents to consider having their child vaccinated against HPV. / Thesis (Master, Kinesiology & Health Studies) -- Queen's University, 2010-07-07 23:06:25.757

Submitted by Maria Creuza Silva (mariakreuza@yahoo.com.br) on 2013-10-03T19:10:15Z No. of bitstreams: 1 Diss MP. Ieda Carvalho 2013.pdf: 743354 bytes, checksum: 86a38cc8c18f66fee690c10a1336c161 (MD5) / Approved for entry into archive by Maria Creuza Silva(mariakreuza@yahoo.com.br) on 2013-10-03T19:10:31Z (GMT) No. of bitstreams: 1 Diss MP. Ieda Carvalho 2013.pdf: 743354 bytes, checksum: 86a38cc8c18f66fee690c10a1336c161 (MD5) / Made available in DSpace on 2013-10-03T19:10:31Z (GMT). No. of bitstreams: 1 Diss MP. Ieda Carvalho 2013.pdf: 743354 bytes, checksum: 86a38cc8c18f66fee690c10a1336c161 (MD5) Previous issue date: 2013 / O câncer de colo de útero (CCU) é um importante problema de saúde em todo o mundo. O HPV é o principal fator associado a esta doença. Para a prevenção primária da infecção foi desenvolvido a vacina quadrivalente que protege contra os tipos HPV 16, 18, 11 e 6. Objetivo: este estudo analisou a relação custo-efetividade e custo-utilidade da adição da vacina contra HPV para Sistema Único de Saúde brasileiro, em comparação ao rastreamento pelo exame citopatológico, programa existente. Método: foi adaptado um modelo de Markov da história natural da infecção por HPV para estimar custo e qualidade de vida para uma coorte hipotética de meninas de 10 anos de idade acompanhadas por 70 anos. Duas estratégias foram comparadas: vacinar e rastrear (estratégia alternativa) em relação ao rastreamento (estratégia base). No modelo a cobertura para o rastreamento foi de 77,1% e para a vacina 95%. A taxa de desconto aplicada para calcular custos e efeitos futuros de saúde foi de 5%. A análise de sensibilidade foi realizada para avaliar as incertezas quanto à cobertura vacinal, a sensibilidade do exame citopatológico e o valor da vacinação. Resultados: o modelo simulou que a adição da vacina poderia reduzir em 76,18% o risco de morrer por CCU, evitando 12.072 óbitos por esta doença a um custo médio de US$ 633.559,32/óbitos evitados, com um ganho de 1.389.478 anos de vida ajustado por qualidade. Quanto aos anos de vida ganhos ajustado por qualidade (AVAQ), a estratégia base (rastreamento) representaria um custo médio de US$ 11,62/AVAQ enquanto a estratégia teste (vacina e rastreamento) teria um custo médio de 241,66 US$/ AVAQ. A razão de custo-efetividade incremental (RCEI) desta estimativa foi de US$ 5.504,46/AVAQ. Conclusão: Esta análise, apesar das limitações metodológicas, demonstra que a incorporação, pelo SUS, da vacina quadrivalente ao programa de rastreamento pode ser uma alternativa custo-efetiva para reduzir a mortalidade por CCU. / Salvador

Persistent infection of the cervix with high risk (HR) types of Human Papilloma Virus (HPV) (HR-HPV) can result in precancerous lesions and cancers. However, most HPV infections can be cleared naturally by the immune response without causing disease. Although genetic variations have long been considered as the main explanation for individual heterogeneity in cancer susceptibility, the underlying mechanisms remain unclear. In this project, a panel of routinely taken clinical samples was assessed for 32 rationally selected SNPs with allele frequency related to disease outcome using the Taqman® OpenArray® system. The panel incorporated 475 HR-HPV negative, cytologically-normal cervical samples, 413 HR-HPV positive cervical high grade squamous intraepithelial lesion (HSIL) cases and 62 HR-HPV positive cervical cancers. Two SNPs, rs2234671 and rs2623047, were found with significant differences between HR-HPV negative, cytologically-normal samples and HR-HPV positive cervical HSIL cases. In the validation step, these two SNPs were further genotyped in the same set of samples using TaqMan® SNP genotyping assay and/or LightSNiP assay and in additional samples including 83 HR-HPV positive, cytologically-normal cervical samples, 21 HR-HPV positive cervical cancer cases, 129 HR-HPV positive vulval intraepithelial neoplasia cases and 23 HR-HPV positive vulval cancer cases. Statistical analysis was then performed based on pooled and re-grouped genotyping data of the above-mentioned samples under different genetic models so as to evaluate the associations with different stages in the disease process. After validation, SULF1 rs2623047 revealed a strong significant association with the susceptibility to HR-HPV infection but not with the development of high-grade squamous intraepithelial lesion and the progression to cervical cancer. CXCR1 rs2234671, by contrast, was associated with the progression of HR-HPV-related cancers and the minor allele CXCR1 827C was significantly enriched in HPV16 positive cancers. CXCR1 is a receptor for the chemokine CXCL8/IL-8 and CXCR1 rs2234671 leads to a serine to threonine change in an extracellular loop of the receptor. Functionally, the CXCR1 827C allele was shown to enhance cell motility in response to IL-8 stimulation in a chemotaxis assay with transiently transfected fibroblasts (HEK293 cells) and also in a wound healing assay with stably transduced cervical cancer (CaSki) cells. In addition, significantly increased cell proliferation upon IL-8 treatment was observed in two cervical cancer derived cell lines, CaSki and SiHa, transduced with CXCR1-827C allele, but not in their CXCR1 827G transduced counterparts. These findings suggest that SULF1 rs2623047 and CXCR1 rs2234671 may be genetic risk factors for HR-HPV-related cervical disease and CXCR1 rs2234671 might affect HR-HPV-related cancer susceptibility by functionally altering IL-8-CXCR1 signalling. This information has potential for use in the risk stratification of HR-HPV infected women and may also suggest new therapeutic targets to be exploited for treatment of cervical cancer patients.

ATTITUDES AND KNOWLEDGE OF HPV INFECTION AND VACCINATION Author: Dominika Blašková Supervisor: PharmDr. Eva Zimčíková, Ph.D. INTRODUCTION Human papillomavirus (HPV) is a DNA virus. The virus causes benign and malignant diseases of men and women such as laryngeal papillomatosis, genital warts, oropharyngeal carcinoma, cervical cancer, penile cancer and anus cancer. HPV can be prevented by appropriate precautionary measures. The main preventative method is vaccination against HPV. Besides vaccination, regular screening is necessary to detect premalignant changes on time. AIMS The aim of the theoretical part of the diploma thesis was to summarize the information about HPV, the diseases caused by human papillomavirus and vaccination against HPV, the main preventive measure. The primary aim of the practical part was to find out the level of HPV awareness among girls and boys and diseases caused by HPV. The secondary aim of the practical part was to find out opinions on HPV vaccination and determine the rate of vaccination against HPV among young people in Slovakia. METHODS The method of quantitative research taken in the form of a questionnaire was used in the diploma thesis. The survey was realized at two secondary schools in Svidník, Slovakia. The age range of respondents was 15-20 years. The data...