The Pathogenesis Of Human Papilomavirus Related Dermatosis

The pathogenesis of human papilomavirus related dermatosis[Objective]To investigate the pathogenesis of human papilomavirus infected dermatosis, we focused on two human papilomavirus related skin diseases-condyloma acuminatum and epidermodysplasia verruciformis.[Methods]To investigate the relationship between condyloma acuminatum and DNA methylation, methylation-specific PCR was performed to study 51 cases of condyloma acuminatum patients and 47 cases of normal controls, and to calculate the positive rate of methylation on EVER1 gene which was the predisposing gene of human papilomavirus.To study the role of langerhans cells and cytokines in pathogenesis of human papilomavirus related disease epidermodysplasia verruciformis. The expression of CDla and CD83 were measured by immunohistochemistry in 10 cases of EV lesions and 10 cases of normal human skin. The form, quantity and distribution of LCs were observed under the light microscope. Furthermore, Immunohistochemical stain was also utilized to measure the expressions of IL-10, IL-23 and CD86 in 10 patients with epidermodysplasia verruciformis and in 10 healthy human controls[Results]The positive rate of DNA methylation in condyloma acuminatum patients was 13.73%(7/51).partly positive rate 17.65%(9/51).negative rate 68.62% (35/51),total positive rate 31.38%, while in normal controls that was 8.51%(4/47),2.13%(1/47),89.36%, and 10.64%, respectively.There were CD1a+LCs in all cases of epidermodysplasia verruciformis patients and normal controls, but CD83+LC could not be found in all cases. The quantity of CD1a+LCs in the lesions of epidermodysplasia verruciformis was statistically significant lower(P<0.01)than that in the normal skin. We could also observe the distribution of LCs in epidermodysplasia verruciformis lesions was uneven. And the expressions of IL-10,IL-23 and CD86 could be found in 10 lesional epidermodysplasia verruciformis skin while only IL-10 could be found in the epidermal keratinacytes from one normal control human skin;the score of epidermodysplasia verruciformis group was between three and six, while in normal control group only one case of IL-10 was three, and others were zero; the positive rate of epidermodysplasia verruciformis group were (++) and (+++), while in normal control group only one case of IL-10 was (++),and others were negative.[Conclusion]The positive rate of methylation in condyloma acuminatum patients was higher than than in the normal controls(p<0.05), demonstrating that the pathogenesis of condyloma acuminatum may be related to the methylation of EVER1 gene promoter region.The results indicate that the density of LCs is decreased and the function of LCs is inhibited in EV patients. LCs can not be transformed into the mature status, as a result, immunologic reaction can not be started by antigen presenting and stimulating T lymphocytes. This may account for the HPV infection in EV patients. And the pathogenesis of epidermodysplasia verruciformis may also be correlated with IL-10, IL-23 and CD86 which were secreted by lesional keratinocytes.