Human papillomavirus and pterygium. Is the virus a risk factor?

Eye Pathology Institute, University of Copenhagen, Frederik V's Vej 11, DK-2100 Copenhagen, Denmark.
British Journal of Ophthalmology (Impact Factor: 2.81). 09/2007; 91(8):1016-8. DOI: 10.1136/bjo.2006.108829
Source: PubMed

ABSTRACT Pterygium is a disease of unknown origin and pathogenesis that might be vision threatening. It is characterised by a wing-like conjunctival overgrowth of the cornea. Several studies have investigated human papillomavirus (HPV) as a risk factor for the development of pterygia, but the results are inconclusive.
To investigate a large sample of pterygia for the presence of HPV in order to clarify the putative association between pterygia and HPV.
100 specimens of pterygium from Danish patients and 20 normal conjunctival biopsy specimens were investigated for the presence of HPV with PCR technique using beta-globin primers to access the quality of the extracted DNA and the HPV primers MY09/11 and GP5+/6+. HPV-positive specimens underwent subsequent HPV typing with type-specific HPV primers and further investigation with DNA in situ hybridisation (ISH).
90 of 100 investigated pterygia proved suitable for HPV analysis by PCR. As beta-globin could not be amplified, 10 specimens were excluded from the study. 4 of 90 pterygia harboured HPV. HPV type 6 was identified in all four HPV-positive pterygia. The 20 normal conjunctival biopsy specimens were beta-globin positive and HPV negative. All four pterygia that were HPV type 6 positive were DNA ISH negative.
The low presence of HPV DNA in pterygia does not support the hypothesis that HPV is involved in the development of pterygia in Denmark.

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    ABSTRACT: Purpose: Human papillomavirus (HPV) infection has been implicated as a possible inducing factor for benign and neoplastic ocular surface diseases such as pterygia and ocular-surface squamous neoplasia (OSSN). However, the wide range in HPV prevalence previously reported for both diseases adds controversy to, and highlights the limitations of this field. The aim of this study was to determine the prevalence of HPV in pterygia and OSSN and to devise a standardized approach for detecting viral DNA in ocular tissue samples. Methods: DNA was extracted from a variety of specimens (n=160) including formalin-fixed paraffin-embedded tissue shavings, fresh tissue and cultured cells. Nested PCR for HPV with consensus and subtype-specific primers was used to detect viral DNA. Confirmatory assays including molecular sequencing, histology, and immunohistochemistry for HPV E6 protein and p16 were also performed. Results: HPV was not detected in pterygia or normal conjunctiva. However, 6.5% (3/46) of OSSN samples were HPV-positive by PCR, sequencing and immunohistochemistry. Positive cases were all squamous cell carcinoma of the conjunctiva (SCCC), the most severe form of OSSN, representing 12.5% (3/24) of SCCCs in our cohort. HPV-16 was the genotype identified in each case and this correlated with the presence of koilocytes and intense immunoreactivity for p16. Our study found no association between pterygia and OSSN with other oncogenic viruses, such as EBV or CMV since they were just as prevalent in normal conjunctiva. Conclusions: The low prevalence of HPV-16 in ocular surface disease suggests infection is not a cause but a cofactor in disease development.
    Investigative ophthalmology & visual science 11/2013; 54(13). DOI:10.1167/iovs.13-13140 · 3.66 Impact Factor
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    ABSTRACT: Abstract Pterygium is a type of benign uncontrolled growth of the conjunctive tissue that lays over the sclera. It can significantly alter visual function in advanced cases and become inflamed, leading to redness and irritation in the area. Although the exact etiology of pterygium remains uncertain, recent advances have provided important insight into the pathogenesis of pterygium. These studies indicate that tumor suppressor gene p53 and other genes associated with DNA repair, cell proliferation, migration and angiogenesis are critical for the development of pterygium. In addition, Human papillomavirus infection has been shown to be a risk factor in some populations. In this article, the current understanding of the pathogenesis of pterygium is reviewed.
    Current eye research 09/2013; DOI:10.3109/02713683.2013.823212 · 1.66 Impact Factor
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    ABSTRACT: Background and Objective: Pterygium is a fibrovascular lesion of the ocular surface with unknown origin, decrease in the vision. This study was done to evaluate the possible role of Epstein-Barr virus (EBV) in the formation of pterygia. Methods: This case-control study was done on 50 tissue specimens of pterygium from the patients who underwent pterygium surgery as the case group and 10 conjunctival biopsy specimens of individuals without pterygium including the patients whom underwent cataract surgery, as controls. The evidence of EBV infection was tested by polymerase chain reaction (PCR). Results: EBV was detected in three (6%) patients with pterygia. EBV was not detected in controls. There was not any significant correlation between pterygium and the presence of EBV. Conclusion: According to this study, EBV virus is not associated with pterygium formation. Keywords: Pterygium, Epstein-Barr virus, PCR

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