Abstract
In 2010, a new mouse papillomavirus, MmuPV1, was discovered in a colony of NMRI- Foxn1nu /Foxn1nu athymic mice in India. This finding was significant because it was the first papillomavirus to be found in a laboratory mouse. In this paper we report successful infections of both dorsal and ventral surfaces of the rostral tongues of outbred athymic nude mice. We also report the observation that the base of the tongue, the area of the tongue often targeted by cancer-associated high-risk papillomavirus infections in humans, is especially susceptible to infection. A suitable animal model for the study of oral papillomavirus infections, co-infections, and cancers has long been sought. The work presented here suggests that such a model is now at hand.
INTRODUCTION
Human papillomavirus infections are ubiquitous in the general population and a subset of these viruses is associated with significant disease. Papillomavirus infection is an obligate co-factor for most cervical cancers and this cancer is a leading cause of death in women worldwide with in excess of 300,000 deaths reported each yea[1]. The viruses are also increasingly associated with anal and oral cancers [2–4]. While two vaccines are now available that target a few of the viruses most commonly associated with clinical disease including malignant neoplasia, the uptake of these vaccines has been disappointing and the price is out of reach for use in developing nations. Importantly, the vaccines do not eliminate established infections and no effective treatment or therapy is available. More research will be necessary to achieve satisfactory control of these common infections and to assure that the cancers to which they contribute will be minimized in the years to come.
Oropharyngeal cancers associated with papillomavirus infection are increasing, especially in the young male population [5]. The reasons are unclear although it has been postulated that an increased practice of oral sex may be a factor [6]. Papillomaviruses are strictly species specific and consequently no animal can be infected with a human virus. With the demonstration that MmuPV1 can infect oral tissues of the athymic mouse, and with the observation that the virus appears to have a preference for the base of the tongue, we have demonstrated the practicality of this model for the study of oral infections and, potentially, of papillomavirus-associated oral cancers.
MATERIALS AND METHODS
Viral stock
MmuPV1 virus was isolated from lesions on the tails of mice from our previous study [7]. The lesions were scraped from the tail with a scalpel blade and homogenized in phosphate buffered saline (PBS) using a Polytron homogenizer (Brinkman PT10–35) at highest speed for three minutes while chilling in an ice bath. The homogenate was centrifuged at 10,000 rpm and the supernatant was decanted into Eppendorf tubes for storage at −20°C. For these experiments, the virus was diluted 1:5 in PBS and 200μl was passed through a 0.2μm cellulose acetate sterile syringe filter. This was chased by the addition of 200μl PBS. The PBS filtrate was added to the filtered virus to give a total of 250μl sterile virus solution when taking into account loss in the filter. Viral DNA was quantitated following extraction of the DNA from 5μl of this stock. The DNA was isolated in 50 μl water and SYBR green Q PCR assay was conducted on a series of 1:2 dilutions. Dilutions of plasmid DNA of known concentration were used to develop a standard curve. One μl of DNA was determined to contain 0.012ng viral DNA. 1 ng contains 1.2 x108 copies of viral DNA (http://cels.uri.edu/gsc/cndna.html). Thus, 1 μl of the DNA extract contains 1.4x106 copies of viral DNA meaning such that 1 μl of the viral extract contains 1.4 x 107 viral genome equivalents.
MmuPV1 tongue infections
All mouse work was approved by the Institutional Animal Care and Use Committee of the Pennsylvania State University College of Medicine. Outbred athymic nude mice (Hsd: NU-Foxn1nu) were obtained from Harlan Laboratories and were housed in sterile microisolator cages and were fed sterilized food and water. Four mice, ages 8–12 weeks, were sedated i.p. with ketamine/xylazine mixture (100mg/10mg per kg body weight in PBS). Tongues were withdrawn using a sterile forceps and micro needles (Microneedle Systems, LLC, GA) were used to superficially wound both the dorsal and ventral surfaces of the rostral tongues. Some bleeding occurred but care was taken to minimize this bleeding. Animals were allowed to recover overnight. The following day, each animal was again anaesthetized. Tongues were again gently abraded with the microneedles and 10μl of sterile virus (1.4 x 108 viral genome equivalents) was applied to the freshly abraded surfaces. Animals were monitored weekly and photo documentation was performed. All work was conducted in biosafety cabinets.
Harvest and analysis of tissues
Animals were euthanized by ketamine/xylazine anesthesia followed by cervical dislocation and the entire tongue, with submandibular and palatine mucosae attached, was excised. Specimens were routinely processed to paraffin blocks. Sequential sections were cut for H and E analysis, in situ hybridization and immunohistochemistry. Standard conditions were used for H and E staining. A subgenomic fragment of MmuPV1 (3913bp EcoRV/BamH1 fragment) was used as an in situ hybridization probe for the detection of MmuPV1 DNA in tissues. The probe was biotinylated using the random priming method and diluted in a hybridization cocktail described in previous work [7]. Access to target DNA was obtained with 0.2 mg/ml pepsin in 0.1N HCl incubation at 37°C for 8 minutes. After thorough washing, the biotinylated probe was applied and heated to 95°C for 5 minutes to achieve dissociation of target and probe DNA. Reannealing was allowed to occur for 2 hours at 37°C. Target- bound biotin was detected using a streptavidin AP conjugate followed by colorimetric development in BCIP/NBT. For immunohistochemical (IHC) L1 capsid detection, a goat Group Specific Antibody (GSA) to a conserved region of L1 (ViroStat #5001) was used on FFPE sections. Detection was achieved using the ImmPRESS anti-goat IgG polymer system (Vector #MP-7405). Tissues were examined by an ACVP diplomate pathologist blinded to treatment. All images were obtained with an Olympus BX51 microscope and DP71 digital camera using cellSens Standard 1.12 imaging software (Olympus America, Center Valley, PA).
RESULTS
Both the dorsal and ventral surfaces of the rostral tongues of outbred athymic nude mice are susceptible to infection with MmuPV1
Mice infected on the dorsal and ventral surfaces of the rostral tongues were sacrificed at an early time point of 3.5 months or at later time points of 8, 8.5 and 9 months post infection (one mouse per time point). By 3.5 months, a section of the rostral dorsal surface of the tongue of mouse 3-3L showed significant papillomavirus infection. Figure 1A–C shows H and E, ISH, and IHC respectively of a dorsal lesion of this tongue.
By 8 months post infection, both the dorsal and ventral surfaces of the tongue of animal 3-3R showed very strong hybridization signal and antigen expression. See sagittal sections Figure 2A–C. There was a sharp demarcation between positive and negative signals, the significance of which is not yet understood. Figure 2 D–F shows a higher magnification of a dorsal section of the tongue.
Animals sacrificed at 8.5 and 9 months also exhibited extensive positivity on both dorsal and ventral surfaces of the rostral tongue. (Data not shown).
A Base of tongue lesion was observed in an animal that had been infected on the rostral tongue
Since tongue infections were initiated on the dorsal and ventral surfaces of the rostral (“mobile”) tongue, we did not expect to see lesions at the caudal (base) of the tongue. However, careful examination of the sections of the entire tongue revealed a base-of-tongue lesion in one of the animals. The base of the tongue is of special interest due to its involvement in papillomavirus-associated human cancers [8]. Figure 3A and B shows H and E and ISH sections of the lesion at the base of the tongue at the dorsal fornix of animal 3-3R. Surrounding tissue is negative for the virus.
Inner cheek infections were found in animals infected on the dorsal and ventral surfaces of the tongue
At the time of sacrifice of the four animals infected on the tongue, inner cheek samples were excised and paraffin-embedded. Our earlier studies had shown that secondary infections can occur and we wished to determine whether this proximal tissue was also infected. Figure S1 A and B shows strong in situ hybridization signal in representative sections of both left and right cheek tissue from animal 3-3L.
The base of the tongue was preferentially targeted by secondary infections
During the course of this work, we also conducted infectivity studies in other animals at mucosal sites such as the vagina and anus as well as cutaneous sites including tail and muzzle. Our observation that primary infection of the rostral tongue yielded a secondary infection at the base of the tongue led us to examine the tongues of some of these animals. Tongues from a total of 18 animals infected at sites other than the oral cavity had been archived as tissue blocks. Of these, ten (56%) were found to have lesions at the base of the tongue. Eight of these involved the caudal dorsal tongue and two involved the caudal ventral tongue. Three of the 18 animals (17%) had small areas of secondary infection on the rostral tongue. Table 1 summarizes the secondary base-of-tongue infections found in animals with primary infections at sites other than the oral cavity.
Table 1.
Animal | Primary infection | Location of secondary infection | Figure |
---|---|---|---|
5-2L | Tail | Caudodorsal tongue; | ND |
7-2L | Back and tail | Caudodorsal tongue extending into the duct of the serous lingual accessory salivary gland | 5 E, F |
8-2R | Anus | Caudodorsal tongue extending into the duct of the serous lingual accessory salivary gland | 4 A–C |
10-2L | Vagina | Caudodorsal tongue extending into the duct of the serous lingual accessory salivary gland | 4 D–F |
1-3R | Anus | Dorsal/pharynx in area of palate | S 2 A, B |
4-3L | Vagina | Caudal margin of dorsal tongue near reflection to palatine mucosa; lingual salivary gland duct involvement | 5 A, B |
5-3R | Vagina | Caudal margin of dorsal tongue near reflection to palatine mucosa; lingual salivary gland duct involvement | ND |
6-3R | Muzzle, tail, anus, vagina | Caudoventral tongue near reflection to sublingual oral mucosa | 6 A, B |
7-3L | Muzzle, tail, anus, vagina | Caudoventral tongue near reflection to sublingual oral mucosa | 6 C–E |
10-3 | Muzzle, tail, anus, vagina | Caudodorsal tongue extending into the duct of the serous lingual accessory salivary gland | 5 C, D |
The circumvallate papilla and adjacent Von Ebners glands represent a preferred locus for MmuPV1 infection in mice secondarily infected in the oral cavity
Careful observation of the tongue sections positive for secondary MmuPV1 infection identified the location of seven of the eight dorsal tongue infections as the single circumvallate papilla of the mouse tongue and the adjacent Von Ebners glands. More advanced infections were associated with significant hyperplasia and dysplasia (Figures 4A–F; 5A,B). Figure 5 C–F shows sites in two of four additional tongues with less advanced lesions. Supplemental figure 2 A, B shows the single dorsal back of the tongue lesion not found in the area of the circumvallate papilla. This lesion was located in the dorsal pharynx/palate area of the caudal tongue.
The two secondary infections at the caudoventral tongue were found to target the same locus
Only two secondary infections targeted the caudoventral tongue and both of these were located in an area near the reflection to the sublingual oral mucosa. The limited number of samples does not allow the conclusion that this is a preferred site on the ventral tongue but the data are suggestive. Figure 6A–E.
DISCUSSION
Papillomavirus-associated diseases pose a major problem throughout the world. To date, more than 150 species of human PVs have been fully sequenced. Most of these are relatively benign but a number are implicated in cancers, especially anogenital cancers, as well as some skin cancers and head and neck malignancies. Others do not cause cancer under normal conditions but do present significant medical challenges (reviewed in [9]). Because human papillomaviruses do not infect animals, finding a suitable in vivo model to study the disease has been challenging. Our laboratory [10–16] and those of others [17–21] have used the cottontail rabbit papillomavirus (CRPV) model to good advantage. We have also pioneered the rabbit oral papillomavirus (ROPV) model [22,23]. Due to limited reagents for the rabbit and technical challenges with ROPV, we sought another small laboratory animal model to complement our studies. We were especially interested in a mouse model because of the abundance of reagents available for this common laboratory animal. When the new mouse virus, MmuPV1, was reported [24] we initiated studies to see if this virus would aid our studies on preclinical papillomavirus infections.
MmuPV1 was reported to be a strictly cutaneous pathogen [24] but our early studies revealed mucosal secondary infections [7,25]. This observation was later corroborated by Sundberg et al [26]. We have shown that MmuPV1 has a broad tropism in athymic Foxn1nu mice and that it infects anal, vaginal and cervical tissues [25]. In this paper we extend our observations to demonstrate that the virus can also infect oral mucosal sites, specifically both the dorsal and ventral surfaces of the rostral tongue, the inner cheek, and the oropharyngeal cavity. We show that the oropharyngeal cavity, including base of tongue and surrounding tissues, is especially susceptible to infection and we have localized most of the infections to the circumvallate papilla and associated Von Ebner’s glands. The more advanced lesions (figures 4 A–F; 5A,B) exhibit florid pseudocarcinomatosis and cytopathic effect (CPE) associated with papillomavirus infections.
Oropharyngeal squamous cell carcinomas have been on the rise in much of the world in the past few decades [8]. Two different populations of individuals have been identified as having this disease and it appears to present differently in these two populations [27]. One of the groups is older on average and has risk factors such as heavy drinking and smoking. The other group tends to be younger and healthier. In the latter case, disease is frequently associated with papillomavirus infection, commonly HPV16 but also other types. These infections tend to be located at the base of the tongue and in the tonsillar region [28]. We have demonstrated in this study that the base of the tongue of the nude mouse appears to be a preferred target for oral cavity MmuPV1 infection. We postulate that the MmuPV1/mouse model could be very useful for the study of papillomavirus infection at this anatomical site. We also anticipate that the model will be useful for studies of cancer initiation and progression, studies that will have significant relevance to the human condition. Extensive hyperplasia and dysplasia as well as viral CPE were noted in some of the lesions reported here. Cancers develop over time and we hypothesize that given more time these lesions might have progressed to cancer. Addition of a cofactor such as tobacco smoke or ozone could accelerate malignant conversion. Our research with the rabbit model has shown that synonymous codon modifications in the oncogenes E6 and E7 of CRPV result in genomes that yield infections that rapidly progress to cancer [14]. MmuPV1 genomes with codon modifications may similarly enhance the malignant potential of this virus.
Another use for this model will be to study papillomavirus infection under conditions of immune suppression, conditions that are naturally present in the Hsd: NU-Foxn1nu mouse. As the population of individuals infected with the Human Immunodeficiency Virus (HIV) increases and as more patients receive organ transplants, papillomavirus infections are becoming more prevalent as are associated oral cancers. [29,30]. Until now, there has been no in vivo model to study the disease under these unique conditions. The MmuPV1 /athymic mouse model is ideally suited for these studies.
CONCLUSIONS
We have shown in this study that mouse papillomavirus 1(MmuPV1) infects the oral cavity of outbred nude mice and has a preference for the base of the tongue. Of the 18 tongues of animals infected at sites other than the oral cavity, 10 (56%) had secondary infections at the base of the tongue. The circumvallate papilla and associated Von Ebner’s glands on the caudal dorsal tongue was the preferred site of infection with 7 (70%) of infected animals demonstrating secondary infections only at this locus and not at other oral sites. Two animals (20%) had lesions on the caudal ventral tongue and these lesions targeted the same location suggesting that this might also be a susceptible site. A single lesion was found on the caudal dorsal tongue at the pharynx/palate area. To date, there has been no suitable in vivo model to study oral papillomavirus-associated lesions. Human lesions associated with papillomavirus-induced cancers also tend to occur at the back of the tongue. The MmuPV1 model for papillomavirus infection should provide a viable option for gaining insights into human lesions and associated cancers.
Supplementary Material
Highlights.
Mouse papillomavirus 1 (MmuPV1) preferentially targets the back of the mouse tongue.
Human oral cancers associated with papillomavirus also target the back of the tongue.
The MmuPV1 model will allow the study of oral papillomavirus infections in an in vivo animal model.
Acknowledgments
Financial support. The authors are appreciative of funding provided by NIH grant R01 CA047622 as well as contributions from the Jake Gittlen Memorial Golf Tournament.
Footnotes
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