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55 Cards in this Set

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Oval cells
Hepatic stem cells

These proliferate in response to Hep B infection
These are more prone to transformation
ORF X
Can function as a transcription factor
May be involved in signaling via MAP kinase

Expression causes HCC in mice
Insertion that occurs in majority of HCC tumor cells
Viral insertion close to proto-oncogene N-MYC

Up-regulates N-MYC expression
% risk of carrier state in Hep B infection
5%
% of chronic Hep B pts. that develop HCC?
25%
Other risk factors for HCC
Alcohol
Aflatoxin exposure
Hepatitis B/C
Aflatoxin
Toxin made by apserpgillus

Contaminates some foods (ie peanuts)
Treatments used in Hep B carrier state
Interferon
Nucleoside analog
Strains of HPV associated with cancer
16, 18, 31, 33
Cancer type that HPV is classically associated with
Cervical cancer
% of HPV+ pts. that go on to get cancer
< 10%
Other risk factors for cervical cancer
Sexual promiscuity
Smoking
Loss of genomic sequences on chrom. 3 & 11
Immune suppression
Other sites (beyond cervix)
where HPV can cause cancer
Anogenital area
Head
Neck
p21
Actual suppressor that arrests cell cycle in response to DNA damage

p21 levels are dependent upon p53 levels
Degraded p53 cannot signal this protein to arrest the cycle
Cellular protein that E6 effects
p53

NOTE: E6-AP actually binds directly to p53
Complex is made: E6/E6-AP/p53
Cellular protein that binds to E7
Rb
Effect of E7-Rb binding
Rb binding to E2F is disrupted
Rb is released and activated

Active Rb activates cell cycle progression
Area of cervix most vulnerable to infection
Transformation zone
Celular layers in which HPV replication occurs
Only the UPPER layers

Note: basal layers DO contain HPV, just not growing
What is the first sign of cervical cancer?
Cervical dysplasia

Note: a.k.a. Cervical Intraepithelial Neoplasia (CIN)
Hallmark of HPV infection
Koilocyte
% of CIN+ smears that go onto invasive cervical cancer
5 - 10%
HPV protein being used in vaccine
L1 capsid protein
Etiological agent in Burkitt's lymphoma
EBV
EBV Protein LMP1
Latency protein

Can cause immortilization (via abrogation of contact inhibition)
What cells is EBV tropic for?
B cells
Common translocation in Burkitt's lymphoma
t(8;14)

myc proto-oncogene
How quickly can a Burkitt's tumor double in size?
In 24 hours
Characteristics of Endemic Burkitt's
95% EBV+
Found in equatorial Africa

UPSTREAM activation of myc
Tumors mostly in jaw
Characteristics of NON-endemic Burkitt's
15% EBV+
NO geographical restriction

Activation WITHIN myc
Tumors mostly in abdomen
Lineage of Reed-Sternberg cell
B cell
Effect of LMP1 in Hodgkin's Lymphoma
Resembles a TNF protein
Associated w/ upregulation of bcl-2 and IL-10
Poor prognostic factors in Hodgkin's
Lymphocyte-poor type
"B" symptoms -- itch, fever
Bulky disease
Distant disease
Tumors assoc. w/ EBV
Hodgkin's
Burkitt's lymphoma
Peripheral B cell lymphoma
Leiomyosarcoma
Nasopharyngeal Carcinoma
X-linked lymphoproliferative disease
Disease marked by fulminant infectious mono
Mediated by EBV+ B cells and activated T cells

Leads rapidly to death (most pts. dead before 10 y.o.)

Mortality w/ fulminant mono is >90%
Post-transplant Lymphoproliferative Disorder
EBV infected B cells gain a growth advantage
May manifest as acute mono picture

Risk factors include:
Pediatric pts.; Previously EBV negative
T cell depletion; T cell immunosuppression

Treatment focuses on reduction of immunosuppression
EBV Ag w/ most oncogenic activity
LMP-1

Can confer ligand effect on CD40
Thus, can activate B cells
KSHV genes that lead to immortalization
LNA - latency gene
Viral cyclin
v-FLIP - anti-apoptosis homolog
Other diseases that can be caused by KSHV
Primary Effusion Lymphoma
Castleman's Disease
KSHV is highly associated w/ what other virus?
HTLV-1
% of homosexual men that KSHV shows up in
20%
Primary Effusion Lymphoma pts. are often co-infected w/ what virus?
EBV
What cells does HTLV-1 target?
CD4 cells
(NOT cytopathic to these)
What disease does HTLV-1 cause?
Adult T cell leukemia
Geographical clustering of ATL
Japan
Brazil
Caribbean
Chief etiological agent of HTLV-1
Tax1
Effects of Tax1
Transforming gene all by itself
Can act as transcription factor in vitro
Represses p53 and p16
Activates NF-kappaB
Cells targeted by HTLV-2
CD8 cells
Cells targeted by HTLV-3 (HIV)
CytoPATHIC for CD4 cells

Association w/ cancer is likely secondary
Due to repression of immune surveillance
AIDS related malignancies
Non-Hodgkin's Lymphoma
Castleman's Disease
Primary Effusion Lymphoma
Kaposi's Sarcoma
Leimyosarcoma
Successful therapy for SCID involved what?
Supply of gamma chain of T cell receptor
Latency period of how long is typical w/ Hep C?
20 - 30 years
Liver disease that accompanies almost all HCC that's assoc. w/ Hep C?
Cirrhosis of the liver
Which one integrates into the host genome?

Hep B OR Hep C
Hepatitis B
HCV core protein has been shown to have what oncogenic activities?
Diminishing p53 levels
Subsequently diminishing p21 levels