title: BCL-2-related apoptosis markers in cutaneous human papillomavirus-associated lesions.
abstract: BACKGROUND
  Human papilloma virus (HPV) is an etiological agent in benign and malignant epithelial tumors. Resistance to apoptotic stimuli by viral strategies represents an immunologic escape mechanism during virus-induced tumor development and is critical for efficient replication of the virus.
  
  
  OBJECTIVE
  The aim of the present study was to investigate a role of bcl-family proteins in the anti-apoptotic pathways modulated by low-risk HPVs in the development of benign HPV-associated cutaneous tumors.
  
  
  METHODS
  Forty lesional biopsy specimens from HPV-associated cutaneous lesions and 11 non-lesional control skin biopsies were studied by immunohistochemical analysis for the differential expressions of HPV antigens, the pro-apoptotic bax protein, and the anti-apoptotic bcl-2 and bcl-x proteins.
  
  
  RESULTS
  Compared with the normal epidermis, bcl-2 and bcl-x expression were significantly reduced in the lesional epidermis. Bax was expressed in HPV-associated cutaneous lesions, although the expression did not reveal a significant deviation from that in normal skin.
  
  
  CONCLUSIONS
  These findings indicate a discordant expression of bcl-2/ bcl-x and bax proteins in HPV-associated skin lesions and suggest that low-risk HPVs mediate other pathways that bypass the action of anti-apoptotic bcl-2 and bcl-x proteins. The presence of bax expression with a prominent decrease in bcl-2/ bax ratio and the lack of massive apoptosis in HPV-associated benign epithelial lesions may imply that interference with the pro-apoptotic proteins of bcl-family may constitute one of the several mechanisms mediated by HPV oncoproteins for the suppression of apoptotic process.
authors.affiliation: Kirikkale University Faculty of Medicine, Ankara, Turkey. emelerkek@hotmail.com
authors.forename: Emel
authors.initials: E
authors.lastname: Erkek
authors.forename: Onder
authors.initials: O
authors.lastname: Bozdoğan
authors.forename: Pinar
authors.initials: P
authors.lastname: Atasoy
authors.forename: Ahu
authors.initials: A
authors.lastname: Birol
authors.forename: Mukadder
authors.initials: M
authors.lastname: Koçak
mesh_terms: D000956:Antigens, Viral / Q000032:analysis; D017209:Apoptosis; D015415:Biomarkers / Q000032:analysis; D006801:Humans; D007124:Immunoenzyme Techniques; D027383:Papillomaviridae / Q000276:immunology / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000378:metabolism* / Q000473:pathology; D011518:Proto-Oncogene Proteins / Q000378:metabolism; D019253:Proto-Oncogene Proteins c-bcl-2 / Q000378:metabolism*; D012189:Retrospective Studies; D017193:Skin Diseases, Viral / Q000378:metabolism* / Q000473:pathology; D051028:bcl-2-Associated X Protein; D051020:bcl-X Protein
chemical_list: D000956:Antigens, Viral; C494826:BAX protein, human; C494811:BCL2L1 protein, human; D015415:Biomarkers; D011518:Proto-Oncogene Proteins; D019253:Proto-Oncogene Proteins c-bcl-2; D051028:bcl-2-Associated X Protein; D051020:bcl-X Protein