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J Gen Virol 88 (2007), 2662-2669; DOI 10.1099/vir.0.82911-0

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Short Communication

Genetic diversity of cutaneous human papillomaviruses

Ola Forslund

Department of Laboratory Medicine, Division of Medical Microbiology, Lund University, University Hospital MAS, SE-20502 Malmö, Sweden

Correspondence
Ola Forslund
Ola.forslund{at}med.lu.se


   ABSTRACT
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Human papillomaviruses (HPVs) of the genera Betapapillomavirus and Gammapapillomavirus are common on human skin. Sequencing of subgenomic amplicons of cutaneous HPVs has revealed a large number of novel putative HPV types within these genera. Phylogenetic analysis based on these amplicons revealed 133 putative HPV types with <90 % sequence identity to any known HPV type or to each other. As there are already 34 characterized HPV types described within the genera Betapapillomavirus and Gammapapillomavirus, they appear to be the most genetically diverse of the HPVs, apparently comprising at least 167 different HPV types.

A supplementary table showing GenBank accession numbers for all sequences used in this study is available with the online version of this paper.


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Numerous bacteria and at least one fungus appear to be normal colonizers of the human skin ecosystem (Fredricks, 2001Down). It is also clear that cutaneous human papillomaviruses (HPV) are commonly present on healthy human skin (Antonsson et al., 2000Down, 2003aDown, bDown; Astori et al., 1998Down; Boxman et al., 1997Down; Forslund et al., 2003bDown, 2004Down; Harwood et al., 2004Down; Wieland et al., 2000Down). Based on phylogenetic relatedness of the L1 gene, the cutaneous HPV types are classified in different genera, of which Betapapillomavirus contains 25 fully characterized HPV types [previously designated epidermodysplasia verruciformis (EV) types], Gammapapillomavirus contains seven characterized HPV types, Mupapillomavirus includes two HPV types (HPV1 and 63) and Nupapillomavirus harbours only one HPV type (HPV41) (de Villiers et al., 2004Down). The genus Betapapillomavirus has been divided further into five distinct species with related HPV types (Beta-1: HPV5, 8, 12, 14, 19, 20, 21, 24, 25, 36, 47, 93; Beta-2: HPV9, 15, 17, 22, 23, 37, 38, 80; Beta-3: HPV49, 75, 76; Beta-4: HPV92; and Beta-5: HPV96), and Gammapapillomavirus into five species (Gamma-1: HPV4, 65, 95; Gamma-2: HPV48; Gamma-3: HPV50; Gamma-4: HPV60; Gamma-5: HPV88) (de Villiers et al., 2004Down). In addition, species Alpha-2, -4 and -8 contain 13 HPV types that cause cutaneous lesions (HPV2, 3, 7, 10, 27, 28, 29, 40, 43, 57, 78, 91, 94) (de Villiers et al., 2004Down).

Although no cutaneous high-risk HPV types, similar to the genital HPVs, have been defined (Lörincz et al., 1992Down), HPV5 and HPV8 are associated with squamous cell carcinoma among individuals with the rare hereditary disease EV (Orth, 1986Down). Furthermore, among immunosuppressed renal-transplant recipients, the betapapillomaviruses have frequently been detected in both pre-malignant and malignant skin lesions (Antonsson et al., 2000Down; Berkhout et al., 1995Down, 2000Down; de Jong-Tieben et al., 2000Down; de Villiers et al., 1997Down; Forslund et al., 2003bDown; Hopfl et al., 1997Down; Shamanin et al., 1994bDown). Also, among immunocompetent patients, the betapapillomaviruses have been commonly detected in both skin tumours (Antonsson et al., 2000Down; Boxman et al., 2000Down; Forslund et al., 2003aDown, bDown; Harwood et al., 2000Down, 2004Down; Iftner et al., 2003Down; Meyer et al., 2000Down, 2001Down; Pfister et al., 2003Down; Shamanin et al., 1996Down; Wieland et al., 2000Down) and healthy skin (Antonsson et al., 2000Down; Astori et al., 1998Down; Harwood et al., 2004Down; Iftner et al., 2003Down; Meyer et al., 2001Down).

The development of PCR testing with general primers for amplification of a broad range of HPV types has had a major impact on the molecular epidemiology of HPV, including detection of novel putative cutaneous HPV types identified by sequencing of subgenomic amplicons. Several putative HPV types have been detected by PCRs with general primers that target the L1 open reading frame (Fig. 1Down) (Berkhout et al., 1995Down, 2000Down; Forslund et al., 1999Down, 2003aDown; Harwood et al., 1999Down; Shamanin et al., 1994aDown, bDown, 1996Down). However, although the number of cutaneous putative HPV types has increased considerably, knowledge about their phylogeny is insufficient.


Figure 1
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Fig. 1. Schematic positions of general primers in the L1 open reading frame (HPV8) for amplification of cutaneous HPV. (a) Single-round PCR system using primers FAP59 and FAP64 (Forslund et al., 1999Down) and nested FAP-primers for ‘hanging-droplet’ PCR (Forslund et al., 2003aDown). (b) Nested PCR (Berkhout et al., 1995Down). (c) Nested PCR (Harwood et al., 1999Down). (d) Single-round PCR (Shamanin et al., 1994bDown). (e) Nested PCR for which the outer reverse primer was CP71A. CP71B and CP71C were used in separate assays (Berkhout et al., 2000Down). The grey box indicates the FA sequence used for phylogenetic analysis in the present study.

 
The aim of the present survey was to perform a comprehensive phylogenetic analysis of subgenomic amplicons of putative HPV types, detected by the use of primers FAP59 and FAP64 (Forslund et al., 1999Down) and reported previously in 10 studies (Alotaibi et al., 2006Down; Antonsson & Hansson, 2002Down; Antonsson et al., 2000Down, 2003aDown, bDown; Forslund et al., 1999Down, 2003bDown, 2004Down; Hazard et al., 2007bDown; Nordin et al., 2007Down).

To define a novel papillomavirus type, the complete L1 sequence should be <90 % identical to the L1 of characterized types (de Villiers et al., 2004Down). Although the FA sequence generated by the primers FAP59 and FAP64 only constitutes about 30 % of the L1, it could be considered for identification of putative HPV types (Fig. 1Up). In order to investigate whether the FA sequence is valid for taxonomic purposes, the FA sequence and the L1 sequence of HPV5 were aligned pairwise with corresponding sequences of 24 characterized HPV types within the genus Betapapillomavirus, and those of HPV4 with eight HPV types across the genus Gammapapillomavirus, by using BioEdit, allowing ends to slide (Hall, 1999Down). Furthermore, comparative analysis was performed on phylogenetic trees based on the FA sequence and the entire L1 for 34 HPV types within the beta- and gammapapillomaviruses (see below for description of method).

In the present study, the analysis included FA sequences up to FA164 (putative subtypes and variants were omitted) within the genera Betapapillomavirus and Gammapapillomavirus with <90 % sequence identity to any known HPV type or to each other. No HPV sequences from the genera Alphapapillomavirus, Mupapillomavirus or Nupapillomavirus were included, as only one FA sequence (FAIMVS3; GenBank accession no. AF489705) has hitherto been grouped within the alphapapillomaviruses. FA sequences were obtained from GenBank; accession numbers are available in Supplementary Table S1 in JGV Online. Due to partially overlapping amplicons, FA53 was presented in the tree as vs73-1, FA114 as vs102-4, FA118 as vs42-1, FA119 as vs75-3 and FA127 as vs20-4 (Shamanin et al., 1994bDown). Corresponding sequences of characterized HPV types were included from HPV4, HPV5, HPV8, HPV9, HPV12, HPV14, HPV15, HPV17, HPV19, HPV20, HPV21, HPV22, HPV23, HPV24, HPV25, HPV36, HPV37, HPV38, HPV47, HPV48, HPV49, HPV50, HPV60, HPV65, HPV75, HPV76, HPV80, HPV88, HPV92, HPV93, HPV95, HPV96, HPV101, HPV103 and RTRX7. Members of the genus Gammapapillomavirus have been shown to have a phylogenetic position adjacent to some animal papillomaviruses (de Villiers et al., 2004Down), and their FA sequences were therefore included as an outgroup: hamster oral papillomavirus (HaOPV; GenBank accession no. E15110 [GenBank] ), Phocoena spinipinnis papillomavirus (PsPV; AJ238373 [GenBank] ), bovine papillomavirus 3 (BPV3; NC_004197 [GenBank] ), BPV4 (X05817 [GenBank] ) and BPV6 (AJ620208 [GenBank] ).

The average size of the subgenomic fragments was 438 nt (range, 424–449 nt) without primer sequences. For all sequences, one N was added to the first nucleotide to make up a triplet and sequences were aligned by CLUSTAL_W using BioEdit (Hall, 1999Down). Then, sequences were edited manually to repair disrupted codons of amino acids. Aligned sequences were converted to the format of MEGA version 2.1 (Kumar et al., 2001Down). A neighbour-joining tree was generated by the Tamura three-parameter (Tamura-3) algorithm, using pairwise deletions of gaps, and bootstrap values were estimated on 1000 replicates. The aligned sequences were also used to calculate a pairwise sequence identity matrix using BioEdit.

In order to investigate the taxonomic validity of the FA sequence, it was compared with the L1 sequence of HPV by pairwise comparisons with corresponding sequences of 24 characterized HPV types within the genus Betapapillomavirus. The mean difference of nucleotide identity was 1.4 % (range, 0–4 %) across the genus Betapapillomavirus between the FA sequence and the L1 sequence of HPV5. The corresponding analysis of HPV4 with eight HPV types across the genus Gammapapillomavirus showed a mean difference of 1.1 % (range, 0–2 %). This is in agreement with that of Hazard et al. (2007a)Down, reporting a mean difference of 1.1 % between the FA sequence and the L1 sequence. Comparative analysis of trees based on the FA sequence and the L1 for 34 HPV types within the genera Betapapillomavirus and Gammapapillomavirus demonstrated largely congruent tree topologies (Fig. 2a, bDown). The bootstrap values were generally high for both the FA sequences and the entire L1 sequences, although they were slightly lower for the FA sequences. Thus, the comparable results suggest that the FA sequence is representative for phylogenetic analysis.


Figure 2
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Fig. 2. (a, b) Phylogenetic trees of 34 cutaneous HPV types of the genera Betapapillomavirus and Gammapapillomavirus: (a) constructed from alignment of the FA sequence in the L1 gene; (b) constructed from alignment of the entire L1 gene. Bootstrap values >70 % are shown. (c) Phylogenetic tree with 167 cutaneous HPV types/putative types of the genera Betapapillomavirus and Gammapapillomavirus. Constructed from alignment of the FA sequence in the L1 gene. The corresponding sequences of the animal papillomaviruses HaOPV, PsPV, BPV3, -4 and -6 were used as an outgroup. The numbers within each genus refer to papillomavirus species. Dots indicate characterized HPV types. (d, e) Phylogenetic sub-trees of Fig. 2(c)Up, with 61 HPV types/putative types of the genus Betapapillomavirus (d) and 106 HPV types/putative types of the genus Gammapapillomavirus (e). Dots indicate characterized HPV types. Bootstrap values >70 % are shown.

 
In total, the analysis revealed 167 different HPV types/putative types among the genera Betapapillomavirus and Gammapapillomavirus: 34 already characterized HPV types and 133 putative HPV types (Fig. 2cUp). The right part of the tree harbours HPVs of the genus Betapapillomavirus, with 36 putative HPV types (including RTRX7) and 25 characterized HPV types, comprising a total of 61 HPV types/putative types (Fig. 2cUp). The left part of the tree displays HPVs of the genus Gammapapillomavirus, with 97 putative HPV types and nine characterized HPV types, thus with a total of 106 HPV types/putative types (Fig. 2cUp). The bootstrap values were generally high for the nodes of the betapapillomaviruses (Fig. 2dUp), whereas for the gammapapillomaviruses, several of the nodes had bootstrap values of <70 %, indicating less powerful discrimination within this genus (Fig. 2eUp). Comparative analysis of trees generated by the Tamura-3 distance model/neighbour-joining tree and by the maximum-likelihood algorithm by PhyML (Guindon & Gascuel, 2003Down) revealed very similar and congruent topologies (data not shown), further supporting the adequacy of the presented tree (Fig. 2cUp).

HPV types within a species share between 71 and 89 % nucleotide identity of the complete L1 sequence (de Villiers et al., 2004Down). Among the 36 putative HPV types clustered in the tree within the species Beta-1, -2, -3 or -5, nucleotide identities to the HPV type representing each species were generally >71 % (Table 1Down). Among the 97 putative HPV types within the genus Gammapapillomavirus, only FA41 and FA104 were grouped within species 1, and FA27 and FA58 were within species 2 (Table 1Down). The other 93 putative HPV types demonstrated mean sequence identities of <71 % to the HPV types representing each species (Table 1Down). Thus, the vast majority of the putative HPV types within the genus Gammapapillomavirus were segregated outside the defined species. Accumulation of complete L1 gene sequence information from these putative HPV types would probably allow additional species in the genus Gammapapillomavirus to be defined.


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Table 1. Pairwise nucleotide identities (%) between putative HPV types (FA sequence) and HPV types representing each species

Value in bold represent nucleotide identities of ≥71.0 %, classifying putative HPV types in a species.

 
Noteworthily, the left-hand part of the tree included HPV101 and HPV103, which were isolated from genital samples of women with CIN3 (cervical intra-epithelial neoplasia grade 3) and normal cytology (Chen et al., 2006Down). Comparative analysis of the FA sequences of HPV101 and HPV103 demonstrated 63 and 61 % nucleotide identity to HPV4 (species 1), respectively (Table 1Up). They probably belong to a separate species within the genus Gammapapillomavirus because, within a genus, an HPV type of a species shares 60–70 % nucleotide identity to an HPV type in another species (de Villiers et al., 2004Down). However, the FA sequences of these HPV types also showed nucleotide identities of 60 and 61 % to HaOPV (Table 1Up), which may indicate that these HPV types overlap between the genera Gammapapillomavirus and Pipapillomavirus (HaOPV), as has been proposed previously (Chen et al., 2006Down).

The included animal papillomaviruses formed a branch separated from the gamma- and betapapillomaviruses (Fig. 2cUp). In addition, pairwise nucleotide comparisons demonstrated that the animal papillomaviruses within the genera Omicronpapillomavirus and Xipapillomavirus had <60 % sequence identities to the gamma- and betapapillomaviruses, although those of the genera Xipapillomavirus showed identities of about 60 % to species Beta-1 (Table 1Up).

It was also noted that the majority of the putative HPV types had been initially isolated from healthy skin (83 %, 105/127) compared with lesions (17 %, 22/127). This observation strengthens the earlier suggestion of a commensal nature of the cutaneous HPVs (Antonsson et al., 2000Down).

The mucosal HPV types, such as HPV16 and others within the genus Alphapapillomavirus, comprise about 60 HPV types/putative types (de Villiers et al., 2004Down). Thus, it appears that HPV types/putative types of the genera Betapapillomavirus and Gammapapillomavirus with cutaneous tropism substantially outnumber those with mucosal tropism. Albeit, additional HPV types within the genus Alphapapillomavirus might be discovered in future. The evolutionary basis for the larger genetic diversity within the genera Betapapillomavirus and Gammapapillomavirus is unknown. Speculatively, UV light-induced damage may contribute to a higher mutation rate of the sun-exposed papillomaviruses of the skin. Moreover, genetic variation of cutaneous papillomaviruses also appears to be common on skin of other mammals (Antonsson & Hansson, 2002Down).

In summary, the present survey demonstrates a large genetic diversity within the genera Betapapillomavirus and Gammapapillomavirus and suggests that the majority of the putative HPV types within the genus Gammapapillomavirus appear to be segregated outside the defined species.


   ACKNOWLEDGEMENTS
 
The study was financed by a grant from the Swedish Research Council (K2003-06XD-14532-01A) and the Cancer Foundation of the University Hospital, Malmö. Joakim Dillner, Bengt-Göran Hansson, Michael Lindberg and Anders Widell are acknowledged for helpful comments on the manuscript. Johanna Kullander is acknowledged for permission to use the sequence of FA164.


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Received 7 February 2007; accepted 6 June 2007.


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