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HPV May Lurk In Your Throat

Wednesday, January 31, 2018

By Susanne Pallo

Human papilloma virus (HPV), the culprit behind cervical cancer and some forms of head and neck cancer may hide in small pockets on the surface of tonsils in people not known to carry the virus. The finding, reported by University of Rochester Medical Center researchers in the Journal of the American Medical Association, could be pivotal for the prevention of oropharyngeal cancers that form on the tonsils and tongue.

By mid-adulthood, most people have been exposed to HPV. The same strains that cause cervical cancer (mainly HPV 16 and 18) cause head and neck cancers. While verified tests exist to detect HPV in people before they develop cervical cancer, the same is not true for HPV-related head and neck cancers, which are expected to outnumber cervical cancer cases by 2020.

Only about five percent of HPV-infected people will develop cancer of the mouth or throat, suggesting most people’s immune systems can easily hold back HPV infections. Which begs the question, why doesn’t the immune system protect the five percent who develop cancer?

Our findings could have far-reaching implications for identifying people at risk of developing HPV-related head and neck cancers and ultimately preventing them.

Matthew Miller, M.D., associate professor of Otolaryngology and Neurosurgery at URMC believes the answer lies is biofilms - thin, slimy sheets of bacteria. He and his colleagues found HPV encased in biofilms inside pockets on the tonsil surface, called tonsil crypts, which is where HPV-related head and neck cancers often originate.

Miller and study co-author, Katherine Reith, M.D., an Otolaryngology resident at URMC, studied tissue samples from 102 patients who had elective tonsillectomies. Five of those samples contained HPV and four contained high risk strains, HPV 16 and 18. In every case, HPV was found in tonsil crypts biofilms.

The group believes HPV is shed from the tonsil during an active infection and gets trapped in the biofilm, where it may be protected from immune attack. In the crypts, the virus likely lays in wait for an opportunity to reinstate infection or invade the tonsil tissue to develop cancer.

“Given the lack of universal HPV immunization and the potential for the virus to evade the immune system even in individuals with detectable HPV in their blood, our findings could have far-reaching implications for identifying people at risk of developing HPV-related head and neck cancers and ultimately preventing them,” Miller said.

Now, the team plans to investigate potential screening tools, such as an oral rinse, to detect HPV in the mouth and throat. The next step would be to develop topical antimicrobials that would disrupt the biofilm and allow the immune system to clear the virus.

While scientists still do not know if HPV vaccines reduce head and neck cancer, Miller recommends all young boys and girls receive a full course of the vaccinations. He hopes that better oral HPV screening tools will help determine the impact of the vaccine on these cancers.

Read the full study in JAMA.

“Bubbles” Boost Search for Treatment to Aid Head and Neck Cancer Patients

Wednesday, October 25, 2017

A scientific team at the University of Rochester is using innovative technology to discover preventative treatments for salivary gland radiation damage typical for head and neck cancer patients—and recently received a $3.8 million National Institutes of Health grant to support their investigation.

Cancer patients can lose salivary gland function during treatment for head and neck tumors. The irreversible damage, which prevents patients from producing saliva, often results in permanent dry mouth and makes it difficult to eat, speak, and swallow. The team will develop salivary gland tissues using a unique chip technology called “microbubbles,” which are tiny spherical wells or bubbles that can hold cells.

The use of the microbubble platform is based on several years of salivary gland research, led by Catherine E. Ovitt, Ph.D., associate professor of Biomedical Genetics, a member of the UR Center for Oral Biology, and an expert in the repair and regeneration of salivary glands, and Danielle Benoit, Ph.D., associate professor of Biomedical Engineering and an expert in drug delivery systems and hydrogel platforms for tissue engineering approaches. Together with Lisa A. DeLouise, Ph.D., associate professor of Dermatology and Biomedical Engineering, who developed and received several patents for the microbubble concept, the scientists are working as co-principal investigators on the NIH project.

Their goal is to find drugs that could be given to patients prior to radiation treatment that would prevent damage to the glands.

The team is collaborating with Shawn D. Newlands, M.D., Ph.D., M.B.A., chair of the Department of Otolaryngology and member of the Wilmot Cancer Institute’s head and neck oncology team, to collect salivary tissue from consenting patients undergoing salivary gland surgery. Salivary gland cells are isolated from these tissues for seeding into microbubbles for the investigation. Additionally, Paul Dunman, Ph.D., associate professor of Microbiology and Immunology, will provide high-throughput drug-screening expertise during the second phase of the project, which is contingent upon successful development of the human gland chips.

Read More: “Bubbles” Boost Search for Treatment to Aid Head and Neck Cancer Patients

March 2017

URMC Otolaryngology Residency Program Matches Two Medical Students

The department is pleased to welcome incoming first-year residents Martha Luitje from the University of Massachusetts Medical School and Sheela Saidha from Eastern Virginia Medical School to the five-year Otolaryngology Residency Program.

January 2017

Shawn Newlands Appointed Associate CMO for Ambulatory Care

Shawn NewlandsIn a move that reflects the importance of our expanding outpatient network, Shawn Newlands, M.D., Ph.D., M.B.A, has been appointed to the newly created role of Associate Chief Medical Officer for URMC’s ambulatory care enterprise.

URMC Otolaryngology Resident Receives Award for Presentation

Otolaryngology second-year resident Stephanie Wong won 1st place in pediatric otolaryngology for her poster presentation on the management of pediatric orbital cellulitis at the Triological Society's 2017 Combined Sections Meeting held in New Orleans, LA, January 19th-21st, 2017.