Bilateral pre-auricular papillary squamous cell carcinomas associated with papillomavirus infection in a domestic cat.

BACKGROUND: Cutaneous papillary squamous cell carcinomas (SCCs) are extremely rare in humans and have not been reported in any nonhuman species. In humans, oral papillary SCCs are often caused by papillomavirus infection and have a more favourable prognosis than other SCC subtypes. CASE: A 10-year-old ginger and white domestic short hair cat had a 12 month history of symmetrical, roughly circular, exophytic 2 cm diameter masses in both pre-auricular regions. Surgical excision was performed, although with only narrow margins. METHODS AND RESULTS: Histology of both masses revealed a proliferation of neoplastic keratinocytes arranged in numerous filiform projections that were supported by fibrovascular stalks. Although the cells were confined to the epidermis predominantly, nests of neoplastic cells were visible within the superficial dermis. The neoplastic cells demonstrated significant atypia with a variable nuclear:cytoplasmic ratio and a high mitotic index. A papillary subtype SCC was diagnosed. Felis catus papillomavirus type 2 (FcaPV-2) was the only papillomavirus detected in the masses and FcaPV-2 E6/E7 gene expression and p16CDKN2A protein immunostaining were detected. Six months after surgery neither recurrence nor further masses had developed. CONCLUSIONS: This is the first cutaneous papillary SCC reported in a nonhuman species. Papillary SCCs may be a rare manifestation of FcaPV-2 infection in cats. The unusual location of the SCCs suggests that both papillomavirus infection and ultraviolet light exposure could have contributed to neoplasia development. Evidence from this single case suggests that papillary SCCs may have a more favourable prognosis than conventional SCCs in cats.

Frequent detection of transcriptionally active Felis catus papillomavirus 2 in feline cutaneous squamous cell carcinomas.

Felis catus papillomavirus 2 (FcaPV-2) causes premalignant skin lesions in cats and has also been found in a proportion of cutaneous squamous cell carcinomas (SCCs) - a common and potentially fatal cancer of cats. Whilst this could suggest a role of the virus in cancer development, FcaPV-2 has also been detected in skin swabs of normal cats, making it difficult to discern whether the papillomavirus is causing the cancer or merely an 'innocent bystander'. To distinguish between these two possibilities, real-time PCR was used to determine the viral copy number and the transcriptional activity of FcaPV-2 infections present in 70 formalin-fixed paraffin-embedded skin lesions including 10 papillomavirus-induced premalignant lesions and 60 SCCs. FcaPV-2 gene expression was found in 21 of 60 (35 %) SCCs, all 10 premalignant lesions and none of 10 normal skin samples. The results showed two distinct subsets of SCCs. The majority of the SCCs had low copy numbers of FcaPV-2 DNA (mean of 17 copies per copy of reference gene DNA) and no FcaPV-2 gene expression, suggesting the virus was an incidental finding. In contrast, 20 SCCs had detectable FcaPV-2 E6/E7 gene expression and very high copy numbers of FcaPV-2 DNA, with a mean of 32 930 copies per copy of reference gene DNA. The relative quantity of E6/E7 gene expression and the viral copy number in this group were similar to those found in the papillomavirus-induced premalignant lesions, suggesting that FcaPV-2 may play a role in the development of a subset of feline cutaneous SCCs.

Papillomaviruses in Domestic Cats.

Papillomaviruses (PVs) are well established to cause hyperplastic papillomas (warts) in humans and animals. In addition, due to their ability to alter cell regulation, PVs are also recognized to cause approximately 5% of human cancers and these viruses have been associated with neoplasia in a number of animal species. In contrast to other domestic species, cats have traditionally been thought to less frequently develop disease due to PV infection. However, in the last 15 years, the number of viruses and the different lesions associated with PVs in cats have greatly expanded. In this review, the PV life cycle and the subsequent immune response is briefly discussed along with methods used to investigate a PV etiology of a lesion. The seven PV types that are currently known to infect cats are reviewed. The lesions that have been associated with PV infections in cats are then discussed and the review finishes with a brief discussion on the use of vaccines to prevent PV-induced disease in domestic cats.

Rapid Patient-Side Evaluation of Endothelial Glycocalyx Thickness in Healthy Sedated Cats Using GlycoCheck® Software.

The endothelial glycocalyx (EG) determines transvascular fluid fluxes, and influences inflammation, coagulation, and capillary blood flow. The GlycoCheck® software calculates EG thickness using sidestream dark field videomicroscopy recordings. This method has not been evaluated for use in cats. The aim of the present study was to evaluate the use of GlycoCheck® for estimating EG thickness in healthy cats, and to investigate the variability of EG thickness in this population. One hundred and one healthy research-purposed cats were included in the study. The cats were sedated, and a handheld videomicroscope, connected to GlycoCheck® software, was used to evaluate the sublingual microvasculature. The parameters measured included perfused boundary region (PBR, an indirect measurement of EG thickness) in vessels between 5 and 25 µm in diameter, valid vessel density, percentage red blood cell filling, and median red blood cell column width. Heart rate, respiratory rate, pulse oximetry and oscillometric blood pressure readings were also recorded. There were 35 neutered male cats, 11 intact males, 38 neutered females, and 17 intact females. The average age was 63 months (range, 11-160 months). Tolerance intervals for PBR (vessel diameter 5-25 µm) were 1.89-3.00 µm (95% CI, lower limit 1.76-2.04, upper limit 2.83-3.13 µm); for valid vessel density were 73.33-333.33 µm/mm2 (95% CI, lower limit 77.00-99.33, upper limit 312.67-350.33 µm/mm2); for percentage red blood cell filling were 59.85-85.07% (95% CI, lower limit 58.97-63.33, upper limit 83.07-88.20 %); and for median red blood cell column width were 5.63-8.59 µm (95% CI, lower limit 5.28-6.07, upper limit 8.14-9.51 µm). There was a negative association between median red blood cell column width and body weight (p = 0.007). The median red blood cell column was significantly wider in intact females when compared to spayed females (p = 0.033). The GlycoCheck® analysis was easily performed in healthy sedated cats. Clinical variables did not have an effect on the EG thickness. These results suggest that this technique could be valuable for evaluation of the EG and microvascular parameters in cats.

Increased programmed death ligand (PD-L1) and cytotoxic T-lymphocyte antigen-4 (CTLA-4) expression is associated with metastasis and poor prognosis in malignant canine mammary gland tumours.

Aberrant expression of immune check point molecules, programmed death ligand (PD-L1) and cytotoxic T-lymphocyte antigen-4 (CTLA-4) has been reported in many human cancers with increased protein and gene expression correlated with an aggressive behaviour in some neoplasms. Additionally, PD-L1 blockade has been shown to be an effective therapy for some human cancers. Canine mammary gland tumours have previously been shown to produce PD-L1 protein, but there are no previous studies investigating CTLA-4 in these common canine neoplasms. The present study investigated protein and gene expression of PD-L1 and CTLA-4 using immunohistochemistry and RT-PCR in 41 histologically-malignant, outcome-known CMGTs. The PD-L1 and CTLA-4 immunostaining scores of the mammary gland tumours that subsequently metastasised were significantly higher than those of tumours which did not metastasise (PD-L1: p = 0.005, CTLA-4: p = 0.003). Gene expression of PD-L1 and CTLA-4 was also significantly higher in tumours which subsequently metastasised (PD-L1: p = 0.023, CTLA-4: p = 0.022). Further, higher PD-L1 or CTLA-4 immunostaining scores correlated with shorter survival times of dogs (PD-L1: rs = - 0.42, p = 0.008, CTLA-4: rs = - 0.4, p = 0.01) while PD-L1 immunostaining was independently prognostic of survival time (Δ F = 4.9, p = 0.035). These findings suggest that higher protein and gene expression of PD-L1 and CTLA-4 by tumour cells increases the chances of metastasis and measuring these proteins may predict likely neoplasm behaviour. Additionally, if increased expression of these proteins promotes metastasis, blocking PD-L1 or CTLA-4 may be beneficial to treat canine mammary gland tumours.

Immunostaining for p53 and p16CDKN2A Protein Is Not Predictive of Prognosis for Dogs with Malignant Mammary Gland Neoplasms.

Mammary gland tumors (MGTs) are common in dogs and show a variable clinical behavior that is difficult to predict. Currently, few immunohistochemical markers have been established to predict the prognosis of a canine MGT. However, p53 immunostaining has been variably reported to be prognostic for canine MGTs. Additionally, while p16CDK2NA protein (p16) immunostaining has been found to be prognostic for human breast cancers, this marker has never been evaluated as a prognostic marker for canine neoplasms. In the present study, the prognostic utility of p53 and p16 was evaluated in 35 canine malignant MGTs. It was observed that 19 (54%) dogs died due to their MGTs with an overall mean survival time (MST) of 882 days. Seven MGTs showed p53 immunostaining, but this was not significantly associated with death (4 of 7 vs. 15 of 28; p = 0.6) or MST (670 vs. 934 days; p = 0.57). Five dogs had MGTs with no p16 immunostaining, 28 MGTs had intermediate p16 immunostaining, and two MGTs had increased p16 immunostaining. Neither death due to MGT (4 of 5, 14 of 28, or 1 of 2; p = 0.28) nor MST (683, 927, and 307 days; p = 0.31) were significantly associated with p16 immunostaining. Interestingly, p53 immunostaining was significantly associated with an increase or loss of p16 immunostaining. This is the first time that p16 has been evaluated as a prognostic marker for canine neoplasms. While these results suggest that a proportion of canine MGTs develop by cellular mechanisms that alter both p53 and p16 expression, there was no evidence that defects in p53 or p16 alter the behavior of a MGT. Neither p53 nor p16 was found to significantly predict prognosis, although this could reflect the limited number of MGTs included in the study.

Felis catus papillomavirus type 2 virus-like particle vaccine is safe and immunogenic but does not reduce FcaPV-2 viral loads in adult cats.

Felis catus papillomavirus type 2 (FcaPV-2) commonly infects the skin of domestic cats and has been associated with the development of skin cancer. In the present study, a FcaPV-2 virus-like particle (VLP) vaccine was produced and assessed for vaccine safety, immunogenicity, and impact on FcaPV-2 viral load. This is the first report of the use of a papillomavirus VLP vaccine in domestic cats. The FcaPV-2 VLP vaccine was given to ten adult cats that were naturally infected with FcaPV-2, and a further ten naturally infected cats were sham vaccinated as a control group. The rationale for vaccinating cats already infected with the virus was to induce neutralizing antibody titers that could prevent reinfection of new areas of skin and reduce the overall viral load, as has been demonstrated in other species. Reducing the overall FcaPV-2 viral load could reduce the risk for subsequent PV-associated cancer. The vaccine in this study was well-tolerated, as none of the cats developed any signs of local reaction or systemic illness. In the treatment group, the geometric mean anti-papillomavirus endpoint antibody titers increased significantly following vaccination from 606 (95% CI 192-1913) to 4223 (2023-8814), a 7.0-fold increase, although the individual antibody response varied depending on the level of pre-existing antibodies. Despite the immunogenicity of the vaccine, there was no significant change in FcaPV-2 viral load in the treatment group compared to the control group, over the 24 week follow-up period. A possible reason is that FcaPV-2 was already widespread in the basal skin layer of these adult cats and so preventing further cells from becoming infected had no impact on the overall viral load. Therefore, these results do not support the use of a FcaPV-2 VLP vaccine to reduce the risk for PV-associated cancer in cats in which FcaPV-2 infection is already well established. However, these results justify future studies in which the vaccine is administered to younger cats prior to FcaPV-2 infection becoming fully established.

Felis catus papillomavirus type 2 DNA loads on kittens are transient and do not reflect their susceptibility to infection.

Objectives Felis catus papillomavirus type 2 (FcaPV-2) commonly infects the skin of domestic cats, and mounting evidence suggests that the virus could be involved in a subset of feline skin cancers. The reason why some cats develop FcaPV-2-induced disease and others do not is currently unknown. However, it has been shown that kittens in different litters have markedly different FcaPV-2 DNA loads and the aim of this study was to determine whether these differences could be due to inherent differences in susceptibility to infection. Such differences could potentially explain why only a small proportion of cats develop FcaPV-2-associated skin disease. Methods Repeated skin swabs were taken to measure FcaPV-2 DNA loads in queens and kittens in a research colony. The kittens either stayed in their original litters or were moved between litters; eventually, all of the kittens were housed together. A subset of samples was also analysed for FcaPV-2 mRNA. Results While there were initially large differences in FcaPV-2 DNA loads between litters of kittens, these differences disappeared when the kittens were moved between litters or housed together. Importantly, the viral DNA loads changed too rapidly to be due to the acquisition or clearance of infection. In contrast, the differences in viral DNA loads between the different queens were sustained throughout the experiment. FcaPV-2 mRNA was also detected in samples from 1- to 8-day-old kittens. Conclusions and relevance The results suggest that the FcaPV-2 DNA load in a swab sample from an individual kitten largely reflects the overall level of FcaPV-2 shedding in the group of in-contact cats, rather than the infection status of the individual kitten. Therefore, there was no evidence for inherent differences in susceptibility to infection. However, the finding of FcaPV-2 mRNA suggests that at least some kittens do become infected with FcaPV-2 early in life.

Identification of Felis catus papillomavirus 3 in skin neoplasms from four cats.

Bowenoid in situ carcinomas (BISCs) are papillomavirus (PV)-induced skin neoplasms that are thought to be caused by Felis catus papillomavirus (FcaPV) 2. As BISCs are typically multiple and can become extensive, they can be difficult to treat. Herein we describe 4 cats that developed skin neoplasms that contained FcaPV-3 DNA. One cat developed multiple basal cell carcinomas (BCCs), 1 a BISC with unusual extension into hair follicles, and 2 developed a single typical-appearing BISC. All neoplasms contained prominent PV-induced cell changes and intense p16CDKN2a protein immunostaining. Results from these 4 cats provide evidence that FcaPV-3 could cause a proportion of feline skin cancers, albeit less frequently than FcaPV-2. Excision of the typical BISCs and the BCCs appeared curative. Although the cat with the unusual BISC was euthanized because of the large size of the lesion, evidence from these 4 cats suggests that skin neoplasms that contain FcaPV-3 DNA may have a less aggressive clinical behavior than those associated with FcaPV-2. A consistent feature of the neoplasms in all 4 cats was the presence of prominent basophilic intracytoplasmic inclusion bodies; these inclusions have not been reported in lesions caused by FcaPV-2, to our knowledge, and their detection may allow differentiation between the different PV types and could therefore be a useful prognostic feature.

Papillomaviruses in dogs and cats.

Papillomaviruses (PVs) cause disease in both dogs and cats. In dogs, PVs are thought to cause oral papillomatosis, cutaneous papillomas and canine viral pigmented plaques, whereas PVs have been rarely associated with the development of oral and cutaneous squamous cell carcinomas in this species. In cats, PVs are currently thought to cause oral papillomas, feline viral plaques, Bowenoid in situ carcinomas and feline sarcoids. Furthermore, there is increasing evidence that PVs may also be a cause of cutaneous squamous cell carcinomas and basal cell carcinomas in cats. These diseases are discussed in this review. Additionally, there is a brief overview of PV biology, including how these viruses cause disease. Diagnostic techniques and possible methods to prevent PV infection are also discussed.

Genomic characterisation of Felis catus papillomavirus type 5 with proposed classification within a new papillomavirus genus.

Four Felis catus papillomavirus (FcaPV) types have been fully sequenced from domestic cats. Of these, FcaPV-2 and -3 are thought to cause feline viral plaques and Bowenoid in situ carcinomas. Two short sequences of DNA from a previously unreported PV type were amplified from a feline viral plaque using consensus PCR primers. DNA was then extracted from a swab of the lesion and two sets of 'outward facing' primers were designed using the short sequences to amplify the entire 7600bp genome of the novel PV. The PV was designated FcaPV-5 and contained putative coding regions that were predicted to produce five early proteins and two late ones. The ORF L1 showed over 65% similarity to that of FcaPV-3 and -4. Assignment to a genus was difficult as the PV was over 60% similar to PV types from 4 different genera. However, due to the ORF L1 similarity of FcaPV-3, -4, and -5, the shared host species of all three PVs, and the similar lesions associated with FcaPV-3 and -5, it is proposed all three PVs are classified within a new genus. FcaPV-5 is the third PV type to be associated with feline viral plaques. The plaque that contained FcaPV-5 showed unusual histological features including hyperplasia and PV-induced cell changes in sebaceous glands and deep within hair follicles. While additional study of further lesions of this type is required, it is possible that FcaPV-5 may be able to infect a broader range of cells than other PV types.