Background: Human papillomavirus (HPV) infection represents the most important risk factor for cervical carcinoma. Levels of expression of E6 and E7 transforming oncoproteins of high risk HPV genotypes (i.e., HPV-16 and HPV-18) have been linked specifically to the mitotic activity of cervical carcinoma and appear to be necessary for maintaining the malignant phenotype. However, E6/E7 viral proteins recently have been reported to be effective tumor rejection antigens in animal models and humans. Radiation treatment represents a standardized and effective modality for contemporary cervical carcinoma therapy. However, although the physiologic and cellular changes associated with high doses of irradiation have been well documented it has been shown only recently that an increased synthesis of specific cellular proteins is observed after irradiation. In this study, the authors analyzed the effects of high doses of gamma irradiation on the expression of E6/E7 oncoproteins in HPV-16-infected cervical carcinoma cell lines. In addition, the effects of radiation on major histocompatibility complex (MHC) restriction elements also were studied.
Methods: The effect of high doses of gamma irradiation (i.e., 1250, 2500, 5000, and 10,000 centigray [cGy]) on the kinetics of E6/E7 oncoprotein expression in two HPV-16 positive cervical carcinoma cell lines (i.e., CaSki and SiHa) was evaluated by Northern blot analysis. In addition, the effect of radiation on the expression of MHC molecules also was studied by Northern blot and fluorescence activator cell sorter (FACS) analysis.
Results: Dose ranging from 1250 (sublethal) to 10,000 (lethal) cGy significantly increased the expression of E6/E7 oncoproteins as well as MHC Class I molecules in CaSki and SiHa cell lines when compared with untreated tumor cells. Both cell lines showed increased mRNA expression for MHC Class I molecules in a dose-dependent manner. E6/E7 oncoproteins also were up-regulated in a dose-dependent manner in the CaSki cell line, whereas in the SiHa cell line their expression plateau at 5000 cGy. When the kinetics of radiation-induced up-regulation of E6/E7 were studied, persistent up-regulation of the viral oncoproteins was noted for all doses of irradiation, with the lower and sublethal doses (i.e., 1250-2500 cGy) inducing the most significant enhancement.
Conclusions: High doses of irradiation can induce a significant and long-lasting up-regulation of E6/E7 oncogenes and MHC Class I restriction elements on HPV positive cervical carcinoma cell lines. These effects by themselves suggest that irradiation could enhance local tumor immunogenicity in patients receiving radiation therapy. However, in contrast to this possible beneficial effect, sublethal tumor irradiation (up-regulating E6/E7 transforming oncoproteins) also could confer a significant growth advantage to radiation-resistant tumor cells. These findings, combined with the previously reported acquisition of a radiation-induced drug resistance, could provide a biologic basis for the poor prognosis of patients with cervical carcinoma recurrence after radiation therapy.