Factors that link HPV and oesophageal cancer

The human papillomavirus (HPV) triples the risk of people developing yet another cancer, oesophageal squamous cell carcinoma (OSCC), according to research led by University of New South Wales (UNSW) academics.
In addition to causing cervical, anal and genital cancers, HPV has more recently been found to cause some head and neck cancers.
"One of the main issues is this form of oesophageal cancer is usually diagnosed quite late and so has a very high mortality," says the first author of the paper, Dr Surabhi Liyanage, a PhD candidate with the School of Public Health and Community Medicine, UNSW Medicine.
OSCC is the most common of two types of oesophageal cancer. While it is rare in Australia, it is the sixth highest cause of cancer-related deaths world-wide. It is particularly prevalent in China, South Africa and Iran among men in their mid-70s to 80s. It is unknown why the prevalence is so high in those countries, but it is thought to be linked to dietary, lifestyle and environmental factors.
"HPV is another factor which we can add to a long list of causes of OSCC," says Dr Liyanage. "Smoking and alcohol are the main causes, as well as the consumption of extremely hot liquids, lots of red meat and possibly environmental toxins in the diet."
The findings, published today in PLOS ONE, could have implications for vaccination programs around the world.
"This is an important new finding which resolves a previous uncertainty," says senior author, UNSW Professor Raina MacIntyre.
"Given that the most common two cervical cancer-causing HPVs are now preventable by early vaccination, this may be significant in countries where OSCC is frequently found," says Professor MacIntyre, head of the School of Public Health and Community Medicine.
"In China, it is one of the leading causes of cancer death, so Chinese health authorities could consider this in any deliberations they are having about potential benefits of HPV vaccination in their population," she says.
Currently, HPV vaccinations are used most commonly in young people in developed countries to prevent cervical cancer.
"Time will tell whether our universal HPV vaccination program has any additional benefit in prevention of cancers other than cervical cancer," says Professor MacIntyre.
"The findings from this meta-analysis should rekindle the debate about looking at the potential causative role for oncogenic HPVs in oesophageal cancer," says another of the authors and a leader in HPV vaccination, Dr Suzanne Garland, from the Royal Women's Hospital in Melbourne.
"These findings will assist the expert group, International Agency for Research on Cancer (IARC), which examines evidence for potential oncogenic roles in various cancers," says Dr Garland. "We look forward to a potential review by IARC of the meta-analysis and other studies in establishing a role or not for HPV."

University of New South Wales. (2013, July 26). "Factors that link HPV and oesophageal cancer." Medical News Today. Retrieved from
http://www.medicalnewstoday.com/releases/263919.php. 

Preventing nerve injury during thyroid surgery by routine exposure of recurrent laryngeal nerve

Recurrent laryngeal nerve injury is the most common serious complication of thyroid surgery. Therefore, preventing recurrent laryngeal nerve injury is an important goal in thyroid surgery.
A retrospective clinical controlled study from Xinhua Hospital, Shanghai Jiao Tong University School of Medicine demonstrates that dissecting the recurrent laryngeal nerve during thyroid surgery is clinically significant for preventing nerve injury.
To determine the value of dissecting the recurrent laryngeal nerve during thyroid surgery with respect to preventing recurrent laryngeal nerve injury, this study retrospectively analyzed clinical data from 5 344 patients undergoing thyroidectomy. Among these cases, 548 underwent dissection of the recurrent laryngeal nerve, while 4 796 did not. There were 12 cases of recurrent laryngeal nerve injury following recurrent laryngeal nerve dissection (injury rate of 2.2%) and 512 cases of recurrent laryngeal nerve injury in those not undergoing nerve dissection (injury rate of 10.7%). This difference remained statistically significant between the two groups in terms of type of thyroid disease, type of surgery, and number of surgeries.
Among the 548 cases undergoing recurrent laryngeal nerve dissection, 128 developed anatomical variations of the recurrent laryngeal nerve (incidence rate of 23.4%), but no recurrent laryngeal nerve injury was found. In addition, the incidence of recurrent laryngeal nerve injury was significantly lower in patients with the inferior parathyroid gland and middle thyroid veins used as landmarks for locating the recurrent laryngeal nerve compared with those with the entry of the recurrent laryngeal nerve into the larynx as a landmark.
Among the 548 cases, seven of the 442 cases (1.6%) with the inferior parathyroid gland as a landmark for locating recurrent laryngeal nerves showed recurrent laryngeal nerve injury; two of the 79 cases (2.5%) with the middle thyroid vein as a landmark were injured; and three of the 27 cases (11.1%) with the recurrent laryngeal nerve into the larynx as the landmark showed recurrent laryngeal nerve injury.
These findings were published in Neural Regeneration Research (Vol. 8, No. 17, 2013).

Article: " Routine exposure of recurrent laryngeal nerve in thyroid surgery can prevent nerve injury " by Chenling Shen, Mingliang Xiang, Hao Wu, Yan Ma, Li Chen, Lan Cheng (Department of Otolaryngology & Head and Neck Surgery, Ear Institute, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China)
Shen CL, Xiang ML, Wu H, Ma Y, Chen L, Cheng L. Routine exposure of recurrent laryngeal nerve in thyroid surgery can prevent nerve injury. Neural Regen Res. 2013;8(17):1568-1575.
Full text: http://www.sjzsyj.org:8080/Jweb_sjzs/CN/article/downloadArticleFile.do?attachType=PDF&id=625
Neural Regeneration Research

Successful restoration of hearing and balance in mouse model

The sounds of success are ringing at Kansas State University through a research project that has potential to treat human deafness and loss of balance.
Philine Wangemann, university distinguished professor of anatomy and physiology in the College of Veterinary Medicine, and her international team have published the results of their study in the July issue of the journal PLOS Genetics: "SLC26A4Targeted to the Endolymphatic Sac Rescues Hearing and Balance in SLC26A4 Mutant Mice."
"When the SLC26A4 gene is mutated, it leads to a loss of pendrin expression, which causes swelling of the inner ear and loss of hearing and balance," Wangemann said. "In my research, I have been interested in how the inner ear functions. We worked on the idea that if you keep one domino in the chain standing, then the others would continue to stand and function normally. In other words, if we could restore the proper expression of pendrin in the endolymphatic sac and thereby prevent swelling of the sac, this may prevent swelling of other parts of the inner ear and rescue hearing and balance."
More than 28 million people in the United States suffer some form of hearing loss. Wangemann said mutation of SLC26A4is one of the most common forms of hereditary hearing loss in children, not only in the U.S. and Europe, but also in China, Japan and Korea, which makes this research very significant on a global scale.
The foundation of Wangemann's study is that this human disease is largely recapitulated in a mutant mouse model. SLC26A4 is normally found in the cochlea and vestibular organs of the inner ear as well as in the endolymphatic sac, which is a non-sensory part of the inner ear. When the mutant mice lack SLC26A4 expression, their inner ears swell during embryonic development. This leads to failure of the cochlea and the vestibular organs, resulting in deafness and loss of balance. The multitude of sites where SLC26A4 is located made the goal to restore function look futile, unless some sites were more important than others.
"We generated a new mutant mouse that expresses SLC26A4 in the endolymphatic sac, but not in the cochlea or the vestibular organs of the inner ear," Wangemann said. "Fantastically, this mouse did not develop the detrimental swelling of the inner ear and even more exciting, the mouse developed normal hearing and balance."
That restoration of hearing and balance lasted for the duration of the testing period, which suggests that the restoration is permanent.
"Our study provides the proof-of-concept that a therapy aimed at repairing the endolymphatic sac during embryonic development is sufficient to restore a lifetime of normal hearing and balance," Wangemann said.
While these findings are made in a mouse model, Wangemann said that eventually the idea is to develop a pharmacological treatment for human patients, but much more research will be necessary, such as to understand how fluid secretion and absorption is supported and how the balance of secretion and absorption is maintained to prevent the detrimental swelling.

University, K. (2013, July 23). "Successful restoration of hearing and balance in mouse model." Medical News Today. Retrieved from
http://www.medicalnewstoday.com/releases/263676.php.