Untersuchung zur möglichen Assoziation von Humanen Papillomaviren bei der Pathogenese vaskulärer Anomalien des Kopf-Hals-Bereiches - eine explorative immunhistochemische Studie

Vascular anomalies (VA) often manifest in the head and neck area and can lead to life-threatening complications. Although a few causative gene mutations have been found in recent years, the exact origin of most vascular anomalies has not yet been conclusively clarified. In this thesis the possible role of human papilloma viruses (HPV) was examined by means of immunohistochemical staining. For this purpose, a total of 27 VA samples were examined and assessed microscopically. As a control, the same immunohistochemical examinations were carried out on 20 oropharyngeal tumour samples. A positive reaction of the vascular endothelium to the antibody HPV16 E6 /18 E6 was detected in 7 VA samples. A positive reaction in neural structures to the same antibody was also observed in 11 VA samples. Investigations deploying the antibodies HPV16 E7, HPV16 E1 /E4 and HPV18 E7 did not show any positive reactions. The anti-human papillomavirus antibody test from Dako showed only three out of 27 weakly positive reactions. The staining with the anti-HPV16 L1 antibody (CAMVIR-1) showed a positive reaction in muscles, epithelia of the skin, endothelial cells and nerves in all samples. A positive p16INK4a staining of the vessels was shown in only one sample, which, however, was negative for Ki67, so that a viral cause of the p16INK4a upregulation appears unlikely. The immunohistochemical staining gave mostly negative results. After a detailed analysis, the positive reactions of the HPV16 L1 antibody have to be regarded as non-specific reactions. The reactions of the antibody directed against HPV16 E6/18 E6 also indicate a non-specific reaction possibly against β-galactosidase, which was used during antibody production. In the present, purely exploratory study, there was no evidence that active viral infections are present in vascular abnormalities. However, a transient infection during pregnancy, which leads to a change in the formation of blood vessels and the development of vascular anomalies, cannot be ruled out. This should be investigated in further studies.