Abstract

Fanconi anemia (FA) is a recessive DNA repair disease characterized by a high predisposition to developing neoplasms. DNA tumor polyomavirus simian virus 40 (SV40) transforms FA fibroblasts at high efficiency suggesting that FA patients could be highly susceptible to SV40 infection. To test this hypothesis, the large tumor (LT) antigen of SV40, BKV, JCV and Merkel Cell (MC) polyomaviruses were tested in blood samples from 89 FA patients and from 82 of their parents. Two control groups consisting of 47 no-FA patients affected by other genetic bone marrow failure diseases and 91 healthy subjects were also evaluated. Although JCV, BKV and MC were not found in any of the FA samples, the prevalence and viral load of SV40 were higher in FA patients (25%; mean viral load: 1.1×102 copies/105cells) as compared with healthy individuals (4.3%; mean viral load: 0.8×101 copies/105cells) and genetic controls (0%) (p<0.005). A marked age-dependent frequency of SV40 was found in FA with respect to healthy subjects suggesting that, although acquired early in life, the virus can widespread more easily in specific groups of population. From the analysis of family pedigrees, 60% of the parents of SV40-positive probands were positive for the virus compared to 2% of the parents of the SV40-negative probands (p<0.005). It is worthy of note that the relative frequency of SV40-positive relatives detected in this study was the highest ever reported, showing that asymptomatic FA carriers are also more susceptible to SV40. In conclusion, we favor the hypothesis that SV40 spread could be facilitated by individuals who are genetically more susceptible to infection, such as FA patients. The increased susceptibility to SV40 infection seems to be associated with a specific defect of the immune system which supports a potential interplay of SV40 with an underlying genetic alteration that increases the risk of malignancies.

Highlights

  • Fanconi anemia (FA) syndrome, together with other genetic disorders and breast cancer 1 (BRCA1), a hereditary breastovarian cancer syndrome, are striking examples that the loss of genomic stability caused by a deficiency of the DNA repair pathways can confer an increased susceptibility to cancer [1,2,3].FA is a rare autosomal or X-linked recessive disease with an estimated incidence of one to five per 1,000,000 live births and is caused by at least 15 genes [4]

  • The aim of this study was to investigate the prevalence of simian virus 40 (SV40) large tumor (LT) sequences in blood samples from a cohort of FA families, in order to evaluate a possible association of SV40 infection with FA syndrome

  • AFA: Fanconi anemia patients. bThe DNA used for the analysis derived from different biological sources

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Summary

Introduction

FA is a rare autosomal or X-linked recessive disease with an estimated incidence of one to five per 1,000,000 live births and is caused by at least 15 genes [4]. These genes all cooperate in the DNA repair mechanism specialized in solving DNA interstrand crosslinks through a complex pathway that requires homologous recombination [1], [2]. FA subjects show an extraordinary risk for acute myeloid leukemia or myelodysplastic syndrome Non-hematologic tumors, including esophageal or vulvar and squamous cell carcinomas, mainly of the head and neck, are less frequent but have a higher distribution compared to the general population [5]. Evidence linking SV40 to human cancer includes detection of SV40 DNA predominantly in brain and bone tumors, non-Hodgkin lymphoma and mesothelioma [7,8,9]

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