Abstract
Papillomaviruses (PVs) were the first viruses recognized to cause tumors and cancers in mammalian hosts by Shope, nearly a century ago (Shope and Hurst, 1933). Over 40 years ago, zur Hausen (1976) first proposed that human papillomaviruses (HPVs) played a role in cervical cancer; in 2008, he shared the Nobel Prize in Medicine for his abundant contributions demonstrating the etiology of HPVs in genital cancers. Despite effective vaccines and screening, HPV infection and morbidity remain a significant worldwide burden, with HPV infections and HPV-related cancers expected increase through 2040. Although HPVs have long-recognized roles in tumorigenesis and cancers, our understanding of the molecular mechanisms by which these viruses interact with cells and usurp cellular processes to initiate infections and produce progeny virions is limited. This is due to longstanding challenges in both obtaining well-characterized infectious virus stocks and modeling tissue-based infection and the replicative cycles in vitro. In the last 20 years, the development of methods to produce virus-like particles (VLPs) and pseudovirions (PsV) along with more physiologically relevant cell- and tissue-based models has facilitated progress in this area. However, many questions regarding HPV infection remain difficult to address experimentally and are, thus, unanswered. Although an obligatory cellular uptake receptor has yet to be identified for any PV species, Rab-GTPases contribute to HPV uptake and transport of viral genomes toward the nucleus. Here, we provide a general overview of the current HPV infection paradigm, the epithelial differentiation-dependent HPV replicative cycle, and review the specifics of how HPVs usurp Rab-related functions during infectious entry. We also suggest other potential interactions based on how HPVs alter cellular activities to complete their replicative-cycle in differentiating epithelium. Understanding how HPVs interface with Rab functions during their complex replicative cycle may provide insight for the development of therapeutic interventions, as current viral counter-measures are solely prophylactic and therapies for HPV-positive individuals remain archaic and limited.
Introduction
HPVs in Human Disease
Human papillomaviruses (HPVs) are small, non-enveloped icosahedral viruses of 55 nm containing a circular, ≈8-kb double-stranded DNA genome condensed by cellular histones. All PVs cause benign epithelial hyperproliferative diseases and tumors in mucosal or cutaneous epithelial sites as part of their normal replicative processes. As strictly human pathogens, HPVs have a narrow tropism for human keratinocytes and can only complete their replicative cycles in stratifying and differentiating squamous epithelium (). Many HPV infections are inapparent, but certain HPV types cause symptomatic hyper-proliferative lesions (i.e., tumors, warts, or papillomas). Typically, HPV-induced lesions are self-limiting, and eventually cleared by a competent host immune system. However, some individuals fail to clear lesions, and if uncontrolled the lesions can cause clinical morbidity. Of the 225 recognized HPV genotypes, a handful termed “high-risk” or “oncogenic” are found associated with squamous cell or adeno-carcinomas (Van Doorslaer, 2013; Van Doorslaer et al., 2013; ). Approximately 15 high-risk HPVs, including HPV types 16, 18, 31, 33, 45, 52, and 58, are etiologically linked to cervical, anogenital, and oropharyngeal cancers. HPVs with a low-risk of causing malignant carcinomas comprise the majority of the known HPV genotypes (). However, the world-wide morbidity caused by low-risk HPVs cannot be overstated. Low-risk HPV types 6 and 11 most generally cause benign anogenital or laryngeal warts. Although these lesions infrequently progress to malignancies, they often require multiple clinical interventions, with treatment strategies advancing little over the last century. Despite the availability of effective vaccines that prevent infections by mucosal HPV genotypes 6, 11, 16, 18, 31, 33, 45, 52, and 58, many people remain unvaccinated and therapeutic approaches have yet to be successful in curing persistent HPV infections. Overall, HPVs are the most common sexually transmitted infectious agents with ≥80% of sexually active, unvaccinated individuals acquiring one or more genital HPV infection in their lifetimes. Oncogenic HPVs are responsible for ≈35% of all pathogen-linked cancers () and nearly 5% of the total worldwide cancer burden (; Schiffman et al., 2016).
Overview of the Replicative Cycle of HPVs
Nearly all mammalian DNA viruses, including PVs, must deliver their genomes to the host cell nucleus to begin their replicative cycles and have evolved to usurp Rab-GTPase functions and diverse intracellular endocytic trafficking routes to do so (Figure 1; Spearman, 2018). However, to initiate a productive infection that can lead to the release of progeny virions (i.e., the complete replicative cycle), the PVs must also traverse the epithelial barrier to gain entrance into their susceptible target host cells, the mitotically active, basal squamous cells (Figure 2A step 1). Wounding or micro-abrasion of the epithelium has long been known to be important in facilitating efficient PV infections in vivo (Shope and Hurst, 1933; Rous and Beard, 1934; Reuter et al., 2001). Yet, besides providing the incoming virions access to the basal cells, whether additional aspects of the wound response play roles in early infection has not been methodically assessed.
FIGURE 1
FIGURE 2
In general, a complete viral replicative cycle is divided into five discrete steps that include (1) virion attachment to susceptible cells, (2) cellular uptake or virion penetration into the cytoplasm, including release and trafficking of the genome to the replication site, (3) viral genome replication, (4) progeny virion assembly, and (5) release of infectious particles. However, as illustrated in Figure 2, compared to most animal viruses, the complete replicative cycles of PVs are quite complex and rely intimately on intracellular processes that are modulated as cells leave the basal epithelial layer and epithelial differentiation ensues (
The Challenges of Investigating Papillomavirus Uptake Into Host Keratinocytes in vitro
Difficulties in obtaining purified, high-titer infectious HPV stocks from epithelial tissues have impeded efforts to carry out microscopy and genetic assays to investigate early HPV infection events. The most medically relevant (i.e., the sexually transmitted) HPVs produce low numbers of infectious virions in human lesions (Ozbun and Kivitz, 2012).
The vast majority of reports providing insight into HPV entry mechanisms utilized viral particles isolated from monolayer cell cultures ectopically overexpressing HPV L1 and L2 capsid proteins. These viral particles include infectious pseudovirions (PsVs) that carry a “reporter” expression plasmid as a pseudogenome (
Two additional methods used to obtain infectious HPV virions include experimental epithelial tissue models that are commonly used to study the complete virus replicative cycle. First, the grafting of human epithelial tissue explants beneath the renal capsule of immunocompromised mice has been used to propagate virion stocks from HPV11 and HPV16 (Kreider et al., 1987;
To date, no differences have been determined in comparing mature HPV virions from differentiation-independent models with those from differentiated epithelial tissue models. Yet, recognizing the rather unique transmission mode of HPV virions with unstable DCCs in the epithelium, certain caveats should be considered when studying laboratory produced virions. Extracting and isolating intracellular HPV virions from intact monolayer cells or from whole epithelial tissues may yield virus stocks that are fundamentally different from virions shed in the milieu of fragile DCCs. For example, HPV transmission in vivo might be augmented by the presence of viral non-structural proteins or cell factors, whereas highly purified virions might be stripped of these factors. Conversely, virion stocks processed from whole-cell or tissue extracts may contain factors that would not be present in DCCs. This commentary is intended for consideration and not meant to discount any of the findings described below.
Rab-GTPases in HPV Infectious Entry
In this section, we will describe the interaction of HPV virions, QVs, or PsVs with cell uptake and trafficking machinery (Figure 1), where it is important to note that the only viral proteins thought to be present are the L1 and L2 capsid proteins. Rab-GTPases play critical roles in directing the uptake and trafficking of infecting viral particles and also have functions in regulating many of the cellular factors involved in this process.
Primary Attachment
Human papillomavirus particles preferentially attach to heparan sulfonated proteoglycans (HSPGs) present in the extracellular matrix (ECM) and epithelial tissue basement membrane (Figure 1 step 1; Joyce et al., 1999;
Rab-GTPases are involved in the regulation of Sdc-1 and MMP activities, which may influence the priming of HPV virions on the cell surface. Increased cleavage of the Sdc-1 ectodomain (termed “ectodomain shedding”) is regulated by Rab5, MMP9, and growth factors. Rab5-GDP directly interacts with the cytoplasmic tail of Sdc-1 at the plasma membrane. This interaction prevents Sdc-1 ectodomain shedding until Rab5-GDP exchange to Rab5-GTP via ras-related signaling mediated by growth factor receptors (GFRs), such as the epidermal GFR (EGFR), and heparinase (Hayashida et al., 2008). As will be discussed in more detail below, it is known that HPV PsVs activate EGFR signaling as a requirement for HPV infection (Schelhaas et al., 2012; Surviladze et al., 2012), and that Rab5 functions are critical for proper trafficking post-HPV entry (Table 1; Smith et al., 2008; Schelhaas et al., 2012). However, whether efficient HPV particle movement from Sdc-1 to the entry receptor complex is influenced by Rab5 activity or its Sdc-1 interaction has not been investigated. Rab40b plays a role in the intracellular trafficking of MMPs 2 and 9 to the plasma membrane (Jacob et al., 2013), yet whether Rab40b influences HPV infection has not been tested.
TABLE 1
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Rab-GTPase and related GTPase Involvement in HPV infection1.
1Positive effects are noted by red font. 2Relative to unaltered cells unless otherwise noted. 3Cervical carcinoma cells that express HPV18 E6 and E7 proteins. 4Spontaneously immortalized human keratinocytes. 5Mislabeled as S22N in the reference. 6Human embryonic kidney cells that express Adenovirus 5 E1A and E1b proteins and SV40 large T (tumor) antigen. 7Not compared to untransfected cells. 8Not compared to untransfected cells. 9A clonal derivative of HeLa cells. 10Not compared to untransfected cells
Human papillomavirus exposure to keratinocytes activates EGFR signaling and leads to Src kinase-mediated phosphorylation of annexin A2 (AnxA2). This leads to the translocation of the AnxA2/S100A10 tetrameric complex (A2t) to the plasma membrane surface where HPV particles colocalize with EGFR and A2t (
Entry Pathways
The current paradigm suggests that HPV uptake occurs via a receptor complex assembled by tetraspanin-enriched microdomains (TEMs) containing the tetraspanins CD151 and CD63, integrins, EGFR and A2t (Figure 1 step 2;
Additional plasma membrane-associated proteins have been shown to impact infectious HPV entry to some degree. These proteins include α6β4 integrin, the CD9 and CD81 tetraspanins, and EGFR (Figure 2 step 2;
EE Entry and Acidification
Following conformational priming of the viral capsid at the cell surface and uptake, HPVs exploit EE acidification to promote capsid dissociation (Figure 1 steps 3,4; Smith et al., 2008). Virions enter CD63-positive EEs, potentially in an A2t-dependent manner, triggering vesicle-associated membrane protein (VAMP) associated protein (VAP)-dependent tubulation and endosomal acidification (Figure 1 steps 3,4) (Huotari and Helenius, 2011; Siddiqa et al., 2018b). VAP is important for actin nucleation and endosome-to-Golgi transport, and loss of VAP suppressed endosomal tubulation and reduced HPV trafficking to the trans-Golgi network (TGN) and infection (Siddiqa et al., 2018b). VAP mediates endoplasmic reticulum (ER) contacts with endosomes, the Golgi, and the plasma membrane. Recruitment of VAP to the ER-Golgi interface is regulated by the Rab3 GTPase activating protein 1/2 complex (Rab3GAP/2) (Hantan et al., 2014), implicating this Rab-GAP in HPV infection.
Rab5 is critical for endosomal biogenesis and recruits ATP-dependent ion channels that flood the endosome with protons to lower the pH. Rab5 is a key regulator of HPV infection. Rab5 knockdown resulted in decreased infection along with the loss of all endocytic vesicles beyond the EE and dominant negative (DN) Rab5 trapped virions in EE (Smith et al., 2008; Schelhaas et al., 2012). Rab5 activities in EEs are well understood and require many interacting factors. EE Rab5 recruits Rabaptin5, which is complexed with the Rab5 exchange factor, Rabex5. These complexes are thought to interact with Rab4-GTP orchestrating a GTPase cascade resulting in recruitment of endosomal sorting domains and machinery (
Rab Conversion and EE-to-LE Transfer
Human papillomaviruses have adapted to use the canonical endocytic process of EE maturation into LE to continue their journey to the nucleus (Figure 1 step 6). Rab conversion (or “switching”) generally occurs at the EE and is responsible for endosomal maturation to either LEs or recycling endosomes (Figure 1 steps 5,6i). Cargo sorting is generally mediated by Rab interactions, particularly Rab4, Rab5, Rab7a, and Rab11. Post-EE acidification Rab5 is replaced by Rab7a (Figure 1 step 5ii), which promotes the conversion from EE to LE (Kälin et al., 2016). The absence of Rab7a prevents the fusion of LE to lysosomes, ablating function, whereas Rab7a overexpression results in formation of large endocytic structures suggesting enhancement of cargo degradation (
During endosomal maturation, the L1 capsid partially dissociates from L2 complexed to vDNA (Figure 1 steps 5,6;
LE to TGN
Rab7b and Rab9a contribute to trafficking from the LE to the TGN, and siRNA-mediated knockdown or expression of DN versions of both inhibit HPV infection (
The L2/vDNA complex seems to enter the TGN by at least two routes, one that is Rab7b dependent and one that is Rab9a dependent. Rab7b resides prominently in the TGN and Golgi apparatus, functioning to transport vesicles toward the Golgi (Progida et al., 2012). SiRNA knockdown and DN Rab7b substantially impeded HPV infection (Smith et al., 2008; Schelhaas et al., 2012;
Activation of Autophagy Inhibits HPV Infection
Alternative to HPV transport to the TGN, the activation of macroautophagy, an autophagy variant, impairs HPV infection (Griffin et al., 2013; Surviladze et al., 2013). Autophagy, an evolutionarily conserved process, functions to degrade damaged organelles or proteins in the cytoplasm and serves as an intrinsic cellular defense to facilitate the capture and clearance of invading pathogens. A recent review details how HPVs subvert and manipulate keratinocyte autophagy during infection and cancer progression (Mattoscio et al., 2018). We and the Pyeon Lab showed that HPV infectivity is dramatically enhanced by biochemical inhibition or knockdown of essential autophagy genes (Griffin et al., 2013; Surviladze et al., 2013). We showed that HPV virion-activated EGFR signaling suppresses the autophagic response through the PI3K/Akt/mTOR pathway (Surviladze et al., 2013). In HeLa cells (which express HPV E6 and E7 proteins) electron microscopy analysis of autophagosomes upon HPV internalization demonstrated HPV particle-containing autophagosomes; biochemical inhibition of autophagy enhanced HPV infectivity (Ishii, 2013). These findings support autophagy’s involvement in intrinsic host cell defense against HPV infection. Several Rab-GTPases (Rab1, Rab5, Rab4, Rab7a, Rab8, Rab9a, Rab11, Rab24, Rab32, Rab33) are implicated in the regulation of autophagy at various stages. Of these, Rab7a’s role in autophagy is the best characterized. Rab7a is recruited to autophagosomes where it regulates the fusion with lysosomes (reviewed in Hyttinen et al., 2013). Of three studies employing Rab7a DN mutants, only one showed a moderate increase in HPV infection and found that overexpressing wild-type Rab7a slightly enhanced infection (Smith et al., 2008;
Transport From the TGN to the Nucleus
To utilize the cellular transcription and DNA replication machinery, the HPV vDNA must exit the TGN and enter the nucleus. The L2/vDNA complex enters and resides in the cis and cis-medial Golgi until the onset of mitosis (
The egress of L2/vDNA from the Golgi to the nucleus is initiated by cell cycle progression and nuclear envelope breakdown during mitosis (Pyeon et al., 2009;
Intranuclear Activities
The intranuclear L2/vDNA complex is directed to promyelocytic leukemia (PML)- and nuclear domain 10 (ND10)-containing bodies (
In the last steps of HPV infectious entry, vDNA localization to ND10/PML bodies is thought to facilitate initial genome transcription, followed by vDNA replication to establish a persistent infection (Figure 1 step 10;
Rab Proteins, Differentiating Epithelium and the HPV Replicative Cycle
Figure 2B illustrates a productive lesion, similar to a low-grade cervical neoplasia caused by high-risk HPV16. We focus on what is understood about high-risk HPV infections, as these viruses and their resulting lesions are the best studied (
TABLE 2
| Stratified epithelial layer | Rab protein predominant expression1 |
| Basal | Rab1a, Rab1b, Rab5a, Rab5c, Rab6a, Rab7a, Rab9a, Rab11a, Rab14, Rab17, Rab21, Rab22a, Rab28, Rab34, Rab29, Rab31, Rab43 |
| Suprabasal | Rab1a, Rab1b, Rab5c, Rab6a, Rab7a, Rab14, Rab43 |
| Cornified | Rab7a2, Rab113, Rab43 |
Rab expression in human skin and cervical epithelium.
1Compiled from the Human Protein Atlas (https://www.proteinatlas.org). 2Raymond et al. (2008). 3Reynier et al. (2016).
Human papillomaviruses’ requirement for tissue-based differentiation and the technical challenges associated with studying membrane function therein have hampered studies of Rab functions during later replication stages. Yet, there is emerging evidence that three of the HPV nonstructural proteins, E5, E6, and E7, each of which have roles in transformation, modulate aspects of endocytic transport pathways (reviewed by Siddiqa et al., 2018a). Below we highlight the known HPV-Rab interactions and will suggest potential roles for Rab-GTPases during viral replication.
The Productive HPV Replicative Cycle
In the HPVs’ strict dependence on normal cell functions, viral gene expression disrupts epithelial polarity to enhance cell proliferation in suprabasal cells (Thomas et al., 2008;
The multifunctional viral oncoproteins, E6 and E7, are expressed at relatively low levels and predominantly in the lower-to-middle epithelial layers. Therein, they maintain and augment cell cycle and viral genome replicative capacity and promote proliferation as suprabasal cells begin the differentiation program (Thomas et al., 1999;
Studies of E6 and E7 cellular localization and how they alter cellular pathways has generally been limited to their ectopic overexpression in monolayer cells. The E6 oncoprotein is localized primarily to the nucleus, but it can also be detected in the cytoplasm (Howie et al., 2009). In cervical cancer-derived HeLa cells, the majority of endogenously expressed E6 is found in the membrane fractions, with lower levels detected in the cytosolic and nuclear compartments (Guccione et al., 2002; Kranjec et al., 2016). Proteomic analyses suggest that E6 interacts with several different components of the endocytic sorting machinery, including the retromer components (VPS26, VPS29, and VPS35) and SNX27 (Rozenblatt-Rosen et al., 2012;
Epithelial Differentiation and HPV-Induced Polarity Alterations
While E7 stimulates S-phase entry with E6 in the suprabasal layers, high-risk HPV E6 proteins interact with a number of PDZ-domain-containing cellular proteins involved in cell polarity (Thomas et al., 2008;
Concomitant with altered cell polarity in the middle to upper epithelial layers, increased expression of the HPV E1 and E2 replicative proteins facilitate viral genome amplification to >1000 copies per cell nucleus (Figure 2B step 3iii; Ozbun and Meyers, 1998). This is enhanced by expression of HPV E4 and E5 proteins (
In the upper-suprabasal epithelial layers of epithelial tissues and 3D-organotypic tissue models, EGFR and phopho-ERK1/2 signaling gradually diminish (Nanney et al., 1986; Groves et al., 1992), paralleling the pattern of HPV oncogene expression in early neoplasia (
Late Viral Functions
Increasing differentiation in the upper suprabasal layers drives strong activation of the late viral promoter and heightened expression of the non-structural E4 gene and the capsid genes, L1 and L2 (
Progeny virions do not appear to be fully released from the top epithelial layers of DCCs, which can transmit infection (
Conclusion
Hijacking of common host trafficking pathways is a common theme for many intracellular pathogens (Spearman, 2018). A growing body of evidence suggests a complex network of interactions between viruses and Rab proteins, with recent work confirming the requirement of Rabs, GAPs, and GEFs during HPV infection and differentiation-dependent replication (Table 1). A clearer understanding of specific roles that Rab5, Rab6a, Rab7b, Rab9a, TRAPPC8, and Rab6bIPI have in HPV infectious entry is likely to increase our understanding of how HPV navigates the intracellular highways to gain access to the nucleus and begin vDNA replication. Further, many logical interfaces in the HPV replicative cycle for the contributions of additional, uninvestigated Rab proteins and their effectors. Expansion of HPV research into networks to include other common host processes like autophagy will continue to close gaps in our understanding of cell biology and how HPVs alter or adapt to these cellular processes to benefit their replicative cycles. Future investigation into Rab-GTPase functions and their roles in cellular trafficking pathways may provide ample opportunity to understand and abrogate viral infections using molecular approaches targeting these processes.
Statements
Author contributions
All authors listed have made a substantial, direct and intellectual contribution to the work, and approved it for publication.
Funding
This work was supported by the US National Institutes of Health (NIH) including R01CA207368 and P30CA118100. The funders had no role in the work.
Acknowledgments
We thank Adrian Luna for helpful comments on the manuscript and help compiling Table 2. We apologize to all authors whose work has not been cited owing to space restrictions, and for not always citing primary literature.
Conflict of interest
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
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Summary
Keywords
HPV, virus entry, Rab5, Rab7, virus infection, epithelial biology, Rab9A, Rab6A
Citation
Young JM, Zine El Abidine A, Gómez-Martinez RA and Ozbun MA (2019) The Known and Potential Intersections of Rab-GTPases in Human Papillomavirus Infections. Front. Cell Dev. Biol. 7:139. doi: 10.3389/fcell.2019.00139
Received
23 December 2018
Accepted
09 July 2019
Published
14 August 2019
Volume
7 - 2019
Edited by
Mary-Pat Stein, California State University, Northridge, United States
Reviewed by
Christopher Stroupe, University of Virginia, United States; Craig Meyers, Pennsylvania State University, United States
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Copyright
© 2019 Young, Zine El Abidine, Gómez-Martinez and Ozbun.
This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Michelle A. Ozbun, mozbun@salud.unm.edu
†These authors have contributed equally to this work
This article was submitted to Membrane Traffic, a section of the journal Frontiers in Cell and Developmental Biology
Disclaimer
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
