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Whole transcriptome–based skin virome profiling in typical epidermodysplasia verruciformis reveals α-, β-, and γ-HPV infections
Amir Hossein Saeidian, Leila Youssefian, Mahtab Naji, Hamidreza Mahmoudi, Samantha M. Barnada, Charles Huang, Karim Naghipoor, Amir Hozhabrpour, Jason S. Park, Flavia Manzo Margiotta, Fatemeh Vahidnezhad, Zahra Saffarian, Kambiz Kamyab-Hesari, Mohammad Tolouei, Niloofar Faraji, Seyyede Zeinab Azimi, Ghazal Namdari, Parvin Mansouri, Jean-Laurent Casanova, Vivien Béziat, Emmanuelle Jouanguy, Jouni Uitto, Hassan Vahidnezhad
Amir Hossein Saeidian, Leila Youssefian, Mahtab Naji, Hamidreza Mahmoudi, Samantha M. Barnada, Charles Huang, Karim Naghipoor, Amir Hozhabrpour, Jason S. Park, Flavia Manzo Margiotta, Fatemeh Vahidnezhad, Zahra Saffarian, Kambiz Kamyab-Hesari, Mohammad Tolouei, Niloofar Faraji, Seyyede Zeinab Azimi, Ghazal Namdari, Parvin Mansouri, Jean-Laurent Casanova, Vivien Béziat, Emmanuelle Jouanguy, Jouni Uitto, Hassan Vahidnezhad
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Research Article Dermatology Genetics

Whole transcriptome–based skin virome profiling in typical epidermodysplasia verruciformis reveals α-, β-, and γ-HPV infections

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Abstract

HPVs are DNA viruses include approximately 450 types that are classified into 5 genera (α-, β-, γ-, μ-, and ν-HPV). The γ- and β-HPVs are present in low copy numbers in healthy individuals; however, in patients with an inborn error of immunity, certain species of β-HPVs can cause epidermodysplasia verruciformis (EV), manifesting as recalcitrant cutaneous warts and skin cancer. EV presents as either typical or atypical. Manifestations of typical EV are limited to the skin and are caused by abnormal keratinocyte-intrinsic immunity to β-HPVs due to pathogenic sequence variants in TMC6, TMC8, or CIB1. We applied a transcriptome-based computational pipeline, VirPy, to RNA extracted from normal-appearing skin and wart samples of patients with typical EV to explore the viral and human genetic determinants. In 26 patients, 9 distinct biallelic mutations were detected in TMC6, TMC8, and CIB1, 7 of which are previously unreported to our knowledge. Additionally, 20 different HPV species, including 3 α-HPVs, 16 β-HPVs, and 1 γ-HPV, were detected, 8 of which are reported here for the first time to our knowledge in patients with EV (β-HPV-37, -47, -80, -151, and -159; α-HPV-2 and -57; and γ-HPV-128). This study expands the TMC6, TMC8, and CIB1 sequence variant spectrum and implicates new HPV subtypes in the pathogenesis of typical EV.

Authors

Amir Hossein Saeidian, Leila Youssefian, Mahtab Naji, Hamidreza Mahmoudi, Samantha M. Barnada, Charles Huang, Karim Naghipoor, Amir Hozhabrpour, Jason S. Park, Flavia Manzo Margiotta, Fatemeh Vahidnezhad, Zahra Saffarian, Kambiz Kamyab-Hesari, Mohammad Tolouei, Niloofar Faraji, Seyyede Zeinab Azimi, Ghazal Namdari, Parvin Mansouri, Jean-Laurent Casanova, Vivien Béziat, Emmanuelle Jouanguy, Jouni Uitto, Hassan Vahidnezhad

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Figure 2

Gene and protein structures of TMC6, TMC8, and CIB1, and the positions of pathogenic mutations.

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Gene and protein structures of TMC6, TMC8, and CIB1, and the positions o...
(A) Plots of CADD score versus minor allele frequency (MAF) of all previously reported (black) and potentially novel (red) variants in TMC6, TMC8, and CIB1. Although the CADD score of 20 for any given sequence variant indicates the theoretical top 1% of deleterious variants, the TMC6, TMC8, and CIB1 gene-specific MSC with 99% CIs was 23.5, 26, and 8.931, respectively. The recommended gene-specific MAF thresholds for TMC6, TMC8, and CIB1 are 0.015, 0.015, and 0.003, respectively. There are 4 groups for variants on each plot: (a) rare variants with CADD score greater than the MSC of each gene and MAF less than the gene-specific MAF (red region, top left); (b) rare variants with CADD score less than the MSC of each gene and MAF less than the gene-specific MAF (light yellow region, bottom left); (c) variants with CADD score greater than the MSC of each gene and MAF greater than the gene-specific MAF (blue region, top right); (d) common variants with CADD score less than the MSC of each gene and MAF greater than the gene-specific MAF (green region, bottom right). (B) Gene structure and the exon numbers with their sizes (bps) are indicated in parentheses. The introns are not drawn to scale. (C) 3D protein structures and the location of variants are shown, generated with PyMOL software. The mutations we believe to be previously unreported are indicated in red. Created with BioRender.com.

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