Journal of Zoo and Wildlife Medicine 27(1): 61-70, 1996 Copyrighl 1996 by American Association of Zoo Veterinarians PAPILLOMAVIRUS-ASSOCIATED FOCAL ORAL HYPERPLASIA IN WILD AND CAPTIVE ASIAN LIONS iPANTHERA LEO P?RSICA) John P. Sundberg, D.V.M., Ph.D., Richard J. Montali, D.V.M., Mitchell Bush, D.V.M., Lyndsay G. Phillips, Jr., D.V.M., Stephen J. O'Brien, Ph.D., A. Bennett Jenson, M.D., Robert D. Burk, M.D., and Marc Van Ranst, M.D. Abstract: Four Asian lions (Panthera leo p?rsica), two wild and two captive, were diagnosed with focal oral hyperplasia affecting the ventral surface of their tongues. Focal, flat, sessile lesions consisted of hyperplastic, stratified squamous epithelium. Koilocytotic atypia was evident in the upper layers of cells, some of which contained characteristic intranuclear papillomavirus particles visible by electron microscopy. In addition, large amphophilic cytoplasmic inclusions were evident in the koilocytes and were considered to be a product of the viral E4 gene. Papillomavirus group- specific antigens were detected by immunohistochemistry in the atypical cell nuclei. Conserved papillomavirus antigenic epitopes differed from epitopes found in cutaneous papillomavirus-induced lesions from domestic cats. An 8,000-base pair DNA fragment, linearized by Bam HI digestion, was detected by Southern blot hybridization probed with a mixed human papillomavirus genomic probe. Limited restriction endonuclease studies of DNA prepared using an oral hyperplastic lesion from an Asian lion indicate that this is a novel feline papillomavirus different from the domestic cat cutaneous papillomavirus. This new virus has been designated "PIPV." Key words: Papillomavirus, Asian lion, Panthera leo p?rsica, felidae, PIPV. INTRODUCTION The success of captive breeding pro- grams for endangered species depends on careful evaluation of wild-caught animals to prevent introduction of serious infectious diseases into the captive population. Fur- thermore, introduction of subclinical dis- eases into taxonomic families can be dev- astating. Such has been the case in Felidae, with outbreaks of feline infectious perito- nitis'^ and rhinotracheitis*"* in captive chee- tahs. Careful physical examination together with s?rologie testing during quarantine must be practiced in order to detect novel From The Jackson Laboratory, Bar Harbor, Maine 04609, USA (Sundberg); The National Zoological Park, Smithsonian Institution, Washington, D.C. 20008, USA (Montali, Bush); School of Veterinary Medicine, University of California, Davis, California 92112, USA (Phillips); The National Cancer Institute, National Institutes of Health, Frederick, Maryland 21702, USA (O'Brien); Georgetown University School of Medicine, Washington, D.C. 20007, USA (Jenson); Rega Institute for Medical Research, University of Leuven, Leuven B-3000, Belgium (Ranst); and the Al- bert Einstein College of Medicine, Yeshiva University, New York, New York 10461, USA (Burk, Ranst). or unsuspected diseases that could be dev- astating for other species. The Asian lion {Panthera leo p?rsica) is an endangered species for which a captive breeding program was established in the United States and India. During routine physical examinations of seven wild-born, captive lions at the Szkkarbang Zoo in Gu- jarat, India, and four wild lions at the Gir Forest Sanctuary in India, focal oral hyper- plasia was observed on the ventral surfaces of the tongues of four animals. This lesion in felids and similar lesions in other verte- brate species are caused by papillomavirus- es,2' herpesviruses,^ poxviruses,'^ chemical carcinogens,^^ diet," and genetic defects.^*' Several of these infectious agents can limit the value of the animal in the breeding pro- gram .^^ Furthermore, since poxviruses" and papillomaviruses""-" can infect related spe- cies, there is concern about possible spread of infection to other felids within the cap- tive collection and perhaps to domestic cats that enter zoo grounds. MATERIALS AND METHODS Over a 10-day period, the eleven adult Asian lions (seven males, four females) 61 62 JOURNAL OF ZOO AND WILDLIFE MEDICINE Figure 1. Ventral surface of tongue of Asian lion showing papillomaviras-induced focal epithelial hyperplasia. were anesthetized with tiletamine HCl and zolazepam HCl (Telazol, Aveco, Fort Dodge, Iowa 50501, USA) delivered by blow dart at a dose of 400-500 mg for a male and 350-450 mg for a female. The lions were clinically evaluated for repro- ductive and genetic studies. Two of the wild and two of the captive lions (three males, one female) had small, soft, light pink, oval, slighdy raised, flat sessile lesions ranging from 4-8 mm in diameter on the ventral surfaces of their tongues (Fig. 1). Repre- sentative tongue lesions from a wild and a captive lion were bisected, fixed in 10% neutral buffered formalin and cacodylate- buffered glutaraldehyde, and frozen in tis- sue culture media in liquid nitrogen for fur- ther testing. Formalin-fixed tissues were embedded routinely in paraffin, serially sec- tioned at 6 |i,m, and stained with hematox- ylin and eosin. Thin sections of the glutar- aldehyde-fixed specimens were prepared for electron microscopy utilizing standard embedding techniques. One-micron-thick sections, stained with toluidine blue, were examined by light microscopy to select sites for electron microscopic evaluation. Ultrathin sections were stained with uranyl acetate and lead citrate and examined as previously described.^' Serial sections of paraffin-embedded tis- sues were stained for papillomavirus group- specific antigens using a rabbit polyclonal antibody (DAKO Corp., Carpenteria, Cali- fornia 93013, USA) that broadly cross-re- acts with mammalian and avian papillo- maviruses.'"" A panel of mouse monoclo- nal antibodies directed against linear epi- topes of phylogenetically conserved bovine papillomavirus type 1 (BPV-1) LI and L2 gene products was also used.'" The reaction was developed using a modification of the avidin-biotin complex technique.'" Frozen hyperplastic lesions were finely minced, and genomic DNA was prepared as previously described." Briefly, the tis- sue was digested with proteinase K (Boeh- ringer Mannheim, Indianapolis, Indiana 46250, USA), treated with DNase-free RNase A (Boehringer Mannheim), extract- SUNDBERG ET AL.?LION ORAL PAPILLOMATOSIS 63 _f,-^p^Sr^-lK^? \ .^^m^'^ '-^"^'^m Figure 2. Focal sessile plaque of proliferating stratified squamous epithelium is supported by thin fibrovas- cular stalks. H&E, X40. ed with phenol and chloroform, and pre- cipitated with 70% ethanol. Total cellular DNA (5 |jLg) was digested with Bam HI restriction endonuclease, and electropho- retically separated on a 1% agarose gel. The DNA on the gel was depurinated, de- natured, and transferred under alkaline conditions to a charge-modified nylon membrane (Genescreen Plus, DuPont NEN Research Products, Boston, Massachusetts 02118, USA).^'' The membrane was hy- bridized under low-stringency conditions with a radiolabeled cocktail probe consist- ing of equal amounts (50 ng each) of hu- man papillomavirus (HPV) DNA (HPV-1, -11, -16, and -18). After posthybridization washing of the membranes under low- stringency conditions, the membrane was exposed to Kodak XAR-5 film (Eastman Kodak, Rochester, New York 14650, USA) for 72 hr at -70? C using intensifying screens (Cronex Lightning-Plus, DuPont de Nemours, Wilmington, Delaware 19801, USA). RESULTS Microscopically, the sessile tongue le- sions consisted of marked squamous cell proliferation with short, broad, rete ridge formation. Thin dermal papillae containing capillaries separated the short rete ridges (Fig. 2). Foci of degenerating cells were ev- ident in the upper stratum spinosum and stratum granulosum (Fig. 3). These cells displayed atypical nuclei surrounded by clear cytoplasm. Single large, amphophilic, inclusion-like structures were eccentrically located in the cytoplasm adjacent to the nu- cleus; a prominent round, vesiculated nu- cleus was centrally or eccentrically located within affected cells (Fig. 3). These degen- erating cells had features consistent with those described for koilocytes, cells exhib- iting the cytopathic effects of papillomavi- rus infection.^' By electron microscopy the inclusions in the koilocytes appeared as finely granular to fibrillar, electron-dense, cytoplasmic aggregates that often molded around nuclei (Fig. 4). Within the nucleus 64 JOURNAL OF ZOO AND WILDLIFE MEDICINE ? Figure 3. Higher magnification of a field from Figure 2 sliowing a cluster of degenerated cells (koilocytes) in the upper stratum spinosum with swollen, clear cytoplasm, cytoplasmic inclusion bodies, and vesicular nuclei. H&E, X500. of some of these cells were 50-52-nm, vi- ruslike particles that were ultrastructurally compatible with papillomaviruses (Fig. 5). Papillomavirus cross-reactive antigens, several of which are recognized by careful- ly characterized monoclonal antibodies, were identified within the nuclei of koilo- cytotic cells (Table 1, Fig. 6). The cyto- plasmic, inclusion-like structures did not stain for structural viral proteins. The BPV- 1 epitopes conserved by the Asian lion oral papillomavirus were different from those of the domestic cat cutaneous papillomavirus (Table 1). However, the canine oral papil- lomavirus had similar epitope conservation. A low-stringency Southern blot hybrid- ization of a Bam HI restriction endonucle- ase digest on the DNA extract of the oral lesion with a cocktail probe of HPV-1, -11, -16, and -18 DNA revealed a single, linear, 8,000-bp hybridizing band (Fig. 7). This novel papillomavirus was abbrevi- ated "PIPV" following the nomenclature guidelines for nonhuman papilloma- viruses.^'* DISCUSSION Until recently, felids were thought to be one of the few taxa of mammals that did not become infected by their own papillo- mavirus(es). Although reports indicated that domestic cats were afflicted by cutaneous SUNDBERG ET AL.?LION ORAL PAPILLOMATOSIS 65 Figure 4. Ultrastructural appearance of koilocyte with granular intracytoplasmic inclusion body (non-viral) from Asian lion with focal oral hyperplasia. X5,550). and oral papillomas,'^ no viral etiology had been demonstrated.^^ Recently, a unique papillomavirus was identified and partially characterized in focal epidermal and follic- ular hyperplasia in aged Persian cats.^ A subsequent report identified a papillomavi- rus infection in an immunosuppressed do- mestic cat." Referenced in the first article^ is an unpublished case of papillomavirus- positive, focal oral hyperplasia in a clouded leopard {Neofelis nebulosa), and we have identified papillomavirus-positive, hyper- plastic tongue lesions (unpubl. data) in an Asian lion from-the London Zoo (provided by Dr. A. Cunningham) and in three captive snow leopards {Panthera uncid), a clouded leopard, and an Asian desert cat {Felis bieti) from zoos in the former U.S.S.R. Focal oral hyperplasia has also been associated with papillomavirus infection in Florida panthers {Felis concolor cory?) and bobcats {Felis rufus)?'^ These observations indicate that domestic and exotic felids (both wild and captive) are infected by papillomavimses. Although originally considered to be spe- cies- and anatomic-site-specific, we now know that some papillomaviruses cross-in- fect closely related species, usually within the same genus; for example, canine pap- illomaviruses infect both dogs and coyotes. 66 JOURNAL OF ZOO AND WILDLIFE MEDICINE Figure 5. Ultrastructural appearance of koilocyte containing numerous round-uniformly sized (50-52 nm), viruslike structures compatible with papillomaviruses within the karyoplasm (arrows). X86,625. and domestic rabbit (Oryctolagus cunnicu- lus) oral papillomaviruses infect wild cot- tontail rabbits (Sylvalagus floridanus).'''-^' Papillomaviruses also induce fibromatous lesions that do not produce infectious viri- ons (i.e., are nonproductive lesions) in a wider range of hosts (equine sarcoid, ham- ster cutaneous fibroma), for example, BPV- 1."* Our findings of papillomavirus cross- reactive antigens, homologous papilloma- virus DNA sequences, and papillomavirus- like particles 50-55 nm in diameter confirm that the focal oral hyperplasia in the Asian lions was associated with a papillomavirus infection. These findings also indicate that the virus is unique. The single Bam HI site Table 1. Papillomavirus antigenic epitopes are conserved to various degrees between different papilloma- viruses, providing a means to differentiate new viruses. Antibodies host Lesion DAKO- AU-l' AU-2'' AU-3' AU-4'' AU-51' AU-?" IHS- Asian lion Focal oral hyperplasia pos pos neg neg neg neg neg pos Domestic cat Cutaneous papilloma pos pos neg neg neg neg pos pos Domestic dog Oral papilloma pos pos neg neg neg neg neg pos Cow (BPV-1) Cutaneous fibropapilloma pos pos pos pos pos pos pos pos Cow (BPV-2) Cutaneous fibropapilloma pos pos neg pos pos pos pos pos ' Rabbit polyclonal antibody. '? Mouse monoclonal antibody. BPV = bovine papillomavirus; neg = negative by immunohistochemistry; pos = positive by immunohistochemistry. SUNDBERG ET AL?LION ORAL PAPILLOMATOSIS 67 0 %? W ? * m % % ?'* jt ?^ f A i 1 ? ? M', 9 Figure 6. Cells with swollen cytoplasm and cytoplasmic inclusions have a black-staining nucleus (arrows) containing papillomavirus antigen. Immunoperoxidase, hematoxylin counterstain, X500. of the Asian lion papillomavirus is not pres- ent in the domestic cat papillomavirus (M. Van Ranst et al., unpubl. data), confirming that these are two novel and distinct feline papillomaviruses. The canine oral papillo- mavirus is also different since its genome is larger and yields three fragments when digested with Bam HI?'^ Detailed molecular studies are in progress utilizing the frozen tissues from these cases to confirm these preliminary observations. Cloning, charac- terization, and sequencing of the DNA of the Asian lion papillomavirus will reveal its phylogenetic relationship to papillomavi- ruses associated with focal oral hyperplasia in other species and to the other feline pap- illomaviruses. Papillomaviruses typically induce a va- riety of benign proliferative lesions in most species, that have been classified as focal hyperplasia, papillomas, fibropapillomas, keratoacanthomas, fibromas, or related tu- mor types.^?"?^'""'?" Focal oral hyperplasia is a papillomavirus-induced disease in hu- mans and chimpanzees {Pan Spp.) in which the lesions are broad, flat, and unstalked. These features differentiate them from pap- illomas,"'^^" and are similar to mild forms of oral papillomatosis that occur in dogs (Canis spp.)^' rabbits {Lagomorpha Spp.)'"-^^ and characterize the sublingual forms observed in our Asian lions. Some human and animal papillomaviruses are also capable of inducing malignant neo- plasms, primarily squamous cell carcino- mas.^** Productive papillomavirus infections re- sult in specific cytopathology of infected cells. The cytopathology varies with specif- ic virus type'; however, the general changes consist of cytoplasmic swelling, clearing of the cytoplasm (failure to take up stain), and formation of bizzare, keratohyalin-like granules or cytoplasmic, inclusion-like structures. The cytoplasmic, inclusion-like structures are considered to be a product of the early viral gene, E4.' These distinct morphologic features create a cell that is referred to as a clear cell,^ pale cell,*" or koilocyte.' This general cytopathologic pat- 68 JOURNAL OF ZOO AND WILDLIFE MEDICINE M PI ?ifSt**?'