'Metastatic effect' of exfoliative cells in cervical human papillomavirus lesions - A possible explanation for vaginal and vulvar spread

HPV infections are most often multicentric, appearing synchronously on cervical, vaginal and vulvar surfaces. In trying to understand why there are multiple infections in the same individual, we examined the ability of the lesions to shed living exfoliative cells which might be a source of metastatic infections. In eleven young healthy women, cervical condylomas, flat and papillary, were excised. Fluorescent antibodies against the enzyme synthetase were used to detect the enzyme activiry within the condylomatous tissue and the exfoliative cells. Results show that condylomatous lesions, mainly the flat type, are capable of producing synthetase in even the most superficial layers, shedding living diseased cells into its immediate environment. This is in contrast to physiologic states in which most of the shed superficial cells are either dead or cannot produce new proteins. We therefore postulate that living infectious cells, capable of producing new proteins, may be the source of distant, metastanc infection.