Human papillomaviruses (HPVs) infect epithelia and can lead to the development of lesions, some of which have malignant potential. HPV type 16 (HPV16) is the most oncogenic genotype and causes various types of cancer, including cervical, anal, and head and neck cancers. However, despite significant research, our understanding of the mechanism by which HPV16 binds to and enters host cells remains fragmented. Over several decades, many HPV receptors and entry pathways have been described. This review puts those studies into context and offers a model of HPV16 binding and entry as a framework for future research. Our model suggests that HPV16 binds to heparin sulfate proteoglycans (HSPGs) on either the epithelial cell surface or basement membrane through interactions with the L1 major capsid protein. Growth factor receptors may also become activated through HSPG/growth factor/HPV16 complexes that initiate signaling cascades during early virion-host cell interactions. After binding to HSPGs, the virion undergoes conformational changes, leading to isomerization by cyclophilin B and proprotein convertasemediated L2 minor capsid protein cleavage that increases L2 N terminus exposure. Along with binding to HSPGs, HPV16 binds to ␣6 integrins, which initiate further intracellular signaling events. Following these primary binding events, HPV16 binds to a newly identified L2-specific receptor, the annexin A2 heterotetramer. Subsequently, clathrin-, caveolin-, lipid raft-, flotillin-, cholesterol-, and dynamin-independent endocytosis of HPV16 occurs.
Since the discovery of human papillomaviruses (HPVs), researchers in the field have sought to identify the mechanism by which these viruses enter host cells. Although much work has been done to date and many possible receptors have been identified, a clearly defined description of the entry of HPVs has remained controversial. In many cases of viral infection, our understanding of simple binding and uptake through a singular mechanism has given way to a model of a more complex interaction between several specific receptors, coreceptors, and cofactors (1-3). The purpose of this review is to synthesize the known data regarding HPV type 16 (HPV16) binding proteins at the cell surface, and their associated molecules, and attempt to connect them, if possible, into a testable framework of binding and entry. Due to the fact that HPVs are a diverse group of over 150 viruses, this review focuses primarily on the most common of the cancer-causing genotypes, HPV16, while making it clear when non-HPV16 genotypes are reviewed. The development of several HPV particle production systems has allowed researchers to begin to delineate the mechanisms behind viral entry; however, important differences between particles developed in vitro made direct comparisons challenging. Therefore, not only HPV16 structure but also the multiple forms the virus structure takes in the laboratory are discussed below. Finally, due to the tropism of HPV16 for human epithelial cells during a natural infection, this rev...