Research focuses on the prevention of human papillomavirus-related cancers including oral, cervical, and anal.
Cervical cancer is a preventable disease. Primary prevention with the use of the available HPV vaccines coupled with the ability to screen, biopsy suspicious lesions, and treat pre-cancerous tissue as secondary prevention could lead to significant worldwide reductions in cancer rates. Many women who develop cervical cancer have not had the recommended screening completed. The reasons for not being screened and methods to overcome these barriers are critical to further reduce the incidence of cervical cancer. Over my lengthy clinical and research career, I have been fortunate to contribute to many insights into HPV infections and cervical cancer preventative measures. I began my research studies on HPV and cervical cancer in 1994 during my Infectious Disease Fellowship at University of Washington in the laboratory of Dr. Denise A. Galloway. In her laboratory, we showed that expression of the L1gene of HPV could lead to virus-like particle (VLPs) formation utilizing a vaccinia-virus expression system. These initial feasibility studies eventually led to the development of prophylactic vaccine for HPV which are currently in use worldwide. Production of HPV VLPs also was used to develop serological assays to detect HPV serum and mucosal site antibodies.
I started at LSUHSC in 1996 and have focused my research efforts primarily on molecular epidemiological studies on women and cervical HPV infections. My laboratory performed numerous serological studies on cohorts of HIV+ and HIV-negative women; determined the HPV virus types that infect high-risk groups of women; examined the HPV-16 variants in HIV+ women; determined the rate of multiple HPV infections as well as developed urine and self-vaginal swab methodologies focused on screening at-risk women. More recently, I have worked with the School of Public Health, Drs. Williams and McLarty on moving these self-testing methods into the clinic setting with the goal of screening those women who are not engaged into clinical care. Finally, relatively recent studies have been exploring the detection of Epstein-Barr virus (EBV) detection in genital fluids coupled with HPV detection as a triage test for at-risk women. Women co-shedding both EBV and HPV have a 4-5 fold increase risk of a concurrent dysplastic Pap smear and the exact role of EBV is currently being determined.
Clinically, I have been an HIV primary-care provider for over 20 years including many women living with HIV. I have first-hand experience about the many barriers to healthcare in this high-risk population for cervical cancer
prevention. My recent clinical endeavor has been to create and run an anal dysplasia clinic and be the site lead for the ANCHOR clinical trial. The clinic has seen over 600 patients since its opening in 2011 and actively follows over 200 people living with HIV and those men who have sex with men who are also at high risk for the development of anal cancer. We are also actively following 100 subjects on the ANCHOR trial. I have also been the site PI for many pharmaceutical trials including phase 2 trials of both the Gardasil and Cevarix prophylactic vaccines, therapeutic HPV vaccines (A-fem and Stress-Gen). Sure-path cytology comparison, the optimal collection of oral specimens for HPV detection (Merck) and others. I have been the Vice Chair of Research in the Department for Medicine for over 5-years where I assist junior faculty in getting their own research underway. I have been on the Institutions Review Board for over 15 years and seen how this has evolved in the oversight of clinical trials. I have had research funding from the NIH, ACS, CDC to name a few. I have been involved in larger efforts with teams of scientists in the ACTG,AMC, ANCHOR and now the RECOVER COVID-19 clinical trial. I have also been the PI for a state-funded pilot program project entitled Preventing Cervical cancer in Louisiana. Our four projects were focused on increasing HPV vaccination rates (Williams), home self-testing for HPV (McLarty, Williams), nutritional biomarker development (Naresh) and triage of at-risk women using micro RNA profiling (Cameron). All of these studies led either to publications or to external funding. Finally, I have had the opportunity to work with Dillard University (a traditional Black college) with Dr. Charlotte Hurst on developing culturally focused educational material focused on increasing HPV vaccination rates and access to colposcopic services. Also, I worked with the lower 9thward community leaders to focus efforts on what health-care issues are foremost in the minds of the residents in the New Orleans metropolitan area. For all of these past experiences and accomplishments, I feel that I am well qualified tobe the Lead PI for the American Cancer Society’s Interdisciplinary Team Award entitled “Improving Cervical Cancer Prevention in Louisiana”
Publications focused on preventing cervical cancer:
Hagensee, M. E., Yaegashi, N., and Galloway, D. A. Self-assembly of Human Papillomavirus type 1 capsids by expression of the L1protein alone or by co-expression of the L1 and L2 capsid proteins. J. Virology67:315-322, 1993. PMCID: PMC237365
Chaturvedi, A.K., Myers, L., Hammons, A.F., Clark, R.A. ,Dunlap, K., Kissinger, P.J. and Hagensee, M. E.. Prevalence and Clustering Patterns of Human Papillomavirus Genotypes in Multiple Infections. Cancer Epidemiology and Biomarkers, 14:2439-2445, 2005
Charlotte S. Hurst, Michael E. Hagensee, Syed Adeel Ahmed, Jennifer S. Smith. Validation of Educational Tools for Use in a Human Papillomavirus Intervention Study. Cancer and Oncology Research: 3:35-43, 2015
Cameron JE, Dennis DC, Herrel NR, Chapple AG, and Hagensee ME. Risk of abnormal cervical cytology in HIV-infected women testing positive for both human papillomavirus and Epstein-Barr virus in genital tract specimens. Cancer Causes and Control 2020 Apr;31(4):365-375. PMID: 32112173
I examined the role of DNA polymerase III of E. Coli in DNA repair functions against numerous DNA damaging agents. I determined the DNA polymerase III was essential for certain types of DNA damage and not for others. Furthermore, I determined that DNA polymerase III was required for the fixation of mutations into the genome.
I developed the vaccinia virus system to produce capsids of HPV for types 1, 6,11, 16, 18, 31, and 45. I characterize the structure of these viruses,and determined their immunogenicity in mice. I also assisted in thedevelopment of ELISAs to detect capsids antibodies from serum and cervicalsecretions. Finally, I examined the presence of HPV antibodies innumerous patient populations especially homosexual men with or without HIVinfection.