Immunotherapy of cervical intraepithelial neoplasia associated with human papillomavirus in the COVID-19 pandemic. Clinicians’ view

2021 ◽  
Vol 20 (5) ◽  
pp. 131-135
Author(s):  
A.I. Davydov ◽  
◽  
R.A. Chilova ◽  
M.N. Shakhlamova ◽  
V.A. Lebedev ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
Cervical Intraepithelial Neoplasia ◽  
Intraepithelial Neoplasia ◽  
Postoperative Treatment ◽  
Review Of The Literature ◽  
Inosine Pranobex ◽  
Standard Regimen ◽  
Second Stage ◽  
Cervical Surgery ◽  
Inflammatory Syndrome

In the context of the COVID-19 pandemic, the connection between SARS-CoV-2 and other immune-dependent human conditions, including cervical intraepithelial neoplasia (CIN) associated with human papillomavirus (HPV), are being discussed. A review of the literature and the results of observation of patients who are currently receiving therapy with inosine pranobex (IP) according to the standard regimen (as the second stage after organ-preserving cervical surgery) indicate the absence of any abnormalities during the postoperative period. Moreover, publications on the interaction of IP and COVID-19 provide a chance for a favorable outcome regarding not only the treatment of CIN, but also minimizing the inflammatory syndrome in case of SARS-CoV-2 infection. Conclusion. The use of IP as medication-assisted (postoperative) treatment of patients with CIN-HPV in the COVID-19 pandemic conditions is, firstly, as effective with respect to cervical pathology as it is outside the pandemic; secondly, in case of SARS-CoV-2 infection, it can potentially reduce the severity of the course and consequences of respiratory viral infection. Key words: COVID-19, SARS-CoV-2, cervical intraepithelial neoplasia, inosine pranobex

Clinical and immunological rationale for comprehensive approach to prevention and treatment of cervical intraepithelial neoplasia associated with human papillomavirus

2021 ◽  
Vol 20 (3) ◽  
pp. 161-168
Author(s):  
A.I. Davydov ◽  
◽  
D.V. Isakov ◽  
R.А. Chilova ◽  
V.A. Lebedev ◽  
...  
Keyword(s):  
T Cells ◽  
Human Papillomavirus ◽  
Cervical Intraepithelial Neoplasia ◽  
Antiviral Agent ◽  
Intraepithelial Neoplasia ◽  
Inosine Pranobex ◽  
Trained Immunity ◽  
Adaptive Immune Cells ◽  
Infected Cells ◽  
E6 And E7

A clinical and immunological analysis of the use of antiviral agent Inosine Pranobex (IP) as postoperative drug therapy in patients with cervical intraepithelial neoplasia (CIN) associated with human papillomavirus (HPV) is performed. It is known that IP has a high anti-relapse activity adapted to the mechanisms of HPV elimination (through the sequence of oncoproteins E5, E6 and E7, a decrease in the synthesis of interferons (IFNs) occurs and resistance of HPV-infected cells to IFN is formed). In this work, a number of statements justifying the priority of IP in the treatment of patients with CIN associated with HPV is covered, namely that IP induces trained immunity, differentiation of the Th1 subset of CD4+ T cells and proliferation of CD8+ T cells. Conclusion. Inosine Pranobex should be considered as the medication of choice for postoperative monotherapy in patients with HPV-associated CIN. Inosine Pranobex is characterized by mechanisms of action in both virus-infected cells and through the activation of innate and adaptive immune cells. Key words: CIN, human papillomavirus, inosine pranobex, clinical and immunological aspects, trained immunity

Pathogenetic rationale for a comprehensive approach to the treatment of cervical intraepithelial neoplasia induced by human papillomavirus

2020 ◽  
Vol 19 (6) ◽  
pp. 111-116
Author(s):  
A.I. Davydov ◽  
◽  
M.N. Shakhlamova ◽  
V.A. Lebedev ◽  
◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
Antiviral Activity ◽  
Cervical Intraepithelial Neoplasia ◽  
Key Words ◽  
Intraepithelial Neoplasia ◽  
Interferon Production ◽  
Inosine Pranobex ◽  
Drug Of Choice ◽  
Comprehensive Therapy ◽  
High Incidence

Cervical intraepithelial neoplasia (CIN) induced by human papillomavirus (HPV) has always been the object of discussion primarily due to the high incidence of CIN relapses after combination (comprehensive) therapy. Inadequate postoperative pharmacotherapy is believed to be one of the main causes of CIN recurrence. This is confirmed by the evidence of interaction between HPV and interferons, in which the virus indirectly suppresses interferon production. This mechanism explains suboptimal efficacy of interferons and/or their inducers in patients with HPV-induced CIN. Conclusion. Inosine pranobex as an immunostimulating agent with antiviral activity should be considered the drug of choice for postoperative pharmacotherapy in patients with HPV-induced CIN and can be used as monotherapy. Key words: CIN, human papillomavirus, comprehensive therapy, CIN relapses, inosine pranobex

PECULIARITIES OF PAPILLOMAVIRUS GENOTYPING IN PATIENTS WITH CERVICAL INTRAEPITHELIAL NEOPLASIA

2020 ◽  
pp. 104-111
Author(s):  
N.A. Shmakova ◽  
G.N. Chistyakova ◽  
I.N. Kononova ◽  
I.I. Remizova
Keyword(s):  
Cervical Cancer ◽  
Human Papillomavirus ◽  
Viral Load ◽  
Cervical Intraepithelial Neoplasia ◽  
Intraepithelial Neoplasia ◽  
Squamous Intraepithelial Lesions ◽  
Hpv 16 ◽  
The World ◽  
Intraepithelial Lesions ◽  
Hpv 18

Recently, there has been a steady growth of cervical cancer all over the world, especially in Russia. Patients with cervical cancer have become much younger. At the same time, the human papillomavirus is not only the main factor in the neoplastic process, but it is also one of the most common sexually transmitted infections in the world. The aim of the paper is to assess the prevalence and characteristics of human papillomavirus genotypes in patients with cervical intraepithelial neoplasia. Materials and Methods. During the periodic screening we examined 213 women of a reproductive age with HPV infection. All patients underwent liquid-based cytology and human papillomavirus genotyping by polymerase chain reaction. Results. We revealed that the prevalence of cervical intraepithelial neoplasia among women with papillomavirus infection was 80.3 % (n=171). According to human papillomavirus genotyping, HPV 16 (38 %) and HPV 33 (32 %) prevailed. We also observed positive high correlation between high-grade squamous intraepithelial lesions (HSIL) and HPV 18 (r=+0.759, p=0.001), a negative mean correlation between HPV 45 and low-grade squamous intraepithelial lesions (LSIL) (r=-0.643, p=0.002). A cohort of patients with severe intraepithelial cervical lesions demonstrated high viral load rates. Conclusion. According to the results obtained, we established the dominance of HPV 16 and HPV 33 genotypes in cervical intraepithelial neoplasia. There were significant differences between HSIL and LSIL patients with HPV 18 and HPV 45. There was also a correlation between an increase in the viral load with the severity of the pathological process. Keywords: human papillomavirus, intraepithelial cervical neoplasms, cervical cancer. В последние годы в мире, особенно в России, наблюдается неуклонный рост и «омолаживание» рака шейки матки. При этом вирус папилломы человека является не только основным фактором прогрессирования неопластического процесса, но и одной из наиболее распространенных инфекций, предаваемых половым путем, в мире. Цель. Оценить распространенность и характеристику генотипов папилломавирусной инфекции у пациенток с цервикальными интраэпителиальными неоплазиями. Материалы и методы. Проведено обследование 213 пациенток репродуктивного возраста с ВПЧ-инфекцией, пришедших на профилактический осмотр. Всем женщинам было выполнено цитологическое исследование жидкостным методом и генотипирование вируса папилломы человека методом полимеразной цепной реакции. Результаты. Распространенность цервикальных интраэпителиальных неоплазий среди женщин с папилломавирусной инфекцией составила 80,3 % (171 пациентка). Согласно данным генотипирования вируса папилломы человека превалировал 16-й (38 %) и 33-й типы (32 %). Выявлена положительная высокая корреляционная связь между цервикальными неоплазиями высокой степени онкогенного риска (HSIL) и 18-м типом ВПЧ-инфекции (r=+0,759 при р=0,001), отрицательная средняя корреляционная связь 45-го типа ВПЧ с низкой степенью онкогенного риска (LSIL) (r=-0,643 при р=0,002). Продемонстрированы высокие показатели вирусной нагрузки в когорте пациенток с тяжелыми внутриэпителиальными цервикальными поражениями. Выводы. По результатам полученных данных установлено доминирование 16-го и 33-го генотипов ВПЧ при цервикальных интраэпителиальных неоплазиях с наличием значимых различий между пациентами с HSIL и LSIL в отношении 18-го и 45-го типов, а также связь роста уровня вирусной нагрузки с увеличением степени тяжести патологического процесса. Ключевые слова: вирус папилломы человека, интраэпителиальные новообразования шейки матки, рак шейки матки.

Monitoring of patients with cervical intraepithelial neoplasia after excisional treatment

2021 ◽  
Vol 20 (1) ◽  
pp. 113-120
Author(s):  
N.V. Zarochentseva ◽  
◽  
L.K. Dzhidzhikhiya ◽  
V.N. Nabieva ◽  
◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
Cervical Intraepithelial Neoplasia ◽  
World Literature ◽  
Intraepithelial Neoplasia ◽  
Routine Screening ◽  
Diagnostic Methods ◽  
Almost Everywhere ◽  
Combined Test ◽  
Operative Monitoring

Cervical intraepithelial neoplasia (CIN) refers to precancerous changes in the cervix. After surgical treatment, a certain proportion of patients remain at risk of disease reccurence. Therefore, monitoring of patients after CIN surgery is an important and necessary part of their management tactics. Objective. Review of world literature on modern approaches to patients monitoring after using excisional methods of CIN treatment. Materials and methods. The information material includes data from scientific articles on the subject available in Pubmed and published over the past 20 years. Results. The analysis of data contained in modern literature on the frequency and risk factors for the development of reccurent CIN after excisional methods of treatment, diagnostic methods, the timing of follow-up examinations during post-operative monitoring, the main approaches to monitoring in different countries and the effectiveness of the proposed strategies for postoperative follow-up of patients after treatment was conducted. It was established that the approaches to the observation of this category of patients differ in various countries. Almost everywhere, the priority tool for monitoring of patients with CIN after treatment is a combined test, which involves a joint use of cytology and human papillomavirus tests. The main difference between countries is the timing of the first post-treatment follow-up visit. In some countries a follow-up visit is recommended within 24 months, while in others it is suggested to return to routine screening if the primary combined test is negative. Conclusion. Despite existing disagreements, the proposed post-operative monitoring strategies for CIN patients provide a fairly high percentage of “healing” and return to routine screening. Key words: human papillomavirus, monitoring, cervical cancer, cervical intraepithelial neoplasia, excisional treatment

scholarly journals Presence of human papillomavirus DNA sequences in cervical intraepithelial neoplasia.

BMJ ◽  
1983 ◽  
Vol 287 (6395) ◽  
pp. 784-788 ◽  
Author(s):  
D J McCance ◽  
P G Walker ◽  
J L Dyson ◽  
D V Coleman ◽  
A Singer
Keyword(s):  
Human Papillomavirus ◽  
Cervical Intraepithelial Neoplasia ◽  
Dna Sequences ◽  
Intraepithelial Neoplasia ◽  
Papillomavirus Dna

scholarly journals Ten-year follow-up of human papillomavirus vaccine efficacy against the most stringent cervical neoplasia end-point—registry-based follow-up ofthree cohorts from randomized trials

BMJ Open ◽  
2017 ◽  
Vol 7 (8) ◽  
pp. e015867 ◽  
Author(s):  
Matti Lehtinen ◽  
Camilla Lagheden ◽  
Tapio Luostarinen ◽  
Tiina Eriksson ◽  
Dan Apter ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
Cervical Intraepithelial Neoplasia ◽  
Cancer Registry ◽  
Vaccine Efficacy ◽  
Invasive Cervical Cancer ◽  
Intraepithelial Neoplasia ◽  
Cervical Intraepithelial Neoplasia Grade ◽  
Hpv 16 ◽  
Link Type

ObjectiveDue to long lag time between infection/cancer diagnoses human papillomavirus (HPV) vaccination programs will deliver vaccine efficacy (VE) estimates against cancer end-points late. Cancer registry follow-up of population-based, randomised trial cohorts of vaccinated and unvaccinated women was undertaken for the estimation of VE against cervical intraepithelial neoplasia grade three and invasive cancer (CIN3+).MethodsWe report interim results with 98 561 person years of Finnish Cancer Registry -based follow-up of individually and/or cluster randomised cohorts of HPV-16/18 vaccinated and unvaccinated adolescent women enrolled in June 2003/2005, and between May 2004 and April 2005, respectively. The cohorts comprised 15 627 18- to 19-year-old unvaccinated women (NCT01393470), and 2 401 and 64 16- to 17-year-old HPV-16/18 vaccinated women participating the PATRICIA (NCT00122681) and HPV-012 (NCT00169494) trials, respectively. The age-aligned passive follow-up started 6 months after the clinical trials’ end.ResultsDuring the follow-up of 4.5 to 10 years post enrolment we identified 75 cases of cervical intraepithelial neoplasia grade 3 (CIN3) and 4 cases of invasive cervical cancer (ICC) in the unvaccinated cohort, and 4 CIN3 cases in the HPV-16/18 vaccinated women. Diagnostic blocks were available for HPV typing from 87% of the cases. CIN3+ lesions were detectable in 54 cases. HPV16 was found in 26 of 50 unvaccinated CIN3+ cases, and in 3 CIN3+ cases in the HPV-16/18 vaccinated women. The latter were all baseline positive for cervical HPV16 DNA. Baseline data was not available for the unvaccinated women. Intention-to-treat VE against any CIN3+ was 66% (95% CI 8, 88).ConclusionsTen years post vaccination the AS04-adjuvanted HPV-16/18 vaccine shows continued efficacy against CIN3+ irrespectively of HPV type. Vaccine efficacy was not observed in baseline HPV16 DNA positive subjects.Trial registration numberNCT01393470.

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