Efficacy of immunological antivirus therapy for papillomavirus-associated grade I cervical intraepithelial neoplasia

AIM: The study aimed to assess the effectiveness of alloferon in human papillomavirus (HPV)-associated cervical neoplasia (grade I) based on the analysis of the cytokine profile in cervical mucus as well as markers of apoptosis in cervical epithelial cells. MATERIALS AND METHODS: The study enrolled 98 women, including 55 women of reproductive age with cervical intraepithelial neoplasia (CIN) associated with HPV infection and 43 conditionally healthy women without HPV infection. Factors of cytokine response and markers of apoptosis under normal and pathology conditions were assessed and compared. RESULTS: The imbalance of pro-inflammatory and anti-inflammatory cytokines, in favor of the latter, is an important factor that supports the persistence of HPV-associated grade I CIN. Reducing caspase-3 and caspase-9, increasing interleukin-18, and subsequent activation of interferon gamma against the background of alloferon use are favorable signs of substantial elimination of the HPV. CONCLUSIONS: The results of this study show considerable elimination of HPV in patients with grade I CIN when using immunological antivirus therapy.

SIGNIFICANCE OF PD-L1 AND COX-2 RECEPTOR EXPRESSION IN THE COMPREHENSIVE DIAGNOSIS OF CERVICAL NEOPLASIA

Cervical cancer is still one of the hot topics in modern oncology. Despite the results achieved in the fight against cervical cancer, the observed trend of «rejuvenation» in developed countries, as well as the increasing incidence in developing countries, create the need to improve the effectiveness of diagnostic methods.

Distribution of Human Papillomavirus in Precancerous and Cancerous Cervical Neoplasia in Tunisian Women

BackgroundHigh-risk human papillomavirus (HR-HPV) are responsible for cervical cancer (CC), that is a major health problem worldwide and the second most prevalent gynecological cancer among Tunisian women. Preventive tools against CC are based on screening and prophylactic vaccines. Improving the preventive strategies as well as the therapeutic algorithms needs the understanding of HPV distribution in cervical lesions in Tunisian women. MethodsA total of 200 formalin-fixed paraffine embedded biopsies were collected in our study. DNA was extracted using Qiagen Mini prep kit. DNA quality was controlled by Beta Globin PCR. Only positive samples for Beta Globin test were used. HPV detection was performed by a nested PCR using PYGMY and GP5+/6+ primers. Genotyping was performed by Reverse Line hybridization using 31 probes. ResultsThe mean age of participants was 38.97 years and 54.5% were over 40 years. Cervical neoplasia distribution according to age showed that CINII/CINIII was observed in women over 30 years old. All samples were positive for Beta Globin PCR. Global HPV prevalence in cervical lesions was 83% (166/200). HPV was present in 65% in CINI, 82% in CINII/CINIII and 85% in CC. HR-HPV was statically associated with cervical intraepithelial neoplasia (p<10-3). HR-HPV distribution according to lesion grade and cervical cancer showed that HPV16 and HPV18 were present in all lesions. For CINII/CINIII, HPV 35 (33,33%) was the most detected type, followed by HPV18 (28,6%), HPV 45 (25%) and HPV 16 (21,7%). HPV 45(62%), HPV 18 (47%) were the most detected in CC. HPV58, 59, 66 were only detected in CC and associated with HPV45,18 and HPV16. HPV39, 31, 33, 52, 56, 68 and HPV70 was associated only with CINI. ConclusionsThese findings show that HR-HPV represents 54,6 % of all infections in all cervical lesions. Five HR-HPV (35, 18, 45,16, 51) were detected in CINII/CINIII with a high incidence of HPV 35, 18, 45, and 16 that are included in the proposed vaccines. These findings give useful information for vaccine implementation consideration as well as personalized decision algorithms of intra-epithelial cervical lesions in Tunisian women.

Human Papillomavirus Infection of the Cervix

In 1992 Lorincz et al. were the first to evaluate the clinicopathologic correlation with 11 recently identified human papillomavirus (HPV) genotypes: 31, 33, 35, 42, 43, 44, 45, 51, 52, 56, and 58. Using cervical samples from 8 studies that included specimens from 2627 women, HPV genotypes were categorized by the likelihood of association with grades of cervical neoplasia (from normal to cancer). These findings were the basis of the determination that (a) HPV causes cervical cancer, (b) detection of the cancer associated HPV genotypes could identify women at risk for cervical pre-cancer and cancer, and (c) a prophylactic HPV vaccine should include protection against (at least) HPV 16 and 18.