1
|
Podophyllotoxin and its derivatives: Potential anticancer agents of natural origin in cancer chemotherapy. Biomed Pharmacother 2023; 158:114145. [PMID: 36586242 DOI: 10.1016/j.biopha.2022.114145] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 12/16/2022] [Accepted: 12/21/2022] [Indexed: 12/31/2022] Open
Abstract
The use of plant secondary metabolites has gained considerable attention among clinicians in the prevention and treatment of cancer. A secondary metabolite isolated mainly from the roots and rhizomes of Podophyllum species (Berberidaceae) is aryltetralin lignan - podophyllotoxin (PTOX). The purpose of this review is to discuss the therapeutic properties of PTOX as an important anticancer compound of natural origin. The relevant information regarding the antitumor mechanisms of podophyllotoxin and its derivatives were collected and analyzed from scientific databases. The results of the analysis showed PTOX exhibits potent cytotoxic activity; however, it cannot be used in its pure form due to its toxicity and generation of many side effects. Therefore, it practically remains clinically unusable. Currently, high effort is focused on attempts to synthesize analogs of PTOX that have better properties for therapeutic use e.g. etoposide (VP-16), teniposide, etopophos. PTOX derivatives are used as anticancer drugs which are showing additional immunosuppressive, antiviral, antioxidant, hypolipemic, and anti-inflammatory effects. In this review, attention is paid to the high potential of the usefulness of in vitro cultures of P. peltatum which can be a valuable source of lignans, including PTOX. In conclusion, the preclinical pharmacological studies in vitro and in vivo confirm the anticancer and chemotherapeutic potential of PTOX and its derivatives. In the future, clinical studies on human subjects are needed to certify the antitumor effects and the anticancer mechanisms to be certified and analyzed in more detail and to validate the experimental pharmacological preclinical studies.
Collapse
|
2
|
Niemann D, Akinjobi Z, Jeon S, Rahman HH. Arsenic exposure and prevalence of human papillomavirus in the US male population. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:1263-1275. [PMID: 35915301 DOI: 10.1007/s11356-022-22306-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 07/26/2022] [Indexed: 06/15/2023]
Abstract
Arsenic is a known carcinogen and is naturally available in earth's crust. Inorganic arsenic is an environmental pollutant with immunosuppressive properties. Human papillomavirus (HPV) is considered one of the most common sexually transmitted diseases in the United States. HPV is linked to several types of cancers in males, including oral, anal, and penile cancer. However, limited information is available on the effect of arsenic on HPV in males. The purpose of this study was to examine the association of urinary arsenic species (speciated and total) and the prevalence of HPV infection in the male population. HPV prevalence in males was analyzed using the 2013-2014 and 2015-2016 National Health and Nutrition Examination Survey (NHANES) dataset. Logistic regression analysis was used to examine associations of seven types of urinary arsenic species (arsenous acid, arsenic acid, arsenobetaine, arsenocholine, dimethylarsinic acid (DMA), monomethylarsonic acid (MMA), total arsenic acid) with HPV risk for male participants aged 18-59 years (N = 1516). Demographic characteristics were included in the logistic regression model for each arsenic variable. All statistical analyses were conducted by using the software R (version 4.2.0). Increasing DMA was positively associated with the prevalence of low-risk HPV (odds ratio (OR): 1.075, 95% confidence interval (CI): 1.025, 1.128) in addition to the sum of total toxic arsenic species (TUA1) including arsenous acid, arsenic acid, DMA, and MMA (OR: 1.068, 95% CI: 1.022, 1.116). High-risk HPV strains were found to be positively associated with arsenic acid (OR: 1.806, 95% CI: 1.134, 2.876) and total arsenic minus the sum of the two organic arsenic species arsenobetaine and arsenocholine (TUA2) at quartile 3 (Q3) level (OR: 1.523, 95% CI: 1.102, 2.103). The logistic regression models also showed that race and marital status were significant factors related to high-risk HPV. Our study reported that DMA and TUA1 are associated with low-risk HPV and arsenic acid is associated with high-risk HPV infections in males. Future research is required to confirm or refute this finding.
Collapse
Affiliation(s)
- Danielle Niemann
- Burrell College of Osteopathic Medicine, 3501 Arrowhead Dr, Las Cruces, NM, 88003, USA
| | - Zainab Akinjobi
- Department of Economics, Applied Statistics & International Business, New Mexico State University, Las Cruces, NM, 88003, USA
| | - Soyoung Jeon
- Department of Economics, Applied Statistics & International Business, New Mexico State University, Las Cruces, NM, 88003, USA
| | | |
Collapse
|
3
|
Güneş Ö, Özkaya-Parlakay A, Güney AY, Güder L, Mustafaoğlu Ö, Bayraktar P, Kanık-Yüksek S, Gülhan B. A Survey on Parents' Health Literacy on Childhood Human Papilloma Virus Vaccination. J PEDIAT INF DIS-GER 2023. [DOI: 10.1055/s-0042-1760374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Abstract
Objective The aim of this study is to determine parents' knowledge levels and attitudes about childhood human papillomavirus (HPV) vaccination and reveal the differences between parents who are health care workers and nonhealth care workers. The HPV vaccine can potentially prevent initial HPV infection and HPV-related genital and anal precancerous disorders and cancers.
Methods Questions and attitudes toward childhood HPV vaccination were asked to 564 parents who agreed to participate in the study.
Results In our study, the rate of health care worker parents considering having their children vaccinated against HPV (63.1%) was higher than that of nonhealth care worker parents (11.4%). Only 5% of parents had their children previously vaccinated against HPV; however, there was no difference between parents who were health care workers and those who were not. In addition, this rate was relatively low compared to other paid vaccines (49.8, 35.3, and 18.8%, respectively). Parents who had not previously vaccinated their children against HPV were considering getting their children vaccinated, especially if a pediatrician recommended it.
Conclusion The parents' high level of health literacy may not be effective in deciding to vaccinate their children against HPV. Therefore, adequate information and awareness should be provided to all parents about HPV vaccination as early as possible for all children of appropriate age. Pediatricians should be given important roles in raising the awareness of parents about childhood HPV vaccination by health authorities.
Collapse
Affiliation(s)
- Ömer Güneş
- Department of Pediatric Infectious Diseases, Ankara City Hospital, Ankara, Türkiye
| | - Aslınur Özkaya-Parlakay
- Department of Pediatric Infectious Diseases, Yildirim Beyazit University, Ankara City Hospital, Ankara, Türkiye
| | - Ahmet Yasin Güney
- Department of Pediatric Infectious Diseases, Ankara City Hospital, Ankara, Türkiye
| | - Latife Güder
- Department of Pediatric Infectious Diseases, Ankara City Hospital, Ankara, Türkiye
| | - Özlem Mustafaoğlu
- Department of Pediatric Infectious Diseases, Ankara City Hospital, Ankara, Türkiye
| | - Pınar Bayraktar
- Department of Pediatric Infectious Diseases, Ankara City Hospital, Ankara, Türkiye
| | - Saliha Kanık-Yüksek
- Department of Pediatric Infectious Diseases, Ankara City Hospital, Ankara, Türkiye
| | - Belgin Gülhan
- Department of Pediatric Infectious Diseases, Ankara City Hospital, Ankara, Türkiye
| |
Collapse
|
4
|
Chen TYT, Chang R, Hung YM, Yip HT, Wei JCC. Association between human papillomavirus infection and sudden sensorineural hearing loss: A nationwide population-based cohort study. EClinicalMedicine 2022; 47:101402. [PMID: 35497058 PMCID: PMC9046791 DOI: 10.1016/j.eclinm.2022.101402] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 03/22/2022] [Accepted: 04/01/2022] [Indexed: 11/02/2022] Open
Abstract
BACKGROUND While the etiology of sudden sensorineural hearing loss (SSNHL) remains unclear, viral infection has been suggested as a possible cause. Human papillomavirus (HPV) might trigger immune-mediated reaction and induce inflammatory cytokines which are injurious to the cochlea. This study aimed to investigate the association between HPV infection and the risk of developing SSNHL using a nationwide population-based data set. METHODS In this study, we used the population-based National Health Insurance Research Database of Taiwan to enroll 49,247 individuals with HPV infection from January 1st, 2000, to December 31st, 2013, and compared with a control group of 98,494 individuals who had never been diagnosed with HPV infection (at a 1:2 ratio matched by age, sex, index year, and comorbidities) in relation to the risk of subsequent SSNHL. The primary outcome was the time from the index date to the date when the first diagnosis of SSNHL occurred, death, withdrawal from the National Health Insurance Program, or the end of the study. Cox model with frailty was conducted to estimate hazard ratios (HRs) and 95% confidence intervals (CIs), relative to comparison group. Sensitivity analyses were performed to validate our findings. FINDINGS The adjusted hazard ratio (aHR) of developing SSNHL was 1.37 (95% CI, 1.07-1.74) after adjustment for demographic characteristics, comorbidities, and medications. Sensitivity analyses showed consistent positive association. In our sub-group analysis, a significantly higher effect of HPV on SSNHL was noted in the patients with a previous diagnosis of cerebrovascular disease, compared with those without cerebrovascular disease (aHR: 4.59 versus 1.27, p-value for interaction = 0.024). INTERPRETATION HPV infections are associated with higher risk of subsequent SSNHL in the Taiwanese population. More research is needed to examine the causality and to determine the potential efficacy of specific precautions. FUNDING This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.
Collapse
Affiliation(s)
- Thomas Yen-Ting Chen
- Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Medical Research and Education, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Renin Chang
- Department of Emergency Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
- Department of Recreation and Sports Management, Tajen University, Pingtung, Taiwan
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Yao-Min Hung
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- College of Health and Nursing, Meiho University, Pingtung, Taiwan
- Department of Internal Medicine, Kaohsiung Municipal United Hospital, Kaohsiung, Taiwan
- School of Medicine, National Yang Ming University, Taipei, Taiwan
- Corresponding author at: Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.
| | - Hei-Tung Yip
- Department: Management office for Health Data, China Medical University Hospital, Taichung, Taiwan
- College of Medicine, China Medical University, Taichung, Taiwan
- Institute of Public Health, National Yang Ming University, Taiwan
| | - James Cheng-Chung Wei
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Division of Allergy, Immunology and Rheumatology, Chung Shan Medical University Hospital, Taichung, Taiwan
- Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan
- Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan
- Corresponding author at: Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.
| |
Collapse
|
5
|
Khairkhah N, Bolhassani A, Najafipour R. Current and future direction in treatment of HPV-related cervical disease. J Mol Med (Berl) 2022; 100:829-845. [PMID: 35478255 PMCID: PMC9045016 DOI: 10.1007/s00109-022-02199-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 03/24/2022] [Accepted: 04/08/2022] [Indexed: 02/06/2023]
Abstract
Human papillomavirus (HPV) is the most common sexually transmitted virus in the world. About 70% of cervical cancers are caused by the most oncogenic HPV genotypes of 16 and 18. Since available prophylactic vaccines do not induce immunity in those with established HPV infections, the development of therapeutic HPV vaccines using E6 and E7 oncogenes, or both as the target antigens remains essential. Also, knocking out the E6 and E7 oncogenes in host genome by genome-editing CRISPR/Cas system can result in tumor growth suppression. These methods have shown promising results in both preclinical and clinical trials and can be used for controlling the progression of HPV-related cervical diseases. This comprehensive review will detail the current treatment of HPV-related cervical precancerous and cancerous diseases. We also reviewed the future direction of treatment including different kinds of therapeutic methods and vaccines, genome-editing CRISPR/Cas system being studied in clinical trials. Although the progress in the development of therapeutic HPV vaccine has been slow, encouraging results from recent trials showed vaccine-induced regression in high-grade CIN lesions. CRISPR/Cas genome-editing system is also a promising strategy for HPV cancer therapy. However, its safety and specificity need to be optimized before it is used in clinical setting.
Collapse
Affiliation(s)
- Niloofar Khairkhah
- Department of Molecular Medicine, School of Medicine, Qazvin University of Medical Sciences, Qazvin, Iran.,Department of Hepatitis and AIDS, Pasteur Institute of Iran, Tehran, Iran
| | - Azam Bolhassani
- Department of Hepatitis and AIDS, Pasteur Institute of Iran, Tehran, Iran.
| | - Reza Najafipour
- Genetics Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| |
Collapse
|
6
|
Losada Méndez J, Palomares F, Gómez F, Ramírez-López P, Ramos-Soriano J, Torres MJ, Mayorga C, Rojo J. Immunomodulatory Response of Toll-like Receptor Ligand-Peptide Conjugates in Food Allergy. ACS Chem Biol 2021; 16:2651-2664. [PMID: 34761908 PMCID: PMC8609526 DOI: 10.1021/acschembio.1c00765] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
![]()
Covalent conjugation
of allergens to toll-like receptor (TLR) agonists
appears to be a powerful strategy for the development of safety compounds
for allergen-specific immunomodulatory response toward tolerance in
allergy. In this work, we have synthesized two family of ligands,
an 8-oxoadenine derivative as a ligand for TLR7 and a pyrimido[5,4-b]indole as a ligand for TLR4, both conjugated with a T-cell
peptide of Pru p 3 allergen, the lipid transfer protein (LTP) responsible
for LTP-dependent food allergy. These conjugates interact with dendritic
cells, inducing their specific maturation, T-cell proliferation, and
cytokine production in peach allergic patients. Moreover, they increased
the Treg-cell frequencies in these patients and could induce the IL-10
production. These outcomes were remarkable in the case of the TLR7
ligand conjugated with Pru p 3, opening the door for the potential
application of these allergen–adjuvant systems in food allergy
immunotherapy.
Collapse
Affiliation(s)
- Jorge Losada Méndez
- Glycosystems Laboratory, Instituto de Investigaciones Químicas (IIQ), CSIC─Universidad de Sevilla, 41092 Seville, Spain
| | - Francisca Palomares
- Allergy Unit, IBIMA, Regional University Hospital of Malaga, UMA, 29009 Malaga, Spain
| | - Francisca Gómez
- Allergy Clinical Unit, Hospital Regional Universitario de Málaga, 29009 Málaga, Spain
| | - Pedro Ramírez-López
- Glycosystems Laboratory, Instituto de Investigaciones Químicas (IIQ), CSIC─Universidad de Sevilla, 41092 Seville, Spain
| | - Javier Ramos-Soriano
- Glycosystems Laboratory, Instituto de Investigaciones Químicas (IIQ), CSIC─Universidad de Sevilla, 41092 Seville, Spain
| | - Maria Jose Torres
- Allergy Clinical Unit, Hospital Regional Universitario de Málaga, 29009 Málaga, Spain
- Nanostructures for Diagnosing and Treatment of Allergic Diseases Laboratory, Centro Andaluz de Nanomedicina y Biotecnología-BIONAND, 29590 Málaga, Spain
- Allergy Research Group, Instituto de Investigación Biomédica de Málaga-IBIMA, 29009 Málaga, Spain
- Medicine Department, Universidad de Málaga-UMA, 29009 Málaga, Spain
| | - Cristobalina Mayorga
- Allergy Unit, IBIMA, Regional University Hospital of Malaga, UMA, 29009 Malaga, Spain
- Allergy Clinical Unit, Hospital Regional Universitario de Málaga, 29009 Málaga, Spain
- Nanostructures for Diagnosing and Treatment of Allergic Diseases Laboratory, Centro Andaluz de Nanomedicina y Biotecnología-BIONAND, 29590 Málaga, Spain
| | - Javier Rojo
- Glycosystems Laboratory, Instituto de Investigaciones Químicas (IIQ), CSIC─Universidad de Sevilla, 41092 Seville, Spain
| |
Collapse
|
7
|
Denecke A, Iftner T, Iftner A, Riedle S, Ocak M, Luyten A, Üye I, Tunc K, Petry KU. Significant decline of HPV 6 infection and genital warts despite low HPV vaccination coverage in young women in Germany: a long-term prospective, cohort data analysis. BMC Infect Dis 2021; 21:634. [PMID: 34215215 PMCID: PMC8252220 DOI: 10.1186/s12879-021-06139-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 05/05/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The introduction of human papillomavirus (HPV) vaccination has resulted in a remarkable decline of genital warts in women and men, but in Germany historical rates of vaccination are relatively low. We report long-term surveillance data on changes in HPV 6 and HPV 11 infection and the prevalence of genital warts in young women in the Wolfsburg HPV epidemiological study (WOLVES). METHODS Women born in 1983/84, 1988/89, and 1993/94 participated in four cohorts between 2009/10 and 2014/15. Quadrivalent vaccination coverage and prevalence of HPV 6/11 infection and genital warts are reported for participants aged 19-22 years and 24-27 years at the time of sample collection. Statistical analyses were done to compare similarly aged participants using 2 × 2 contingency tables (Röhmel-Mansmann unconditional exact test; two-side alpha of 0.05). RESULTS A total of 2456 women were recruited. Between 2010 and 2015, there was a statistically significant decrease in the prevalence of HPV 6 infection among women aged 24-27 years (2.1% versus 0.0%; P < 0.0001) and women aged 19-22 years (2.0% versus 0.0%; P = 0.0056). There was no significant decline in HPV 11 infection. In total, 52 of 2341 participants were diagnosed with genital warts. There was a statistically significant drop in the risk of developing genital warts in women aged 24-27 years between 2010 and 2015 (4.7% versus 1.7%, respectively; P = 0.0018). The overall risk of developing genital warts in women aged 19-27 years decreased from 3.1% in 2010 to 1.2% in 2015 (P = 0.0022). CONCLUSIONS An increase in vaccination coverage was associated with a decreased prevalence of genital warts in young women. A protective effect greater than herd immunity alone was seen despite low vaccination rates. Quadrivalent vaccine had a protective effect on genital HPV 6 infection and an almost fully protective effect on the development of genital warts in the youngest population.
Collapse
Affiliation(s)
- Agnieszka Denecke
- Department of Obstetrics and Gynecology, Klinikum Wolfsburg, Wolfsburg, Germany. .,Department of Obstetrics, Gynecology and Reproductive Medicine, Medical Hannover School, Hannover, Germany.
| | - Thomas Iftner
- Institute of Medical Virology, University of Tübingen, Tübingen, Germany
| | - Angelika Iftner
- Institute of Medical Virology, University of Tübingen, Tübingen, Germany
| | - Sebastian Riedle
- MD research, Statistics in clinical research, Pullach i, Isartal, Germany
| | - Marion Ocak
- MD research, Statistics in clinical research, Pullach i, Isartal, Germany
| | | | - Isak Üye
- Department of Obstetrics and Gynecology, Klinikum Wolfsburg, Wolfsburg, Germany
| | - Kübra Tunc
- Department of Obstetrics and Gynecology, Klinikum Wolfsburg, Wolfsburg, Germany
| | - Karl Ulrich Petry
- Department of Obstetrics and Gynecology, Klinikum Wolfsburg, Wolfsburg, Germany
| |
Collapse
|
8
|
McClymont E, Lee M, Raboud J, Coutlée F, Walmsley S, Lipsky N, Loutfy M, Trottier S, Smaill F, Klein MB, Harris M, Cohen J, Yudin MH, Wobeser W, Money D. The Efficacy of the Quadrivalent Human Papillomavirus Vaccine in Girls and Women Living With Human Immunodeficiency Virus. Clin Infect Dis 2020; 68:788-794. [PMID: 29985988 DOI: 10.1093/cid/ciy575] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Accepted: 07/06/2018] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Human papillomavirus (HPV) vaccination is safe and efficacious in women without human immunodeficiency virus (HIV). Although good immunogenicity has been observed in women living with HIV (WLWH), efficacy data in this population are needed. METHODS We enrolled 420 females aged ≥9 years (range, 9-65) living with HIV. Participants were to receive 3 doses of qHPV vaccine (0/2/6 months). The main endpoint was vaccine failure (ie, incident persistent qHPV infection, cervical intraepithelial neoplasia of grade 2 or higher [CIN2+], or genital warts). We compared these rates to published rates in vaccinated and unvaccinated women without HIV as well as unvaccinated WLWH. RESULTS Among 279 eligible women, median follow-up was 2 years. In the intention-to-treat population, the incidence rate (IR) of persistent qHPV (HPV6/11/16/18) was 2.3 per 100 person-years (/100PY) (95% confidence interval [CI], 1.1-4.1), and IR of genital warts was 2.3/100PY (95% CI, 1.2-4.1). In the per-protocol efficacy population, IR of persistent qHPV was 1.0/100PY (95% CI, 0.3-2.6) and of genital warts was 1.0/100PY (95% CI, 0.3-2.5). No cases of CIN2+ occurred. Reported rates of qHPV-related infection and disease within vaccinated women without HIV, unvaccinated women without HIV, and vaccinated WLWH: 0.1 (95% CI, 0.02-0.03), 1.5 (95% CI, 1.1-2.0), and 1.2 (95% CI, 0.2-3.4) /100PY, respectively. The rate of persistent qHPV among vaccinated WLWH was lower than among unvaccinated WLWH (2.3 vs 6.0/100PY). CONCLUSIONS Vaccinated WLWH may be at higher risk for vaccine failure than vaccinated women without HIV. However, overall rates of vaccine failure were low, and rates of persistent qHPV were lower than in unvaccinated WLWH.
Collapse
Affiliation(s)
- Elisabeth McClymont
- Department of Obstetrics and Gynecology, University of British Columbia, Vancouver
| | - Marette Lee
- Department of Obstetrics and Gynecology, University of British Columbia, Vancouver
| | - Janet Raboud
- Toronto General Hospital Research Institute, University Health Network, Ontario.,Dalla Lana School of Public Health, University of Toronto, Ontario
| | - François Coutlée
- Département de Microbiologie Médicale et Infectiologie, l'Université de Montréal, Québec
| | - Sharon Walmsley
- Toronto General Hospital Research Institute, University Health Network, Ontario.,Department of Medicine, University of Toronto, Ontario
| | - Nancy Lipsky
- Women's Health Research Institute, Vancouver, British Columbia
| | - Mona Loutfy
- Women's College Research Institute, University of Toronto, Ontario
| | - Sylvie Trottier
- Infectious Diseases Research Centre, Université Laval, Québec City, Québec
| | - Fiona Smaill
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario
| | | | - Marianne Harris
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver
| | - Jeffrey Cohen
- Windsor Regional Hospital HIV Care Program, Ontario, Canada
| | - Mark H Yudin
- Women's College Research Institute, University of Toronto, Ontario.,Department of Obstetrics and Gynecology, St. Michael's Hospital, University of Toronto, Ontario, Canada
| | - Wendy Wobeser
- Department of Medicine, Queen's University, Kingston, Ontario, Canada
| | - Deborah Money
- Department of Obstetrics and Gynecology, University of British Columbia, Vancouver
| | | |
Collapse
|
9
|
Kelati A, Khemis A, Montaudié H, Lacour JP, Passeron T. Successful treatment of resistant condylomas with nitrizinc complex solution: a retrospective study in 11 patients. J Eur Acad Dermatol Venereol 2018; 33:e88-e89. [PMID: 30198596 DOI: 10.1111/jdv.15241] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- A Kelati
- Department of Dermatology, Centre Hospitalier Universitaire Nice, Université Nice Côte d'Azur, Nice, France
| | - A Khemis
- Department of Dermatology, Centre Hospitalier Universitaire Nice, Université Nice Côte d'Azur, Nice, France
| | - H Montaudié
- Department of Dermatology, Centre Hospitalier Universitaire Nice, Université Nice Côte d'Azur, Nice, France.,INSERM U1065, C3M, Team 12, Université Nice Côte d'Azur, Nice, France
| | - J-P Lacour
- Department of Dermatology, Centre Hospitalier Universitaire Nice, Université Nice Côte d'Azur, Nice, France
| | - T Passeron
- Department of Dermatology, Centre Hospitalier Universitaire Nice, Université Nice Côte d'Azur, Nice, France.,INSERM U1065, C3M, Team 12, Université Nice Côte d'Azur, Nice, France
| |
Collapse
|
10
|
Delmonte S, Benardon S, Cariti C, Ribero S, Ramoni S, Cusini M. Anogenital warts treatment options: a practical approach. GIORN ITAL DERMAT V 2018; 155:261-268. [PMID: 30251804 DOI: 10.23736/s0392-0488.18.06125-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Anogenital warts (AGWs) are an important issue for public health centers dealing with Sexually Transmitted Infections. They are epidemiologically relevant, with significant morbidity and an established effective treatment is lacking. In this article, we examine the epidemiological, diagnostic, and therapeutic aspect of the problem in order to give an up to date picture of the situation and a practical clue for the management of AGWs.
Collapse
Affiliation(s)
- Sergio Delmonte
- Clinic of Dermatology, Department of Medical Science, University of Turin, Turin, Italy -
| | - Susanna Benardon
- Department of Internal Medicine and Medical Specialties, State University of Milan, Milan, Italy.,Unit of Dermatology, Maggiore Polyclinic Hospital, Ca' Granda IRCCS and Foundation, Milan, Italy
| | - Caterina Cariti
- Clinic of Dermatology, Department of Medical Science, University of Turin, Turin, Italy
| | - Simone Ribero
- Clinic of Dermatology, Department of Medical Science, University of Turin, Turin, Italy
| | - Stefano Ramoni
- Unit of Dermatology, Maggiore Polyclinic Hospital, Ca' Granda IRCCS and Foundation, Milan, Italy
| | - Marco Cusini
- Unit of Dermatology, Maggiore Polyclinic Hospital, Ca' Granda IRCCS and Foundation, Milan, Italy
| |
Collapse
|
11
|
Zhang Y, Jiang S, Lin H, Guo X, Zou X. Application of dermoscopy image analysis technique in diagnosing urethral condylomata acuminata. An Bras Dermatol 2018; 93:67-71. [PMID: 29641700 PMCID: PMC5871365 DOI: 10.1590/abd1806-4841.20186527] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2016] [Accepted: 12/11/2016] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND In this study, cases with suspected urethral condylomata acuminata were examined by dermoscopy, in order to explore an effective method for clinical. OBJECTIVE To study the application of dermoscopy image analysis technique in clinical diagnosis of urethral condylomata acuminata. METHODS A total of 220 suspected urethral condylomata acuminata were clinically diagnosed first with the naked eyes, and then by using dermoscopy image analysis technique. Afterwards, a comparative analysis was made for the two diagnostic methods. RESULTS Among the 220 suspected urethral condylomata acuminata, there was a higher positive rate by dermoscopy examination than visual observation. STUDY LIMITATIONS Dermoscopy examination technique is still restricted by its inapplicability in deep urethral orifice and skin wrinkles, and concordance between different clinicians may also vary. CONCLUSION Dermoscopy image analysis technique features a high sensitivity, quick and accurate diagnosis and is non-invasive, and we recommend its use.
Collapse
Affiliation(s)
- Yunjie Zhang
- Department of Dermatology of First Affiliated Hospital of PLA
General Hospital - Beijing, China
| | - Shuang Jiang
- Department of Dermatology of First Affiliated Hospital of PLA
General Hospital - Beijing, China
| | - Hui Lin
- Department of Dermatology of First Affiliated Hospital of PLA
General Hospital - Beijing, China
| | - Xiaojuan Guo
- Department of Dermatology of First Affiliated Hospital of PLA
General Hospital - Beijing, China
| | - Xianbiao Zou
- Department of Dermatology of First Affiliated Hospital of PLA
General Hospital - Beijing, China
| |
Collapse
|
12
|
Rosales C, Rosales R. Prophylactic and Therapeutic Vaccines against Human Papillomavirus Infections. Vaccines (Basel) 2017. [DOI: 10.5772/intechopen.69548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
|
13
|
Schöfer H, Tatti S, Lynde CW, Skerlev M, Hercogová J, Rotaru M, Ballesteros J, Calzavara-Pinton P. Sinecatechins and imiquimod as proactive sequential therapy of external genital and perianal warts in adults. Int J STD AIDS 2017; 28:1433-1443. [PMID: 28566057 DOI: 10.1177/0956462417711622] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This review about the proactive sequential therapy (PST) of external genital and perianal warts (EGW) is based on the most current available clinical literature and on the broad clinical experience of a group of international experts, physicians who are well versed in the treatment of human papillomavirus-associated diseases. It provides a practical guide for the treatment of EGW, including epidemiology, etiology, clinical appearance, and diagnostic procedures for these viral infections. Furthermore, the treatment goals and current treatment options, elucidating provider- and patient-applied therapies, and the parameters driving treatment decisions are summarized. Specifically, the mode of action of the topical treatments sinecatechins and imiquimod, as well as the PST for EGW to achieve rapid and sustained clearance is discussed. The group of experts has developed a treatment algorithm giving healthcare providers a practical tool for the treatment of EGW which is very valuable in the presence of many different treatment options.
Collapse
Affiliation(s)
- Helmut Schöfer
- 1 Clinic for Dermatology, Venereology, and Allergology, University Hospital, Goethe University Frankfurt, Frankfurt, Germany
| | - Silvio Tatti
- 2 Department of Obstetrics and Gynecology, Buenos Aires University, Buenos Aires, Argentina
| | - Charles W Lynde
- 3 Department of Medicine, University of Toronto, Toronto, Canada
| | - Mihael Skerlev
- 4 Department of Dermatovenereology, Zagreb University School of Medicine and Zagreb University Hospital, Zagreb, Croatia
| | - Jana Hercogová
- 5 Department of Dermatovenereology, 2nd Medical Faculty, Charles University, Bulovka Hospital, Praha, Czech Republic
| | - Maria Rotaru
- 6 Department of Dermatology, SCJ Sibiu University 'Lucian Blaga,' Faculty of Medicine, Sibiu, Romania
| | | | | |
Collapse
|
14
|
Lilungulu A, Mpondo BCT, Mlwati A, Matovelo D, Kihunrwa A, Gumodoka B. Giant Condyloma Acuminatum of Vulva in an HIV-Infected Woman. Case Rep Infect Dis 2017; 2017:5161783. [PMID: 28487788 PMCID: PMC5406734 DOI: 10.1155/2017/5161783] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Accepted: 04/03/2017] [Indexed: 11/17/2022] Open
Abstract
First described in 1925, giant condyloma acuminatum also known as Buschke-Löwenstein tumor (BLT) is a benign, slow-growing, locally destructive cauliflower-like lesion usually in the genital region. The disease is usually locally aggressive and destructive with a potential for malignant transformation. The causative organism is human papilloma virus. The most common risk factor is immunosuppression with HIV; however, any other cause of immunodeficiency can be a predisposing factor. We present a case of 33-year-old female patient, a known HIV patient on antiretroviral therapy for ten months. She presented with seven-month history of an abnormal growth in the genitalia that was progressive accompanied with foul smelling yellowish discharge and friable. Surgical excision was performed successfully. Pap smear of the excised tissue was negative. Despite being a rare condition, giant condyloma acuminatum is relatively common in HIV-infected patients.
Collapse
Affiliation(s)
- Athanase Lilungulu
- Department of Obstetrics and Gynaecology, University of Dodoma, College of Health Sciences, P.O. Box 395, Dodoma, Tanzania
| | - Bonaventura C. T. Mpondo
- Department of Internal Medicine, University of Dodoma, College of Health Sciences, P.O. Box 395, Dodoma, Tanzania
| | - Abdallah Mlwati
- Department of Internal Medicine, University of Dodoma, College of Health Sciences, P.O. Box 395, Dodoma, Tanzania
| | - Dismas Matovelo
- Department of Obstetrics & Gynaecology, Catholic University of Health & Allied Sciences, P.O. Box 1464, Mwanza, Tanzania
| | - Albert Kihunrwa
- Department of Obstetrics & Gynaecology, Catholic University of Health & Allied Sciences, P.O. Box 1464, Mwanza, Tanzania
| | - Balthazar Gumodoka
- Department of Obstetrics & Gynaecology, Catholic University of Health & Allied Sciences, P.O. Box 1464, Mwanza, Tanzania
| |
Collapse
|
15
|
The Prevalence and Genotype Distribution of Human Papillomavirus Types in the General Female Population in West of Iran. Jundishapur J Microbiol 2017. [DOI: 10.5812/jjm.40855] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
16
|
Thurgar E, Barton S, Karner C, Edwards SJ. Clinical effectiveness and cost-effectiveness of interventions for the treatment of anogenital warts: systematic review and economic evaluation. Health Technol Assess 2017; 20:v-vi, 1-486. [PMID: 27034016 DOI: 10.3310/hta20240] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Typically occurring on the external genitalia, anogenital warts (AGWs) are benign epithelial skin lesions caused by human papillomavirus infection. AGWs are usually painless but can be unsightly and physically uncomfortable, and affected people might experience psychological distress. The evidence base on the clinical effectiveness and cost-effectiveness of treatments for AGWs is limited. OBJECTIVES To systematically review the evidence on the clinical effectiveness of medical and surgical treatments for AGWs and to develop an economic model to estimate the cost-effectiveness of the treatments. DATA SOURCES Electronic databases (MEDLINE, MEDLINE In-Process & Other Non-Indexed Citations, EMBASE, The Cochrane Library databases and Web of Science) were searched from inception (or January 2000 for Web of Science) to September 2014. Bibliographies of relevant systematic reviews were hand-searched to identify potentially relevant studies. The World Health Organization International Clinical Trials Registry Platform and ClinicalTrials.gov were searched for ongoing and planned studies. REVIEW METHODS A systematic review of the clinical effectiveness literature was carried out according to standard methods and a mixed-treatment comparison (MTC) undertaken. The model implemented for each outcome was that with the lowest deviance information criterion. A de novo economic model was developed to assess cost-effectiveness from the perspective of the UK NHS. The model structure was informed through a systematic review of the economic literature and in consultation with clinical experts. Effectiveness data were obtained from the MTC. Costs were obtained from the literature and standard UK sources. RESULTS Of 4232 titles and abstracts screened for inclusion in the review of clinical effectiveness, 60 randomised controlled trials (RCTs) evaluating 19 interventions were included. Analysis by MTC indicated that ablative techniques were typically more effective than topical interventions at completely clearing AGWs at the end of treatment. Podophyllotoxin 0.5% solution (Condyline(®), Takeda Pharmaceutical Company Ltd; Warticon(®) solution, Stiefel Laboratories Ltd) was found to be the most effective topical treatment evaluated. Networks for other outcomes included fewer treatments, which restrict conclusions on the comparative effectiveness of interventions. In total, 84 treatment strategies were assessed using the economic model. Podophyllotoxin 0.5% solution first line followed by carbon dioxide (CO2) laser therapy second line if AGWs did not clear was most likely to be considered a cost-effective use of resources at a willingness to pay of £20,000-30,000 per additional quality-adjusted life-year gained. The result was robust to most sensitivity analyses conducted. LIMITATIONS Limited reporting in identified studies of baseline characteristics for the enrolled population generates uncertainty around the comparability of the study populations and therefore the generalisability of the results to clinical practice. Subgroup analyses were planned based on type, number and size of AGWs, all of which are factors thought to influence treatment effect. Lack of data on clinical effectiveness based on these characteristics precluded analysis of the differential effects of treatments in the subgroups of interest. Despite identification of 60 studies, most comparisons in the MTC are informed by only one RCT. Additionally, lack of head-to-head RCTs comparing key treatments, together with minimal reporting of results in some studies, precluded comprehensive analysis of all treatments for AGWs. CONCLUSIONS The results generated by the MTC are in agreement with consensus opinion that ablative techniques are clinically more effective at completely clearing AGWs after treatment. However, the evidence base informing the MTC is limited. A head-to-head RCT that evaluates the comparative effectiveness of interventions used in clinical practice would help to discern the potential advantages and disadvantages of the individual treatments. The results of the economic analysis suggest that podophyllotoxin 0.5% solution is likely to represent a cost-effective first-line treatment option. More expensive effective treatments, such as CO2 laser therapy or surgery, may represent cost-effective second-line treatment options. No treatment and podophyllin are unlikely to be considered cost-effective treatment options. There is uncertainty around the cost-effectiveness of treatment with imiquimod, trichloroacetic acid and cryotherapy. STUDY REGISTRATION This study is registered as PROSPERO CRD42013005457. FUNDING The National Institute for Health Research Health Technology Assessment programme.
Collapse
|
17
|
Surgical Management of Giant Genital Condyloma Acuminata by Using Double Keystone Flaps. Case Rep Urol 2016; 2016:4347821. [PMID: 27974988 PMCID: PMC5128710 DOI: 10.1155/2016/4347821] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Accepted: 11/01/2016] [Indexed: 11/18/2022] Open
Abstract
Condyloma acuminata in the external genitalia (genital warts) is a sexually transmitted disease that is often caused by human papillomavirus (HPV). We report a case of giant genital condyloma acuminata in a 35-year-old male patient with HIV comorbidity treated by wide surgical excision. Excision defect was covered with split thickness skin graft (STSG) and double keystone flaps. There was no complication after surgery. Ten months following surgery, there was no new condyloma lesion and the patient had normal voiding and erectile functions.
Collapse
|
18
|
Abstract
Genital and gynecologic infections are common medical problems, affecting millions of women worldwide. The spectrum of these infections extends from the labia, including processes such as necrotizing fasciitis and anogenital warts, to the upper reproductive tracts in conditions including endometritis and pelvic inflammatory disease. Although often a clinical diagnosis, the radiologist plays an important role in determining the etiology of acute abdominal and pelvic pain as well as facilitating the diagnosis for cases which are not clinically straightforward. Imaging also plays an important role in assessing the complications and sequelae of these conditions, including infertility, chronic abdominal and pelvic pain, and pelvic adhesions. Familiarity with the appearances of these infections, their complications, and their potential mimics on sonography, computed tomography, magnetic resonance imaging, and hysterosalpingography is important for timely diagnosis and optimal clinical outcomes.
Collapse
|
19
|
Foresta C, Garolla A, Parisi S, Ghezzi M, Bertoldo A, Di Nisio A, De Toni L. HPV prophylactic vaccination in males improves the clearance of semen infection. EBioMedicine 2016; 2:1487-93. [PMID: 26629543 PMCID: PMC4634690 DOI: 10.1016/j.ebiom.2015.09.005] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Revised: 09/02/2015] [Accepted: 09/03/2015] [Indexed: 12/15/2022] Open
|
20
|
Goldenberg G, Taylor M, Berman B, Kaufmann M, Abramovits W, Zeichner J. Sinecatechins Ointment, 15% for the Treatment of External Genital and Perianal Warts: Proceedings of an Expert Panel Roundtable Meeting. THE JOURNAL OF CLINICAL AND AESTHETIC DERMATOLOGY 2016; 9:S2-S15. [PMID: 29844847 PMCID: PMC5964656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- Gary Goldenberg
- Assistant Clinical Professor, Dermatology Medical Director of the Dermatology Faculty Practice Department of Dermatology Mount Sinai Medical Center New York, New York
| | - Maida Taylor
- Department of Obstetrics, Gynecology, and Reproductive Sciences University of California, San Francisco San Francisco, California
| | - Brian Berman
- Department of Dermatology and Cutaneous Surgery University of Miami Miller School of Medicine Miami, Florida
| | - Mark Kaufmann
- Associate Clinical Professor of Dermatology Department of Dermatology Mount Sinai Medical Center New York, New York
| | | | - Joshua Zeichner
- Director of Cosmetic and Clinical Research Department of Dermatology Mount Sinai Medical Center New York, New York
| |
Collapse
|
21
|
Khryanin AA, Klyuchareva SV, Baftalovskaya OA, Lobzev NV, Pershchetskaya EB. Modern therapy of anogenital warts. VESTNIK DERMATOLOGII I VENEROLOGII 2015. [DOI: 10.25208/0042-4609-2015-91-5-134-142] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Modern views on human papilloma virus are presented. Actual approaches to diagnostics and treatment of patients with anogenital warts are discussed. Clinical cases of high efficiency of Imiquimodum (Keravort) in treating anogenital warts of men and women are illustrated.
Collapse
|
22
|
Östensson E, Fröberg M, Leval A, Hellström AC, Bäcklund M, Zethraeus N, Andersson S. Cost of Preventing, Managing, and Treating Human Papillomavirus (HPV)-Related Diseases in Sweden before the Introduction of Quadrivalent HPV Vaccination. PLoS One 2015; 10:e0139062. [PMID: 26398189 PMCID: PMC4580320 DOI: 10.1371/journal.pone.0139062] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Accepted: 09/07/2015] [Indexed: 11/18/2022] Open
Abstract
Objective Costs associated with HPV-related diseases such as cervical dysplasia, cervical cancer, and genital warts have not been evaluated in Sweden. These costs must be estimated in order to determine the potential savings if these diseases were eradicated and to assess the combined cost-effectiveness of HPV vaccination and cervical cancer screening. The present study aimed to estimate prevention, management, and treatment costs associated with cervical dysplasia, cervical cancer, and genital warts from a societal perspective in Sweden in 2009, 1 year before the quadrivalent HPV vaccination program was implemented. Methods and Materials Data from the Swedish cervical cancer screening program was used to calculate the costs associated with prevention (cytological cervical cancer screening), management (colposcopy and biopsy following inadequate/abnormal cytological results), and treatment of CIN. Swedish official statistics were used to estimate treatment costs associated with cervical cancer. Published epidemiological data were used to estimate the number of incident, recurrent, and persistent cases of genital warts; a clinical expert panel assessed management and treatment procedures. Estimated visits, procedures, and use of medications were used to calculate the annual cost associated with genital warts. Results From a societal perspective, total estimated costs associated with cervical cancer and genital warts in 2009 were €106.6 million, of which €81.4 million (76%) were direct medical costs. Costs associated with prevention, management, and treatment of CIN were €74 million; screening and management costs for women with normal and inadequate cytology alone accounted for 76% of this sum. The treatment costs associated with incident and prevalent cervical cancer and palliative care were €23 million. Estimated costs for incident, recurrent and persistent cases of genital warts were €9.8 million. Conclusion Prevention, management, and treatment costs associated with cervical dysplasia, cervical cancer, and genital warts are substantial. Defining these costs is important for future cost-effectiveness analyses of the quadrivalent HPV vaccination program in Sweden.
Collapse
Affiliation(s)
- Ellinor Östensson
- Department of Women’s and Children’s Health, Division of Obstetrics and Gynecology, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- * E-mail:
| | - Maria Fröberg
- Department of Neurobiology, Care Science and Society, Centre for Family Medicine and Community Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Amy Leval
- Department of Medicine, Infectious Disease Unit, Karolinska Institutet, Stockholm, Sweden
- Department of Communicable Disease Control and Prevention for Stockholm County, Stockholm, Sweden
| | - Ann-Cathrin Hellström
- Department of Oncology-Pathology, Karolinska University Hospital-Solna, Karolinska Institutet, Stockholm, Sweden
| | - Magnus Bäcklund
- Department of Medicine, Solna (MedS), K2, Karolinska Institutet, Stockholm, Sweden
| | - Niklas Zethraeus
- Medical Management Centre (MMC), Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Stockholm, Sweden
| | - Sonia Andersson
- Department of Women’s and Children’s Health, Division of Obstetrics and Gynecology, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden
| |
Collapse
|
23
|
Gupta SK. Single dose intralesional immunotherapy with BCG of medically resistant condylomata acuminata of the penis: report of two cases. Int J Dermatol 2015; 55:583-6. [PMID: 26341833 DOI: 10.1111/ijd.12900] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2014] [Revised: 10/25/2014] [Accepted: 11/22/2014] [Indexed: 11/30/2022]
Affiliation(s)
- Sunil Kumar Gupta
- Department of Dermatology, Venereology & Leprosy, Hind Institute of Medical Sciences, Safedabad, Barabanki, U.P., India
| |
Collapse
|
24
|
Niazy F, Rostami K, Motabar AR. Giant Condyloma Acuminatum of Vulva Frustrating Treatment Challenge. World J Plast Surg 2015; 4:159-62. [PMID: 26284185 PMCID: PMC4537608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2014] [Revised: 03/10/2015] [Accepted: 05/08/2015] [Indexed: 11/02/2022] Open
Abstract
Giant condylomata are not usually seen nowadays in developed nations, but such cases are still seen in the under-resourced countries. Condylomata acuminata are commonly transmitted through sexual intercourse. Generally diagnosed based on their appearance. Giant condyloma acuminata also named Buschke- Löwenstein tumour (BLT) is a slow growing cauliflower-like tumor, locally aggressive and destructive, with possible malignant transformation. Common clinical treatment of anogenital warts is conservative, however, in extreme cases conservative therapy is insufficient and surgical excision is required. A case of common presentation of giant condylomata in a 50 years old, divorced, multiparous woman is presented and the literature is reviewed. She presented with 15 years history of slowly progressive vulval lesion and associated itching, contact bleeding, malodorous vaginal discharge and difficulty in walking. She had previously been treated with podophyllin and cryosurgery without success. The growth measured 30×10 cm in each side and was successfully excised with no evidence of malignancy concomitant and reconstruction also done.
Collapse
Affiliation(s)
| | | | - Amir Reza Motabar
- Corresponding Authors: Motabar Amir Reza, MD; Department of Plastic Surgery, Shahid Beheshti University of Medical Sciences, Modaress Hospital, Tehran, Iran, Tel/Fax: +98-21-88892314, E-mail:
| |
Collapse
|
25
|
Shi L, Lei Y, Srivastava R, Qin W, Chen JJ. Gallic acid induces apoptosis in human cervical epithelial cells containing human papillomavirus type 16 episomes. J Med Virol 2015; 88:127-34. [DOI: 10.1002/jmv.24291] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Revised: 05/23/2015] [Accepted: 05/30/2015] [Indexed: 12/31/2022]
Affiliation(s)
- Lin Shi
- Department of Immunology and Microbiology; Xi'an Jiaotong University Health Science Center; Xi'an China
- Department of Medicine; University of Massachusetts Medical School; Worcester Massachusetts USA
| | - Yanjun Lei
- Department of Immunology and Microbiology; Xi'an Jiaotong University Health Science Center; Xi'an China
| | - Ranjana Srivastava
- Department of Medicine; University of Massachusetts Medical School; Worcester Massachusetts USA
| | - Weihua Qin
- SoonFast Pharma Science & Technology; Guangzhou; China
| | - Jason J. Chen
- Department of Medicine; University of Massachusetts Medical School; Worcester Massachusetts USA
- Cancer Research Center; Shandong University School of Medicine; Jinan Shandong China
| |
Collapse
|
26
|
Vyas NS, Pierce Campbell CM, Mathew R, Abrahamsen M, Van der Kooi K, Jukic DM, Stoler MH, Villa LL, da Silva RC, Lazcano-Ponce E, Quiterio M, Salmeron J, Sirak BA, Ingles DJ, Giuliano AR, Messina JL. Role of histological findings and pathologic diagnosis for detection of human papillomavirus infection in men. J Med Virol 2015; 87:1777-87. [PMID: 25945468 DOI: 10.1002/jmv.24238] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/10/2015] [Indexed: 12/18/2022]
Abstract
Early HPV infection in males is difficult to detect clinically and pathologically. This study assessed histopathology in diagnosing male genital HPV. External genital lesions (n = 352) were biopsied, diagnosed by a dermatopathologist, and HPV genotyped. A subset (n = 167) was diagnosed independently by a second dermatopathologist and also re-evaluated in detail, tabulating the presence of a set of histopathologic characteristics related to HPV infection. Cases that received discrepant diagnoses or HPV-related diagnoses were evaluated by a third dermatopathologist (n = 163). Across dermatopathologists, three-way concordance was fair (k = 0.30). Pairwise concordance for condyloma was fair to good (k = 0.30-0.67) and poor to moderate for penile intraepithelial neoplasia (k = -0.05 to 0.42). Diagnoses were 44-47% sensitive and 65-72% specific for HPV 6/11-containing lesions, and 20-37% sensitive and 98-99% specific for HPV 16/18. Presence of HPV 6/11 was 75-79% sensitive and 35% specific for predicting pathologic diagnosis of condyloma. For diagnosis of penile intraepithelial neoplasia, HPV 16/18 was 95-96% specific but only 40-64% sensitive. Rounded papillomatosis, hypergranulosis, and dilated vessels were significantly (P < 0.05) associated with HPV 6/11. Dysplasia was significantly (P = 0.001) associated with HPV 16/18. Dermatopathologists' diagnoses of early male genital HPV-related lesions appear discordant with low sensitivity, while genotyping may overestimate clinically significant HPV-related disease. Rounded papillomatosis, hypergranulosis, and dilated vessels may help establish diagnosis of early condyloma.
Collapse
Affiliation(s)
- Nikki S Vyas
- University of South Florida Morsani College of Medicine, Tampa, Florida
| | - Christine M Pierce Campbell
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida.,Center for Infection Research in Cancer, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Rahel Mathew
- Department of Dermatology & Cutaneous Surgery, University of South Florida, Tampa, Florida.,Department of Pathology and Cell Biology, University of South Florida, Tampa, Florida
| | - Martha Abrahamsen
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida.,Center for Infection Research in Cancer, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Kaisa Van der Kooi
- Department of Dermatology & Cutaneous Surgery, University of South Florida, Tampa, Florida.,Department of Pathology and Cell Biology, University of South Florida, Tampa, Florida
| | - Drazen M Jukic
- Department of Dermatology & Cutaneous Surgery, University of South Florida, Tampa, Florida.,Department of Pathology and Cell Biology, University of South Florida, Tampa, Florida.,Pathology and Laboratory Medicine Service, James A. Haley VA Hospital, Tampa, Florida
| | - Mark H Stoler
- Department of Pathology, University of Virginia Health System, Charlottesville, Virginia
| | - Luisa L Villa
- Department of Radiology and Oncology, School of Medicine, University of São Paulo and School of Medical Sciences, Santa Casa de São Paulo, Brazil
| | | | - Eduardo Lazcano-Ponce
- Center for Research on Population Health, National Institute of Public Health, Cuernavaca, Morelos, México
| | - Manuel Quiterio
- Center for Research on Population Health, National Institute of Public Health, Cuernavaca, Morelos, México
| | - Jorge Salmeron
- Center for Research on Population Health, National Institute of Public Health, Cuernavaca, Morelos, México.,Unit for Epidemiologic and Health Services Research, Institute of Mexican Social Security, Cuernavaca, Morelos, México
| | - Bradley A Sirak
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Donna J Ingles
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida.,Center for Infection Research in Cancer, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Anna R Giuliano
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida.,Center for Infection Research in Cancer, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Jane L Messina
- Center for Infection Research in Cancer, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida.,Department of Dermatology & Cutaneous Surgery, University of South Florida, Tampa, Florida.,Department of Pathology and Cell Biology, University of South Florida, Tampa, Florida.,Department of Cutaneous Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| |
Collapse
|
27
|
Petráš M, Adámková V. Rates and predictors of genital warts burden in the Czech population. Int J Infect Dis 2015; 35:29-33. [PMID: 25869075 DOI: 10.1016/j.ijid.2015.04.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2015] [Revised: 03/30/2015] [Accepted: 04/03/2015] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To describe the burden and the predictors of genital warts (GWs) in Czech men and women. METHODS A population-based cross-sectional study was conducted of 32 974 randomly selected health clinic attendees from all 14 regions of the Czech Republic. Information on GWs and lifestyle behaviour was collected using a questionnaire. RESULTS Results revealed a 5.8% prevalence rate of self-reported GWs in the Czech population aged 16-55 years. There was an increase in the incidence of GWs in the years 2010-2013 when compared to lifetime incidence rates, from 205.4 (95% confidence interval (CI) 191.0-219.7) to 441.8 (95% CI 393.1-490.6) per 100 000 person-years. No significant differences were observed between genders. The strongest risk factors found for GWs were an infected sexual partner (adjusted odds ratio (OR) 114.3, 95% CI 78.9-165.4) and a high number of lifetime sexual partners (adjusted OR 3.36, 95% CI 2.72-4.17 for >14 partners vs. one partner). A novel finding was that 22.7% (95% CI 20.9-24.6%) of participants claimed that the pathology had disappeared spontaneously without medical assistance. CONCLUSIONS The results provide baseline information for the development and monitoring of prevention strategies against GWs in the Czech Republic.
Collapse
Affiliation(s)
- Marek Petráš
- Charles University in Prague, Second Faculty of Medicine, V Úvalu 84, 150 06 Prague 5, Czech Republic.
| | - Věra Adámková
- Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| |
Collapse
|
28
|
Vives Á, Vazquez A, Rajmil O, Cosentino M. Urethral condylomas in men: experience in 123 patients without previous treatment. Int J STD AIDS 2015; 27:39-43. [DOI: 10.1177/0956462415574627] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Accepted: 02/01/2015] [Indexed: 11/16/2022]
Abstract
The most common sexually transmitted infection (STI) is infection by human papillomavirus. There are more than 100 types of human papillomavirus, and over 30 of them involve the genital area. Urethral involvement is uncommon and usually limited to the distal 3 cm of the meatus. There are various treatments for urethral condylomas; as a rule, they are limited by a difficult approach, by recurrences, and by potential complications, the most significant of which is urethral stenosis. The purpose of the treatments is to remove the warts and induce lesion-free periods. Such treatments do not eliminate the infection nor do they prevent continued transmission of the virus. We retrospectively evaluated 123 patients diagnosed and treated for condylomas in the genital area at our Institution between April 2009 and April 2012. The patients’ mean age was 28.7 years (range 19–51). Of the 123 patients included, 48 (39%) had a history of previous STIs, most frequently gonococcal urethritis. Three of them had a urethral malformation in the form of hypospadias, and another three reported a previous urologic manipulation (catheterisation). Meatal/urethral condylomas are rare, cryotherapy is simple, easy to apply, and has a very low risk of complications in patients with externally accessible warts.
Collapse
Affiliation(s)
- Álvaro Vives
- Department of Andrology, Fundació Puigvert, Universitat Autonoma de Barcelona, Barcelona, Spain
| | | | - Oswaldo Rajmil
- Department of Andrology, Fundació Puigvert, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - Marco Cosentino
- Department of Andrology, Fundació Puigvert, Universitat Autonoma de Barcelona, Barcelona, Spain
| |
Collapse
|
29
|
Grillo‐Ardila CF, Angel‐Müller E, Salazar‐Díaz LC, Gaitán HG, Ruiz‐Parra AI, Lethaby A. Imiquimod for anogenital warts in non-immunocompromised adults. Cochrane Database Syst Rev 2014; 2014:CD010389. [PMID: 25362229 PMCID: PMC10777270 DOI: 10.1002/14651858.cd010389.pub2] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND 30% of people with anogenital warts (AGW) have spontaneous regression of lesions but there is no way to determine whether a specific lesion will remain. There are a wide range of options available for treating people with AGW and selection is based on clinician's experience, patient preferences and adverse effects. The imiquimod could offer the advantages of patient-applied therapies without incurring the limitations of provider-administered treatments. OBJECTIVES To assess the effectiveness and safety of imiquimod for the treatment of AGW in non-immunocompromised adults. SEARCH METHODS We searched the Cochrane Sexually Transmitted Infections Group Specialized Register (15 April 2014), CENTRAL (1991 to 15 April 2014), MEDLINE (1946 to 15 April 2014), EMBASE (1947 to 15 April 2014), LILACS (1982 to 15 April 2014), World Health Organization International Clinical Trials Registry (ICTRP) (15 April 2014), ClinicalTrials.gov (15 April 2014), Web of Science (2001 to 15 April 2014) and OpenGrey (15 April 2014). We also handsearched conference proceedings, contacted trial authors and reviewed the reference lists of retrieved studies. SELECTION CRITERIA Randomized controlled trials (RCTs) comparing the use of imiquimod with placebo, any other patient-applied or any other provider-administered treatment (excluding interferon and 5-fluorouracil which are assessed in other Cochrane Reviews) for the treatment of AGW in non-immunocompromised adults. DATA COLLECTION AND ANALYSIS Three review authors independently assessed trials for inclusion, extracted data and assessed risk of bias. We resolved any disagreements through consensus. The quality of the evidence was assessed using the GRADE approach. MAIN RESULTS Ten RCTs (1734 participants) met our inclusion criteria of which six were funded by industry. We judged the risk of bias of the included trials as high. Six trials (1294 participants) compared the use of imiquimod versus placebo. There was very low quality evidence that imiquimod was superior to placebo in achieving complete and partial regression (RR 4.03, 95% CI 2.03 to 7.99; RR 2.56, 95% CI 2.05 to 3.20, respectively). When compared with placebo, the effects of imiquimod on recurrence (RR 2.76, 95% CI 0.70 to 10.91), appearance of new warts (RR 0.76, 95% CI 0.58 to 1.00) and frequency of systemic adverse reactions (RR 0.91, 95% CI 0.63 to 1.32) were imprecise. We downgraded the quality of evidence to low or very low. There was low quality evidence that imiquimod led to more local adverse reactions (RR 1.73, 95% CI 1.18 to 2.53) and pain (RR 11.84, 95% CI 3.36 to 41.63).Two trials (105 participants) compared the use of imiquimod versus any other patient-applied treatment (podophyllotoxin and podophyllin). The estimated effects of imiquimod on complete regression (RR 1.09, 95% CI 0.80 to 1.48), partial regression (RR 0.77, 95% CI 0.40 to 1.47), recurrence (RR 0.49, 95% CI 0.21 to 1.11) or the presence of local adverse reactions (RR 1.24, 95% CI 1.00 to 1.54) were imprecise (very low quality evidence). There was low quality evidence that systemic adverse reactions were less frequent with imiquimod (RR 0.30, 95% CI 0.09 to 0.98).Finally, two trials (335 participants) compared imiquimod with any other provider-administered treatment (ablative methods and cryotherapy). There was very low quality of evidence that imiquimod did not have a lower frequency of complete regression (RR 0.84, 95% CI 0.56 to 1.28). There was very low quality evidence that imiquimod led to a lower rate of recurrence during six-month follow-up (RR 0.24, 95% CI 0.10 to 0.56) but this did not translate in to a lower recurrence from six to 12 months (RR 0.71, 95% CI 0.40 to 1.25; very low quality evidence). There was very low quality evidence that imiquimod was associated with less pain (RR 0.30, 95% CI 0.17 to 0.54) and fewer local reactions (RR 0.55, 95% CI 0.40 to 0.74). AUTHORS' CONCLUSIONS The benefits and harms of imiquimod compared with placebo should be regarded with caution due to the risk of bias, imprecision and inconsistency for many of the outcomes we assessed in this Cochrane Review. The evidence for many of the outcomes that show imiquimod and patient-applied treatment (podophyllotoxin or podophyllin) confer similar benefits but fewer systematic reactions with the Imiquimod, is of low or very low quality. The quality of evidence for the outcomes assessing imiquimod and other provider-administered treatment were of very low quality.
Collapse
Affiliation(s)
- Carlos F Grillo‐Ardila
- Faculty of Medicine, Universidad Nacional de ColombiaDepartment of Obstetrics & Gynecology and Clinical Research InstituteCarrera 30 No 45‐03BogotaColombia
| | - Edith Angel‐Müller
- Faculty of Medicine, Universidad Nacional de ColombiaDepartment of Obstetrics & GynecologyCra 30 # 45‐03BogotaColombia
| | - Luis C Salazar‐Díaz
- Faculty of Medicine, Universidad Nacional de ColombiaClinical Research InstituteBogotaColombia
| | - Hernando G Gaitán
- Faculty of Medicine, Universidad Nacional de ColombiaDepartment of Obstetrics & Gynecology and Clinical Research InstituteCarrera 30 No 45‐03BogotaColombia
| | - Ariel I Ruiz‐Parra
- Faculty of Medicine, Universidad Nacional de ColombiaDepartment of Obstetrics & Gynecology and Clinical Research InstituteCarrera 30 No 45‐03BogotaColombia
| | - Anne Lethaby
- University of AucklandDepartment of Obstetrics and GynaecologyPrivate Bag 92019AucklandNew Zealand1142
| | | |
Collapse
|
30
|
Comparison of cryotherapy session intervals in the treatment of external genital warts. DERMATOL SIN 2014. [DOI: 10.1016/j.dsi.2013.10.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
|
31
|
Yu X, Wang Y, Zhao W, Zhou H, Yang W, Guan X. Toll-like receptor 7 promotes the apoptosis of THP-1-derived macrophages through the CHOP-dependent pathway. Int J Mol Med 2014; 34:886-93. [PMID: 24994112 DOI: 10.3892/ijmm.2014.1833] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2013] [Accepted: 06/25/2014] [Indexed: 11/06/2022] Open
Abstract
Macrophage apoptosis is a prominent characteristic of advanced atherosclerotic plaques and leads to plaque destabilization. Certain studies have confirmed that influenza virus A (IVA) infection is related to acute myocardial infarction (AMI). However, it remains unknown as to whether this phenomenon is associated with Toll-like receptor (TLR)7, since single-stranded RNA (ssRNA) of IVA is a natural ligand of TLR7. Thus, in the present study, THP-1‑derived macrophages were infected with IVA or treated with imiquimod (IMQ) in the presence or absence of pre-treatment with oxidized low-density lipoprotein (oxLDL). The macrophages were pre-treated with oxLDL (5 µg/ml) for 24 h to mimic high lipid conditions. Cell viability and apoptosis were detected by 3-(4,5-dimethylthiazol-2-y-1)‑2,5-diphenyl-2H-tetrazolium bromide (MTT) assay and flow cytometry, respectively. Our results revealed that TLR7 played an important role in macrophage apoptosis and cytokine secretion. Both IVA infection and IMQ treatment increased TLR7 expression, as well as the secretion of pro-inflammatory cytokines [interleukin (IL)-6, monocyte chemotactic protein (MCP)-1] and apoptosis. However, this increase in cytokine secretion occurred independently of cell apoptosis. oxLDL had potential synergistic pro-apoptotic effects combined with TLR7 activation. To determine whether endoplasmic reticulum (ER) stress plays a role in cell apoptosis, the mRNA and protein expression of known markers of ER stress [glucose-regulated protein (GRP)78 and C/EBP homologous protein (CHOP)] was detected by reverse transcription PCR (RT-PCR), quantitative reverse transcription PCR (qRT-PCR) and western blot analysis. Our results revealed that apoptosis aggravated ER stress, as shown by the overexpression of the pro-apoptotic sensor, CHOP. In conclusion, our study demonstrates the converging role of oxLDL pre-treatment, IVA infection and IMQ in ER stress-induced cell apoptosis.
Collapse
Affiliation(s)
- Xiaochen Yu
- Department of Laboratory Diagnostics, First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150001, P.R. China
| | - Yang Wang
- Department of Laboratory Diagnostics, First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150001, P.R. China
| | - Wenhui Zhao
- Department of Laboratory Diagnostics, First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150001, P.R. China
| | - Haizhou Zhou
- Department of Laboratory Diagnostics, First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150001, P.R. China
| | - Wei Yang
- Department of Laboratory Diagnostics, First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150001, P.R. China
| | - Xiuru Guan
- Department of Laboratory Diagnostics, First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150001, P.R. China
| |
Collapse
|
32
|
Park SJ, Seo J, Ha SH, Jung GW. Prevalence and determinants of high-risk human papillomavirus infection in male genital warts. Korean J Urol 2014; 55:207-12. [PMID: 24648877 PMCID: PMC3956951 DOI: 10.4111/kju.2014.55.3.207] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2013] [Accepted: 10/04/2013] [Indexed: 11/18/2022] Open
Abstract
Purpose To evaluate the prevalence and type distribution of high-risk human papillomavirus (HPV) infection in genital warts of Korean men, and for the first time, to describe the risk factors associated with high-risk HPV infection in male genital warts. Materials and Methods In a single private clinic, 150 consecutive male patients with histopathologic-confirmed genital warts who underwent HPV genotyping by use of polymerase chain reaction (PCR) were included in this study. We detected HPV DNA in male genital warts and evaluated HPV type distribution, especially high-risk HPV types, by use of PCR. The associations between HPV prevalence and various characteristics, such as age, circumcision status, type of genital warts diagnosis (new vs. recurrent), number of lesions, site of lesions, and gross morphology, were assessed by use of unconditional multiple logistic regression. Results High-risk HPV types were detected in 31 cases (23.5%), and of these, 27 cases (20.5%) contained both high-risk and low-risk HPV types. The most frequently detected high-risk HPV types were HPV16 (6.8%), HPV33 (4.5%), HPV18 (2.3%), and HPV68 (2.3%). In particular, the prevalence of infection with HPV16 and/or HPV18 was 8.3% (11 of 132). In the multivariate analysis, lesions located at sites including the base of the penis or the pubic area, papular or mixed genital warts, and lack of circumcision significantly increased the association with high-risk HPV infection in male genital warts. Conclusions The prevalence of high-risk HPV infection was substantial in male genital warts. The site and morphology of lesions and circumcision status were significantly associated with the prevalence of high-risk HPV infection.
Collapse
|
33
|
Vedham V, Divi RL, Starks VL, Verma M. Multiple infections and cancer: implications in epidemiology. Technol Cancer Res Treat 2013; 13:177-94. [PMID: 23919392 DOI: 10.7785/tcrt.2012.500366] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Approximately 18% of the global cancer burden has been attributed to infectious agents, with estimates ranging from 7% in developed countries to about 22% in developing countries. Chronic infections caused by the hepatitis B and C viruses, human papilloma viruses (HPV), and Helicobacter pylori (H. pylori) are reported to be responsible for approximately 15% of all human cancers. Interestingly, although many of the infectious agents that have been associated with cancer--such as HPV, Epstein-Barr virus (EBV), and H. pylori--are highly prevalent in the world, most infected individuals do not develop cancer but remain lifelong carriers. Malignancies associated with infectious agents may result from prolonged latency as a result of chronic infections. Pathogenic infections are necessary but are not sufficient for cancer initiation or progression. Cancer initiation may require additional cofactors, including secondary infections. Therefore, in patients with chronic infection with one agent, secondary co-infection with another agent may serve as an important co-factor that may cause cancer initiation and progression. Additionally, opportunistic co-infections could significantly inhibit response to cancer treatment and increase cancer mortality. Co-infections are relatively common in areas with a high prevalence of infectious agents, especially in developing countries. These co-infections can cause an imbalance in the host immune system by affecting persistence of and susceptibility to malignant infections. Several articles have been published that focus on infectious agents and cancer. In this article, we discuss the role of infectious agents in malignancies, highlight the role of multiple/co-infections in cancer etiology, and review implications for cancer epidemiology.
Collapse
Affiliation(s)
- Vidya Vedham
- Methods and Technologies Branch, Epidemiology and Genomics Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health (NIH), 6130 Executive Boulevard, Suite 5100, Bethesda, MD 20892-7324, USA.
| | | | | | | |
Collapse
|
34
|
Wikström A, Hedblad MA, Syrjänen S. Human papillomavirus-associated balanoposthitis--a marker for penile intraepithelial neoplasia? Int J STD AIDS 2013; 24:938-43. [PMID: 23970611 DOI: 10.1177/0956462413487325] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The purpose of this study was to analyse, among men treated with diathermy, whether there was a difference in balanoposthitis between men with histopathologically benign human papillomavirus-associated lesions and those with penile intraepithelial neoplasia. Data were derived from patient material from a previously published study. Two clinically identical lesions from the same genital site were collected for analysis with routine histopathology and with nested PCR. In total, 292 men were included, of which 47 (16%) had penile intraepithelial neoplasia. Of those with penile intraepithelial neoplasia, 19/47 (40%) reported problems consistent with balanoposthitis, compared with only 15/245 (6%) patients with benign lesions (p < 0.0001). A statistical difference in percentage distribution was also seen regarding morphology (p = 0.001) and location (p = 0.0003) of the lesions among the men having benign lesions with and without balanoposthitis. It is not possible to take biopsies from patients with genital warts, but this study suggests that one probably should be more observant for genital dysplasia among those men with warts with a history of balanoposthitis than those with no such history.
Collapse
Affiliation(s)
- Arne Wikström
- Department of Dermatology & Venereology, Karolinska Hospital and Institute of Medicine, Karolinska Institute, Stockholm, Sweden
| | | | | |
Collapse
|
35
|
Tamegai H, Takada Y, Okabe M, Asada Y, Kusano K, Katagiri YU, Nagahara Y. Aureobasidium pullulans culture supernatant significantly stimulates R-848-activated phagocytosis of PMA-induced THP-1 macrophages. Immunopharmacol Immunotoxicol 2013; 35:455-61. [PMID: 23786444 DOI: 10.3109/08923973.2013.800106] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Toll-like receptors (TLRs), which recognize a wide range of microbial pathogens and pathogen-related products, play important roles in innate immunology. Macrophages have a variety of TLRs, and pathogen binding to TLR resulted in the activation of macrophages. R-848, an immune response modifier, is an analog of imidazoquinoline derivative and binds to an endosome-localized TLR to exert an anti-viral response on leukocytes. In the present study, we verified that co-treatment of R-848 with other TLR agonists would enhance immune response. The culture supernatant of Aureobasidium pullulans (A. pullulans, which contains predominantly soluble β-glucan), which binds to cell membrane-localized TLR, and to C-type lectin receptor Dectin-1, was treated together with R-848 to THP-1 macrophages. Compared to R-848 treatment alone, co-treatment of R-848 with A. pullulans culture supernatant significantly augmented TNF-α and IL-12p40 cytokine expression. Next, we investigated whether or not apoptotic cell uptake would be increased by co-treatment of R-848 with A. pullulans culture supernatant. To detect engulfed apoptotic cells, we induced apoptosis in human lymphoma Jurkat cells by 5-fluorouracil and stained them with fluorescent dye 5(6)-carboxytetramethylrhodamine (TAMRA), whereas THP-1 macrophage was labeled with fluorescein isothiocyanate-anti-CD14 and determined the percentage increase in TAMRA-positive THP-1 macrophages by flow cytometric assay. Since R-848 or A. pullulans treatment alone stimulated THP-1 macrophages to induce phagocytosis, co-treatment of R-848 with A. pullulans culture supernatant significantly augmented phagocytosis of apoptotic Jurkat cells. These results suggest that the activation of several different innate immune receptor pathways may enhance the immune response of R-848 significantly.
Collapse
Affiliation(s)
- Hidekazu Tamegai
- Department of Biotechnology, College of Science and Engineering, Tokyo Denki University, Hatoyama, Hiki-gun, Saitama, Japan
| | | | | | | | | | | | | |
Collapse
|
36
|
HAN JUHEE, LEE JUNGLIM, JEON SOOJIN, CHOI EUNSUN, CHO SUNGDAE, KIM BOYEON, KIM DONGJAE, PARK JAEHAK, PARK JONGHWAN. In vitro and in vivo growth inhibition of prostate cancer by the small molecule imiquimod. Int J Oncol 2013; 42:2087-93. [DOI: 10.3892/ijo.2013.1898] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2013] [Accepted: 03/21/2013] [Indexed: 11/06/2022] Open
|
37
|
Grillo-Ardila CF, Gaitán HG, Angel-Müller E, Ruiz-Parra AI, Lethaby A. Imiquimod for anogenital warts in non-immunocompromised adults. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2013. [DOI: 10.1002/14651858.cd010389] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|
38
|
Nyitray AG, Lu B, Kreimer AR, Anic G, Stanberry LR, Giuliano AR. The Epidemiology and Control of Human Papillomavirus Infection and Clinical Disease. Sex Transm Dis 2013. [DOI: 10.1016/b978-0-12-391059-2.00013-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
39
|
Maglennon GA, Doorbar J. The biology of papillomavirus latency. Open Virol J 2012; 6:190-7. [PMID: 23341854 PMCID: PMC3547330 DOI: 10.2174/1874357901206010190] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2012] [Revised: 09/21/2012] [Accepted: 09/24/2012] [Indexed: 12/12/2022] Open
Abstract
The presence of viral DNA in the absence of disease has suggested that papillomaviruses, like many other viruses, can exist as latent infections in the skin or other epithelial sites. In animal models, where detailed investigation has been carried out, papillomavirus DNA can be found at sites of previous infection following immune regression, with the site of latent infection being the epithelial basal layer. Such studies suggest that immune surveillance can restrict viral gene expression in the basal and parabasal layers without efficiently suppressing viral genome replication, most probably through the action of memory T-cells in the skin or dermis. Although gradual papillomavirus genome loss appears to occur over time at latent sites, immunosuppression can arrest this, and can lead to an elevation in viral genome copy number in experimental systems. In addition to immune-mediated latency, it appears that a similar situation can be achieved following infection at low virus titres and/or infection at epithelial sites where the virus life cycle is not properly supported. Such silent of asymptomatic infections do not necessarily involve the host immune system and may be controlled by different mechanisms. It appears that virus reactivation can be triggered by mechanical irritation, wounding or by UV irradiation which changes the local environment. Although the duration of papillomavirus latency in humans is not yet known, it is likely that some of the basic principles will resemble those elucidated in these model systems, and that persistence in the absence of disease may be the default outcome for at least some period of time following regression.
Collapse
Affiliation(s)
- Gareth Adam Maglennon
- Pathology & Infectious Diseases, The Royal Veterinary College, North Mymms, AL9 7TA, UK
| | - John Doorbar
- Division of Virology, National Institute for Medical Research, Mill Hill, London, NW7 1AA, UK
| |
Collapse
|
40
|
Zekan J, Petrovic D, El-Safadi S, Banovic M, Hulina D, Hrgovic Z. A surgical approach to giant condyloma (Buschke-Löwenstein tumour) with underlying superficial vulvar carcinoma: A case report. Oncol Lett 2012; 5:541-543. [PMID: 23420321 PMCID: PMC3573067 DOI: 10.3892/ol.2012.1027] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2012] [Accepted: 10/03/2012] [Indexed: 11/06/2022] Open
Abstract
Anogenital warts (condyloma acuminatum or venereal warts) are a common sexually transmitted disease in males and females. Common clinical treatment of anogenital warts is conservative, however, in extreme cases conservative therapy is insufficient and surgical excision is required. Giant condyloma acuminata (Buschke-Löwenstein tumour) is an extremely rare clinical type of genital wart, characterised by aggressive down growth into underlying dermal structures. A 55-year-old female presented with cauliflower-like growth over the anogenital and sacral region, earlier diagnosed as condyloma acuminatum which was resistant to conservative therapy. During the period between 2005 and 2008 the patient underwent five surgical procedures. Due to the size and location of the tumour, gynaecological and plastic surgeons were involved in the procedures. In addition, definitive histology examination identified a superficial vulvar carcinoma.
Collapse
Affiliation(s)
- Josko Zekan
- Departments of Gynaecological Oncology, University Medical School, 10000 Zagreb, Croatia
| | | | | | | | | | | |
Collapse
|
41
|
Baydar DE, Kulac I, Ozagari A, Guler Tezel G. Occurrence of dysplasia and human papilloma virus typing in penile condylomas. Urology 2012; 81:211.e9-15. [PMID: 23153936 DOI: 10.1016/j.urology.2012.09.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2012] [Revised: 08/16/2012] [Accepted: 09/04/2012] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To determine the incidence of dysplasia as a preneoplastic change and high-risk human papilloma virus (HPV) infection in penile condylomas, which are common HPV-related lesions and considered a risk factor for penile cancer. METHODS Histologic analysis was done of 58 consecutive penile condylomas with tissue diagnosis. An immunohistochemical panel that included stains for p53, Ki-67, and p16INK4a was also used. HPV typing was successfully performed in 43 lesions. Genotyping was accomplished through polymerase chain reaction and flow-through hybridization with an HPV GenoArray Diagnostic Test kit. RESULTS Dysplasia was observed in 13 of the 58 condylomas (22%). High-risk HPV DNA was detected in 5 of 10 dysplastic lesions (50%) for which tissue blocks were available for study. High-risk HPV was not detected in the nondysplastic lesions (P<.001). Ki-67≥20% above the basal layer of epithelium and p53-positive immunostaining occurred more frequently in dysplastic lesions than in nondysplastic lesions; however, the difference was not statistically significance. Staining for p16INK4a was not helpful. CONCLUSION Anogenital condylomas in men are usually treated using destructive methods or with medication. We suggest that at least a part of the lesion must be removed and sent for histopathologic examination. If the histologic result shows significant dysplastic alteration, the lesion should be further investigated to determine the subtype of infective virus, because 50% of such lesions are associated with high-risk HPV. When oncogenic pathogens are found, careful patient follow-up for recurrences and counseling for the patient and his sexual partner(s) may be warranted.
Collapse
|
42
|
Domínguez Gómez J, Simón RD, Abreu Daniel A, Zelenkova H. Effectiveness of glycyrrhizinic Acid (glizigen) and an immunostimulant (viusid) to treat anogenital warts. ISRN DERMATOLOGY 2012; 2012:863692. [PMID: 22957266 PMCID: PMC3431102 DOI: 10.5402/2012/863692] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/21/2012] [Accepted: 05/03/2012] [Indexed: 11/25/2022]
Abstract
Genital warts are benign proliferations of skin and mucosa caused by the human papillomavirus infection (hereinafter referred to as HPV). It is one of the most common sexually transmitted diseases in the world, whose incidence rate has increased in the last three decades. Current treatment involves the physical destruction of the infected cells. The fact that there are many different types of treatment goes to show that none of them are uniformly effective or directly antiviral. Objective. Demonstrate the efficacy of Glizigen in the III-phase clinical trial combined with a food supplement (VIUSID) formulated to boost the immune system when treating external anogenital warts. Design. 100 patients clinically diagnosed with anogenital lesions were included in the trial and assigned to two groups of 50 individuals. Those from one group where treated with Glizigen and Viusid and those from the other group with 25% podophyllin in alcohol, the results from each were then compared. Results. The combined Glizigen-Viusid treatment was seen to have an 87.5% efficacy rate, which was slightly more than that of the treatment with podophyllin, and there were hardly any adverse reactions reported during the treatment. Conclusions. the combined Glizigen-Viusid treatment was effective in treating genital warts.
Collapse
|
43
|
|
44
|
Stockfleth E, Meyer T. The use of sinecatechins (polyphenon E) ointment for treatment of external genital warts. Expert Opin Biol Ther 2012; 12:783-93. [DOI: 10.1517/14712598.2012.676036] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
|
45
|
Stanley MA. Genital human papillomavirus infections: current and prospective therapies. J Gen Virol 2012; 93:681-691. [PMID: 22323530 DOI: 10.1099/vir.0.039677-0] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Infection with human papillomaviruses (HPVs) is very common and associated with benign and malignant epithelial proliferations of skin and internal squamous mucosae. A subset of the mucosal HPVs are oncogenic and associated with 5 % of all cancers in men and women. There are two licensed prophylactic vaccines, both target HPV 16 and 18, the two most pathogenic, oncogenic types and one, additionally, targets HPV 6 and 11 the cause of genital warts. The approach of deliberate immunization with oncogenic HPV E6 and/or E7 proteins and the generation of antigen-specific cytotoxic T-cells as an immunotherapy for HPV-associated cancer and their high-grade pre-cancers has been tested with a wide array of potential vaccine delivery systems in Phase I/II trials with varying success. Understanding local viral and tumour immune evasion strategies is a prerequisite for the rational design of therapeutic vaccines for HPV-associated infection and disease, progress in this is discussed. There are no antiviral drugs for the treatment of HPV infection and disease. Current therapies are not targeted antiviral therapies, but either attempt physical removal of the lesion or induce inflammation and a bystander immune response. There has been recent progress in the identification and characterization of molecular targets for small molecule antagonists of the HPV proteins E1, E2 and E6 or their interactions with their cellular targets. Lead compounds that could disrupt E1-E2 protein-protein interactions have been discovered as have inhibitors of E6-E6-AP-binding interactions. Some of these compounds showed nanomolar affinities and high specificities and demonstrate the feasibility of this approach for HPV infections. These studies are, however, at an early phase and it is unlikely that any specific anti-HPV chemotherapeutic will be in the clinic within the next 10-20 years.
Collapse
|
46
|
Olaleye O, Moorthy R, Lyne O, Black M, Mitchell D, Wiseberg J. A 20-year retrospective study of tonsil cancer incidence and survival trends in South East England: 1987-2006. Clin Otolaryngol 2012; 36:325-35. [PMID: 21696555 DOI: 10.1111/j.1749-4486.2011.02361.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND There has been an increasing incidence of tonsil cancer worldwide. Documenting these changes is crucial to cancer prevention and control measures, resource allocation and understanding disease aetiology. OBJECTIVE To analyse the changing epidemiology of tonsil cancer in South East England over a 20-year period between 1987 and 2006. DESIGN A retrospective, quantitative study using secondary anonymised data obtained from the Thames Cancer Registry, London. Data were analysed using spss v.17 and survival analyses with Kaplan-Meier and Cox regression. SETTING This study was conducted in South East of England comprising London, Kent, Surrey and Sussex counties with an average population of 12 million. This population increased from 10.7 to 11.8 million (a 10% increase) between 1987 and 2006. PARTICIPANTS All patients with tonsil cancer in South East England registered with the Thames Cancer Registry (ICD-10 code C09) between 1987 and 2006. A total of 1794 patients' data were analysed. Ethical Considerations: Ethical approval was granted by the Kent Research Ethics Committee. MAIN OUTCOME MEASURES Data were analysed for demographic trends including gender, age at diagnosis, yearly incidence and survival. RESULTS Tonsil cancer incidence has increased significantly from 0.60 to 1.45 per 100,000 in the 20 years (P < 0.001). This increase is mainly amongst men and age groups 40-59 years with a significant reduction in age at diagnosis by 2 years from 61.6 years in the first decade to 59.6 years in the second decade (P < 0.001). Survival was worse in men, older age groups and in the presence of synchronous tumours (P < 0.001). There has been a statistically significant increase in median survival times from tonsil cancer by about 3 years from 2.7 years in the first decade to 5.7 years in the second decade of this study (P < 0.001). CONCLUSIONS Tonsil cancer incidence has increased in the 20 years of this study in South East England, especially amongst men and age groups 40-59 years. There has also been significant reduction in the mean age at diagnosis and an increase in median survival times for tonsil cancer. Further studies are needed to explain these trends.
Collapse
Affiliation(s)
- O Olaleye
- Department of Otolaryngology, Russells Hall Hospital, Dudley, West Midlands UK.
| | | | | | | | | | | |
Collapse
|
47
|
Bogaards JA, Kretzschmar M, Xiridou M, Meijer CJLM, Berkhof J, Wallinga J. Sex-specific immunization for sexually transmitted infections such as human papillomavirus: insights from mathematical models. PLoS Med 2011; 8:e1001147. [PMID: 22205887 PMCID: PMC3243713 DOI: 10.1371/journal.pmed.1001147] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2011] [Accepted: 11/09/2011] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Sex-specific differences regarding the transmissibility and the course of infection are the rule rather than the exception in the epidemiology of sexually transmitted infections (STIs). Human papillomavirus (HPV) provides an example: disease outcomes differ between men and women, as does the potential for transmission to the opposite sex. HPV vaccination of preadolescent girls was recently introduced in many countries, and inclusion of boys in the vaccination programs is being discussed. Here, we address the question of whether vaccinating females only, males only, or both sexes is the most effective strategy to reduce the population prevalence of an STI like HPV. METHODS AND FINDINGS We use a range of two-sex transmission models with varying detail to identify general criteria for allocating a prophylactic vaccine between both sexes. The most effective reduction in the population prevalence of infection is always achieved by single-sex vaccination; vaccinating the sex with the highest prevaccine prevalence is the preferred strategy in most circumstances. Exceptions arise only when the higher prevaccine prevalence is due to a substantially lower rate of natural immunity, or when natural immunity is lifelong, and a prolonged duration of infectiousness coincides with increased transmissibility. Predictions from simple models were confirmed in simulations based on an elaborate HPV transmission model. Our analysis suggests that relatively inefficient genital transmission from males to females might render male vaccination more effective in reducing overall infection levels. However, most existing HPV vaccination programs have achieved sufficient coverage to continue with female-only vaccination. CONCLUSIONS Increasing vaccine uptake among preadolescent girls is more effective in reducing HPV infection than including boys in existing vaccination programs. As a rule, directing prophylactic immunization at the sex with the highest prevaccine prevalence results in the largest reduction of the population prevalence.
Collapse
Affiliation(s)
- Johannes A Bogaards
- Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands.
| | | | | | | | | | | |
Collapse
|
48
|
Scarbrough Lefebvre C, Van Kriekinge G, Gonçalves M, de Sanjose S. Appraisal of the burden of genital warts from a healthcare and individual patient perspective. Public Health 2011; 125:464-75. [DOI: 10.1016/j.puhe.2011.01.016] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2010] [Revised: 12/20/2010] [Accepted: 01/27/2011] [Indexed: 10/17/2022]
|
49
|
Tzellos TG, Sardeli C, Lallas A, Papazisis G, Chourdakis M, Kouvelas D. Efficacy, safety and tolerability of green tea catechins in the treatment of external anogenital warts: a systematic review and meta-analysis. J Eur Acad Dermatol Venereol 2011; 25:345-53. [PMID: 21294779 DOI: 10.1111/j.1468-3083.2010.03796.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND External anogenital warts (EGWs) are non-malignant skin tumours caused by human papillomavirus. They are one of the fastest growing sexually transmitted diseases. Current treatments are unsatisfactory. Green tea sinecatechin Polyphenon E ointment is a botanical extract from green tea leaves exhibiting anti-oxidant, anti-viral and anti-tumour properties. OBJECTIVE The aim of this study was to integrate valid information and provide basis for rational decision making regarding efficacy and safety of green tea extracts in the treatment of EGWs. METHODS A systematic search in electronic databases was conducted using specific key terms. Main search was performed independently by two reviewers. The accumulated relevant literature was subsequently systematically reviewed and a meta-analysis was conducted. RESULTS Three randomized, double-blind, placebo-controlled studies evaluating efficacy and safety of Polyphenon E 15% and 10% in the treatment of warts were included in the systematic review and meta-analysis. A total of 660 men and 587 women were enrolled. Regarding primary outcome, both Polyphenon E 15% and 10% demonstrated significantly higher likelihood of complete clearance of baseline and baseline and new warts compared with controls. No significant heterogeneity was detected. Recurrence rates were very low. Commonest local skin sign was erythema and local skin symptom was itching. CONCLUSIONS Efficacy of Polyphenon 15% and 10%, at least for the primary endpoint, is clearly indicated. Polyphenon E treatment exhibits very low recurrence rates and appears to have a rather favourable safety and tolerability profile. Recommendations for future studies should include evaluation of the efficacy of green tea catechins in the treatment of internal anogenital warts and direct comparison with its principal comparator, imiquimod.
Collapse
Affiliation(s)
- T G Tzellos
- Department of Pharmacology & Clinical Pharmacology, School of Medicine, Aristotle University of Thessaloniki, and Hospital of Venereal & Skin Diseases of Thessaloniki, Thessaloniki, Greece
| | | | | | | | | | | |
Collapse
|
50
|
Wikström A, Hedblad MA, Syrjänen S. Penile intraepithelial neoplasia: histopathological evaluation, HPV typing, clinical presentation and treatment. J Eur Acad Dermatol Venereol 2011; 26:325-30. [DOI: 10.1111/j.1468-3083.2011.04069.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|