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Enskär I, Fransson E, Enskär K, Nevéus T, Grandahl M. School children's perceptions about being offered the HPV vaccination - A focus group study. Acta Paediatr 2024; 113:1672-1678. [PMID: 38551330 DOI: 10.1111/apa.17225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 03/06/2024] [Accepted: 03/21/2024] [Indexed: 06/12/2024]
Abstract
AIM There is limited knowledge about the perceptions of HPV vaccination in middle-school children. This qualitative study aimed to explore their views. METHODS We conducted focus group interviews with children, 10-11 years of age, who had been offered HPV vaccination through the school health services in mid-north Sweden in spring of 2023. Data were analysed with qualitative content analysis. RESULTS This study included six focus group interviews with 49 children (boys n = 29; girls n = 20), mean of 11 years of age. Participating children expressed the need to feel safe to be of utmost importance and the means to do so was to be prepared and informed by someone the child trusted. The school nurse was perceived as the expert, best suited to provide factual information, support and motivation, both to children and their parents. CONCLUSION We confirm that healthcare providers' recommendations are crucial for HPV vaccine acceptance also from the child's perspective. Improved information about HPV vaccination to children is necessary. Children's right to participate on their own terms is not fulfilled today. Vaccine promotion, both to children and parents, should be actively managed by the school nurse.
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Affiliation(s)
- Ida Enskär
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Emma Fransson
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institute, Stockholm, Sweden
| | - Karin Enskär
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Tryggve Nevéus
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Maria Grandahl
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
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Wang S, Wang J, Xia Y, Zhang L, Jiang Y, Liu M, Gao Q, Zhang C. Harnessing the potential of HLA-G in cancer therapy: advances, challenges, and prospects. J Transl Med 2024; 22:130. [PMID: 38310272 PMCID: PMC10838004 DOI: 10.1186/s12967-024-04938-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 01/27/2024] [Indexed: 02/05/2024] Open
Abstract
Immune checkpoint blockades have been prized in circumventing and ablating the impediments posed by immunosuppressive receptors, reaching an exciting juncture to be an innovator in anticancer therapy beyond traditional therapeutics. Thus far, approved immune checkpoint blockades have principally targeted PD-1/PD-L1 and CTLA-4 with exciting success in a plethora of tumors and yet are still trapped in dilemmas of limited response rates and adverse effects. Hence, unveiling new immunotherapeutic targets has aroused immense scientific interest in the hope of expanding the clinical application of immune checkpoint blockades to scale new heights. Human leukocyte antigen-G (HLA-G), a non-classical major histocompatibility complex (MHC) class I molecule, is enriched on various malignant cells and is involved in the hindrance of immune effector cells and the facilitation of immunosuppressive cells. HLA-G stands out as a crucial next-generation immune checkpoint showing great promise for the benefit of cancer patients. Here, we provide an overview of the current understanding of the expression pattern and immunological functions of HLA-G, as well as its interaction with well-characterized immune checkpoints. Since HLA-G can be shed from the cell surface or released by various cells as free soluble HLA-G (sHLA-G) or as part of extracellular vesicles (EVs), namely HLA-G-bearing EVs (HLA-GEV), we discuss the potential of sHLA-G and HLA-GEV as predictive biomarkers. This review also addresses the advancement of HLA-G-based therapies in preclinical and clinical settings, with a focus on their clinical application in cancer.
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Affiliation(s)
- Siyuan Wang
- Department of Geriatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, 430030, China
- Key Laboratory of Vascular Aging, Ministry of Education, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, 430030, China
| | - Jiaxin Wang
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, 430030, China
| | - Yu Xia
- Cancer Biology Research Center (Key Laboratory of Chinese Ministry of Education), Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Ave, Wuhan, 430030, China
- Department of Gynecology and Obstetrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, 430030, China
| | - Le Zhang
- Department of Geriatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, 430030, China
- Key Laboratory of Vascular Aging, Ministry of Education, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, 430030, China
| | - Yueqiang Jiang
- Department of Geriatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, 430030, China
- Key Laboratory of Vascular Aging, Ministry of Education, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, 430030, China
| | - Man Liu
- Department of Geriatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, 430030, China
- Key Laboratory of Vascular Aging, Ministry of Education, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, 430030, China
| | - Qinglei Gao
- Cancer Biology Research Center (Key Laboratory of Chinese Ministry of Education), Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Ave, Wuhan, 430030, China.
- Department of Gynecology and Obstetrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, 430030, China.
| | - Cuntai Zhang
- Department of Geriatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, 430030, China.
- Key Laboratory of Vascular Aging, Ministry of Education, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, 430030, China.
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Kim J, Jo H, Ha MC, Kim H, Lee JK, Han JH, Lee SH, Kang DR, Kim SY, Kim HS, Kim HM. Elevated risk of cervical cancer in elderly women with incident ulcerative colitis in South Korea. Sci Rep 2023; 13:8323. [PMID: 37221276 DOI: 10.1038/s41598-023-33476-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 04/13/2023] [Indexed: 05/25/2023] Open
Abstract
The association between ulcerative colitis (UC) and uterine cervical cancer is still unclear. To investigate cervical cancer risk in South Korean women with UC, we analyzed the Korean National Health Insurance claims data. UC was defined using both ICD-10 codes and UC-specific prescriptions. We analyzed incident cases of UC diagnosed between 2006 and 2015. Age-matched women without UC (control group) were randomly selected from the general population (1:3 ratio). Hazard ratios were calculated using multivariate Cox proportional hazard regression, and the event was defined as occurrence of cervical cancer. A total of 12,632 women with UC and 36,797 women without UC were enrolled. The incidence of cervical cancer was 38.8 per 100,000 women per year in UC patients and 25.7 per 100,000 women per year in controls, respectively. The adjusted HR for cervical cancer was 1.56 (95% CI 0.97-2.50) in the UC group with reference to the control group. When stratified by age, the adjusted HR for cervical cancer was 3.65 (95% CI 1.54-8.66) in elderly UC patients (≥ 60 years) compared to elderly control group (≥ 60 years). Within UC patients, increased age (≥ 40 years) and low socioeconomic status were associated with an increased risk of cervical cancer. The incidence of cervical cancer was found to be higher among elderly patients (≥ 60 years) with newly diagnosed UC in South Korea, compared to age-matched controls. Therefore, regular cervical cancer screening is recommended for elderly patients who have recently been diagnosed with UC.
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Affiliation(s)
- Jihoon Kim
- Department of Physiology, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Halim Jo
- Department of Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Min Chul Ha
- Department of Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Hyunil Kim
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Jung Kuk Lee
- Department of Biostatistics, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Jae Hun Han
- Department of Biostatistics, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - San-Hui Lee
- Department of Obstetrics and Gynecology, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Dae Ryong Kang
- Department of Precision Medicine and Biostatistics, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Su Young Kim
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Hyun-Soo Kim
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
| | - Hee Man Kim
- Health Promotion Center, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
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Wei F, Xia N, Ocampo R, Goodman MT, Hessol NA, Grinsztejn B, Ortiz AP, Zhao F, Kojic EM, Kaul R, Heard I, Morhason-Bello IO, Moscicki AB, de Pokomandy A, Palefsky JM, Rodrigues LLS, Dube Mandishora RS, Ramautarsing RA, Franceschi S, Godbole SV, Tso FK, Menezes LJ, Lin C, Clifford GM. Age-Specific Prevalence of Anal and Cervical Human Papillomavirus Infection and High-Grade Lesions in 11 177 Women by Human Immunodeficiency Virus Status: A Collaborative Pooled Analysis of 26 Studies. J Infect Dis 2023; 227:488-497. [PMID: 35325151 PMCID: PMC10152502 DOI: 10.1093/infdis/jiac108] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 03/22/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Age-specific data on anal, and corresponding cervical, human papillomavirus (HPV) infection are needed to inform female anal cancer prevention. METHODS We centrally reanalyzed individual-level data from 26 studies reporting HPV prevalence in paired anal and cervical samples by human immunodeficiency virus (HIV) status and age. For women with HIV (WWH) with anal high-grade squamous intraepithelial lesions or worse (HSIL+), we also investigated concurrent cervical cytopathology. RESULTS In HIV-negative women, HPV16 prevalence decreased significantly with age, both at anus (4.3% at 15-24 years to 1.0% at ≥55 years; ptrend = 0.0026) and cervix (7.4% to 1.7%; ptrend < 0.0001). In WWH, HPV16 prevalence decreased with age at cervix (18.3% to 7.2%; ptrend = 0.0035) but not anus (11.5% to 13.9%; ptrend = 0.5412). Given anal HPV16 positivity, concurrent cervical HPV16 positivity also decreased with age, both in HIV-negative women (ptrend = 0.0005) and WWH (ptrend = 0.0166). Among 48 WWH with HPV16-positive anal HSIL+, 27 (56%) were cervical high-risk HPV-positive, including 8 with cervical HPV16, and 5 were cervical HSIL+. CONCLUSIONS Age-specific shifts in HPV16 prevalence from cervix to anus suggest that HPV infections in the anus persist longer, or occur later in life, than in the cervix, particularly in WWH. This is an important consideration when assessing the utility of cervical screening results to stratify anal cancer risk.
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Affiliation(s)
- Feixue Wei
- Early Detection, Prevention and Infections Branch, International Agency for Research on Cancer/World Health Organization, Lyon, France
| | - Ningshao Xia
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, School of Public Health, Xiamen University, Xiamen, Fujian, China
| | - Rebeca Ocampo
- Agencia Costarricense de Investigaciones Biomédicas-Fundación INCIENSA, San José, Costa Rica
| | - Marc T Goodman
- Cancer Prevention and Control Program, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Nancy A Hessol
- Department of Clinical Pharmacy, University of California, San Francisco, California, USA
- Department of Medicine, University of California, San Francisco, California, USA
| | - Beatriz Grinsztejn
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Ana P Ortiz
- Puerto Rico Cancer Control and Population Sciences Division, University of Puerto Rico Comprehensive Cancer Center, San Juan, Puerto Rico
- Department of Biostatistics and Epidemiology, Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico
| | - Fanghui Zhao
- Department of Cancer Epidemiology, National Cancer Center & Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Erna M Kojic
- Division of Infectious Diseases, Department of Medicine, Mount Sinai West and Morningside, New York, New York, USA
| | - Rupert Kaul
- Department of Medicine, University of Toronto and University Health Network, Toronto, Ontario, Canada
| | - Isabelle Heard
- Department of Endocrinology and Reproductive Medicine, Institut Endocrinologie, Maladies Métaboliques et Médecine Interne, Assistance Publique - Hôpitaux de Paris, Groupe Hospitalier Pitié- Salpêtrière, Paris, France
| | - Imran O Morhason-Bello
- Department of Obstetrics and Gynaecology, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria
- Institute of Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria
| | | | - Alexandra de Pokomandy
- McGill University Department of Family Medicine and McGill University Health Centre, Montreal, Quebec, Canada
| | - Joel M Palefsky
- Department of Medicine, University of California, San Francisco, California, USA
| | - Luana L S Rodrigues
- Programa de Pós-Graduação em Ciências da Saúde, Instituto de Saúde Coletiva, Universidade Federal do Oeste do Pará, Santarém, Pará, Brazil
- Laboratório de AIDS e Imunologia Molecular, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Racheal S Dube Mandishora
- Early Detection, Prevention and Infections Branch, International Agency for Research on Cancer/World Health Organization, Lyon, France
- Medical Microbiology Unit, University of Zimbabwe Faculty of Health Sciences, Harare, Zimbabwe
| | | | - Silvia Franceschi
- Centro di Riferimento Oncologico, Istituto di Ricovero e Cura a Carattere Scientifico, Aviano, Italy
| | - Sheela V Godbole
- Division of Epidemiology and Biostatistics, Indian Council of Medical Research, National AIDS Research Institute, Pune, India
| | - Fernanda K Tso
- Department of Gynecology, Federal University of São Paulo, São Paulo, Brazil
| | - Lynette J Menezes
- Division of Infectious Disease and International Medicine, University of South Florida, Tampa, Florida, USA
| | - Chunqing Lin
- National Cancer Center, National Clinical Research Center for Cancer, and Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Gary M Clifford
- Early Detection, Prevention and Infections Branch, International Agency for Research on Cancer/World Health Organization, Lyon, France
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Kosumi E, Kosumi M, Spasovski M. Attitude and practice on Human Papillomavirus, Human Papillomavirus Vaccine and associated factors among population in the Republic of Kosova. Arch Public Health 2022. [DOI: 10.3889/aph.2022.6067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Аpproximately 50–80% of sexually active women are exposed to at least one HPV variant during their lifetime. Based on the 2015 annual report of the National Institute of Public Health of Kosova, 68 new cases of cervical cancer were detected. The aim of the study was to investigate the attitude and practice regarding Human Papillomavirus (HPV) infections and the Human Papillomavirus vaccine in the population of the Republic of Kosova. Material and methods: A cross-sectional survey was conducted to assess the knowledge concerning HPV infections among the population aged 18 to 35+ years. The study was conducted during the period of time June 2021 –to August 2021. The sample included 500 participants. The questionnaire was anonymous, and participants were free to end their participation any time, without completing the questionnaire. Results: Regarding the claim "The HPV vaccine is safe", more than half of the respondents, respectively58.6% declare that they do not know, 33.4% of the respondents agree, 6.0% gave an incorrect answer / disagree, and 2.0% did not answer. The percentage difference between the unknown and correct answers is statistically significant for p<0.05. Conclusion: This study found out that the attitude towards the HPV vaccine among people of the Republic of Kosova is low to moderate. HPV vaccines should be included in the national immunization programs, since there is not still established national vaccination program for HPV vaccination.
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DUYMUŞ ME, BAYRAMOĞLU Z, AYİK H, BAG YM. The analysis of anal cytology positivity in women with pathological cervical cytology. MUSTAFA KEMAL ÜNIVERSITESI TIP DERGISI 2022. [DOI: 10.17944/mkutfd.1142816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Objective: Cervical cytology (CC) is a routine screening method used to reduce cervical cancer. Although anal cancer and cervical cancer have similar etiological factors the opinion about the anal cancer screening program is unclear. We aimed to determine the features of women with abnormal anal cytology (AC) who had screened via CC for cervical neoplasia.
Methods: Two hundred and five females' CC results were investigated. The patients with normal CC were excluded, finally 87 participants were included. The demographics, medical, sexual, and reproductive features, CC and AC results were analyzed.
Results: The study group had a mean age of 40.77 ± 9.50 years. AC was pathological in six patients (6.9%). Four of these (66.7%) were high-grade squamous intraepithelial lesions (HSIL) and two (33.3%) were low-grade squamous intraepithelial lesions (LSIL). The CC results of these patients were all HSIL, all of them were human papillomavirus (HPV) positive, with the most common type being 16 (83.3%).
Conclusion: Women with HSIL in CC (especially with concomitant HPV) may be riskier for AC positivity. The others are most likely to have negative AC results. The use of AC for early diagnosis of risky anal intraepithelial lesions (such as a screening tool) may be considered for this group of patients.
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Modeling and Mathematical Analysis of the Dynamics of HPV in Cervical Epithelial Cells: Transient, Acute, Latency, and Chronic Infections. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:8650071. [PMID: 36050998 PMCID: PMC9427304 DOI: 10.1155/2022/8650071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 07/14/2022] [Accepted: 07/20/2022] [Indexed: 11/18/2022]
Abstract
The aim of this paper is to model the dynamics of the human papillomavirus (HPV) in cervical epithelial cells. We developed a mathematical model of the epithelial cellular dynamics of the stratified epithelium of three (basale, intermedium, and corneum) stratums that is based on three ordinary differential equations. We determine the biological condition for the existence of the epithelial cell homeostasis equilibrium, and we obtain the necessary and sufficient conditions for its global stability using the method of Lyapunov functions and a theorem on limiting systems. We have also developed a mathematical model based on seven ordinary differential equations that describes the dynamics of HPV infection. We calculated the basic reproductive number (R0) of the infection using the next-generation operator method. We determine the existence and the local stability of the equilibrium point of the cellular homeostasis of the epithelium. We then give a sufficient condition for the global asymptotic stability of the epithelial cell homeostasis equilibrium using the Lyapunov function method. We proved that this equilibrium point is nonhyperbolic when R0 = 1 and that in this case, the system presents a forward bifurcation, which shows the existence of an infected equilibrium point when R0 > 1. We also study the solutions numerically (i.e., viral kinetic in silico) when R0 > 1. Finally, local sensitivity index was calculated to assess the influence of different parameters on basic reproductive number. Our model reproduces the transient, acute, latent, and chronic infections that have been reported in studies of the natural history of HPV.
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Mari A, Gianolio L, Edefonti V, Khaleghi Hashemian D, Casini F, Bergamaschi F, Sala A, Verduci E, Calcaterra V, Zuccotti GV, Fabiano V. HPV Vaccination in Young Males: A Glimpse of Coverage, Parental Attitude and Need of Additional Information from Lombardy Region, Italy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137763. [PMID: 35805445 PMCID: PMC9265455 DOI: 10.3390/ijerph19137763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 06/04/2022] [Accepted: 06/22/2022] [Indexed: 12/10/2022]
Abstract
Background: In the Lombardy Region, Italy, HPV vaccination is recommended and offered free of charge to 12-years-old males since 2017. The expected vaccination thresholds are still far to be reached. Methods: A cross-sectional survey to investigate parents’ attitudes towards the HPV vaccine and knowledge about HPV was administered to parents of boys aged 6 to 18 years attending a large pediatric hospital for outpatient specialistic evaluations. Two parallel multiple logistic regression analyses were conducted to estimate the odds ratios (ORs) and the corresponding 95% confidence intervals (CIs) for attitude towards HPV vaccination and perceived need for more information about HPV vaccination. Results: A positive attitude towards HPV vaccination was found in 74% of interviewed parents. Knowledge of HPV, having a generally positive attitude toward vaccination, and mothers filling in the survey were positively associated with a positive attitude to the HPV vaccine. Parents’ perceived need for more information about HPV vaccination was positively associated with the child’s age, general positive attitude toward vaccination, Christian religion, and positive attitude toward HPV vaccination; knowing that HPV vaccination is free of charge significantly reduced the risk of asking for more information on HPV vaccination. Conclusions: The majority of parents of male children and adolescents in our study have a positive attitude toward HPV vaccination. Attitude toward HPV vaccination and perceived need for more information on HPV vaccination were directly related to a positive attitude toward vaccines in general. In addition, knowledge of HPV and related pathologies favors a positive attitude toward HPV vaccination. Future health programs should target an even wider diffusion of evidence-based information on vaccines in general and on the HPV vaccine in young males, to support a positive attitude toward vaccines in the general population.
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Affiliation(s)
- Alessandra Mari
- Department of Pediatrics, V. Buzzi Children’s Hospital, Università degli Studi di Milano, 20154 Milano, Italy; (A.M.); (L.G.); (F.C.); (F.B.); (A.S.); (E.V.); (V.C.); (G.V.Z.)
| | - Laura Gianolio
- Department of Pediatrics, V. Buzzi Children’s Hospital, Università degli Studi di Milano, 20154 Milano, Italy; (A.M.); (L.G.); (F.C.); (F.B.); (A.S.); (E.V.); (V.C.); (G.V.Z.)
| | - Valeria Edefonti
- Laboratory of Medical Statistics, Biometry and Epidemiology “G. A. Maccacaro”, Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20133 Milano, Italy; (V.E.); (D.K.H.)
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milano, Italy
| | - Dariush Khaleghi Hashemian
- Laboratory of Medical Statistics, Biometry and Epidemiology “G. A. Maccacaro”, Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20133 Milano, Italy; (V.E.); (D.K.H.)
| | - Francesca Casini
- Department of Pediatrics, V. Buzzi Children’s Hospital, Università degli Studi di Milano, 20154 Milano, Italy; (A.M.); (L.G.); (F.C.); (F.B.); (A.S.); (E.V.); (V.C.); (G.V.Z.)
| | - Francesco Bergamaschi
- Department of Pediatrics, V. Buzzi Children’s Hospital, Università degli Studi di Milano, 20154 Milano, Italy; (A.M.); (L.G.); (F.C.); (F.B.); (A.S.); (E.V.); (V.C.); (G.V.Z.)
| | - Anna Sala
- Department of Pediatrics, V. Buzzi Children’s Hospital, Università degli Studi di Milano, 20154 Milano, Italy; (A.M.); (L.G.); (F.C.); (F.B.); (A.S.); (E.V.); (V.C.); (G.V.Z.)
| | - Elvira Verduci
- Department of Pediatrics, V. Buzzi Children’s Hospital, Università degli Studi di Milano, 20154 Milano, Italy; (A.M.); (L.G.); (F.C.); (F.B.); (A.S.); (E.V.); (V.C.); (G.V.Z.)
- Department of Health Sciences, Università degli Studi di Milano, 20146 Milano, Italy
| | - Valeria Calcaterra
- Department of Pediatrics, V. Buzzi Children’s Hospital, Università degli Studi di Milano, 20154 Milano, Italy; (A.M.); (L.G.); (F.C.); (F.B.); (A.S.); (E.V.); (V.C.); (G.V.Z.)
- Department of Internal Medicine and Therapeutics, University of Pavia, 27100 Pavia, Italy
| | - Gian Vincenzo Zuccotti
- Department of Pediatrics, V. Buzzi Children’s Hospital, Università degli Studi di Milano, 20154 Milano, Italy; (A.M.); (L.G.); (F.C.); (F.B.); (A.S.); (E.V.); (V.C.); (G.V.Z.)
- Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, 20147 Milano, Italy
| | - Valentina Fabiano
- Department of Pediatrics, V. Buzzi Children’s Hospital, Università degli Studi di Milano, 20154 Milano, Italy; (A.M.); (L.G.); (F.C.); (F.B.); (A.S.); (E.V.); (V.C.); (G.V.Z.)
- Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, 20147 Milano, Italy
- Correspondence: ; Tel.: +39-026-363-5324
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Swai P, Rasch V, Linde DS, Mchome B, Manongi R, Wu CS, Waldstrom M, Iftner T, Mwaiselage J, Kjaer SK. Persistence and risk factors of high-risk human papillomavirus infection among HIV positive and HIV negative tanzanian women: a cohort study. Infect Agent Cancer 2022; 17:26. [PMID: 35690838 PMCID: PMC9188099 DOI: 10.1186/s13027-022-00442-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Accepted: 05/30/2022] [Indexed: 11/22/2022] Open
Abstract
Background High-risk (HR) human papillomavirus (HPV) persistence is the most important risk factor for cervical cancer. We have assessed the type-specific HR HPV persistence among HIV positive and HIV negative Tanzanian women and factors associated with HR HPV persistence. Methods In a cohort study including 4080 Tanzanian women, 3074 attended follow-up examination (up to 32 months after enrollment). Cervical samples were obtained for liquid-based cytology and HPV DNA testing using Hybrid Capture 2 and Inno-Lipa Extra II. Information on lifestyle factors was collected through a personal interview. The probability of HR HPV persistence at a given time point since enrollment was estimated non-parametrically using the EMICM algorithm.
Results Among the 462 women HR HPV positive at enrollment, 158 had at least one identical type detected at follow-up. The probability of persistence at 18 months after enrollment was 34.2 (95% CI 29.0–39.4). Stratifying by HIV status, the persistence probability was 42.9% (95% CI 33.5–51.9) among HIV positive, and 28.0% (95% CI 22.1–34.2) among HIV negative. Overall, HR HPV persistence was most common for HPV58, 35, 16, 31, and 52. Among HIV positive women it was HPV45, and HPV16, followed by HPV58 and HPV18, and among HIV negative women it was HPV31, HPV33 and HPV58. Risk factors associated with persistence of HR HPV were older age, longer interval between enrollment and follow-up, binge drinking, and HIV status. Conclusions HR HPV persistence was common in Tanzania, and most common among HIV positive women. Overall, persistence was most frequent for HPV 58, 35, 16, 31 and 52. The nonavalent HPV vaccine should be considered.
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Affiliation(s)
- Patricia Swai
- Kilimanjaro Christian Medical Centre, 3060, Moshi, Tanzania.
| | - Vibeke Rasch
- University of Southern Denmark, Odense, Denmark.,Department of Gynaecology and Obstetrics, Odense University Hospital, Odense, Denmark
| | - Ditte S Linde
- University of Southern Denmark, Odense, Denmark.,Department of Gynaecology and Obstetrics, Odense University Hospital, Odense, Denmark
| | - Bariki Mchome
- Kilimanjaro Christian Medical Centre, 3060, Moshi, Tanzania
| | - Rachel Manongi
- Kilimanjaro Christian Medical Centre, 3060, Moshi, Tanzania
| | - Chun Sen Wu
- University of Southern Denmark, Odense, Denmark
| | | | - Thomas Iftner
- Institute of Medical Virology, University Hospital of Tübingen, Tübingen, Germany
| | | | - Susanne K Kjaer
- Danish Cancer Society Research Center, Unit of Virus, Lifestyle and Genes, Copenhagen, Denmark.,Department of Gynecology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
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10
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Eriksen DO, Jensen PT, Schroll JB, Hammer A. Human papillomavirus vaccination in women undergoing excisional treatment for cervical intraepithelial neoplasia and subsequent risk of recurrence: A systematic review and meta-analysis. Acta Obstet Gynecol Scand 2022; 101:597-607. [PMID: 35470865 DOI: 10.1111/aogs.14359] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 03/17/2022] [Accepted: 03/23/2022] [Indexed: 12/14/2022]
Abstract
INTRODUCTION In this review and meta-analysis we aimed to investigate whether human papilloma virus (HPV) vaccination administered after excisional treatment of cervical intraepithelial neoplasia (CIN) is associated with a reduced risk of recurrence of CIN grade 2 or worse (CIN2+). MATERIAL AND METHODS We performed a systematic literature search in three online databases through June 2021. Observational studies and randomized controlled trials (RCTs) were eligible for inclusion if the prophylactic HPV vaccine was administered after excisional treatment for histologically verified CIN. Only English language literature was included. The primary outcome measure was recurrence of CIN2+ after treatment. A meta-analysis was performed using fixed and random-effects models, and results were reported as pooled odds ratios (OR) with 95% confidence intervals (95% CI). Quality assessment was performed using ROB2-tool for RCTs and ROBINS-I for observational studies. The protocol was registered in PROSPERO (CRD42021238257). RESULTS A total of 1561 studies were identified, of which nine, including 19 971 women, were included. Two studies were RCTs and seven were observational studies. Using the fixed-effect model on the two RCTs, the OR for recurrence of CIN2+ was 0.29 (95% CI 0.16-0.53). Due to considerable heterogeneity in observational studies, the random-effects model was used to estimate pooled OR for CIN2+ recurrence in these studies. Thus, using unadjusted data from observational studies, the OR for CIN2+ recurrence was 0.35 (95% CI 0.18-0.67), whereas when using adjusted data, the OR for CIN2+ recurrence was 0.54 (95% CI 0.21-1.35). However, quality assessment revealed a serious risk of bias for the majority of the studies included. CONCLUSIONS HPV vaccination post-treatment was associated with a significantly reduced risk of CIN2+ recurrence when using unadjusted estimates from observational studies and RCTs. We found no significant effect of HPV vaccination on risk of CIN2+ recurrence when using the outcome measure from observational studies with the least risk of bias. Large, well-designed randomized placebo-controlled trials are needed to determine whether post-treatment HPV vaccination should be recommended to all women undergoing excisional treatment for CIN.
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Affiliation(s)
- Dina Overgaard Eriksen
- Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.,Department of Gynecology and Obstetrics, NIDO, Center for Research and Education, Gødstrup Hospital, Herning, Denmark
| | - Pernille Tine Jensen
- Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Jeppe Bennekou Schroll
- Department of Obstetrics and Gynecology, Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Anne Hammer
- Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.,Department of Gynecology and Obstetrics, NIDO, Center for Research and Education, Gødstrup Hospital, Herning, Denmark
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11
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Determination of Human Papillomavirus Type 18 Lineage of E6: A Population Study from Iran. BIOMED RESEARCH INTERNATIONAL 2022; 2022:2839708. [PMID: 35342765 PMCID: PMC8956376 DOI: 10.1155/2022/2839708] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 03/07/2022] [Indexed: 11/17/2022]
Abstract
The epidemiological studies in Iran on HPV18 nucleotide changes are rare. This type of virus is prevalent in the Iranian population. Therefore, in the present study, we aimed to identify the genetic variability in HPV18 in the E6 region to evaluate the prevalence of lineage distribution and sublineages in a sample population in Iran. Overall, 60 HPV18 confirmed cases were investigated between 2019 and 2021. The specimens were collected, and molecular genotyping was done using the Linear Array HPV Genotyping Test. DNA extraction was performed by a viral DNA/RNA kit. The HPV E6 gene was amplified by using type-specific primers designed according to the HPV18 genome prototype sequence. The sequencing of the E6 region was successfully done on 43 samples which were then compared to the reference sequence. The most frequent sublineage of HPV18 in this study was A4 (69.7%), followed by A1 (18.6%) and A3 (11.6%). Neither A2 nor A5 sublineage was not detected in this study. The related nucleotide acid changes according to the main references were as follows: A3: T104C/T232G/T485C/C549A, A4: T104C/T485C/C549A. The predominance of A lineage with the high frequency of A4 sublineage was found in the present research. The importance of sublineages in susceptibility to a progressive form of infection requires to be more investigated among the different population.
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12
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Feng M, Duan R, Gao Y, Zhang H, Qiao Y, Li Q, Zhao F. Role of Epstein-Barr Virus and Human Papillomavirus Coinfection in Cervical Intraepithelial Neoplasia in Chinese Women Living With HIV. Front Cell Infect Microbiol 2021; 11:703259. [PMID: 34557425 PMCID: PMC8453025 DOI: 10.3389/fcimb.2021.703259] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 08/19/2021] [Indexed: 01/04/2023] Open
Abstract
Given that only a small percentage of human papillomavirus (HPV)-positive women develop cancer, HPV is necessary but insufficient for carcinogenesis. Mucosally transmitted viral cofactors appear to contribute to HPV-related cervical cancer, such as Epstein-Barr virus (EBV), but previous studies have shown inconsistent outcomes. The exact role of EBV in cervical cancer remains unclear, and more studies are needed to determine its involvement. In this study, we describe the prevalence of EBV and HPV coinfection in HIV-positive women and explore how abnormal host immune status induced by viral coinfections modulates epithelial gene expression. We found a significant correlation between EBV-HPV coinfection and the incidence of high-grade cervical intraepithelial neoplasia (CIN2+). RNA sequencing indicated that CIN tissues coinfected with EBV and HPV led to significant changes in the gene expression of epithelial differentiation and development compared to normal tissues with HPV infection alone. In particular, several differentially expressed genes (DEGs) are closely associated with cancer, such as CACNG4, which was confirmed to be upregulated at both the mRNA and protein levels. Therefore, these findings provide some evidence that EBV may act as a cofactor or mediator in HPV-related cervical cancer. Specific genes or proteins, such as CACNG4, may serve as biomarkers that can risk stratify patients based on pathological changes in the cervix.
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Affiliation(s)
- Min Feng
- Institute of Medical Biology, Chinese Academy of Medicine Sciences and Peking Union Medical College, Kunming, China
| | - Rufei Duan
- Department of Gynecology, The Third Affiliated Hospital of Kunming Medical University/Yunnan Cancer Hospital/Yunnan Cancer Center, Kunming, China.,Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yang Gao
- Institute of Medical Biology, Chinese Academy of Medicine Sciences and Peking Union Medical College, Kunming, China
| | - Han Zhang
- Institute of Medical Biology, Chinese Academy of Medicine Sciences and Peking Union Medical College, Kunming, China
| | - Youlin Qiao
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Qihan Li
- Institute of Medical Biology, Chinese Academy of Medicine Sciences and Peking Union Medical College, Kunming, China
| | - Fanghui Zhao
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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13
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Troja C, Hoofnagle AN, Szpiro A, Stern JE, Lin J, Winer RL. Understanding the Role of Emerging Vitamin D Biomarkers on Short-term Persistence of High-Risk Human Papillomavirus Infection Among Mid-Adult Women. J Infect Dis 2021; 224:123-132. [PMID: 33205195 DOI: 10.1093/infdis/jiaa711] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Accepted: 11/10/2020] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Associations between vitamin D biomarkers and persistent high-risk human papillomavirus (hrHPV) detection have not been evaluated. METHODS 2011-2012 stored sera from 72 women aged 30-50 years with prevalent hrHPV (n = 116 type-specific infections) were tested for 5 vitamin D biomarkers: 25(OH)D and 4 emerging biomarkers, 1,25(OH)2D; 24,25(OH)2D; free vitamin D; and vitamin D binding protein (DBP). The hrHPV detection patterns (persistent vs transient/sporadic) were determined using cervicovaginal swabs collected monthly for 6 months. Associations between vitamin D and short-term type-specific hrHPV persistence were estimated using logistic regression. Our primary exposure was continuous 25(OH)D, with additional biomarkers evaluated as secondary exposures. Primary models were adjusted for age, race, body mass index, education, contraceptives, smoking, season, and calcium/phosphate levels. Sensitivity analyses were restricted from 19 hrHPV types to 14 used in cervical cancer screening. RESULTS In primary analyses, nonsignificant positive associations with hrHPV persistence were observed for measures of 25(OH)D and 24,25(OH)2D. Associations were stronger and significant when restricting to 14 hrHPV types (25(OH)D per 10 ng/mL increase: adjusted odds ratio [aOR], 1.82 [95% confidence interval {CI}, 1.15-2.88] and aOR, 4.19 [95% CI, 1.18-14.88] DBP-adjusted; 25(OH)D ≥30 vs <30 ng/mL: aOR, 8.85 [95% CI, 2.69-29.06]; 24,25(OH)2D: aOR, 1.85 [95% CI, 1.18-2.88]). 1,25(OH)2D was unassociated with persistence. CONCLUSIONS Serum vitamin D measured by multiple biomarkers showed positive associations with short-term hrHPV persistence that were significant only when restricting to 14 clinically relevant hrHPV types.
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Affiliation(s)
- Catherine Troja
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
| | - Andrew N Hoofnagle
- Department of Laboratory Medicine, University of Washington, Seattle, Washington, USA
| | - Adam Szpiro
- Department of Biostatistics, University of Washington, Seattle, Washington, USA
| | - Joshua E Stern
- Department of Global Health, University of Washington, Seattle, Washington, USA
| | - John Lin
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
| | - Rachel L Winer
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
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14
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Ellsworth GB, Stier EA, Chiao EY, Lensing SY, Darragh T, Jay N, Berry-Lawhorn JM, Einstein M, Barroso LF, Cranston RD, Levine R, Guiot HM, French AL, Goldstone SE, Preiser W, Claassen M, Palefsky JM, Wilkin TJ. Xpert HPV as a Screening Tool for Anal Histologic High-Grade Squamous Intraepithelial Lesions in Women Living With HIV. J Acquir Immune Defic Syndr 2021; 87:978-984. [PMID: 34110312 PMCID: PMC8341010 DOI: 10.1097/qai.0000000000002672] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 01/15/2021] [Indexed: 01/01/2023]
Abstract
BACKGROUND Women living with HIV (WLWH) experience high rates of anal cancer. Screening using anal cytology, high-resolution anoscopy (HRA) with biopsies, can histologically diagnose anal cancer precursors called high-grade squamous intraepithelial lesions (HSIL). The low specificity of screening using anal cytology results in HRA referral for many WLWH without HSIL. Screening using high-risk human papillomavirus (HR-HPV) may improve specificity. METHODS Two hundred seven WLWH (63% non-Hispanic black) were screened for anal histologic HSIL (hHSIL) using cytology, HRA-guided biopsies, and Xpert HPV. Xpert performance for predicting anal hHSIL was compared with that of cytology. Usng Xpert 5 HPV genotypic results and accompanying cycle thresholds, receiver operator characteristic curve and recursive partitioning analyses were used to create predictive models for hHSIL. RESULTS The performance of Xpert to predict hHSIL was not different from that of cytology with a sensitivity (Sn) of 89% and specificity (Sp) of 49%. Interpretation of Xpert was modified using genotypic results and receiver operator characteristic curve analysis, which produced a screen with an Sn and Sp of 75% and 84% for hHSIL, respectively. Another reinterpretation of Xpert was created using recursive partitioning and cycle thresholds, which predicted hHSIL with an Sn and Sp of 75% and 86%, respectively. The detection of HPV-16 was highly predictive of hHSIL in all analyses. These modified screening tests would reduce HRA referral in this population by almost half compared with anal cytology. CONCLUSIONS Xpert HPV is an alternative to anal cytology to screen for anal HSIL and can be optimized to reduce the number of unnecessary HRAs performed in WLWH.
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Affiliation(s)
| | | | | | | | - Teresa Darragh
- University of California San Francisco, San Francisco, CA
| | - Naomi Jay
- University of California San Francisco, San Francisco, CA
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15
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R S J. The Immune Microenvironment in Human Papilloma Virus-Induced Cervical Lesions-Evidence for Estrogen as an Immunomodulator. Front Cell Infect Microbiol 2021; 11:649815. [PMID: 33996630 PMCID: PMC8120286 DOI: 10.3389/fcimb.2021.649815] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 03/29/2021] [Indexed: 12/24/2022] Open
Abstract
Globally, human papilloma virus (HPV) infection is a common sexually transmitted disease. However, most of the HPV infections eventually resolve aided by the body’s efficient cell-mediated immune responses. In the vast majority of the small group of patients who develop overt disease too, it is the immune response that culminates in regression of lesions. It is therefore a rarity that persistent infection by high-risk genotypes of HPV compounded by other risk factors progresses through precancer (various grades of cervical intraepithelial neoplasia—CIN) to cervical cancer (CxCa). Hence, although CxCa is a rare culmination of HPV infection, the latter is nevertheless causally linked to >90% of cancer. The three ‘Es’ of cancer immunoediting viz. elimination, equilibrium, and escape come into vogue during the gradual evolution of CIN 1 to CxCa. Both cell-intrinsic and extrinsic mechanisms operate to eliminate virally infected cells: cell-extrinsic players are anti-tumor/antiviral effectors like Th1 subset of CD4+ T cells, CD8+ cytotoxic T cells, Natural Killer cells, etc. and pro-tumorigenic/immunosuppressive cells like regulatory T cells (Tregs), Myeloid-Derived Suppressor Cells (MDSCs), type 2 macrophages, etc. And accordingly, when immunosuppressive cells overpower the effectors e.g., in high-grade lesions like CIN 2 or 3, the scale is tilted towards immune escape and the disease progresses to cancer. Estradiol has long been considered as a co-factor in cervical carcinogenesis. In addition to the gonads, the Peyer’s patches in the gut synthesize estradiol. Over and above local production of the hormone in the tissues, estradiol metabolism by the gut microbiome: estrobolome versus tryptophan non-metabolizing microbiome, regulates free estradiol levels in the intestine and extraintestinal mucosal sites. Elevated tissue levels of the hormone serve more than one purpose: besides a direct growth-promoting action on cervical epithelial cells, estradiol acting genomically via Estrogen Receptor-α also boosts the function of the stromal and infiltrating immunosuppressive cells viz. Tregs, MDSCs, and carcinoma-associated fibroblasts. Hence as a corollary, therapeutic repurposing of Selective Estrogen Receptor Disruptors or aromatase inhibitors could be useful for modulating immune function in cervical precancer/cancer. The immunomodulatory role of estradiol in HPV-mediated cervical lesions is reviewed.
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Affiliation(s)
- Jayshree R S
- Department of Microbiology, Kidwai Memorial Institute of Oncology, Bangalore, India
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16
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HPV Type-Specific Prevalence a Decade after the Implementation of the Vaccination Program: Results from a Pilot Study. Vaccines (Basel) 2021; 9:vaccines9040336. [PMID: 33916132 PMCID: PMC8066234 DOI: 10.3390/vaccines9040336] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 03/27/2021] [Accepted: 03/30/2021] [Indexed: 12/04/2022] Open
Abstract
Human papillomavirus infection is a cause of the development of invasive cervical cancer. Three types of vaccine are currently available to prevent precancerous/cancerous lesions due to persistent infection, which is supported mainly by 7 different high-risk genotypes. The aim of this pilot study was to acquire preliminary data on type-specific prevalence 10 years after the implementation of the HPV vaccination program in Italy, in order to subsequently plan appropriate observational studies in the Italian population. First-voided urine samples were collected from 393 consenting subjects, both females and males, aged 18–40 years, and HPV DNA was detected by PCR amplification of a 450 bp L1 fragment. All amplified products were genotyped by means of the Restriction Fragment Length Polymorphism (RFLP) method. The female population was divided into three cohorts (“vaccine-eligible”, “pre-screening” and “screening” cohorts) according to the preventive intervention scheduled by age; males were included in the same three cohorts according to their year of birth. The overall prevalence of HPV infection was 19%, being higher in females than in males (22.1% vs. 13.6%, p = 0.03729). In the female population, 10 years after the start of the national immunization program, we observed a reduction in the prevalence of vaccine types and the number of circulating genotypes, especially in the “vaccine-eligible” cohort. The frequency of HPV vaccine types increased with age, particularly in males in the “pre-screening” and “screening” cohorts. Our study highlights the importance of monitoring HPV infection in both genders, to validate the effect of the HPV vaccination program.
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17
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Xia Q, Jin H, Zhang X, Yan W, Meng D, Ding B, Cao J, Li D, Wang S. Prognosis prediction signature of seven immune genes based on HPV status in cervical cancer. Int Immunopharmacol 2020; 88:106935. [PMID: 32889244 DOI: 10.1016/j.intimp.2020.106935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 08/20/2020] [Accepted: 08/22/2020] [Indexed: 12/24/2022]
Abstract
Cervical cancer (CC) has a high incidence and mortality rate, with a low 5-year survival rate, and human papillomavirus (HPV) is one of its carcinogenic risks. However, little evidence exists on the impact of HPV infection on the survival of patients with CC. In the present study, the CC cohort and immune genes were downloaded from the TCGA database and the ImmPort database, respectively. Subsequently, the Gene Set Enrichment Analysis was performed and found that HPV status was involved in multiple immune signaling pathways, which revealed that HPV infection might play critical roles in the immune response. Then seven prognostic immune genes were identified according to HPV status in CC. Using the seven immune genes, we established an immune risk score (IRS) signature and the Kaplan-Meier curve showed that high IRS was significantly correlated with poor prognosis of CC in both the training sets (HR = 2.32, 95% CI = 1.66-3.33; AUC = 0.712) and the validation sets (HR = 1.38, 95% CI = 1.02-1.85 and AUC = 0.583 in TCGA-HNSCC; HR = 2.58, 95% CI = 1.364-4.893, AUC = 0.676 in GSE44001). A nomogram of IRS combined with clinical features was established, and further analyses demonstrated that the power of the nomogram to predict the prognosis of CC was more reliable than that of a single independent factor. In conclusion, this study provided a more comprehensive understanding of the correlation between HPV and immune mechanisms as well as a novel signature that can effectively predict the prognosis of CC patients.
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Affiliation(s)
- Qianqian Xia
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China
| | - Hua Jin
- Clinical Laboratory, Affiliated Tumor Hospital of Nantong University (Nantong Tumor Hospital), Nantong, China
| | - Xing Zhang
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China.
| | - Wenjing Yan
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China.
| | - Dan Meng
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China
| | - Bo Ding
- Department of Gynecology and Obstetrics, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Jian Cao
- Department of Gynecology, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China
| | - Dake Li
- Department of Gynecology, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China.
| | - Shizhi Wang
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, China.
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18
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Qiao YL, Wu T, Li RC, Hu YM, Wei LH, Li CG, Chen W, Huang SJ, Zhao FH, Li MQ, Pan QJ, Zhang X, Li Q, Hong Y, Zhao C, Zhang WH, Li YP, Chu K, Li M, Jiang YF, Li J, Zhao H, Lin ZJ, Cui XL, Liu WY, Li CH, Guo DP, Ke LD, Wu X, Tang J, Gao GQ, Li BY, Zhao B, Zheng FX, Dai CH, Guo M, Zhao J, Su YY, Wang JZ, Zhu FC, Li SW, Pan HR, Li YM, Zhang J, Xia NS. Efficacy, Safety, and Immunogenicity of an Escherichia coli-Produced Bivalent Human Papillomavirus Vaccine: An Interim Analysis of a Randomized Clinical Trial. J Natl Cancer Inst 2020; 112:145-153. [PMID: 31086947 DOI: 10.1093/jnci/djz074] [Citation(s) in RCA: 85] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 04/05/2019] [Accepted: 04/23/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The high cost and insufficient supply of human papillomavirus (HPV) vaccines have slowed the pace of controlling cervical cancer. A phase III clinical trial was conducted to evaluate the efficacy, safety, and immunogenicity of a novel Escherichia coli-produced bivalent HPV-16/18 vaccine. METHODS A multicenter, randomized, double-blind trial started on November 22, 2012 in China. In total, 7372 eligible women aged 18-45 years were age-stratified and randomly assigned to receive three doses of the test or control (hepatitis E) vaccine at months 0, 1, and 6. Co-primary endpoints included high-grade genital lesions and persistent infection (over 6 months) associated with HPV-16/18. The primary analysis was performed on a per-protocol susceptible population of individuals who were negative for relevant HPV type-specific neutralizing antibodies (at day 0) and DNA (at day 0 through month 7) and who received three doses of the vaccine. This report presents data from a prespecified interim analysis used for regulatory submission. RESULTS In the per-protocol cohort, the efficacies against high-grade genital lesions and persistent infection were 100.0% (95% confidence interval = 55.6% to 100.0%, 0 of 3306 in the vaccine group vs 10 of 3296 in the control group) and 97.8% (95% confidence interval = 87.1% to 99.9%, 1 of 3240 vs 45 of 3246), respectively. The side effects were mild. No vaccine-related serious adverse events were noted. Robust antibody responses for both types were induced and persisted for at least 42 months. CONCLUSIONS The E coli-produced HPV-16/18 vaccine is well tolerated and highly efficacious against HPV-16/18-associated high-grade genital lesions and persistent infection in women.
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Affiliation(s)
- You-Lin Qiao
- National Cancer Center, National Center for Cancer Clinical Research, The Cancer Institute, Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing, China
| | - Ting Wu
- The State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Collaborative Innovation Center of Biologic Products, School of Public Health, Xiamen University, Xiamen, Fujian, China
| | - Rong-Cheng Li
- Guangxi Center for Disease Control and Prevention, Nanning, Guangxi, China
| | - Yue-Mei Hu
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu, China
| | - Li-Hui Wei
- Peking University People's Hospital, Beijing, China
| | - Chang-Gui Li
- National Institute for Food and Drug Control, Beijing, China
| | - Wen Chen
- National Cancer Center, National Center for Cancer Clinical Research, The Cancer Institute, Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing, China
| | - Shou-Jie Huang
- The State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Collaborative Innovation Center of Biologic Products, School of Public Health, Xiamen University, Xiamen, Fujian, China
| | - Fang-Hui Zhao
- National Cancer Center, National Center for Cancer Clinical Research, The Cancer Institute, Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing, China
| | - Ming-Qiang Li
- Liuzhou Center for Disease Control and Prevention, Liuzhou, Guangxi, China
| | - Qin-Jing Pan
- National Cancer Center, National Center for Cancer Clinical Research, The Cancer Institute, Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing, China
| | - Xun Zhang
- National Cancer Center, National Center for Cancer Clinical Research, The Cancer Institute, Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing, China.,Xinmi Maternal and Child Health Hospital, Xinmi, Henan, China
| | - Qing Li
- Shenzhen Maternity and Child Healthcare Hospital, Shenzhen, Guangdong, China
| | - Ying Hong
- The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, Jiangsu, China
| | - Chao Zhao
- Peking University People's Hospital, Beijing, China
| | - Wen-Hua Zhang
- National Cancer Center, National Center for Cancer Clinical Research, The Cancer Institute, Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing, China
| | - Yan-Ping Li
- Guangxi Center for Disease Control and Prevention, Nanning, Guangxi, China
| | - Kai Chu
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu, China
| | - Mei Li
- The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, Jiangsu, China
| | - Yun-Fei Jiang
- The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, Jiangsu, China
| | - Juan Li
- National Institute for Food and Drug Control, Beijing, China
| | - Hui Zhao
- National Institute for Food and Drug Control, Beijing, China
| | - Zhi-Jie Lin
- Xiamen Innovax Biotech Company, Xiamen, Fujian, China
| | - Xue-Lian Cui
- Liuzhou Center for Disease Control and Prevention, Liuzhou, Guangxi, China
| | - Wen-Yu Liu
- Funing Center for Disease Control and Prevention, Funing, Jiangsu, China
| | - Cai-Hong Li
- Xinmi Maternal and Child Health Hospital, Xinmi, Henan, China
| | - Dong-Ping Guo
- Yangcheng Maternal and Child Health Hospital, Yangcheng, Shanxi, China
| | - Li-Dong Ke
- Fengning Hospital of Traditional Chinese Medicine, Fengning, Hebei, China
| | - Xin Wu
- Liuzhou Center for Disease Control and Prevention, Liuzhou, Guangxi, China
| | - Jie Tang
- Funing Center for Disease Control and Prevention, Funing, Jiangsu, China
| | - Guo-Qi Gao
- Xinmi Maternal and Child Health Hospital, Xinmi, Henan, China
| | - Ba-Yi Li
- Yangcheng Maternal and Child Health Hospital, Yangcheng, Shanxi, China
| | - Bin Zhao
- Fengning Hospital of Traditional Chinese Medicine, Fengning, Hebei, China
| | - Feng-Xian Zheng
- Xinmi Maternal and Child Health Hospital, Xinmi, Henan, China
| | - Cui-Hong Dai
- Fengning Hospital of Traditional Chinese Medicine, Fengning, Hebei, China
| | - Meng Guo
- The State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Collaborative Innovation Center of Biologic Products, School of Public Health, Xiamen University, Xiamen, Fujian, China
| | - Jun Zhao
- The State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Collaborative Innovation Center of Biologic Products, School of Public Health, Xiamen University, Xiamen, Fujian, China
| | - Ying-Ying Su
- The State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Collaborative Innovation Center of Biologic Products, School of Public Health, Xiamen University, Xiamen, Fujian, China
| | - Jun-Zhi Wang
- National Institute for Food and Drug Control, Beijing, China
| | - Feng-Cai Zhu
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu, China
| | - Shao-Wei Li
- The State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Collaborative Innovation Center of Biologic Products, School of Public Health, Xiamen University, Xiamen, Fujian, China
| | - Hui-Rong Pan
- Xiamen Innovax Biotech Company, Xiamen, Fujian, China
| | - Yi-Min Li
- Xiamen Innovax Biotech Company, Xiamen, Fujian, China
| | - Jun Zhang
- The State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Collaborative Innovation Center of Biologic Products, School of Public Health, Xiamen University, Xiamen, Fujian, China
| | - Ning-Shao Xia
- The State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, Collaborative Innovation Center of Biologic Products, School of Public Health, Xiamen University, Xiamen, Fujian, China
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Cornall AM, Saville M, Pyman J, Callegari ET, Tan FH, Brotherton JML, Malloy MJ, Tabrizi SN, Wrede CD, Garland SM. HPV16/18 prevalence in high-grade cervical lesions in an Australian population offered catch-up HPV vaccination. Vaccine 2020; 38:6304-6311. [PMID: 32736938 DOI: 10.1016/j.vaccine.2020.07.037] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 07/16/2020] [Accepted: 07/17/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVES Using laser capture microdissection (LCM) and sensitive human papillomavirus (HPV) genotyping, we aimed to determine the distribution of vaccine-preventable types in cervical intraepithelial neoplasia grade 3 (CIN3) lesions and adenocarcinoma in situ (AIS) in young women in Victoria, Australia, offered catch-up HPV vaccination, as a baseline for ongoing vaccine impact monitoring. We also compared findings with available pre-vaccination estimates from women with HPV detected on concurrently-collected cytology samples. METHODS Consecutive histologically-confirmed CIN3/AIS biopsies were collected between May 2011 and December 2014 from vaccine-eligible women (born after 30th June 1981). Genotypes present in whole tissue sections (WTS) were determined by a sensitive reverse hybridisation assay; RHA kit HPV SPF10-LiPA25, v1 (Labo Bio-medical Products). Where multiple genotypes were detected, lesions were isolated using LCM and genotyped. Cervical cytology samples from a pre-vaccine cohort had been previously collected and genotyped using HPV Linear Array HPV Genotyping Test (Roche Diagnostics). Mixed-genotype detections in this cohort were resolved to single-lesion-attributable genotypes using hierarchical attribution. RESULTS Overall, 213 and 530 cases were included from pre- and post-vaccine time-periods, respectively. In 18-25 year-olds, the proportion of HPV16/18-positive CIN3/AIS decreased significantly over time from 69% in 2001-2005 (pre-vaccine), to 62% in 2011-2012 (post-vaccine), to 47% in 2013-2014 (p-trend = 0.004). There was no significant change in HPV16/18 in 26-32 year-olds (p-trend = 0.15). In 2013/14, nonavalent vaccine types accounted for 80% of CIN3/AIS in 18-25 year old women and 90% in 26-32 year old women. CONCLUSION Four to 8 years following implementation of HPV vaccination in Australia, approximately 70% of CIN3/AIS in young women was due to HPV16/18. Our data, despite some limitations due to change in methods between pre- and post-vaccine periods, suggests that for vaccine-eligible women aged 18-25 at the time of biopsy, the proportion of HPV16/18-attributable CIN3/AIS lesions is significantly declining post-vaccination.
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Affiliation(s)
- Alyssa M Cornall
- Regional HPV LabNet Reference Laboratory, Centre for Women's Infectious Diseases, The Royal Women's Hospital, Parkville 3052, Victoria, Australia; Murdoch Childrens Research Institute, Parkville 3052, Victoria, Australia; Department of Obstetrics and Gynaecology, The University of Melbourne, Parkville 3050, Victoria, Australia.
| | - Marion Saville
- VCS Population Health, VCS Foundation, East Melbourne 3002, Victoria, Australia; VCS Pathology, VCS Foundation, Carlton 3053, Victoria, Australia.
| | - Jan Pyman
- Department of Anatomical Pathology, The Royal Women's Hospital, Parkville 3052, Victoria, Australia.
| | - Emma T Callegari
- Department of Medicine, The University of Melbourne, Royal Melbourne Hospital, Parkville 3050, Victoria, Australia.
| | - Fiona H Tan
- Department of Surgery, The University of Melbourne, The Royal Melbourne Hospital, Parkville 3050, Victoria, Australia.
| | - Julia M L Brotherton
- VCS Population Health, VCS Foundation, East Melbourne 3002, Victoria, Australia; Melbourne School of Population and Global Health, The University of Melbourne, Parkville 3052, Victoria, Australia.
| | - Michael J Malloy
- VCS Population Health, VCS Foundation, East Melbourne 3002, Victoria, Australia; Melbourne School of Population and Global Health, The University of Melbourne, Parkville 3052, Victoria, Australia.
| | - Sepehr N Tabrizi
- Regional HPV LabNet Reference Laboratory, Centre for Women's Infectious Diseases, The Royal Women's Hospital, Parkville 3052, Victoria, Australia; Murdoch Childrens Research Institute, Parkville 3052, Victoria, Australia; Department of Obstetrics and Gynaecology, The University of Melbourne, Parkville 3050, Victoria, Australia.
| | - C David Wrede
- Department of Obstetrics and Gynaecology, The University of Melbourne, Parkville 3050, Victoria, Australia; Melbourne School of Population and Global Health, The University of Melbourne, Parkville 3052, Victoria, Australia.
| | - Suzanne M Garland
- Regional HPV LabNet Reference Laboratory, Centre for Women's Infectious Diseases, The Royal Women's Hospital, Parkville 3052, Victoria, Australia; Murdoch Childrens Research Institute, Parkville 3052, Victoria, Australia; Department of Obstetrics and Gynaecology, The University of Melbourne, Parkville 3050, Victoria, Australia.
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20
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Petrini CG, Bastos LB, Duarte G, Dos Santos Melli PP, Alves-Filho JC, Quintana SM. Downregulation of IL-2 and IL-23 in Cervical Biopsies of Cervical Intraepithelial Lesions: A Cross-Sectional Study. Acta Cytol 2020; 64:442-451. [PMID: 32599588 DOI: 10.1159/000508015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Accepted: 04/15/2020] [Indexed: 01/02/2023]
Abstract
INTRODUCTION Persistent infection with high-risk human papillomavirus (HPV) types is associated with high-grade intraepithelial lesions (HSILs) and invasive cervical cancer. The host immune response plays a key role in whether HPV clears or persists. Most studies on local immune response to HPV collect cervical mucus in order to quantify secreted cytokines; however, cells located inside the tissue can release different cytokines associated with HPV infection. OBJECTIVE This study compared the cytokine levels in cervical biopsy specimens of women with abnormal colposcopic findings according to the histopathological results: low-grade intraepithelial lesion (LSIL), HSIL, and no intraepithelial lesion (NSIL). METHODS A cross-sectional study enrolling 141 cervical biopsy specimens examined the cytokine profile for interleukin (IL-) 2, IL-4, IL-10, IL-12, IL-17, and IL-23 and interferon-γ, using the Luminex assay/ELISA. Differences in cytokine levels among the cervical lesion groups were assessed using the Kruskal-Wallis test. RESULTS The 141 specimens included 90 HSILs, 22 LSILs, and 29 NSILs. IL-2 levels were significantly higher in NSIL samples than in LSIL or in HSIL samples (p = 0.0001) and IL-23 levels were significantly higher in NSIL than in HSIL samples (p = 0.003). CONCLUSIONS Our study shows that in samples from the lesion site point, 2 important pro-inflammatory cytokines, IL-2 and IL-23, are downregulated in HPV lesions.
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Affiliation(s)
- Caetano Galvão Petrini
- Gynecology and Obstetrics Department, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Larissa Brito Bastos
- Gynecology and Obstetrics Department, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Geraldo Duarte
- Gynecology and Obstetrics Department, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | | | - José Carlos Alves-Filho
- Pharmacology Department, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Silvana Maria Quintana
- Gynecology and Obstetrics Department, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil,
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Garbuglia AR, Lapa D, Sias C, Capobianchi MR, Del Porto P. The Use of Both Therapeutic and Prophylactic Vaccines in the Therapy of Papillomavirus Disease. Front Immunol 2020; 11:188. [PMID: 32133000 PMCID: PMC7040023 DOI: 10.3389/fimmu.2020.00188] [Citation(s) in RCA: 78] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 01/24/2020] [Indexed: 12/30/2022] Open
Abstract
Human papillomavirus (HPV) is the most common sexually transmitted virus. The high-risk HPV types (i.e., HPV16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59) are considered to be the main etiological agents of genital tract cancers, such as cervical, vulvar, vaginal, penile, and anal cancers, and of a subset of head and neck cancers. Three prophylactic HPV vaccines are available that are bivalent (vs. HPV16, 18), tetravalent (vs. HPV6, 11, 16, 18), and non-avalent (vs. HPV6, 11, 16, 18, 31, 33,45, 52, 58). All of these vaccines are based on recombinant DNA technology, and they are prepared from the purified L1 protein that self-assembles to form the HPV type-specific empty shells (i.e., virus-like particles). These vaccines are highly immunogenic and induce specific antibodies. Therapeutic vaccines differ from prophylactic vaccines, as they are designed to generate cell-mediated immunity against transformed cells, rather than neutralizing antibodies. Among the HPV proteins, the E6 and E7 oncoproteins are considered almost ideal as targets for immunotherapy of cervical cancer, as they are essential for the onset and evolution of malignancy and are constitutively expressed in both premalignant and invasive lesions. Several strategies have been investigated for HPV therapeutic vaccines designed to enhance CD4+ and CD8+ T-cell responses, including genetic vaccines (i.e., DNA/ RNA/virus/ bacterial), and protein-based, peptide-based or dendritic-cell-based vaccines. However, no vaccine has yet been licensed for therapeutic use. Several studies have suggested that administration of prophylactic vaccines immediately after surgical treatment of CIN2 cervical lesions can be considered as an adjuvant to prevent reactivation or reinfection, and other studies have described the relevance of prophylactic vaccines in the management of genital warts. This review summarizes the leading features of therapeutic vaccines, which mainly target the early oncoproteins E6 and E7, and prophylactic vaccines, which are based on the L1 capsid protein. Through an analysis of the specific immunogenic properties of these two types of vaccines, we discuss why and how prophylactic vaccines can be effective in the treatment of HPV-related lesions and relapse.
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Affiliation(s)
- Anna Rosa Garbuglia
- Laboratory of Virology, "Lazzaro Spallanzani" National Institute for Infectious Diseases, IRCCS, Rome, Italy
| | - Daniele Lapa
- Laboratory of Virology, "Lazzaro Spallanzani" National Institute for Infectious Diseases, IRCCS, Rome, Italy
| | - Catia Sias
- Laboratory of Virology, "Lazzaro Spallanzani" National Institute for Infectious Diseases, IRCCS, Rome, Italy
| | - Maria Rosaria Capobianchi
- Laboratory of Virology, "Lazzaro Spallanzani" National Institute for Infectious Diseases, IRCCS, Rome, Italy
| | - Paola Del Porto
- Department of Biology and Biotechnology "C. Darwin," Sapienza University, Rome, Italy
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Self-Collected Specimens Revealed a Higher Vaccine- and Non-Vaccine-Type Human Papillomavirus Prevalences in a Cross-Sectional Study in Akuse. Adv Prev Med 2020; 2020:8343169. [PMID: 32411484 PMCID: PMC7204098 DOI: 10.1155/2020/8343169] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 10/16/2019] [Accepted: 11/22/2019] [Indexed: 12/24/2022] Open
Abstract
Background Population-specific epidemiologic data on human Papillomavirus infection, which are limited in most of the SubSaharan African countries, are necessary for effective cervical cancer prevention. This study aimed to generate population-specific data on human Papillomavirus infections, and determine which of these, self-collected and provider-collected specimens, gives a higher estimate of the prevalence of human Papillomaviruses, including vaccine and non-vaccine-type human Papillomavirus. Methods In this cross-sectional study, following a questionnaire-based collection of epidemiological data, self-, and provider-collected specimens, obtained from women 15−65 years of age, were analysed for human Papillomavirus types by a nested-multiplex polymerase chain reaction, and for cervical lesions by Pap testing. HPV data were categorised according to risk type and vaccine types for further analysis. Results The difference between the overall human Papillomavirus infection prevalences obtained with the self-collected specimens, 43.1% (95% CI of 38.0–51.0%) and that with the provider-collected samples, 23.3% (95% CI of 19.0–31.0%) were significant (p ≤ 0.001). The prevalence of quadrivalent vaccine-type human Papillomaviruses was 12.3% with self-collected specimens, but 6.0% with provider-collected specimens. For the nonavalent vaccine-types, the prevalences were 26.6% and 16.7% respectively. There were multiple infections involving both vaccine-preventable and nonvaccine preventable high-risk human Papillomavirus genotypes. Conclusion The Akuse subdistrict can, therefore, be said to have a high burden of human Papillomavirus infections, which included nonvaccine types, as detected with both self-collected and provider-collected specimens. These imply that self-collection is to be given a higher consideration as a means for a population-based high-risk human Papillomavirus infections burdens assessment/screening. Additionally, even with a successful implementation of the HPV vaccination, if introduced in Ghana, there is still the need to continue with the screening of women.
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Nicoli F, Mantelli B, Gallerani E, Telatin V, Bonazzi I, Marconi P, Gavioli R, Gabrielli L, Lazzarotto T, Barzon L, Palù G, Caputo A. HPV-Specific Systemic Antibody Responses and Memory B Cells are Independently Maintained up to 6 Years and in a Vaccine-Specific Manner Following Immunization with Cervarix and Gardasil in Adolescent and Young Adult Women in Vaccination Programs in Italy. Vaccines (Basel) 2020; 8:vaccines8010026. [PMID: 31947611 PMCID: PMC7175219 DOI: 10.3390/vaccines8010026] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 01/09/2020] [Accepted: 01/10/2020] [Indexed: 12/26/2022] Open
Abstract
Human papillomavirus (HPV) persistent infections are associated with cervical cancer and other HPV-related diseases and tumors. Thus, the characterization of long lasting immunity to currently available HPV vaccines is important. A total of 149 female subjects vaccinated with Cervarix or Gardasil participated to the study and they were stratified according to age (10–12-year-old and 16–20-year-old). Humoral immune responses (IgG and neutralizing antibody titers, antibody avidity) and circulating memory B cells were analyzed after an average of 4–6 years from the third immunization. The humoral responses against HPV-16 and HPV-18 (and HPV-6 and HPV-11 for Gardasil) were high in both age groups and vaccines up to six years from the third dose. However, Cervarix induced significantly higher and more persistent antibody responses, while the two vaccines were rather equivalent in inducing memory B cells against HPV-16 and HPV-18. Moreover, the percentage of subjects with vaccine-specific memory B cells was even superior among Gardasil vaccinees and, conversely, Cervarix vaccinated individuals with circulating antibodies, but undetectable memory B cells were found. Finally, a higher proportion of Cervarix-vaccinated subjects displayed cross-neutralizing responses against non-vaccine types HPV-31 and HPV-45. Gardasil and Cervarix may, thus, differently affect long-lasting humoral immunity from both the quantitative and qualitative point of view.
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Affiliation(s)
- Francesco Nicoli
- Department of Chemical and Pharmaceutical Sciences, University of Ferrara, 44121 Ferrara, Italy; (F.N.); (E.G.); (P.M.); (R.G.)
- Department of Molecular Medicine, University of Padova, 35121 Padova, Italy; (B.M.); (V.T.); (I.B.); (L.B.); (G.P.)
| | - Barbara Mantelli
- Department of Molecular Medicine, University of Padova, 35121 Padova, Italy; (B.M.); (V.T.); (I.B.); (L.B.); (G.P.)
| | - Eleonora Gallerani
- Department of Chemical and Pharmaceutical Sciences, University of Ferrara, 44121 Ferrara, Italy; (F.N.); (E.G.); (P.M.); (R.G.)
| | - Valentina Telatin
- Department of Molecular Medicine, University of Padova, 35121 Padova, Italy; (B.M.); (V.T.); (I.B.); (L.B.); (G.P.)
| | - Irene Bonazzi
- Department of Molecular Medicine, University of Padova, 35121 Padova, Italy; (B.M.); (V.T.); (I.B.); (L.B.); (G.P.)
| | - Peggy Marconi
- Department of Chemical and Pharmaceutical Sciences, University of Ferrara, 44121 Ferrara, Italy; (F.N.); (E.G.); (P.M.); (R.G.)
| | - Riccardo Gavioli
- Department of Chemical and Pharmaceutical Sciences, University of Ferrara, 44121 Ferrara, Italy; (F.N.); (E.G.); (P.M.); (R.G.)
| | - Liliana Gabrielli
- Operative Unit of Clinical Microbiology, St Orsola-Malpighi University Hospital, 40138 Bologna, Italy;
| | - Tiziana Lazzarotto
- Department of Specialized, Experimental and Diagnostic Medicine, University of Bologna, 40138 Bologna, Italy;
| | - Luisa Barzon
- Department of Molecular Medicine, University of Padova, 35121 Padova, Italy; (B.M.); (V.T.); (I.B.); (L.B.); (G.P.)
| | - Giorgio Palù
- Department of Molecular Medicine, University of Padova, 35121 Padova, Italy; (B.M.); (V.T.); (I.B.); (L.B.); (G.P.)
| | - Antonella Caputo
- Department of Chemical and Pharmaceutical Sciences, University of Ferrara, 44121 Ferrara, Italy; (F.N.); (E.G.); (P.M.); (R.G.)
- Department of Molecular Medicine, University of Padova, 35121 Padova, Italy; (B.M.); (V.T.); (I.B.); (L.B.); (G.P.)
- Correspondence: ; Tel.: +39-0532-974410
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24
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Liu Y, Fan P, Yang Y, Xu C, Huang Y, Li D, Qing Q, Sun C, Zhou H. Human papillomavirus and human telomerase RNA component gene in cervical cancer progression. Sci Rep 2019; 9:15926. [PMID: 31685833 PMCID: PMC6828729 DOI: 10.1038/s41598-019-52195-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Accepted: 09/24/2019] [Indexed: 01/05/2023] Open
Abstract
This study aimed to examine hTERC gene in different grades of cervical intraepithelial neoplasia (CIN) and cervical cancer, and the association between hTERC and high risk-human papillomavirus (HR-HPV) infection. Patients who underwent cervical cancer screening at the Second Affiliated Hospital of Kunming Medical University between October 2010 and December 2011 were enrolled. All patients underwent liquid-based cytology test and hybrid capture 2 (HC2) for HPV detection. hTERC was examined using fluorescence in situ hybridization (FISH). Cervical colposcopy biopsy was performed if any of the three results was positive. HC2, FISH, and pathology were compared. A total of 1200 women underwent screening, 150 patients underwent cervical biopsy: 32 in the normal group, 38 in the CIN1 group, 66 in the CIN2/3 group, and 14 in the invasive cervical cancer group. More patients had HR-HPV infection in the CIN2/3 group and ICC group compared with the CIN1 group. hTERC increased with increasing histological dysplasia. There was significant difference in hTERC positive rate between each of the three groups. More patients with hTERC gene amplification were observed in the positive HR-HPV group than in the HR-HPV negative group. In conclusion, hTERC is a potential marker for precancerous cervical cancer lesions. hTERC might be correlated with HR-HPV infection in cervical diseases.
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Affiliation(s)
- Yang Liu
- Department of Reproductive, the Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, 650101, P.R. China
| | - Pianping Fan
- Department of Gynecology, LinFen Central Hospital of Shanxi Province, LinFen, Shanxi, 041000, P.R. China
| | - Yingying Yang
- Department of Gynecology, the Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, 650101, P.R. China
| | - Changjun Xu
- Department of Gynecology, the Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, 650101, P.R. China
| | - Yajuan Huang
- Department of Gynecology, the Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, 650101, P.R. China
| | - Daizhu Li
- Department of Gynecology, the Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, 650101, P.R. China
| | - Qing Qing
- Department of Gynecology, the Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, 650101, P.R. China
| | - Chunyi Sun
- Department of Gynecology, the Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, 650101, P.R. China.
| | - Honglin Zhou
- Department of Gynecology, the Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, 650101, P.R. China.
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Reinholdt K, Juul KE, Dehlendorff C, Munk C, Kjaer SK, Thomsen LT. Triage of low-grade squamous intraepithelial lesions using human papillomavirus messenger ribonucleic acid tests-A prospective population-based register study. Acta Obstet Gynecol Scand 2019; 99:204-212. [PMID: 31562779 DOI: 10.1111/aogs.13741] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 09/18/2019] [Accepted: 09/24/2019] [Indexed: 11/26/2022]
Abstract
INTRODUCTION The optimal clinical management of women diagnosed with low-grade squamous intraepithelial lesions (LSIL) during cervical cancer screening remains unclear. In this prospective cohort study, we compared the clinical performance of two human papillomavirus (HPV) mRNA tests for triage of women with LSIL in Denmark. MATERIAL AND METHODS In a nationwide pathology register, we identified women aged 23-65 years with LSIL during 2008-2012. We included women tested for HPV mRNA with the PreTect HPV Proofer test for five high-risk HPV types (n = 2176) or the Aptima assay for 14 high-risk HPV types (n = 426). Subsequent histological diagnoses of cervical intraepithelial neoplasia grades 2, 3 or cancer (CIN2+) were identified in the register. We calculated the sensitivity and specificity for CIN2+ at 18 and 36 months of follow up, and the cumulative incidence of CIN2+ among women testing positive and negative, overall and by age (23-29, 30-39, 40-65 years). RESULTS The proportion of women with a positive mRNA test at baseline was higher in women tested with Aptima (66.7%) than in women tested with Proofer (42.8%). After 18 months, Aptima had higher sensitivity for CIN2+ than Proofer (98% [95% CI 94% to 100%] vs 85% [95% CI 82% to 88%]), whereas Proofer showed higher specificity than Aptima (67% [95% CI 64% to 70%]) vs (40% [95% CI 33% to 46%]). Aptima had particularly low specificity in women aged <40 years (23-29: 19% [95% CI 5% to 36%]; 30-39: 10% [95% CI 0% to 33%]). The 36-month cumulative incidence of CIN2+ was higher in Proofer positive (54.3% [95% CI 50.9% to 57.8%]) than in Aptima positive women (37.6% [95% CI 31.2% to 44.8%]). In women with a negative mRNA test, the 36-month cumulative incidences of CIN2+ were 13.1% (95% CI 10.8% to 15.8%) and 5.9% (95% CI 1.7% to 19.0%) for Proofer and Aptima, respectively. CONCLUSIONS In women with LSIL, Aptima had high sensitivity for CIN2+, but low specificity, especially in women aged <40 years. The Proofer test may be useful to limit immediate colposcopy referrals in younger women with LSIL, but given its low sensitivity and negative predictive value, Proofer negative women must be followed with repeat cytology.
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Affiliation(s)
- Kristian Reinholdt
- Unit of Virus, Lifestyle, and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Kirsten E Juul
- Unit of Virus, Lifestyle, and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Christian Dehlendorff
- Unit of Statistics and Pharmacoepidemiology, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Christian Munk
- Unit of Virus, Lifestyle, and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Susanne K Kjaer
- Unit of Virus, Lifestyle, and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark.,Department of Gynecology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Louise T Thomsen
- Unit of Virus, Lifestyle, and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
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Suppression of Stromal Interferon Signaling by Human Papillomavirus 16. J Virol 2019; 93:JVI.00458-19. [PMID: 31292244 DOI: 10.1128/jvi.00458-19] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 06/29/2019] [Indexed: 01/09/2023] Open
Abstract
Human papillomaviruses (HPVs) infect squamous epithelia and cause several important cancers. Immune evasion is critical for viral persistence. Fibroblasts in the stromal microenvironment provide growth signals and cytokines that are required for proper epithelial differentiation, maintenance, and immune responses and are critical in the development of many cancers. In this study, we examined the role of epithelial-stromal interactions in the HPV16 life cycle using organotypic (raft) cultures as a model. Rafts were created using uninfected human foreskin keratinocytes (HFKs) and HFKs containing either wild-type HPV16 or HPV16 with a stop mutation to prevent the expression of the viral oncogene E5. Microarray analysis revealed significant changes in gene expression patterns in the stroma in response to HPV16, some of which were E5 dependent. Interferon (IFN)-stimulated genes (ISGs) and extracellular matrix remodeling genes were suppressed, the most prominent pathways affected. STAT1, IFNAR1, IRF3, and IRF7 were knocked down in stromal fibroblasts using lentiviral short hairpin RNA (shRNA) transduction. HPV late gene expression and viral copy number in the epithelium were increased when the stromal IFN pathway was disrupted, indicating that the stroma helps control the late phase of the HPV life cycle in the epithelium. Increased late gene expression correlated with increased late keratinocyte differentiation but not decreased IFN signaling in the epithelium. These studies show HPV16 has a paracrine effect on stromal innate immunity, reveal a new role for E5 as a stromal innate immune suppressor, and suggest that stromal IFN signaling may influence keratinocyte differentiation.IMPORTANCE The persistence of high-risk human papillomavirus (HPV) infections is the key risk factor for developing HPV-associated cancers. The ability of HPV to evade host immunity is a critical component of its ability to persist. The environment surrounding a tumor is increasingly understood to be critical in cancer development, including immune evasion. Our studies show that HPV can suppress the expression of immune-related genes in neighboring fibroblasts in a three-dimensional (3D) model of human epithelium. This finding is significant, because it indicates that HPV can control innate immunity not only in the infected cell but also in the microenvironment. In addition, the ability of HPV to regulate stromal gene expression depends in part on the viral oncogene E5, revealing a new function for this protein as an immune evasion factor.
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Daly CM, Hansen SL, Kwon PO, Roberts TA. Prevalence of Human Papillomavirus Genotypes and Abnormal Pap Smears Among Women in the Military Health System. J Community Health 2019; 43:441-447. [PMID: 29168085 DOI: 10.1007/s10900-017-0447-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Human papillomavirus infection (HPV) is the most common sexually transmitted infection among United States Military Servicemembers, and present in the majority of cervical cancers. Many of these infections are preventable, but HPV immunization is not mandatory during military service. The objective of this study was to examine the prevalence of vaccine-preventable cervical disease among women enrolled in the San Antonio Military Health System. This is a retrospective cross-sectional study of Pap smear results and HPV genotyping data among Military Servicewomen and beneficiaries. Simple descriptive statistics and logistic regression were used to assess the association between demographics, cervical pathology and high-risk HPV (hrHPV) infection. Pap smears were obtained by 16.9% of women and cervical pathology was present in 28.8% of samples. Compared to the 25-34 year group, 35-44 year-olds were more likely to have an abnormal Pap smear (OR 1.25, CI 1.05-1.50). Of the samples tested, 10.5% were positive for hrHPV. Adjusted multivariable analysis revealed that hrHPV infection was more likely among the 23-34 year group when compared to 35-44 (OR 0.50, CI 0.38-0.67), 45-54 (0.40. CI 0.28-0.59) and 55-65 year groups (0.46, CI 0.30-0.71). Active Duty Servicewomen were more likely to test positive for hrHPV when compared to Active Duty Family Members (OR 0.59, CI 0.45-0.79) and Retiree Family Members (OR 0.59, CI 0.41-0.83). Younger women and Active Duty Servicewomen are significantly more likely to have cervical infection with hrHPV. Future studies should assess the cost-effectiveness of mandatory HPV immunization for military members.
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Affiliation(s)
- Christopher M Daly
- Adolescent Medicine, Joint Base San Antonio/Lackland AFB, San Antonio, TX, USA. .,Adolescent Medicine, Tripler Army Medical Center, 1 Jarrett White Rd, Honolulu, HI, 96589, USA.
| | - Shana L Hansen
- Adolescent Medicine, Joint Base San Antonio/Lackland AFB, San Antonio, TX, USA
| | - Paul O Kwon
- Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Timothy A Roberts
- Adolescent Medicine, Joint Base San Antonio/Lackland AFB, San Antonio, TX, USA
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Mutombo AB, Simoens C, Tozin R, Bogers J, Van Geertruyden JP, Jacquemyn Y. Efficacy of commercially available biological agents for the topical treatment of cervical intraepithelial neoplasia: a systematic review. Syst Rev 2019; 8:132. [PMID: 31174598 PMCID: PMC6555029 DOI: 10.1186/s13643-019-1050-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 05/26/2019] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Cervical cancer is a major public health issue in the world, especially in developing countries. It can be prevented through vaccination against HPV (primary prevention) and through screening and treatment of cervical intraepithelial neoplasia (CIN) (secondary prevention). Surgical methods for treatment of CIN are linked to complications such as bleeding and adverse pregnancy outcomes. Furthermore, these methods are not generally available in resource-poor settings. Therefore, topical agents for local application on the cervix have been used since decades to overpass complications and limitations of the surgical methods. AIMS Review of the literature on the efficacy of commercially available biological agents used for topical treatment of cervical intraepithelial neoplasia (CIN). METHODS A systematic search through PubMed and the Cochrane database was performed up to December 2017, using the medical subheadings (MesH) for topical agent, treatment, and cervical intraepithelial neoplasia. Appropriate inclusion/exclusion criteria have been used for the selection of eligible clinical studies. Clinical studies containing a minimum of 20 women, aged 18-50 with a diagnosis of CIN 1-3, and at least a 4 weeks follow-up after the end of the topical treatment were included. RESULTS The initial electronic database search resulted in a total of 849 articles. After screening titles and abstracts, 62 articles were selected as potential studies. Of these, six articles were included in the review after reading the full text: two were on 5-FluoroUracil, two on trans retinoic acid, one on Imiquimod, and one on Cidofovir. The reported regression/remission rates for CIN differed among studies. In CIN2 patients, the overall remission rate ranged between 43 and 93% for the active agents. CONCLUSION Among the topical agents studied, 5-FluoroUracil showed good remission rates above 80%. Varying results seen in this review is due to the differences in quality of the design between studies. Large-scale and less biaised studies are needed to elucidate the true efficacy and safety of topical agents in the treatment of CIN.
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Affiliation(s)
- Alex Baleka Mutombo
- Department of Obstetrics and Gynecology, Kinshasa University Hospital, University of Kinshasa, PO Box 236, Kinshasa XI, Democratic Republic of the Congo. .,Global Health Institute, Faculty of Medicine & Health Sciences, University of Antwerp, Doornstraat 331, 2610, Wilrijk, Belgium.
| | - Cindy Simoens
- Applied Molecular Biology Research Group (AMBIOR), Faculty of Medicine and Health Sciences, Laboratory of Cell Biology & Histology, Universiteitsplein 1, 2610, Wilrijk, Belgium
| | - Rahma Tozin
- Department of Obstetrics and Gynecology, Kinshasa University Hospital, University of Kinshasa, PO Box 236, Kinshasa XI, Democratic Republic of the Congo
| | - Johannes Bogers
- Applied Molecular Biology Research Group (AMBIOR), Faculty of Medicine and Health Sciences, Laboratory of Cell Biology & Histology, Universiteitsplein 1, 2610, Wilrijk, Belgium
| | - Jean-Pierre Van Geertruyden
- Global Health Institute, Faculty of Medicine & Health Sciences, University of Antwerp, Doornstraat 331, 2610, Wilrijk, Belgium
| | - Yves Jacquemyn
- Department of Obstetrics and Gynaecology, UZA Antwerp University Hospital and ASTARC, Antwerp University UA, Wilrijkstraat 10, 2650, Edegem, Belgium
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Human Papilloma Virus and Chlamydia trachomatis: Casual Acquaintances or Partners in Crime? CURRENT CLINICAL MICROBIOLOGY REPORTS 2019. [DOI: 10.1007/s40588-019-00117-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Kovacevic G, Milosevic V, Knezevic P, Knezevic A, Knezevic I, Radovanov J, Nikolic N, Patic A, Petrovic V, Hrnjakovic Cvjetkovic I, Stanisic L. Prevalence of oncogenic Human papillomavirus and genetic diversity in the L1 gene of HPV16 HPV 18 HPV31 and HPV33 found in women from Vojvodina Province Serbia. Biologicals 2019; 58:57-63. [PMID: 30795963 DOI: 10.1016/j.biologicals.2019.02.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 02/09/2019] [Accepted: 02/11/2019] [Indexed: 01/27/2023] Open
Abstract
The main purpose of this paper is to estimate the pre-vaccination prevalence of 12 hrHPV types among 564 women from Vojvodina province (Serbia). The corrected contingency coefficient (Ccorr) was used to estimate the importance of association of examined HPV types and cytological diagnosis. The highest association with the abnormal cytology was observed for HPV 16 (Ccorr = 0.493) in all age groups of participants. The effect of HPV 16 was especially clear within the group of women older than 35 years (Ccorr = 0.691), compared with women younger than 35 (Ccorr = 0.333). The molecular characterization at the level of L1 gene of HPV 16, 18, 31 and 33 variants was for the first time assessed in our region. Nearly all HPV 16 isolates cluster with variant lineage A (96.4%) the remaining isolates clustering with variant lineage D. All of HPV 18 and HPV 33 isolates are clustering within the lineage A while isolates of HPV 31 group with lineages A and C. This contributes to understanding of intrinsic geographical and biological differences of examined HPV types and could be useful for development of cervical cancer screening strategies in Vojvodina (Serbia) and diagnosis of HPV related cervical cancer in general.
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Affiliation(s)
| | - Vesna Milosevic
- Institute for Public Health of Vojvodina, Novi Sad, Serbia; Faculty of Medicine, University of Novi Sad, Serbia
| | - Petar Knezevic
- Laboratory for Microbiology, Department of Biology and Ecology, Faculty of Sciences, University of Novi Sad, Serbia
| | - Aleksandra Knezevic
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Belgrade, Serbia
| | - Ivana Knezevic
- Department of Biochemistry, Faculty of Biology and Medicine, University of Lausanne, Epalinges, Switzerland
| | | | - Natasa Nikolic
- Institute for Public Health of Vojvodina, Novi Sad, Serbia; Faculty of Medicine, University of Novi Sad, Serbia
| | - Aleksandra Patic
- Institute for Public Health of Vojvodina, Novi Sad, Serbia; Faculty of Medicine, University of Novi Sad, Serbia
| | - Vladimir Petrovic
- Institute for Public Health of Vojvodina, Novi Sad, Serbia; Faculty of Medicine, University of Novi Sad, Serbia
| | - Ivana Hrnjakovic Cvjetkovic
- Institute for Public Health of Vojvodina, Novi Sad, Serbia; Faculty of Medicine, University of Novi Sad, Serbia
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Bednarczyk RA. Addressing HPV vaccine myths: practical information for healthcare providers. Hum Vaccin Immunother 2019; 15:1628-1638. [PMID: 30676241 DOI: 10.1080/21645515.2019.1565267] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Human papillomavirus (HPV) vaccine uptake consistently lags behind that of other adolescent vaccines. In 2017, uptake of a single HPV vaccine dose and HPV vaccine series completion was 66% and 49%, respectively, compared to uptake of tetanus, diphtheria, and acellular pertussis vaccine (89%) and quadrivalent meningococcal conjugate vaccine (85%). Reasons for not vaccinating adolescents again HPV are varied, and in many cases, are rooted in commonly spread myths and misperceptions about the vaccine. In this review, we address five key myths - HPV vaccination is not effective at preventing cancer; Pap smears are sufficient to prevent cervical cancer; HPV vaccination is not safe; HPV vaccination is not needed since most infections are naturally cleared by the immune system; 11-12 years of age is too young to vaccinate. For each myth, we summarize the scientific evidence refuting the myth and provide speaking prompts for healthcare professionals to communicate about HPV vaccination.
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Affiliation(s)
- Robert A Bednarczyk
- a Hubert Department of Global Health, Rollins School of Public Health, Emory University , Atlanta GA , USA.,b Department of Epidemiology, Rollins School of Public Health, Emory University , Atlanta GA , USA.,c Cancer Prevention and Control Program, Winship Cancer Institute, Emory University , Atlanta GA , USA.,d Emory Vaccine Center, Emory University , Atlanta GA , USA
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Egli-Gany D, Spaar Zographos A, Diebold J, Masserey Spicher V, Frey Tirri B, Heusser R, Dillner J, Petignat P, Sahli R, Low N. Human papillomavirus genotype distribution and socio-behavioural characteristics in women with cervical pre-cancer and cancer at the start of a human papillomavirus vaccination programme: the CIN3+ plus study. BMC Cancer 2019; 19:111. [PMID: 30700274 PMCID: PMC6354352 DOI: 10.1186/s12885-018-5248-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Accepted: 12/26/2018] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND The Swiss Federal Office of Public Health has recommended vaccination against human papillomavirus (HPV) to prevent cervical cancer since 2008. To establish monitoring of the future public health impact of vaccination, baseline population-based data are required. The objectives of this study were to examine the distribution of oncogenic HPV genotypes in biopsies with cervical intraepithelial neoplasia stage 3 or more severe lesions (CIN3+) at the beginning of HPV vaccination programmes and to compare sociodemographic and behavioural factors of women with CIN3+ with women in the Swiss general population. METHODS We conducted a retrospective and prospective cross-sectional study with women diagnosed with CIN3+ in Switzerland. Ten pathology institutes from six cantons and three language regions participated. We conducted HPV typing on formaldehyde fixed-paraffin embedded specimens from 2014 and 2015. Women enrolled in 2015 were asked to complete a questionnaire. We described frequencies of HPV types. We also compared demographic characteristics and socioeconomic status in the CIN3 + plus group with the Swiss National Cohort in 2014 and compared risk factors for HPV infection with the Swiss Health Survey in 2012. RESULTS We included 768 biopsies from 767 women. Four hundred and seventy-five (61.8%) biopsies were positive for HPV 16 and/or 18, 687 (89.5%) were positive for oncogenic HPV genotypes 16, 18, 31, 33, 45, 52, and/or 58 and five (0.7%) were HPV negative. Twenty-eight (10.3%) of the 273 women who completed the patient questionnaire reported having received at least one dose of an HPV vaccine. When compared with Swiss women in the six study cantons, fewer women in the CIN3+ plus study group were of Swiss nationality, more were born abroad and more were single. The study group also had a higher proportion of women with ≥2 partners in the last year, current smokers and was younger at age of first sexual intercourse. CONCLUSIONS Introduction of the nonavalent vaccine could cover approximately 90% of CIN3+ lesions in Swiss women compared with around 60% with the quadrivalent vaccine. Surveillance of HPV genotype distribution in CIN3+, together with information about vaccination and CIN3+ incidence will allow monitoring of the public health impact of vaccination programmes. TRIAL REGISTRATION ClinicalTrials.gov, NCT02323997 . Registered 24 December 2014.
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Affiliation(s)
- Dianne Egli-Gany
- Institute of Social and Preventive Medicine, University of Bern, Mittelstrasse 43, 3012 Bern, Switzerland
| | - Anne Spaar Zographos
- Federal Office of Public Health, Schwarzenburgstrasse 157, 3003 Bern, Switzerland
| | - Joachim Diebold
- Institute of Pathology, Cantonal Hospital Lucerne, Spitalstrasse, 6000 Luzern 16, Switzerland
| | | | - Brigitte Frey Tirri
- Department of Gynaecology and Obstetrics, Kantonsspital Baselland, Rheinstrasse 26, 4410 Liestal, Switzerland
| | - Rolf Heusser
- National Institute for Cancer Epidemiology and Registration, Hirschengraben 82, 8001 Zurich, Switzerland
| | - Joakim Dillner
- WHO HPV LabNet Global Reference Laboratory, Department of Clinical Microbiology, Center for Cervical Cancer Prevention, Skåne University Hospital, Malmö, Karolinska Institute and Hospital, SE-171, 77 Stockholm, Sweden
| | - Patrick Petignat
- Department of Gynaecology and Obstetrics, Geneva University Hospitals, Boulevard de la Cluse 30, 1205 Genève, Switzerland
| | - Roland Sahli
- Institute of Microbiology, Lausanne University Hospital and University of Lausanne, Rue du Bugnon 48, 1011 Lausanne, Switzerland
| | - Nicola Low
- Institute of Social and Preventive Medicine, University of Bern, Mittelstrasse 43, 3012 Bern, Switzerland
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Genetic variants of the dUTPase-encoding gene DUT increase HR-HPV infection rate and cervical squamous cell carcinoma risk. Sci Rep 2019; 9:513. [PMID: 30679536 PMCID: PMC6345750 DOI: 10.1038/s41598-018-36757-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Accepted: 11/23/2018] [Indexed: 11/09/2022] Open
Abstract
Deoxyuridine 5′-triphosphate nucleotidohydrolase (dUTPase) is involved in the repair and prevention of uracil misincorporations into DNA. Maintenance of DNA integrity is critical for cancer prevention. Many studies have identified susceptibility loci and genetic variants in cervical cancer. The aim of this study was to explore the distribution frequency of six single nucleotide polymorphisms (SNPs) in the dUTPase-encoding gene DUT in a case-control study to identify the relationship between DUT genetic variants and cervical cancer susceptibility. Six DUT intronic SNPs (rs28381106, rs3784619, rs10851465, rs28381126, rs3784621 and rs11637235) were genotyped by mismatch amplification-PCR in 400 cervical squamous cell carcinomas (CSCCs), 400 precursor cervical intraepithelial neoplasia (CIN) III lesions and 1,200 normal controls. No correlations were found between four DUT SNPs (rs3784621, rs10851465, rs28381106 and rs28381126) and CIN III and CSCC risk. However, the homozygous GG allele of rs3784619 and TT allele of rs11637235 correlated significantly with increased risk of CIN III and CSCC (OR = 2.29, 2.05; OR = 3.15, 3.15, respectively). Individuals with the G allele or G carrier allele (AG + GG) at rs3784619 and with the T allele or T carrier allele (CT + TT) at rs11637235 were at higher risk for CIN III and CSCC (OR = 1.26, 1.30; OR = 1.41, 1.65, respectively). Similarly, in the human papillomavirus (HPV)-positive groups, we found that the homozygous GG alleles of rs3784619 and TT alleles of rs11637235 markedly increased the risk of CIN III and CSCC (OR = 2.44, 2.71; OR = 3.32, 4.04, respectively). When performing a stratified analysis of sexual and reproductive histories, we found that the GG genotype of rs3784619 had a particularly high level of enrichment in the group of patients with > one sexual partner in CIN III (P = 0.043) and CSCC (P = 0.007). Meanwhile, the TT genotype of rs11637235 was enriched for in the high risk HPV (HR-HPV)-positive cases of CIN III (P = 0.033) and CSCC (P = 0.022). Analysis of the haplotype between rs3784619 (A/G) and rs11637235 (C/T) revealed that the genotypes with AA-TT (OR = 2.59), AG-TT (OR = 2.29), GG-CC (OR = 2.72), GG-CT (OR = 3.01 (1.83–4.96)) were significantly associated with increased risk of CIN III. More notably, this risk was much greater for CSCC (AA-TT (OR = 3.62), AG-TT (OR = 5.08), GG-CC (OR = 5.28), and GG-CT (OR = 4.23). Additionally, most GG genotypes of rs3784619 were linkage GG-CT, while most TT genotypes of rs11637235 were linkage AA-TT. In conclusion, these findings suggested that the homozygous GG allele of rs3784619 and the TT allele of rs11637235 in the DUT gene significantly increased the risk of CIN III and CSCC. Most GG genotypes of rs3784619 and TT genotypes of rs11637235 were linkage GG-CT and AA-TT, respectively. The TT genotype of rs11637235 was enriched in the HR-HPV-positive cases. These two SNPs of the DUT gene can be early predictive biomarkers of CIN III and CSCC, and may be involved in HR HPV infection.
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Campbell-Tofte J, Vrahatis A, Josefsen K, Mehlsen J, Winther K. Investigating the aetiology of adverse events following HPV vaccination with systems vaccinology. Cell Mol Life Sci 2019; 76:67-87. [PMID: 30324425 PMCID: PMC11105185 DOI: 10.1007/s00018-018-2925-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 09/10/2018] [Accepted: 09/20/2018] [Indexed: 12/18/2022]
Abstract
In contrast to the insidious and poorly immunogenic human papillomavirus (HPV) infections, vaccination with the HPV virus-like particles (vlps) is non-infectious and stimulates a strong neutralizing-antibody response that protects HPV-naïve vaccinees from viral infection and associated cancers. However, controversy about alleged adverse events following immunization (AEFI) with the vlps have led to extensive reductions in vaccine acceptance, with countries like Japan dropping it altogether. The AEFIs are grouped into chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME). In this review, we present a hypothesis that the AEFIs might arise from malfunctions within the immune system when confronted with the unusual antigen. In addition, we outline how the pathophysiology of the AEFIs can be cost-effectively investigated with the holistic principles of systems vaccinology in a two-step process. First, comprehensive immunological profiles of HPV vaccinees exhibiting the AEFIs are generated by integrating the data derived from serological profiling for prominent HPV antibodies and serum cytokines, with data from serum metabolomics, peripheral white blood cells transcriptomics and gut microbiome profiling. Next, the immunological profiles are compared with corresponding profiles generated for matched (a) HPV vaccinees without AEFIs; (b) non-HPV-vaccinated individuals with CFS/ME-like symptoms; and (c) non-HPV-vaccinated individuals without CFS/ME. In these comparisons, any causal links between HPV vaccine and the AEFIs, as well as the underlying molecular basis for the links will be revealed. Such a study should provide an objective basis for evaluating HPV vaccine safety and for identifying biomarkers for individuals at risk of developing AEFI with HPV vaccination.
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Affiliation(s)
| | | | - Knud Josefsen
- Bartholin Institute, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen Ø, Denmark
| | - Jesper Mehlsen
- Coordinating Research Centre, Bispebjerg and Frederiksberg Hospital, Nordre Fasanvej 57, 2000, Frederiksberg, Denmark
| | - Kaj Winther
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Nørre Allé 51, DK-2200, Copenhagen N, Denmark
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Xu HH, Zhang X, Zheng HH, Han QY, Lin AF, Yan WH. Association of HLA-G 3' UTR polymorphism and expression with the progression of cervical lesions in human papillomavirus 18 infections. Infect Agent Cancer 2018; 13:42. [PMID: 30619504 PMCID: PMC6311041 DOI: 10.1186/s13027-018-0217-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2018] [Accepted: 12/20/2018] [Indexed: 12/23/2022] Open
Abstract
Background Human leukocyte antigen (HLA)-G is an immune checkpoint molecule, which expression in cervical cancer cells enables them to escape immunosurveillance. To date, limited information has been published on the association of HLA-G genetic background in malignant cells with levels of HLA-G expression and the clinical outcome of patients. Methods We investigated the influence of the HLA-G 14 bp In/Del (rs66554220) and + 3142C/G (rs1063320) polymorphisms in 130 cases of HPV16 infection, 130 cases of HPV18 infection and 185 age-matched, unrelated, HPV-negative, and cytologically normal Chinese Han women. Case-matched cervical biopsy tissues were evaluated by immunohistochemistry. Results Our findings show that the frequency of alleles, 14 bp In (38.5% vs 29.2%, OR = 1.52, P < 0.05) and + 3142G (72.7% vs 57.0%, OR = 2.01, P < 0.05), were significantly increased in the HPV18-infected group compared with the control group. The HLA-G polymorphisms (alleles 14 bp In and + 3142G) are also associated with the progression of HPV18-related cervical lesions. Moreover, HLA-G expression increased from CIN1 to CIN2/3 lesions and was highest in patients with adenocarcinoma; however, a significant association between these characteristics and the HLA-G polymorphisms was not observed. Conclusion Our results support that the HLA-G 14 bp In and + 3142G alleles are risk factors for HPV18 infections and influence the progression of HPV18-related cervical lesions. This suggests that HLA-G-driven immune mechanisms play an important role in cervical carcinogenesis.
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Affiliation(s)
- Hui-Hui Xu
- 1Medical Research Center, Taizhou Hospital of Zhejiang Province, Wenzhou Medical University, Linhai, Zhejiang, China.,2Laboratory of Gynecologic Oncology, Taizhou Hospital of Zhejiang Province, Wenzhou Medical University, Linhai, Zhejiang, China
| | - Xia Zhang
- 3Human Tissue Bank, Taizhou Hospital of Zhejiang Province, Wenzhou Medical University, Linhai, Zhejiang, China
| | - Hai-Hong Zheng
- 4Department of Pathology, Taizhou Hospital of Zhejiang Province, Wenzhou Medical University, Linhai, Zhejiang, China
| | - Qiu-Yue Han
- 3Human Tissue Bank, Taizhou Hospital of Zhejiang Province, Wenzhou Medical University, Linhai, Zhejiang, China
| | - Ai-Fen Lin
- 3Human Tissue Bank, Taizhou Hospital of Zhejiang Province, Wenzhou Medical University, Linhai, Zhejiang, China
| | - Wei-Hua Yan
- 1Medical Research Center, Taizhou Hospital of Zhejiang Province, Wenzhou Medical University, Linhai, Zhejiang, China.,2Laboratory of Gynecologic Oncology, Taizhou Hospital of Zhejiang Province, Wenzhou Medical University, Linhai, Zhejiang, China
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Pan C, Issaeva N, Yarbrough WG. HPV-driven oropharyngeal cancer: current knowledge of molecular biology and mechanisms of carcinogenesis. CANCERS OF THE HEAD & NECK 2018; 3:12. [PMID: 31093365 PMCID: PMC6460765 DOI: 10.1186/s41199-018-0039-3] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Accepted: 12/09/2018] [Indexed: 12/21/2022]
Abstract
Understanding of oropharyngeal squamous cell carcinoma has significantly progressed over the last decades, and the concept that this disease can be subdivided into two distinct entities based on human papilloma virus (HPV) status has gained acceptance. To combat the constantly growing epidemic of HPV+ oropharyngeal cancer, further investigation and characterization the unique features of the disease, along with the development and implementation of new, targeted therapies, is crucial. In this review, we summarize the etiology, pathogenesis, diagnosis, treatment, and molecular characteristics of HPV-associated oropharyngeal squamous cell carcinoma.
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Affiliation(s)
- Cassie Pan
- 1Department of Surgery, Division of Otolaryngology, Yale University, New Haven, CT USA
| | - Natalia Issaeva
- 2Department of Otolaryngology/Head and Neck Surgery; Lineberger Cancer Center, University of North Carolina at Chapel Hill, 170 Manning Drive, Campus Box 7070, Chapel Hill, NC 27599 USA
| | - Wendell G Yarbrough
- 2Department of Otolaryngology/Head and Neck Surgery; Lineberger Cancer Center, University of North Carolina at Chapel Hill, 170 Manning Drive, Campus Box 7070, Chapel Hill, NC 27599 USA
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Cervical Cancer Screening Programs in Europe: The Transition Towards HPV Vaccination and Population-Based HPV Testing. Viruses 2018; 10:v10120729. [PMID: 30572620 PMCID: PMC6315375 DOI: 10.3390/v10120729] [Citation(s) in RCA: 140] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 12/12/2018] [Accepted: 12/15/2018] [Indexed: 12/25/2022] Open
Abstract
Cervical cancer is the fourth most frequently occurring cancer in women around the world and can affect them during their reproductive years. Since the development of the Papanicolaou (Pap) test, screening has been essential in identifying cervical cancer at a treatable stage. With the identification of the human papillomavirus (HPV) as the causative agent of essentially all cervical cancer cases, HPV molecular screening tests and HPV vaccines for primary prevention against the virus have been developed. Accordingly, comparative studies were designed to assess the performance of cervical cancer screening methods in order to devise the best screening strategy possible. This review critically assesses the current cervical cancer screening methods as well as the implementation of HPV vaccination in Europe. The most recent European Guidelines and recommendations for organized population-based programs with HPV testing as the primary screening method are also presented. Lastly, the current landscape of cervical cancer screening programs is assessed for both European Union member states and some associated countries, in regard to the transition towards population-based screening programs with primary HPV testing.
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Douaiher J, Langenfeld SJ. Multidisciplinary Approach to the Management and Treatment of Anal Dysplasia. Clin Colon Rectal Surg 2018; 31:361-367. [PMID: 30397395 DOI: 10.1055/s-0038-1668106] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The incidence of anal intraepithelial neoplasia (AIN) has been increasing over the years. AIN acts as a precursor lesion for anal squamous cell cancer. Factors leading to progression of AIN into malignancy are complex and involve grade of the lesion, human papillomavirus and HIV coinfection, as well as patient-related risk factors such as immunocompromised state and men who have sex with men. The multifaced aspects of this disease make its management challenging, as it involves several disciplines including pathology, primary care, infectious disease, and colorectal specialties. Each of these fields brings its own expertize to the management of AIN, and their collaborative, coordinated work culminates into best practice and optimized outcomes in the care of the AIN patient.
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Affiliation(s)
- Jeffrey Douaiher
- Kaiser Permanente Medical Center, Walnut Creek, CA; Division of General Surgery, Kaiser Permanente Northern California, Oakland, CA
| | - Sean J Langenfeld
- Kaiser Permanente Medical Center, Walnut Creek, CA; Division of General Surgery, Kaiser Permanente Northern California, Oakland, CA
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Yao L, Yuan M, Yuan J, Zhou P, Mei L, Cheng J. Analysis of cervical human papillomavirus infection in 2300 women in Urumqi, China. Medicine (Baltimore) 2018; 97:e13206. [PMID: 30407360 PMCID: PMC6250538 DOI: 10.1097/md.0000000000013206] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
This study is to investigate the cervical human papillomavirus (HPV) infection rate in women of Urumqi, China.The epidemiological questionnaire survey was used to study 2300 women in Urumqi with a prospective research method. The second-generation hybrid capture assay, cervical liquid-based cytology test, colposcopy, and cervical biopsy were used to screen CC.In 2300 cases, HPV was detected in 385 cases with infection rate of 16.74%. The infection rates of Uygur and Han women were 20.08% and 13.39%, respectively, with significant differences (P <.05). Among all age groups, the infection rate was highest in the age group of 20 to 25 years (with infection rate of 22.22%), followed by the age group of 45 to 49 years (with infection rate of 18.78%). In 8 districts, the highest positive rate was in Saybagh District with infection rate of 24.79%, followed by Urumqi County with infection rate of 19.05%, and the lowest was in Toutunhe District with infection rate of 10.86%. There was no significant difference in HPV infection among all age groups or among 8 districts of Urumqi. HPV infection rates were 10.48%, 84.52%, 92.94%, 100% in chronic cervicitis, low grade and high-grade intraepithelial neoplasia and CC group, respectively. The difference was statistically significant (P <.05).The HPV infection rate of Uygur is higher than that in Han ethnic in Urumqi. The infection rate of HPV increases with the severity of cervical lesions.
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Affiliation(s)
- Lili Yao
- Department of Gynecology, Affliated Tumor Hospital, Xinjiang Medical University, Urumqi
| | - Min Yuan
- Department of Gynecology, Affliated Tumor Hospital, Xinjiang Medical University, Urumqi
| | - Jianlin Yuan
- Department of Gynecology, Affliated Tumor Hospital, Xinjiang Medical University, Urumqi
| | - Ping Zhou
- Department of Gynecology, Affliated Tumor Hospital, Xinjiang Medical University, Urumqi
| | - Lipa Mei
- Department of Gynecology, Affliated Tumor Hospital, Xinjiang Medical University, Urumqi
| | - Jingxin Cheng
- Department of Obstetrics and Gynecology, Dongfang Hospital of Tongji University, Shanghai, China
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Guenat D, Dalstein V, Mauny F, Saunier M, Briolat J, Clavel C, Riethmuller D, Mougin C, Prétet JL. Development and interlaboratory agreement of real-time PCR for HPV16 quantification in liquid-based cervical samples. PAPILLOMAVIRUS RESEARCH 2018; 6:27-32. [PMID: 30343011 PMCID: PMC6202657 DOI: 10.1016/j.pvr.2018.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 08/10/2018] [Accepted: 10/16/2018] [Indexed: 11/18/2022]
Abstract
High risk HPV infection is the necessary cause for the development of precancerous and cancerous lesions of the cervix. Among HPV, HPV16 represents the most carcinogenic type. Since the determination of HPV16 DNA load could be clinically useful, we assessed quantitative real-time PCR targeting E6HPV16 and albumin genes on two different platforms. Series of SiHa cells diluted in PreservCyt were used to assess repeatability and reproducibility of two in-house real-time PCR techniques run in two different laboratories to determine HPV16 load. Furthermore, 97 HPV16 positive cervical samples were evaluated to estimate inter-center variability using Bland-Alman plots. As a whole, both techniques presented coefficients of variation for HPV16 load measurement similar to those established for other virus quantification with commercial kits. Moreover, the two real-time PCR techniques showed a very good agreement for HPV16 load calculation. Finally, we emphasize that robust HPV16 DNA quantification requires normalization of viral load by the cell number. HPV16 viral load could be a useful biomarker for the management of HPV positive women. Coefficient of variation for HPV16 viral load ranged from 7% to 62%. HPV16 viral load quantification requires normalization by the cell number. HPV16 viral load precision increases with the use of an internal calibrator.
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Affiliation(s)
- David Guenat
- EA3181, Université de Franche-Comté, COMUE Université Bourgogne Franche-Comté, LabExLipSTIC ANR-11-LABX-0021, Boulevard Alexandre Fleming, F-25030 Besançon Cedex, France; Centre National de Référence Papillomavirus, CIC 1431, CHU Besançon, F-25000, France
| | - Véronique Dalstein
- INSERM, UMR-S 1250, Reims, France; Champagne-Ardenne, Faculté de Médecine, Reims, France; CHU Reims, Laboratoire Biopathologie, Reims, France
| | | | - Maëlle Saunier
- EA3181, Université de Franche-Comté, COMUE Université Bourgogne Franche-Comté, LabExLipSTIC ANR-11-LABX-0021, Boulevard Alexandre Fleming, F-25030 Besançon Cedex, France
| | - Jenny Briolat
- INSERM, UMR-S 1250, Reims, France; Champagne-Ardenne, Faculté de Médecine, Reims, France; CHU Reims, Laboratoire Biopathologie, Reims, France
| | - Christine Clavel
- INSERM, UMR-S 1250, Reims, France; Champagne-Ardenne, Faculté de Médecine, Reims, France; CHU Reims, Laboratoire Biopathologie, Reims, France
| | - Didier Riethmuller
- EA3181, Université de Franche-Comté, COMUE Université Bourgogne Franche-Comté, LabExLipSTIC ANR-11-LABX-0021, Boulevard Alexandre Fleming, F-25030 Besançon Cedex, France
| | - Christiane Mougin
- EA3181, Université de Franche-Comté, COMUE Université Bourgogne Franche-Comté, LabExLipSTIC ANR-11-LABX-0021, Boulevard Alexandre Fleming, F-25030 Besançon Cedex, France; Centre National de Référence Papillomavirus, CIC 1431, CHU Besançon, F-25000, France
| | - Jean-Luc Prétet
- EA3181, Université de Franche-Comté, COMUE Université Bourgogne Franche-Comté, LabExLipSTIC ANR-11-LABX-0021, Boulevard Alexandre Fleming, F-25030 Besançon Cedex, France; Centre National de Référence Papillomavirus, CIC 1431, CHU Besançon, F-25000, France.
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Ginindza TG, Almonte M, Dlamini X, Sartorius B. Distribution of cervical abnormalities detected by visual inspection with acetic acid in Swaziland, 2011-2014: A retrospective study. Afr J Prim Health Care Fam Med 2018; 10:e1-e7. [PMID: 30456977 PMCID: PMC6244366 DOI: 10.4102/phcfm.v10i1.1773] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Revised: 06/12/2018] [Accepted: 08/15/2018] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Cervical cancer is the fourth most common cancer worldwide among women, with the number of new cases increasing from 493 243 in 2002 to 527 000 in 2012. These numbers are likely to be underestimated because given the lack of registration resources, cervical cancer deaths are usually under-reported in low-income countries. AIM To describe the distribution of and trends in visual inspection with acetic acid (VIA) to detected cervical abnormalities in Swaziland by reviewing records of VIA examinations performed at two main hospitals in Swaziland between 2011 and 2014. SETTING Mbabane Government Hospital and Realign Fitkin Memorial (RFM). METHODS Records of cervical screening using VIA at the Mbabane government hospital and RFM hospital between 2011 and 2014 were retrieved. Positivity rates (PRs) of VIA with 95% confidence intervals (95% CI) were calculated and used as proxies of cervical abnormalities. Odds ratios of the association between VIA-detected cervical abnormalities and human immunodeficiency virus (HIV) status were estimated using logistic regressions. RESULTS VIA was positive in 1828 of 12 151 VIA records used for analysis (15%, 95% CI: 14.4-15.7). VIA was positive in 9% (36 of 403) women under the age of 20, in 15.5% (1714 of 11 046) of women aged 20-49 years and in 11.1% (78 of 624) of women aged 50-64 years. A decreasing trend of VIA positivity was observed over time at both screening centres (p for trend < 0.001). Of 2697 records with Papanicolaou results, 20% (67 of 331) VIA-positives and only 5% (114 of 2366) VIA negatives had high-grade squamous intraepithelial lesion. Among 4578 women with reported HIV status, 1702 were HIV-positive (37.2%, 95% CI: 35.8-38.6). The prevalence of HIV in VIA-positive women was 62.5% (95% CI: 58.7-66.2), almost double that among VIA-negative women (33.0%, 95% CI: 31.6-34.5) and that among all women screened (p < 0.001). HIV-positive women were 3.4 times more likely to have cervical abnormalities on VIA than HIV-negative women (OR: 3.4, 95% CI: 2.8-4.0, p < 0.01). CONCLUSION The high VIA PRs observed over four years in this study may reflect the prevalence of cervical abnormalities, in particular, in HIV-positive women. VIA is not a robust screening test, but it can play a major role in strengthening and expanding cervical cancer screening prevention programmes in resource-limited countries.
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Affiliation(s)
- Themba G Ginindza
- Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal.
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Hooi DJ, Lissenberg-Witte BI, Kenter G, de Koning MNC, Gomes Bravio I, Ardts K, Kleinmoedig S, Benita E, Pinedo HM, Berkhof J, Quint WGV, Meijer CJLM. Human papillomavirus (HPV) prevalence and associated risk factors in women from Curaçao. PLoS One 2018; 13:e0199624. [PMID: 30005066 PMCID: PMC6044524 DOI: 10.1371/journal.pone.0199624] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2018] [Accepted: 05/02/2018] [Indexed: 11/18/2022] Open
Abstract
Background In the Caribbean region, a notable difference in HPV-prevalence and genotypes distribution between the islands is observed. Recently we found in Curaçao a low incidence of HPV16 and 18 in cervical cancer compared to the standard world population. We aimed to determine HPV-prevalence, HPV-genotype distribution and associated risk-factors in women from Curaçao. Methods 5000 women aged 25–65 years were randomly selected from the national Population Register. HPV was detected by means of GP5+/6+PCR EIA and GP 5+/6+amplimers from HPV-positive samples were genotyped with a reverse hybridisation assay. We also collected personal data and data on risk-factors. Results 1075 women were enrolled in the study. Overall HPV-prevalence was 19.7%. Most frequent genotypes were HPV16 (2.3%), 35 (2.1%) and 52 (1.8%). Twenty-seven women detected with abnormal cytology (i.e.≥ASC-US) were referred for biopsy. In women with normal cytology (n = 1048), HPV-prevalence was 17.9% and the most common high-risk HPV (hrHPV)-types were HPV35 (2.0%), 18 (1.8%), 16 (1.5%) and 52 (1.5%). The highest HPV-prevalence (32.8%) was found in the age-group: 25–34 (n = 247). HPV positive women started sex at a younger age (p = 0.032). Conclusions HPV-prevalence in the overall population is high and HPV16 was the most common genotype followed by 35 and 18. In women with normal cytology HPV35 is the most common genotype followed by HPV18, 52 and 16. The high HPV-prevalence (32.8%) in women of 25–34 years argue for introduction of cervical cancer prevention strategies. HPV-type distribution found in Curaçao should be taken into account when considering the choice for prophylactic vaccination.
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Affiliation(s)
- Desiree J. Hooi
- Department of Pathology, VU University Medical Centre, Amsterdam, the Netherlands
- * E-mail:
| | | | - Gemma Kenter
- Department of Gynaecology and Oncology, VU University Medical Centre, Amsterdam, the Netherlands
| | | | | | - Kim Ardts
- Fundashon Prevenshon, Willemstad, Curaçao
| | - Suhaina Kleinmoedig
- Department of Pathology, Analytic Diagnostic Centre (ADC), Willemstad, Curaçao
| | - Edlyn Benita
- Department of Pathology, Analytic Diagnostic Centre (ADC), Willemstad, Curaçao
| | | | - Johannes Berkhof
- Department of Epidemiology and Biostatistics, VU University Medical Centre, Amsterdam, the Netherlands
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Tripathi R, Rath G, Hussain S, Jawanjal P, Bandil K, Sharma V, Bharadwaj M, Mehrotra R. Jagged-1 induced molecular alterations in HPV associated invasive squamous cell and adenocarcinoma of the human uterine cervix. Sci Rep 2018; 8:9359. [PMID: 29921897 PMCID: PMC6008329 DOI: 10.1038/s41598-018-27699-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Accepted: 06/05/2018] [Indexed: 02/07/2023] Open
Abstract
The majority of cervical cancer (CC) cases are attributable to HPV infection. Altered Notch pathway signals and HPV are believed to modify clinicopathogenesis of CC, however, the involvement of each molecular player and its mechanism is still not known. Jagged-1 (JAG1) is one of the ligands that induce Notch pathway. The involvement of JAG1 in the modulation of a disease condition is not very clear. Hence, this study aims to study the role of JAG1 in HPV-16/18 associated different histological sub-types of CC, especially ADC. 40 non-neoplastic cervical tissues, 30 precancer and 118 tumor specimens (total 188 tissue biopsies) were studied for the expression of the JAG1 protein through immunohistochemistry, immunoblotting and for HPV infection. Two folds increase of cytoplasmic (Mean ± S.E, 3.67 ± 0.33; p = 0.0001) and nuclear (3.70 ± 0.38, p = 0.0001) JAG1 expression was identified in normal (N) vs precancer and three folds cytoplasmic (4.44 ± 0.17, p = 0.0001) and nuclear (4.64 ± 0.17; p = 0.0001) in N vs. ISCC. Total 85% of ADC patients were found to be infected with HPV, which were 100% infected with HPV-16. These findings suggest the complex synergistic interplay between JAG1 and HPV in regulating clinicopathological progression of CC through its deregulation.
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Affiliation(s)
- Richa Tripathi
- Division of Molecular Genetics & Biochemistry, ICMR-National Institute of Cancer Prevention and Research (NICPR), Noida, India.,Division of Preventive Oncology, ICMR-National Institute of Cancer Prevention and Research (NICPR), Noida, India
| | - Gayatri Rath
- Department of Anatomy, VMMC & Safdarjung Hospital, New Delhi, India
| | - Showket Hussain
- Division of Molecular Genetics & Biochemistry, ICMR-National Institute of Cancer Prevention and Research (NICPR), Noida, India
| | - Poonam Jawanjal
- Department of Anatomy, VMMC & Safdarjung Hospital, New Delhi, India
| | - Kapil Bandil
- Division of Molecular Genetics & Biochemistry, ICMR-National Institute of Cancer Prevention and Research (NICPR), Noida, India
| | - Vishwas Sharma
- Department of Health Research, ICMR-National Institute of Cancer Prevention and Research (NICPR), Noida, India.,Society for Life Sciences and Human Health, Allahabad, India
| | - Mausumi Bharadwaj
- Division of Molecular Genetics & Biochemistry, ICMR-National Institute of Cancer Prevention and Research (NICPR), Noida, India.
| | - Ravi Mehrotra
- Division of Preventive Oncology, ICMR-National Institute of Cancer Prevention and Research (NICPR), Noida, India.
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Ginindza TG, Sartorius B. Projected cervical Cancer incidence in Swaziland using three methods and local survey estimates. BMC Cancer 2018; 18:639. [PMID: 29879943 PMCID: PMC5992849 DOI: 10.1186/s12885-018-4540-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Accepted: 05/21/2018] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND The scarcity of country data (e.g. a cancer registry) for the burden of cervical cancer (CC) in low-income countries (LCIs) such as Swaziland remains a huge challenge. Such data are critical to inform local decision-making regarding resource allocation [1]. We aimed to estimate likely cervical cancer incidence in Swaziland using three different methodologies (triangulation), to help better inform local policy guidance regarding likely higher "true" burden and increased resource allocation required for treatment, cervical cancer screening and HPV vaccine implementation. METHODS Three methods were applied to estimate CC incidence, namely: 1) application of age-specific CC incidence rates for Southern African region from GLOBOCAN 2012 extrapolated to the 2014 Swaziland female population; 2) a linear regression based model with transformed age-standardised CC incidence against hr-HPV (with and without HIV as a covariate) prevalence among women with normal cervical cytology; and 3) a mathematical model, using a natural history approach based on parameter estimates from various available literature and local survey estimates. We then triangulated estimates and uncertainty from the three models to estimate the most likely CC incidence rate for Swaziland in 2015. RESULTS The projected incidence estimates for models 1-3 were 69.4 (95% CI: 66.7-72.1), 62.6 per 100,000 (95%CI: 53.7-71.8) and 44.6 per 100,000 (41.5 to 52.1) respectively. Model 2 with HIV prevalence as covariate estimated a higher CC incidence rate estimate of 101.1 per 100,000 (95%CI: 90.3-112.2). The triangulated ('averaged') age-standardized CC incidence based across the 3 models for 2015 was estimated at 69.4 per 100,000 (95% CI: 63.0-77.1) in Swaziland. CONCLUSION It is widely accepted that cancer incidence (and in this case CC) is underestimated in settings with poor and lacking registry data. Our findings suggest that the projected burden of CC is higher than that suggested from other sources. Local health policy decisions and decision-makers need to re-assess resource allocation to prevent and treat CC effectively, which is likely to persist given the very high burden of hr-HPV within the country.
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Affiliation(s)
- Themba G Ginindza
- Discipline of Public Health, School of Nursing and Public Health, University of KwaZulu-Natal, Howard College Campus, 2nd Floor George Campbell Building, Mazisi Kunene Road, Durban, 4041, South Africa.
| | - Benn Sartorius
- Discipline of Public Health, School of Nursing and Public Health, University of KwaZulu-Natal, Howard College Campus, 2nd Floor George Campbell Building, Mazisi Kunene Road, Durban, 4041, South Africa
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Aimagambetova G, Azizan A. Epidemiology of HPV Infection and HPV-Related Cancers in Kazakhstan: a Review. Asian Pac J Cancer Prev 2018; 19:1175-1180. [PMID: 29801397 PMCID: PMC6031825 DOI: 10.22034/apjcp.2018.19.5.1175] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Background: Cancer is one of the most prevalent causes of mortality worldwide. In the cervix it is considered to be caused by different high-risk human papillomavirus (HPV) types. Although many studies have already been conducted worldwide on the epidemiology of HPV infection and their oncogenic properties, limited data are available on HPV prevalence, incidence and genotype specific dissemination in Kazakhstan. Methods: To review the distribution of HPV infection, electronic databases (e.g. PubMed, Web of Science and Google Scholar) were searched for peer reviewed articles in English. The study was performed during June-July 2017 with a review of 39 relevant articles, published up to July 31, 2017. The following inclusion criteria were applied: general population data, cytology results available, and use of polymerase chain reaction (PCR) and/or Hybrid Capture® 2, Digene Corp., USA for HPV detection. Results: As reported in limited studies, the prevalence of HPV infection in Kazakhstan ranges from 43.8% to 55.8%. However, the scenario with regard to epidemiology of HPV related cancers in Kazakhstan is not very clear. One study reported a decline of laryngeal cancer observed during the recent years, whereas cervical cancer incidence has increased to about 3000 new cervical cancer cases, and about 1,000 cervical cancer deaths each year. Conclusion: The high incidence of cervical cancer with a significant mortality rate in Kazakhstan is evidence of HPV infection abundance despite an absence of HPV screening and low public awareness of the problem. Having a well-informed understanding of the role of HPV infection could enhance the public’s acceptance of screening and intervention programs to reduce morbidity and mortality in the country due to HPV infection. Thus, the purpose of this review article is to summarize the existing data, identifying directions for future research on HPV epidemiology and HPV-related diseases in Kazakhstan.
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Affiliation(s)
- Gulzhanat Aimagambetova
- Department of Biomedical Sciences, Nazarbayev University School of MedicineKazakhstan. gulzhanat.
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Shigeishi H, Yokoyama S, Ohta K, Takechi M, Sugiyama M. Human papillomavirus type 16 (HPV16) DNA copy number in oral rinse samples from oral cavity cancer patients. TRANSLATIONAL RESEARCH IN ORAL ONCOLOGY 2018. [DOI: 10.1177/2057178x18774683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objectives: The objective of this study is to examine the human papillomavirus type 16 (HPV16) DNA copy number in the oral cavity of cancer patients using oral rinse samples. Methods: We analyzed the HPV16 DNA copy number of oral rinse samples in 13 primary oral cavity cancer patients (mean age 67.8 years, range 48–84 years) who visited the Department of Oral and Maxillofacial Reconstructive Surgery of Hiroshima University Hospital (Hiroshima, Japan). The 13 oral cavity cancers included 6 carcinomas in situ and 7 squamous cell carcinomas. Real-time PCR analysis was performed to examine the number of HPV16 E6 viral copies in oral rinse samples. Additionally, the HPV16 integration status was investigated using the real-time PCR findings for HPV16 E2 genes in HPV16 E6-positive oral rinse samples. Results: HPV16 E6 copy numbers above the detection limit in a standard curve for HPV16 E6 DNA were assessed as HPV16 positive in oral rinse samples from 6 of 13 patients. The average number of HPV16 E6 viral copies was 1.71 ± 1.72 per cell (range, 0.39–4.96 copies/cell) in six oral rinse samples. The HPV16 E2 viral load was detected in four of the six HPV16-positive oral rinse samples. Two of the six HPV16-positive oral rinse samples showed HPV16 E2 copy numbers below the detection limit, indicating the full integration of HPV16 DNA. Conclusions: The number of patients in this study was small; therefore, further investigation using a larger number of participants is required to clarify the level of HPV16 viral copy number in the oral cavity of cancer patients.
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Affiliation(s)
- Hideo Shigeishi
- Department of Public Oral Health, Program of Oral Health Sciences, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Sho Yokoyama
- Department of Oral and Maxillofacial Surgery, Program of Dentistry, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Kouji Ohta
- Department of Oral and Maxillofacial Surgery, Program of Dentistry, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Masaaki Takechi
- Department of Oral and Maxillofacial Surgery, Program of Dentistry, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Masaru Sugiyama
- Department of Public Oral Health, Program of Oral Health Sciences, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
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Gatos KC. A Literature Review of Cervical Cancer Screening in Transgender Men. Nurs Womens Health 2018; 22:52-62. [PMID: 29433700 DOI: 10.1016/j.nwh.2017.12.008] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Revised: 08/20/2017] [Indexed: 06/08/2023]
Abstract
Most female-to-male (FTM) transgender men retain their cervixes and need comprehensive sexual health care, including cervical cancer screening. According to the literature, FTM individuals obtain cervical cancer screening less frequently and are less likely to be up to date on their Pap tests compared with cisgender women. Misinformation related to human papillomavirus and cervical cancer risk was noted for health care providers and FTM individuals. Absence of transgender-specific guidelines or trained health care providers presents barriers to cervical cancer screening for FTM individuals, and further research is indicated to develop comprehensive guidelines unique to the needs and experiences of this population.
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Liu L, Ying C, Zhao Z, Sui L, Zhang X, Qian C, Wang Q, Chen L, Guo Q, Wu J. Identification of reliable biomarkers of human papillomavirus 16 methylation in cervical lesions based on integration status using high-resolution melting analysis. Clin Epigenetics 2018; 10:10. [PMID: 29410710 PMCID: PMC5781301 DOI: 10.1186/s13148-018-0445-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2017] [Accepted: 01/11/2018] [Indexed: 01/13/2023] Open
Abstract
Background The dynamic methylation of human papillomavirus (HPV) 16 DNA is thought to be associated with the progression of cervical lesions. Previous studies that did not consider the physical status of HPV 16 may have incorrectly mapped HPV 16 methylomes. In order to identify reliable biomarkers for squamous cervical cancer (SCC), we comprehensively evaluated the methylation of HPV 16 depending on the integration incidence of each sample. Methods Based on the integration status of 115 HPV 16-infected patients (50 SCC, 30 high-grade squamous intraepithelial lesion [HSIL], and 35 low-grade squamous intraepithelial lesion [LSIL]) and HPV 16-infected Caski cell lines by PCR detection of integrated papillomavirus sequences, we designed a series of primers that would not be influenced by breakpoints for a high-resolution melting (HRM) PCR method to detect the genome methylation. Results A few regions with recurrent interruptions were identified in E1, E2/E4, L1, and L2 despite scattering of breakpoints throughout all eight genes of HPV 16. Frequent integration sites often occurred concomitantly with methylated CpG sites. The HRM PCR method showed 100% agreement with pyrosequencing when 3% was set as the cutoff value. A panel of CpG sites such as nt5606, nt5609, nt5615, and nt5378 can be combined in reweighing calculations to distinguish SCC from HSIL and LSIL patients which have high sensitivity and specificity (88% and 92.31%, respectively). Conclusions Our research shows that combination of CpG sites nt5606, nt5609, nt5615, and nt5378 can be used as potential diagnosis biomarkers for SCC, and the HRM PCR method is suitable for clinical methylation analysis. Electronic supplementary material The online version of this article (10.1186/s13148-018-0445-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Lu Liu
- 1Department of Clinical Laboratory, The Obstetrics and Gynecology Hospital of Fudan University, Fangxie Road No. 419, Huangpu District, Shanghai, 200001 China
| | - Chunmei Ying
- 1Department of Clinical Laboratory, The Obstetrics and Gynecology Hospital of Fudan University, Fangxie Road No. 419, Huangpu District, Shanghai, 200001 China
| | - Zhen Zhao
- 2Department of Clinical Laboratory, Minhang District Central Hospital, Shanghai, China
| | - Long Sui
- 3Medical Center of Diagnosis and Treatment for Cervical Diseases, The Obstetrics and Gynecology Hospital of Fudan University, Fangxie Road No. 419, Huangpu District, Shanghai, 200001 China
| | - Xinyan Zhang
- 4The Research Institute of Obstetrics and Gynecology, The Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Chunyan Qian
- 5Yuhang Branch, Second Affiliated Hospital of Zhejiang University, Hangzhou, China
| | - Qing Wang
- 3Medical Center of Diagnosis and Treatment for Cervical Diseases, The Obstetrics and Gynecology Hospital of Fudan University, Fangxie Road No. 419, Huangpu District, Shanghai, 200001 China
| | - Limei Chen
- 3Medical Center of Diagnosis and Treatment for Cervical Diseases, The Obstetrics and Gynecology Hospital of Fudan University, Fangxie Road No. 419, Huangpu District, Shanghai, 200001 China
| | - Qisang Guo
- 3Medical Center of Diagnosis and Treatment for Cervical Diseases, The Obstetrics and Gynecology Hospital of Fudan University, Fangxie Road No. 419, Huangpu District, Shanghai, 200001 China
| | - Jiangnan Wu
- 6Department of Clinical Statistics, The Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
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Min KJ, Lee JK, So KA, Kim MK. Association Between Passive Smoking and the Risk of Cervical Intraepithelial Neoplasia 1 in Korean Women. J Epidemiol 2017; 28:48-53. [PMID: 29093300 PMCID: PMC5742379 DOI: 10.2188/jea.je20160118] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Background The role of passive smoking on cervical carcinogenesis remains controversial. We investigated the association of passive smoking with the risk of cervical intraepithelial neoplasia (CIN) and cervical cancer. Methods The study recruited 1,322 women, aged 18–65 with normal cytology (n = 592), CIN1 (n = 420), CIN2/3 (n = 165), and cervical cancer (n = 145) from 2006 to 2009. This study is a cross-sectional analysis using the baseline data from the Korean human papillomavirus (HPV) cohort study. Detailed information on smoking behaviors and lifestyles were collected using questionnaires. Multinomial logistic regression analysis was performed to estimate multivariable-adjusted odds ratios (ORs). Results Passive smoking was not statistically related to the risk of CINs and cervical cancer. However, passive smoking among non-smokers was associated with higher CIN 1 risk (OR 1.53; 95% confidence interval [CI], 1.07–2.18), compared to not passive smoking, after adjusting for demographic factors, lifestyles, and oncogenic-HPV infection status. CIN 1 risk increased with longer time exposed to passive smoking (P for trend <0.0003). Multivariate odds of <2 hours/day of passive smoking and that of ≥2 hours/day of passive smoking were 2.48 (95% CI, 1.49–4.14) and 2.28 (95% CI, 1.21–4.26) for CIN 1, compared to not passive smoking. Conclusions This study found that passive smoking among non-smoking women is associated with the risk of CIN 1.
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Affiliation(s)
- Kyung-Jin Min
- Department of Obstetrics and Gynecology, College of Medicine, Korea University
| | - Jae-Kwan Lee
- Department of Obstetrics and Gynecology, College of Medicine, Korea University
| | - Kyeong A So
- Cheil General Hospital & Women's Healthcare Center, Dankook University College of Medicine
| | - Mi Kyung Kim
- Translational Epidemiology Research Branch, Division of Cancer Epidemiology and Management, National Cancer Center
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50
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Shanis D, Anandi P, Grant C, Bachi A, Vyas N, Merideth MA, Pophali PA, Koklanaris E, Ito S, Savani BN, Barrett AJ, Battiwalla M, Stratton P. Risks factors and timing of genital human papillomavirus (HPV) infection in female stem cell transplant survivors: a longitudinal study. Bone Marrow Transplant 2017; 53:78-83. [DOI: 10.1038/bmt.2017.210] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Revised: 07/24/2017] [Accepted: 08/03/2017] [Indexed: 11/09/2022]
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