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Zonta MA, Liljander A, Roque KB, Schillert A, Kai M, dos Santo FA, de Freitas GP, Soane M, Cavalar M, Janaudis G, Shio MT. Prevalence of sexually transmitted infections and human papillomavirus in cervical samples from incarcerated women in São Paulo, Brazil: a retrospective single-center study. Front Public Health 2024; 12:1353845. [PMID: 39109153 PMCID: PMC11300339 DOI: 10.3389/fpubh.2024.1353845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 07/08/2024] [Indexed: 08/10/2024] Open
Abstract
Introduction Sexually transmitted infections (STIs) cause considerable morbidity worldwide and, depending on the specific pathogen, may lead to serious complications in the female reproductive tract. Incarcerated women are particularly vulnerable to health problems with a disproportionate high rate of STIs, including infections with human papillomavirus (HPV). Methods Here, cervical swab samples collected from 299 women (18 to 64 years) living in one of the women's prisons of São Paulo, Brazil were submitted for liquid-based cytology to determine the prevalence of precancerous lesions. Furthermore, direct detection of 30 genital HPV genotypes (18 high-risk and 12 low-risk types) and 11 additional STIs (Chlamydia trachomatis, Neisseria gonorrhoeae, Herpes simplex virus 1 and 2, Haemophilus ducreyi, Mycoplasma genitalium and hominis, Treponema pallidum, Trichomonas vaginalis, Ureaplasma parvum and urealyticum) were performed by molecular typing using two PCR-based DNA microarray systems, i.e., EUROArray HPV and EUROArray STI (EUROIMMUN), respectively. Results The overall prevalence of cytological abnormalities was 5.8%, including five women with low-grade and five women with high-grade squamous intraepithelial lesions. The overall prevalence of HPV was 62.2, and 87.1% of the HPV-positive women were infected with oncogenic high-risk (HR) HPV types. HPV types 16 (24.1%), 33 and 52 (both 10.4%) were the most frequently detected. The prevalence of the other STIs was 72.8%. Up to four different pathogens were found in the infected women, the most frequent being Ureaplasma parvum (45.3%), Mycoplasma hominis (36.2%) and Trichomonas vaginalis (24.8%). Conclusion The high number of HR-HPV infections and other STIs described here highlights the fact that the Brazilian female prison population requires more attention in the country's health policies. The implementation of screening programs and treatment measures might contribute to a decrease in the incidence of STIs and cervical cancer in this vulnerable population. However, for such measures to be effective, further studies are needed to investigate the best practice to get more women to engage in in-prison prevention programs, e.g., through offering further sexual health education and self-sampling.
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Affiliation(s)
- Marco A. Zonta
- Inside Diagnosis, Research and Development S.A., São Paulo, Brazil
| | - Anne Liljander
- Institute of Experimental Immunology, Affiliated to EUROIMMUN Medizinische Labordiagnostika AG, Lübeck, Germany
| | - Karina B. Roque
- Post Graduation Program in Health Sciences, Santo Amaro University, São Paulo, Brazil
| | - Arne Schillert
- Institute of Experimental Immunology, Affiliated to EUROIMMUN Medizinische Labordiagnostika AG, Lübeck, Germany
| | - Marco Kai
- Institute of Experimental Immunology, Affiliated to EUROIMMUN Medizinische Labordiagnostika AG, Lübeck, Germany
| | | | | | - Michel Soane
- EUROIMMUN Brasil – EUROInstitute, São Caetano do Sul, Brazil
| | - Markus Cavalar
- Institute of Experimental Immunology, Affiliated to EUROIMMUN Medizinische Labordiagnostika AG, Lübeck, Germany
| | - Gustavo Janaudis
- Inside Diagnosis, Research and Development S.A., São Paulo, Brazil
| | - Marina Tiemi Shio
- Post Graduation Program in Health Sciences, Santo Amaro University, São Paulo, Brazil
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Tsige AW, Beyene DA. Cervical cancer: Challenges and prevention strategies: A narrative review. Health Sci Rep 2024; 7:e2149. [PMID: 38826620 PMCID: PMC11139676 DOI: 10.1002/hsr2.2149] [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: 02/03/2024] [Revised: 03/25/2024] [Accepted: 05/09/2024] [Indexed: 06/04/2024] Open
Abstract
Background and Aims Human papillomavirus (HPV) infections that continue to exist are the main cause of cervical cancer (CC), two-thirds of CC occurrences worldwide are caused by HPV 16 and HPV 18, and 99.7% of CC tumors are linked to oncogenic HPV infection. To identify challenges of CC and its prevention and treatment modalities. Methods This review examined the epidemiology, predisposing factors, genetic factors, clinical assessment methods, current treatment options, and prevention approaches for CC. We had perform a narrative data synthesis rather than a pooled analysis. A thorough literature search in pertinent databases related to CC was done with the inclusion of data that were published in the English language. Results Early detection of CC is of utmost importance to detect precancerous lesions at an early stage. Therefore, all responsible agencies concerned with health should make all women aware of the benefits of CC screening and educate the general public. HPV vaccination coverage is very low in resource-limited settings. Conclusion To achieve the goal of eliminating CC as a public health problem in 2030, the World Health Organization will pay special attention to increasing HPV vaccination coverage throughout the world. To further improve HPV vaccine acceptability among parents and their children, safety-related aspects of the HPV vaccine should be further investigated through post-marketing surveillance and multicentre randomized clinical trials.
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Affiliation(s)
- Abate Wondesen Tsige
- Department of Pharmacy, Asrat Woldeyes Health Science CampusDebre Berhan UniversityDebre BerhanEthiopia
| | - Dessale Abate Beyene
- Department of Pharmacy, Asrat Woldeyes Health Science CampusDebre Berhan UniversityDebre BerhanEthiopia
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Delanghe JR, Delrue C, Speeckaert R, Speeckaert MM. Unlocking the link between haptoglobin polymorphism and noninfectious human diseases: insights and implications. Crit Rev Clin Lab Sci 2024; 61:275-297. [PMID: 38013410 DOI: 10.1080/10408363.2023.2285929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 11/16/2023] [Indexed: 11/29/2023]
Abstract
Haptoglobin (Hp) is a polymorphic protein that was initially described as a hemoglobin (Hb)-binding protein. The major functions of Hp are to scavenge Hb, prevent iron loss, and prevent heme-based oxidation. Hp regulates angiogenesis, nitric oxide homeostasis, immune responses, and prostaglandin synthesis. Genetic polymorphisms in the Hp gene give rise to different phenotypes, including Hp 1-1, Hp 2-1, and Hp 2-2. Extensive research has been conducted to investigate the association between Hp polymorphisms and several medical conditions including cardiovascular disease, inflammatory bowel disease, cancer, transplantation, and hemoglobinopathies. Generally, the Hp 2-2 phenotype is associated with increased disease risk and poor outcomes. Over the years, the Hp 2 allele has spread under genetic pressures. Individuals with the Hp 2-2 phenotype generally exhibit lower levels of CD163 expression in macrophages. The decreased expression of CD163 may be associated with the poor antioxidant capacity in the serum of subjects carrying the Hp 2-2 phenotype. However, the Hp 1-1 phenotype may confer protection in some cases. The Hp1 allele has strong antioxidant, anti-inflammatory, and immunomodulatory properties. It is important to note that the benefits of the Hp1 allele may vary depending on genetic and environmental factors as well as the specific disease or condition under consideration. Therefore, the Hp1 allele may not necessarily confer advantages in all situations, and its effects may be context-dependent. This review highlights the current understanding of the role of Hp polymorphisms in cardiovascular disease, inflammatory bowel disease, cancer, transplantation, hemoglobinopathies, and polyuria.
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Affiliation(s)
- Joris R Delanghe
- Department of Diagnostic Sciences, Ghent University, Ghent, Belgium
| | - Charlotte Delrue
- Department of Nephrology, Ghent University Hospital, Ghent, Belgium
| | | | - Marijn M Speeckaert
- Department of Nephrology, Ghent University Hospital, Ghent, Belgium
- Research Foundation-Flanders (FWO), Brussels, Belgium
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Bruno MT, Caruso G, Torrisi E, Grimaldi R, Abate B, Luciani FS, Basile S, Panella MM. The Impact of Diagnosis of Human Papillomavirus (HPV) Infection and Electrosurgical Excision Procedure (LEEP) for Cervical Intraepithelial Neoplasia 3 (CIN3) on Women's Sexual Lives. Diagnostics (Basel) 2024; 14:911. [PMID: 38732325 PMCID: PMC11083130 DOI: 10.3390/diagnostics14090911] [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: 02/16/2024] [Revised: 04/24/2024] [Accepted: 04/25/2024] [Indexed: 05/13/2024] Open
Abstract
The aim of the study was to assess sexual health in women who underwent Loop Electrosurgical Excisional Procedure (LEEP) for the treatment of cervical intraepithelial neoplasia 3 (CIN 3). One hundred thirty-one women were enrolled, and the Female Sexual Function Index (FSFI) questionnaire was administered before LEEP and 6 months after the procedure. In almost all of the participants, data revealed a statistically significant worsening in sexual quality of life after LEEP. Therefore, clinicians should be aware of these possible negative effects on sexual behavior, and provide women with appropriate, wide-ranging, and detailed counseling. The data obtained in the present study should help to plan appropriate counseling from communicating HPV diagnosis and medical treatment to CIN3 surgical procedure.
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Affiliation(s)
- Maria Teresa Bruno
- Department of General Surgery and Medical-Surgical Specialties, Gynecological Clinic, University of Catania, 95123 Catania, Italy (E.T.); (R.G.)
- Multidisciplinary Research Center in Papillomavirus Pathology, University of Catania, 95123 Catania, Italy
| | - Giuseppe Caruso
- Department of General Surgery and Medical-Surgical Specialties, Gynecological Clinic, University of Catania, 95123 Catania, Italy (E.T.); (R.G.)
| | - Elena Torrisi
- Department of General Surgery and Medical-Surgical Specialties, Gynecological Clinic, University of Catania, 95123 Catania, Italy (E.T.); (R.G.)
| | - Raffaela Grimaldi
- Department of General Surgery and Medical-Surgical Specialties, Gynecological Clinic, University of Catania, 95123 Catania, Italy (E.T.); (R.G.)
| | - Biagio Abate
- Department of General Surgery and Medical-Surgical Specialties, Gynecological Clinic, University of Catania, 95123 Catania, Italy (E.T.); (R.G.)
| | - Francesco Saverio Luciani
- Methods and Models Department for the Economy, Territory and Finance, La Sapienza University of Rome, 00185 Rome, Italy;
| | - Susanna Basile
- Psychologist and Clinical Sexologist, 95123 Catania, Italy;
| | - Marco Marzio Panella
- Department of General Surgery and Medical-Surgical Specialties, Gynecological Clinic, University of Catania, 95123 Catania, Italy (E.T.); (R.G.)
- Multidisciplinary Research Center in Papillomavirus Pathology, University of Catania, 95123 Catania, Italy
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Akbari E, Milani A, Seyedinkhorasani M, Bolhassani A. HPV co-infections with other pathogens in cancer development: A comprehensive review. J Med Virol 2023; 95:e29236. [PMID: 37997472 DOI: 10.1002/jmv.29236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 10/13/2023] [Accepted: 11/02/2023] [Indexed: 11/25/2023]
Abstract
High-risk human papillomaviruses (HR-HPVs) cause various malignancies in the anogenital and oropharyngeal regions. About 70% of cervical and oropharyngeal cancers are caused by HPV types 16 and 18. Notably, some viruses including herpes simplex virus, Epstein-Barr virus, and human immunodeficiency virus along with various bacteria often interact with HPV, potentially impacting its replication, persistence, and cancer progression. Thus, HPV infection can be significantly influenced by co-infecting agents that influence infection dynamics and disease progression. Bacterial co-infections (e.g., Chlamydia trachomatis) along with bacterial vaginosis-related species also interact with HPV in genital tract leading to viral persistence and disease outcomes. Co-infections involving HPV and diverse infectious agents have significant implications for disease transmission and clinical progression. This review explores multiple facets of HPV infection encompassing the co-infection dynamics with other pathogens, interaction with the human microbiome, and its role in disease development.
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Affiliation(s)
- Elahe Akbari
- Department of Hepatitis and AIDS, Pasteur Institute of Iran, Tehran, Iran
| | - Alireza Milani
- Department of Hepatitis and AIDS, Pasteur Institute of Iran, Tehran, Iran
| | | | - Azam Bolhassani
- Department of Hepatitis and AIDS, Pasteur Institute of Iran, Tehran, Iran
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Bas S, Sijben J, Bischoff EWMA, Bekkers RLM, de Kok IMCM, Melchers WJG, Siebers AG, van der Waal D, Broeders MJM. Acceptability of risk-based triage in cervical cancer screening: A focus group study. PLoS One 2023; 18:e0289647. [PMID: 37585441 PMCID: PMC10431661 DOI: 10.1371/journal.pone.0289647] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 07/22/2023] [Indexed: 08/18/2023] Open
Abstract
BACKGROUND Compared to the previous cytology-based program, the introduction of primary high-risk human papillomavirus (hrHPV) based screening in 2017 has led to an increased number of referrals. To counter this, triage of hrHPV-positive women in cervical cancer screening can potentially be optimized by taking sociodemographic and lifestyle risk factors for cervical abnormalities into account. Therefore, it is essential to gain knowledge of the views of women (30-60 years) eligible for cervical cancer screening. OBJECTIVE The main goal of this qualitative study was to gain insight in the aspects that influence acceptability of risk-based triage in cervical cancer screening. DESIGN A focus group study in which participants were recruited via four general medical practices, and purposive sampling was used to maximize heterogeneity with regards to age, education level, and cervical cancer screening experiences. APPROACH The focus group discussions were transcribed verbatim and analyzed using reflexive thematic analysis. PARTICIPANTS A total of 28 women (average age: 45.2 years) eligible for cervical cancer screening in The Netherlands participated in seven online focus group discussions. Half of the participants was higher educated, and the participants differed in previous cervical cancer screening participation and screening result. KEY RESULTS In total, 5 main themes and 17 subthemes were identified that determine the acceptability of risk-stratified triage. The main themes are: 1) adequacy of the screening program: an evidence-based program that is able to minimize cancer incidence and reduce unnecessary referrals; 2) personal information (e.g., sensitive topics and stigma); 3) emotional impact: fear and reassurance; 4) communication (e.g., transparency); and 5) autonomy (e.g., prevention). CONCLUSION The current study highlights several challenges regarding the development and implementation of risk-based triage that need attention in order to be accepted by the target group. These challenges include dealing with sensitive topics and a transparent communication strategy.
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Affiliation(s)
- Sharell Bas
- Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Jasmijn Sijben
- Department of Gastroenterology and Hepatology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Erik W. M. A. Bischoff
- Department of Primary and Community Care, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, Netherlands
| | - Ruud L. M. Bekkers
- Department of Obstetrics and Gynaecology, Catharina Hospital, Eindhoven, The Netherlands
- Department of Obstetrics and Gynecology, GROW School for Oncology and Reproduction, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Inge M. C. M. de Kok
- Department of Public Health, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Willem J. G. Melchers
- Department of Medical Microbiology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Albert G. Siebers
- The Nationwide Network and Registry of Histo-and Cytopathology in the Netherlands (PALGA Foundation), Houten, The Netherlands
| | - Daniëlle van der Waal
- Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
- Dutch Expert Centre for Screening, Nijmegen, The Netherlands
| | - Mireille J. M. Broeders
- Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
- Dutch Expert Centre for Screening, Nijmegen, The Netherlands
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Vattai A, Kremer N, Meister S, Beyer S, Keilmann L, Buschmann C, Corradini S, Schmoeckel E, Kessler M, Mahner S, Jeschke U, Hertlein L, Kolben T. Increase of the T-reg-recruiting chemokine CCL22 expression in a progressive course of cervical dysplasia. J Cancer Res Clin Oncol 2023; 149:6613-6623. [PMID: 36792811 DOI: 10.1007/s00432-023-04638-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 02/06/2023] [Indexed: 02/17/2023]
Abstract
PURPOSE An increasing infiltration of FoxP3-positive T-regs is associated with a higher grade of cervical intraepithelial neoplasia. The T-reg-recruiting chemokine CCL22 is expressed in various tumour entities. Aim of our study was to investigate the role of CCL22 in the progression and regression of cervical intraepithelial neoplasias, especially in patients with intermediate cervical intraepithelial neoplasias (CIN II). Furthermore, our aim was to characterize the CCL22-producing cells and explore the role of innate immunity in the process of cells recruitment. METHODS CCL22 expression was analyzed immunohistochemically in 169 patient samples. The immunoreactive score as well as the median numbers of positive cells were calculated in each slide and correlated with the histological CIN grade and FoxP3 expression. Additionally, CD68/CCL22 as well as CD68/PPARγ and CD68/FoxP3 expression were examined by double immunofluorescence. Statistical analysis was performed by SPSS 26. RESULTS A significantly higher expression of epithelial CCL22 in CIN II with progression in comparison to CIN II with regression (p = 0.006) could be detected. CCL22 was correlated with FoxP3 (Spearman's Rho: 0.308; p < 0.01). In 88%, CCL22-positive cells were positive for CD68, and 71% of CD68-positive macrophages expressed PPARγ. Colocalization of CD68 and FoxP3 was detected in 12%. CONCLUSION We could demonstrate that increased expression of CCL22, mainly produced by macrophages, correlates with elevated potential of malignancy. CCL22 expression could act as a predictor for regression and progression in cervical intraepithelial neoplasia, and it may help in the decision process regarding surgical treatment versus watchful waiting strategy in order to prevent conisation-associated risks. Furthermore, our findings support the potential of CCL22-producing cells as a target for immune therapy in cervical cancer patients.
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Affiliation(s)
- Aurelia Vattai
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, 81377, Munich, Germany.
- Kinderwunsch Centrum Muenchen, 81241, Munich, Germany.
| | - Nadine Kremer
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, 81377, Munich, Germany
| | - Sarah Meister
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, 81377, Munich, Germany
| | - Susanne Beyer
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, 81377, Munich, Germany
| | - Lucia Keilmann
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, 81377, Munich, Germany
| | - Christina Buschmann
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, 81377, Munich, Germany
| | - Stefanie Corradini
- Department of Radiation Oncology, University Hospital, LMU Munich, 81377, Munich, Germany
| | - Elisa Schmoeckel
- Institute of Pathology, Faculty of Medicine, LMU Munich, 80337, Munich, Germany
| | - Mirjana Kessler
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, 81377, Munich, Germany
| | - Sven Mahner
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, 81377, Munich, Germany
| | - Udo Jeschke
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, 81377, Munich, Germany
- Department of Obstetrics and Gynecology, University Hospital Augsburg, 86156, Augsburg, Germany
| | - Linda Hertlein
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, 81377, Munich, Germany
| | - Thomas Kolben
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, 81377, Munich, Germany
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Boarini LR, Sobrado CW, Mota GR, Villa LL, de Albuquerque IC, Queiroz NSF, Facanali CBG, Nadal SR, Cecconello I. Perianal fistulizing Crohn's disease is associated with a higher prevalence of HPV in the anorectal fistula tract. A comparative study. Clinics (Sao Paulo) 2023; 78:100219. [PMID: 37257365 PMCID: PMC10244904 DOI: 10.1016/j.clinsp.2023.100219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Revised: 05/03/2023] [Accepted: 05/12/2023] [Indexed: 06/02/2023] Open
Abstract
BACKGROUND & AIMS Perianal fistulizing Crohn's disease is the main risk factor for anal cancer in patients with inflammatory bowel disease. Whether this occurs due to a higher frequency of human papillomavirus remains unclear. The authors aimed to evaluate the prevalence of HPV and high-risk HPV in patients with perianal Crohn's disease, compared with a control group. METHODS The authors conducted a two-center cross-sectional study in which perianal fistulizing Crohn's disease patients were matched for age and sex with patients with anorectal fistula without Crohn's disease. Biopsy specimens were obtained from fistulous tracts during examination under anesthesia for both groups. The samples were sent for HPV detection and genotyping using the INNO-LiPA test. RESULTS A total of 108 subjects (54 in each group) were recruited. The perianal fistulizing Crohn's disease group showed a statistically higher frequency of HPV in the fistulous tract than the control group (33.3% vs. 16.7%; p = 0.046). Separate analyses on high-risk types demonstrated that there was a numerically higher frequency of HPV in the perianal fistulizing Crohn's disease group. In multiple logistic regression, patients with perianal fistulizing Crohn's disease were found to have a chance of HPV 3.29 times higher than patients without Crohn's disease (OR = 3.29; 95% CI 1.20‒9.01), regardless of other variables. The types most frequently identified in the perianal fistulizing Crohn's disease group were HPV 11 (12.96%) and HPV 16 (9.26%). CONCLUSION Perianal fistulizing Crohn's disease is associated with a higher prevalence of HPV than in patients with anorectal fistula without Crohn's disease.
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Affiliation(s)
- Lucas Rodrigues Boarini
- Departamento de Gastroenterologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil.
| | - Carlos Walter Sobrado
- Departamento de Gastroenterologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
| | - Giana Rabello Mota
- Centro de Investigação Translacional em Oncologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
| | - Luisa Lina Villa
- Centro de Investigação Translacional em Oncologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
| | | | - Natalia Sousa Freitas Queiroz
- Departamento de Gastroenterologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
| | | | | | - Ivan Cecconello
- Departamento de Gastroenterologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
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Yang H, Xie Y, Guan R, Zhao Y, Lv W, Liu Y, Zhu F, Liu H, Guo X, Tang Z, Li H, Zhong Y, Zhang B, Yu H. Factors affecting HPV infection in U.S. and Beijing females: A modeling study. Front Public Health 2022; 10:1052210. [PMID: 36589946 PMCID: PMC9794849 DOI: 10.3389/fpubh.2022.1052210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 11/25/2022] [Indexed: 12/23/2022] Open
Abstract
Background Human papillomavirus (HPV) infection is an important carcinogenic infection highly prevalent among many populations. However, independent influencing factors and predictive models for HPV infection in both U.S. and Beijing females are rarely confirmed. In this study, our first objective was to explore the overlapping HPV infection-related factors in U.S. and Beijing females. Secondly, we aimed to develop an R package for identifying the top-performing prediction models and build the predictive models for HPV infection using this R package. Methods This cross-sectional study used data from the 2009-2016 NHANES (a national population-based study) and the 2019 data on Beijing female union workers from various industries. Prevalence, potential influencing factors, and predictive models for HPV infection in both cohorts were explored. Results There were 2,259 (NHANES cohort, age: 20-59 years) and 1,593 (Beijing female cohort, age: 20-70 years) participants included in analyses. The HPV infection rate of U.S. NHANES and Beijing females were, respectively 45.73 and 8.22%. The number of male sex partners, marital status, and history of HPV infection were the predominant factors that influenced HPV infection in both NHANES and Beijing female cohorts. However, condom application was not an independent influencing factor for HPV infection in both cohorts. R package Modelbest was established. The nomogram developed based on Modelbest package showed better performance than the nomogram which only included significant factors in multivariate regression analysis. Conclusion Collectively, despite the widespread availability of HPV vaccines, HPV infection is still prevalent. Compared with condom promotion, avoidance of multiple sexual partners seems to be more effective for preventing HPV infection. Nomograms developed based on Modelbest can provide improved personalized risk assessment for HPV infection. Our R package Modelbest has potential to be a powerful tool for future predictive model studies.
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Affiliation(s)
- Huixia Yang
- Labor Model Health Management Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Yujin Xie
- Labor Model Health Management Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Rui Guan
- Labor Model Health Management Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Yanlan Zhao
- Labor Model Health Management Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Weihua Lv
- Labor Model Health Management Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Ying Liu
- Labor Model Health Management Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Feng Zhu
- Labor Model Health Management Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Huijuan Liu
- Labor Model Health Management Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Xinxiang Guo
- Labor Model Health Management Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Zhen Tang
- Labor Model Health Management Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Haijing Li
- Labor Model Health Management Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Yu Zhong
- Labor Model Health Management Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China,Yu Zhong
| | - Bin Zhang
- Respiratory Rehabilitation Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China,Bin Zhang
| | - Hong Yu
- Labor Model Health Management Center, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China,*Correspondence: Hong Yu
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10
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Piña-Sánchez P. Human Papillomavirus: Challenges and Opportunities for the Control of Cervical Cancer. Arch Med Res 2022; 53:753-769. [PMID: 36462952 DOI: 10.1016/j.arcmed.2022.11.009] [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: 11/07/2022] [Accepted: 11/18/2022] [Indexed: 12/05/2022]
Abstract
Viruses are the most abundant and genetically diverse entities on the planet, infect all life forms and have evolved with their hosts. To date, 263 viral species have been identified that infect humans, of which only seven are considered type I oncogenic. Human papillomavirus (HPV) is the main virus associated with cancer and is responsible for practically all cases of cervical carcinoma. Screening tests for early detection have been available since the 1960s. Undoubtedly, the entailment between knowledge of HPV biology and the natural history of cervical cancer has contributed to the significant advances that have been made for its prevention since the 21st century, with the development of prophylactic vaccines and improved screening strategies. Therefore, it is possible to eradicate invasive cervical cancer as a worldwide public health problem, as proposed by the WHO with the 90-70-90 initiative based on vaccination coverage, screening, and treatment, respectively. In addition, the emerging knowledge of viral biology generates opportunities that will contribute to strengthening prevention and treatment strategies in HPV-associated neoplasms.
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Affiliation(s)
- Patricia Piña-Sánchez
- Laboratorio Molecular de Oncología, Unidad de Investigación Oncológica, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México, México.
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11
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Human Virome in Cervix Controlled by the Domination of Human Papillomavirus. Viruses 2022; 14:v14092066. [PMID: 36146871 PMCID: PMC9503738 DOI: 10.3390/v14092066] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 09/12/2022] [Accepted: 09/13/2022] [Indexed: 12/24/2022] Open
Abstract
Although other co-viral infections could also be considered influencing factors, cervical human papillomavirus (HPV) infection is the main cause of cervical cancer. Metagenomics have been employed in the NGS era to study the microbial community in each habitat. Thus, in this investigation, virome capture sequencing was used to examine the virome composition in the HPV-infected cervix. Based on the amount of HPV present in each sample, the results revealed that the cervical virome of HPV-infected individuals could be split into two categories: HPV-dominated (HD; ≥60%) and non-HPV-dominated (NHD; <60%). Cervical samples contained traces of several human viral species, including the molluscum contagiosum virus (MCV), human herpesvirus 4 (HHV4), torque teno virus (TTV), and influenza A virus. When compared to the HD group, the NHD group had a higher abundance of several viruses. Human viral diversity appears to be influenced by HPV dominance. This is the first proof that the diversity of human viruses in the cervix is impacted by HPV abundance. However, more research is required to determine whether human viral variety and the emergence of cancer are related.
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12
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Sundqvist A, Moberg L, Dickman PW, Högberg T, Borgfeldt C. Time Trends for Incidence and Net Survival of Cervical Cancer in Sweden 1960-2014-A Nationwide Population-Based Study. Cancer Epidemiol Biomarkers Prev 2022; 31:1572-1581. [PMID: 35654420 PMCID: PMC9344906 DOI: 10.1158/1055-9965.epi-21-1323] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 03/24/2022] [Accepted: 05/23/2022] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND The aim was to investigate time trends for incidence and long-term net survival in the morphologic subtypes and stages of cervical cancer in Sweden during the period 1960 to 2014. METHODS Women with invasive cervical cancer were identified through the Swedish Cancer Registry. Incidence and net survival were calculated according to morphology, age at diagnosis, and FIGO stage at diagnosis. RESULTS In total, 29,579 cases of invasive cervical cancer between 1960 and 2014 were included. The age-standardized incidence for squamous cell carcinoma (SCC) decreased until 2000; thereafter, the incidence rate stagnated, and a small increase was found in 2014. The incidence of adenocarcinoma continuously increased. The age-standardized 5-year net survival increased. However, decreasing net survival with increasing age was found. A higher stage at diagnosis showed a worse net survival. SCC and adenocarcinoma did not statistically differ as regards net survival in the last years of the study. CONCLUSIONS Age-standardized 5-year net survival improved between 1960 and 2014. A positive trend for short- and long-term net survival was seen for women ages 18 to 64 years but long-term net survival for women ≥75 years decreased. In this study, age and FIGO stage at diagnosis were found to be important prognostic factors in determining net survival. The morphologies, SCC, and adenocarcinoma did not statistically differ as regards net survival in the last years of the study. IMPACT This study demonstrates longitudinal data on cervical cancer in Sweden for over 50 years with sub analyses on morphology, age, and stage at diagnosis.
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Affiliation(s)
- Avalon Sundqvist
- Department of Obstetrics and Gynecology, Skåne University Hospital Lund, Lund University, Sweden.,Corresponding Author: Avalon Sundqvist, Skåne University Hospital, SE-221 85 Lund, Sweden. Phone: 464-617-3751; E-mail:
| | - Louise Moberg
- Department of Obstetrics and Gynecology, Skåne University Hospital Lund, Lund University, Sweden
| | - Paul W. Dickman
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | - Thomas Högberg
- Division of Oncology, Department of Clinical Sciences Lund, Lund University, Sweden
| | - Christer Borgfeldt
- Department of Obstetrics and Gynecology, Skåne University Hospital Lund, Lund University, Sweden
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13
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Alimena S, Davis J, Fichorova RN, Feldman S. The vaginal microbiome: A complex milieu affecting risk of human papillomavirus persistence and cervical cancer. Curr Probl Cancer 2022; 46:100877. [PMID: 35709613 DOI: 10.1016/j.currproblcancer.2022.100877] [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: 03/04/2022] [Revised: 05/13/2022] [Accepted: 05/20/2022] [Indexed: 11/17/2022]
Abstract
The purpose of this review is to describe the existing literature regarding the relationship between the vaginal microbiome, human papillomavirus persistence, and cervical cancer risk, as well as to discuss factors that mediate these relationships. Data suggest that alterations in the vaginal microbiome affect the risk of human papillomavirus infection and persistence, which has downstream effects on cervical dysplasia and cancer risk. The homeostatic Lactobillus species L. crispatus, L. gasseri, L. jensenii act to promote a healthy vaginal environment, while L. iners and pathogens causing bacterial vaginosis are associated with increased inflammation, human papillomavirus infection, cervical dysplasia, and potentially cancer. There are, however, still several large gaps in the literature, particularly related to the modifiable and non-modifiable factors that affect the vaginal microbiome and ensuing risk of pre-cancerous and cancerous lesions. Evidence currently suggests that endogenous and exogenous hormones, tobacco products, and sexual practices influence vaginal microbiome composition, but the nuances of these relationships and how changes in these factors affect dysplasia risk are yet to be delineated. Other studies examining how diet, exercise, race, socioeconomic status, and genetic factors influence the vaginal microbiome are difficult to interpret in the setting of multiple confounders. Future studies should focus on how changes in these modulatory factors might promote a healthy vaginal microbiome to prevent or treat dysplasia in the lower female genital tract.
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Affiliation(s)
- Stephanie Alimena
- Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women's Hospital, Boston, MA; Harvard Medical School, Boston, MA.
| | | | - Raina N Fichorova
- Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women's Hospital, Boston, MA; Harvard Medical School, Boston, MA
| | - Sarah Feldman
- Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women's Hospital, Boston, MA; Harvard Medical School, Boston, MA
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14
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Pimple S, Mishra G. Cancer cervix: Epidemiology and disease burden. Cytojournal 2022; 19:21. [PMID: 35510109 PMCID: PMC9063649 DOI: 10.25259/cmas_03_02_2021] [Citation(s) in RCA: 39] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 11/12/2021] [Indexed: 01/10/2023] Open
Abstract
Cervical cancer remains a major public health problem, ranking as the fourth most common cause of cancer incidence and mortality in women worldwide. Wide variations in cervical cancer incidence and mortality were observed with highest incidence rates in Sub Saharan Africa and with 85% of deaths occurring in developing regions of the world. Non-existent or inadequate screening in public health care settings and limited access to the standard treatment options explains the large geographic variation in cervical cancer rates. Persistent infection with high-risk Human papillomavirus (HPV) types is the major risk factor for cervical cancer. High parity, long-term use of oral contraceptive pills, tobacco consumption, co-infection with other sexually transmitted agents, lifestyle factors such as multiple sexual partners, younger age at first sexual intercourse, immunosuppression, and diet have been identified as the co-factors most likely to influence the risk of acquisition of HPV infection and its further progress to cervical carcinogenesis. Differential screening rates and changes in epidemiological patterns have contributed to decreasing trends in cervical cancer in some developed regions of the world. Lower rates were also observed in North Africa and the Middle East, which may be attributed to cultural norms and conservative sexual behaviors. Across world regions, HPV prevalence was highest in women younger than 35 years of age, declining to a plateau in middle age and showed significant association between national age standardized incidence rates and corresponding estimates of HPV prevalence. The five most common HPV types in HPV-positive women worldwide were HPV16, HPV18, HPV31, HPV58, and HPV52, representing 50% of all HPV infections with HPV-16 and HPV-18 infections accounting for about 70% of the total infection burden. Tracking changing trends in the cervical cancer epidemiological patterns including HPV genotypes will immensely contribute toward effective prevention and control measures for cervical cancer elimination.
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Affiliation(s)
- Sharmila Pimple
- Department of Preventive Oncology, Centre for Cancer Epidemiology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Gauravi Mishra
- Department of Preventive Oncology, Centre for Cancer Epidemiology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India
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15
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Burassakarn A, Phusingha P, Yugawa T, Noguchi K, Ekalaksananan T, Vatanasapt P, Kiyono T, Pientong C. Human Papillomavirus 16 E6 Suppresses Transporter Associated with Antigen-Processing Complex in Human Tongue Keratinocyte Cells by Activating Lymphotoxin Pathway. Cancers (Basel) 2022; 14:cancers14081944. [PMID: 35454851 PMCID: PMC9028769 DOI: 10.3390/cancers14081944] [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: 03/14/2022] [Revised: 04/10/2022] [Accepted: 04/10/2022] [Indexed: 11/16/2022] Open
Abstract
Simple Summary There is still limited knowledge of the critical pathogenic processes by which HPV16 induces oral carcinogenesis. Therefore, we aimed to illuminate the oncogenic role of HPV16 in the context of oral squamous cell carcinomas (OSCCs). Using human tongue keratinocyte cells, we demonstrated that HPV16 E6 promotes LTα1β2 and LTβR expression, thus promoting the lymphotoxin signaling pathway and leading to suppression of the transporter associated with the antigen-processing complex (TAPs; TAP1 and TAP2). Additionally, in vitro, we also demonstrated regulation of the antigenic peptide-loaded machinery in HPV-infected OSCC tissues through analysis of the transcriptomic profiles of the head and neck squamous cell carcinoma (HNSCC) cohort from the TCGA database, which was validated using fresh biopsied specimens. Thus, our study enhances the proposed functional role of HPV16 E6-associated immune-evasive properties in oral epithelial cells, revealing a possible mechanism underlying the development of HPV-mediated OSCCs. Abstract Infection by high-risk human papillomaviruses (hrHPVs), including HPV type 16 (HPV16), is a major risk factor for oral squamous cell carcinomas (OSCCs). However, the pathogenic mechanism by which hrHPVs promote oral carcinogenesis remains to be elucidated. Here, we demonstrated that the suppression of a transporter associated with the antigen-processing complex (TAPs; TAP1 and TAP2), which is a key molecule in the transportation of viral antigenic peptides into MHC class-I cells, is affected by the E6 protein of HPV16. Mechanistically, HPV-mediated immune evasion is principally mediated via the signal-transduction network of a lymphotoxin (LT) pathway, in particular LTα1β2 and LTβR. Our analysis of transcriptomic data from an HNSCC cohort from the Cancer Genome Atlas (TCGA) indicated that expression of TAP genes, particularly TAP2, was downregulated in HPV-infected cases. We further demonstrated that LTα1β2 and LTβR were upregulated, which was negatively correlated with TAP1 and TAP2 expression in HPV-positive clinical OSCC samples. Taken together, our findings imply that HPV16 E6 regulates the machinery of the antigenic peptide-loading system and helps to clarify the role of oncogenic viruses in the context of oral carcinoma.
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Affiliation(s)
- Ati Burassakarn
- Department of Microbiology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand; (A.B.); (T.E.)
- HPV & EBV and Carcinogenesis Research Group, Department of Microbiology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand;
| | - Pensiri Phusingha
- Center of Excellence for Antibody Research (CEAR), Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand;
| | - Takashi Yugawa
- Division of Carcinogenesis and Cancer Prevention, National Cancer Center Research Institute, Tokyo 104-0045, Japan;
| | - Kazuma Noguchi
- Department of Oral and Maxillofacial Surgery, Hyogo Medical University, Mukogawa-Cho 1-1, Nishinomiya 663-8501, Japan;
| | - Tipaya Ekalaksananan
- Department of Microbiology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand; (A.B.); (T.E.)
- HPV & EBV and Carcinogenesis Research Group, Department of Microbiology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand;
| | - Patravoot Vatanasapt
- HPV & EBV and Carcinogenesis Research Group, Department of Microbiology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand;
- Department of Otorhinolaryngology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Tohru Kiyono
- Project for Prevention of HPV-Related Cancer, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center, 6-5-1 Kashiwanoha, Kashiwa 277-8577, Japan
- Correspondence: (T.K.); (C.P.); Tel./Fax: +66-4334-8385 (C.P.)
| | - Chamsai Pientong
- Department of Microbiology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand; (A.B.); (T.E.)
- HPV & EBV and Carcinogenesis Research Group, Department of Microbiology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand;
- Correspondence: (T.K.); (C.P.); Tel./Fax: +66-4334-8385 (C.P.)
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16
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Safi S, Badshah Y, Shabbir M, Zahra K, Khan K, Dilshad E, Afsar T, Almajwal A, Alruwaili NW, Al-disi D, Abulmeaty M, Razak S. Predicting 3D Structure, Cross Talks, and Prognostic Significance of KLF9 in Cervical Cancer. Front Oncol 2022; 11:797007. [PMID: 35047407 PMCID: PMC8761731 DOI: 10.3389/fonc.2021.797007] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 11/30/2021] [Indexed: 12/14/2022] Open
Abstract
Our study aimed to identify the new blood-based biomarkers for the diagnosis and prognosis of cervical cancer. Moreover, the three-dimensional (3D) structure of Kruppel-like factor 9 (KLF9) was also determined in order to better understand its function, and a signaling pathway was constructed to identity its upstream and downstream targets. In the current study, the co-expressions of tumor protein D52 (TPD52), KLF9, microRNA 223 (miR-223), and protein kinase C epsilon (PKCϵ) were evaluated in cervical cancer patients and a possible relation with disease outcome was revealed. The expressions of TPD52, KLF9, miR-223, and PKCϵ were studied in the blood of 100 cervical cancer patients and 100 healthy controls using real-time PCR. The 3D structure of KLF9 was determined through homology modeling via the SWISS-MODEL and assessed using the Ramachandran plot. The predicted 3D structure of KLF9 had a similarity index of 62% with its template (KLF4) with no bad bonds in it. In order to construct a genetic pathway, depicting the crosstalk between understudied genes, STRING analysis, Kyoto Encyclopedia of Genes and Genomes (KEGG), and DAVID software were used. The constructed genetic pathway showed that all the understudied genes are linked to each other and involved in the PI3K/Akt signaling pathway. There was a 23-fold increase in TPD52 expression, a 2-fold increase in miR-223 expression, a 0.14-fold decrease in KLF9 expression, and a 0.05-fold decrease of PKCϵ expression in cervical cancer. In the present study, we observed an association of the expressions of TPD52, KLF9, miR-223, and PKCϵ with tumor stage, metastasis, and treatment status of cervical cancer patients. Elevated expressions of TPD52 and miR-223 and reduced expressions of KLF9 and PKCϵ in peripheral blood of cervical cancer patients may serve as predictors of disease diagnosis and prognosis. Nevertheless, further in vitro and tissue-level studies are required to strengthen their role as potential diagnostic and prognostic biomarkers.
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Affiliation(s)
- Sadia Safi
- Department of Healthcare Biotechnology, Atta-ur-Rahman School of Applied Biosciences, National University of Sciences and Technology, Islamabad, Pakistan
| | - Yasmin Badshah
- Department of Healthcare Biotechnology, Atta-ur-Rahman School of Applied Biosciences, National University of Sciences and Technology, Islamabad, Pakistan
| | - Maria Shabbir
- Department of Healthcare Biotechnology, Atta-ur-Rahman School of Applied Biosciences, National University of Sciences and Technology, Islamabad, Pakistan
| | - Kainat Zahra
- Department of Healthcare Biotechnology, Atta-ur-Rahman School of Applied Biosciences, National University of Sciences and Technology, Islamabad, Pakistan
| | - Khushbukhat Khan
- Department of Healthcare Biotechnology, Atta-ur-Rahman School of Applied Biosciences, National University of Sciences and Technology, Islamabad, Pakistan
| | - Erum Dilshad
- Department of Bioinformatics and Biosciences, Faculty of Health and Life Sciences, Capital University of Science and Technology (CUST), Islamabad, Pakistan
| | - Tayyaba Afsar
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Ali Almajwal
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Nawaf W. Alruwaili
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Dara Al-disi
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Mahmoud Abulmeaty
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Suhail Razak
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
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17
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Tekalegn Y, Sahiledengle B, Woldeyohannes D, Atlaw D, Degno S, Desta F, Bekele K, Aseffa T, Gezahegn H, Kene C. High parity is associated with increased risk of cervical cancer: Systematic review and meta-analysis of case-control studies. WOMEN'S HEALTH (LONDON, ENGLAND) 2022; 18:17455065221075904. [PMID: 35114865 PMCID: PMC8819811 DOI: 10.1177/17455065221075904] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background: Cervical cancer is the fourth most common cancer among women. High parity has
long been suspected with an increased risk of cervical cancer. Evidence from
the existing epidemiological studies regarding the association between
parity and cervical cancer is variable and inconsistent. Therefore, the
objective of this systematic review and meta-analysis was to synthesize the
best available evidence on the epidemiological association between parity
and cervical cancer. Methods: Case–control studies reporting the association between parity and cervical
cancer were systematically searched in databases like MEDLINE/PubMed,
HINARI, Google scholar, Science direct, and Cochrane Libraries. All studies
fulfilling the inclusion criteria and published between 2000 and 7 March
2020 were included in this meta-analysis. This study reported according to
PRISMA guideline. Cochran’s Q-statistics and
I2 tests were performed to assess
heterogeneity among included studies. Egger’s regression analysis was
performed to assess publication bias. A random-effect meta-analysis model
was used to compute pooled odds ratio of the association between parity and
cervical cancer. Results: A total of 6685 participants (3227 patients and 3458 controls) were
incorporated in the 12 studies included in this meta-analysis. The
meta-analysis revealed that women with high parity had 2.65 times higher
odds of developing cervical cancer compared to their counterparts (odds
ratio = 2.65, 95% confidence interval = 2.08–3.38). Conclusion: High parity is positively associated with cervical cancer. Strong
epidemiological studies are recommended to further explore the mechanisms
and role of parity in the causation of cervical cancer.
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Affiliation(s)
- Yohannes Tekalegn
- Department of Public Health, School of Health Sciences, Goba Referral Hospital, Madda Walabu University, Goba, Ethiopia
| | - Biniyam Sahiledengle
- Department of Public Health, School of Health Sciences, Goba Referral Hospital, Madda Walabu University, Goba, Ethiopia
| | - Demelash Woldeyohannes
- Department of Public Health, College of Medicine and Health Sciences, Wachemo University, Hosaena, Ethiopia
| | - Daniel Atlaw
- Department of Human Anatomy, School of Medicine, Goba Referral Hospital, Madda Walabu University, Goba, Ethiopia
| | - Sisay Degno
- Department of Human Anatomy, School of Medicine, Goba Referral Hospital, Madda Walabu University, Goba, Ethiopia
| | - Fikreab Desta
- Department of Public Health, School of Health Sciences, Goba Referral Hospital, Madda Walabu University, Goba, Ethiopia
| | - Kebebe Bekele
- Department of Surgery, School of Medicine, Goba Referral Hospital, Madda Walabu University, Goba, Ethiopia
| | - Tesfaye Aseffa
- Department of Nursing, School of Health Sciences, Goba Referral Hospital, Madda Walabu University, Goba, Ethiopia
| | - Habtamu Gezahegn
- Department of Human Physiology, School of Medicine, Goba Referral Hospital, Madda Walabu University, Goba, Ethiopia
| | - Chala Kene
- Department of Midwifery, School of Health Sciences, Goba Referral Hospital, Madda Walabu University, Goba, Ethiopia
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18
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Singini MG, Sitas F, Bradshaw D, Chen WC, Motlhale M, Kamiza AB, de Villiers CB, Lewis CM, Mathew CG, Waterboer T, Newton R, Muchengeti M, Singh E. Ranking lifestyle risk factors for cervical cancer among Black women: A case-control study from Johannesburg, South Africa. PLoS One 2021; 16:e0260319. [PMID: 34879064 PMCID: PMC8654217 DOI: 10.1371/journal.pone.0260319] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 11/07/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Aside from human papillomavirus (HPV), the role of other risk factors in cervical cancer such as age, education, parity, sexual partners, smoking and human immunodeficiency virus (HIV) have been described but never ranked in order of priority. We evaluated the contribution of several known lifestyle co-risk factors for cervical cancer among black South African women. METHODS We used participant data from the Johannesburg Cancer Study, a case-control study of women recruited mainly at Charlotte Maxeke Johannesburg Academic Hospital between 1995 and 2016. A total of 3,450 women in the study had invasive cervical cancers, 95% of which were squamous cell carcinoma. Controls were 5,709 women with cancers unrelated to exposures of interest. Unconditional logistic regression models were used to calculate adjusted odds ratios (ORadj) and 95% confidence intervals (CI). We ranked these risk factors by their population attributable fractions (PAF), which take the local prevalence of exposure among the cases and risk into account. RESULTS Cervical cancer in decreasing order of priority was associated with (1) being HIV positive (ORadj = 2.83, 95% CI = 2.53-3.14, PAF = 17.6%), (2) lower educational attainment (ORadj = 1.60, 95% CI = 1.44-1.77, PAF = 16.2%), (3) higher parity (3+ children vs 2-1 children (ORadj = 1.25, 95% CI = 1.07-1.46, PAF = 12.6%), (4) hormonal contraceptive use (ORadj = 1.48, 95% CI = 1.24-1.77, PAF = 8.9%), (5) heavy alcohol consumption (ORadj = 1.44, 95% CI = 1.15-1.81, PAF = 5.6%), (6) current smoking (ORadj = 1.64, 95% CI = 1.41-1.91, PAF = 5.1%), and (7) rural residence (ORadj = 1.60, 95% CI = 1.44-1.77, PAF = 4.4%). CONCLUNSION This rank order of risks could be used to target educational messaging and appropriate interventions for cervical cancer prevention in South African women.
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Affiliation(s)
- Mwiza Gideon Singini
- National Cancer Registry, National Health Laboratory Service, Johannesburg, South Africa
- Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
| | - Freddy Sitas
- Burden of Disease Research Unit, South African Medical Research Council, Cape Town, South Africa
- Centre for Primary Health Care and Equity, School of Public Health and Community Medicine, University of New South Wales Sydney, Australia
- Menzies Centre of Health Policy, School of Public Health, University of Sydney, Australia
| | - Debbie Bradshaw
- Burden of Disease Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Wenlong Carl Chen
- National Cancer Registry, National Health Laboratory Service, Johannesburg, South Africa
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Melitah Motlhale
- National Cancer Registry, National Health Laboratory Service, Johannesburg, South Africa
- Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
| | - Abram Bunya Kamiza
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Chantal Babb de Villiers
- Division of Human Genetics, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Cathryn M. Lewis
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
- Department of Medical and Molecular Genetics, Faculty of Life Sciences and Medicine, King’s College, London, United Kingdom
| | - Christopher G. Mathew
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Department of Medical and Molecular Genetics, Faculty of Life Sciences and Medicine, King’s College, London, United Kingdom
| | - Tim Waterboer
- Division of Infections and Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Robert Newton
- MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda
- University of York, York, United Kingdom
| | - Mazvita Muchengeti
- National Cancer Registry, National Health Laboratory Service, Johannesburg, South Africa
- Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
- South African DSI-NRF Centre of Excellence in Epidemiological Modelling and Analysis (SACEMA), Stellenbosch University, Stellenbosch, South Africa
| | - Elvira Singh
- National Cancer Registry, National Health Laboratory Service, Johannesburg, South Africa
- Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
- * E-mail:
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19
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Prevalence and Distribution of HPV Genotypes in Immunosuppressed Patients in Lorraine Region. Viruses 2021; 13:v13122454. [PMID: 34960723 PMCID: PMC8707108 DOI: 10.3390/v13122454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 11/11/2021] [Accepted: 12/02/2021] [Indexed: 11/23/2022] Open
Abstract
Background: The primary objective of this work was to assess the prevalence and distribution of HPV genotypes in immunosuppressed patients, and to compare them with the French Monsonego cohort. Secondary objectives were to evaluate whether the risk of HPV infection was correlated with HIV viral load, CD4 cell count in HIV-infected patients and the type, number of immunosuppressive therapies or type of pathology (transplant vs. autoimmune diseases) in patients undergoing long-term immunosuppressive therapy. Methods: An observational, monocentric and historical study was conducted including all immunosuppressed patients having received an HPV testing, in the Laboratory of Virology, Nancy Regional Teaching Hospital Center, between 2014 and 2020. Immunosuppressed patients were either HIV-infected or received long-term immunosuppressive therapy. Results: In our cohort, the prevalence of HPV infection (75.6% vs. 16.1% p < 0.05), the proportion of patients with high-risk HPV infection (48.9% vs. 15.1% p < 0.05) and with multiple HPV infection (41.1% vs. 5.7% p < 0.05) were significantly higher than in the Monsonego cohort. HPV 52 (13%), 53 (13%) and 16 (10%) were the most common in the immunosuppressed population, while it was HPV 16, 42 and 51 in the Monsonego cohort. Conclusions: This study supports that a particular attention must be given to all the immunosuppressed patients for the screening and care of HPV-related diseases because of major modifications of HPV epidemiology compared with the overall population.
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20
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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: 11] [Impact Index Per Article: 3.7] [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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21
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Gil da Costa RM, Neto T, Estêvão D, Moutinho M, Félix A, Medeiros R, Lopes C, Bastos MMSM, Oliveira PA. Ptaquiloside from bracken (Pteridium spp.) promotes oral carcinogenesis initiated by HPV16 in transgenic mice. Food Funct 2021; 11:3298-3305. [PMID: 32222741 DOI: 10.1039/d0fo00207k] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Bracken (Pteridium spp.) is a common weed that is consumed as food especially in Asia, and is suspected of promoting carcinogenesis induced by papillomaviruses in the digestive and urinary systems. This is particularly worrying because the incidence of head-and-neck cancers associated with the human papillomavirus (HPV) is rapidly increasing, and HPV co-carcinogens urgently need to be identified. This study tested the hypothesis that two bracken compounds, ptaquiloside and rutin, are able to promote head-and-neck and bladder carcinogenesis in HPV16-transgenic mice. Expression of HPV16 E6 and E7 in oral and bladder tissues was confirmed using quantitative real-time PCR. Mice were exposed orally to ptaquiloside (0.5 mg per animal per week for 10 weeks from 20 weeks-old) or rutin (413 mg kg-1 day-1 for 24 weeks from 6 weeks-old), sacrificed at 30 weeks-old and studied histologically. HPV16 E6 and E7 expression was higher in oral mucosa compared with the bladder (p 0.001). Importantly, ptaquiloside, but not rutin, increased the incidence of oral squamous cell carcinomas (p = 1.2 × 10-8) in HPV16-transgenic mice. Also, cancers of unexposed transgenic mice were restricted to the tongue base, while ptaquiloside-exposed mice showed multifocal lesions throughout the oral cavity. Wild-type controls showed no oral lesions. No bladder lesions were observed in any treated or untreated group. These results indicate that ptaquiloside from bracken is able to promote oral carcinogenesis initiated by HPV16. Rutin did not show any carcinogenic effects in this model. The absence of bladder lesions may reflect an insufficient incubation period or factors related to the specific viral oncogenes present in this model.
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Affiliation(s)
- Rui M Gil da Costa
- LEPABE, Faculdade de Engenharia, Universidade do Porto, Porto, Portugal. and Grupo de Oncologia Molecular e Patologia Viral, CI-IPOP, Instituto Português de Oncologia do Porto, Porto, Portugal and Centro de Investigação e Tecnologia de Ciências Agroambientais e Biológicas (CITAB), Universidade de Trás-os-Montes e Alto Douro, UTAD, Vila Real, Portugal
| | - Tiago Neto
- Grupo de Oncologia Molecular e Patologia Viral, CI-IPOP, Instituto Português de Oncologia do Porto, Porto, Portugal and ICBAS, Universidade do Porto, Porto, Portugal
| | - Diogo Estêvão
- Grupo de Oncologia Molecular e Patologia Viral, CI-IPOP, Instituto Português de Oncologia do Porto, Porto, Portugal and Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - Magda Moutinho
- Centro de Investigação e Tecnologia de Ciências Agroambientais e Biológicas (CITAB), Universidade de Trás-os-Montes e Alto Douro, UTAD, Vila Real, Portugal
| | - Ana Félix
- Nova Medical School, Universidade Nova de Lisboa, Lisboa, Portugal and Serviço de Anatomia Patológica, Instituto Português de Oncologia de Lisboa, Lisboa, Portugal
| | - Rui Medeiros
- Grupo de Oncologia Molecular e Patologia Viral, CI-IPOP, Instituto Português de Oncologia do Porto, Porto, Portugal and Faculdade de Medicina, Universidade do Porto, Porto, Portugal and Serviço de Virologia, Instituto Português de Oncologia do Porto, Porto, Portugal and Liga Portuguesa Contra o Cancro-Núcleo Regional do Norte, Porto, Portugal and CEBIMED, Faculdade de Ciências da Saúde, Universidade Fernando Pessoa, Porto, Portugal
| | | | | | - Paula A Oliveira
- Centro de Investigação e Tecnologia de Ciências Agroambientais e Biológicas (CITAB), Universidade de Trás-os-Montes e Alto Douro, UTAD, Vila Real, Portugal and Departamento de Ciências Veterinárias, Universidade de Trás-os-Montes e Alto Douro, UTAD, Vila Real, Portugal
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22
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Berggrund M, Gustavsson I, Aarnio R, Lindberg JH, Sanner K, Wikström I, Enroth S, Bunikis I, Olovsson M, Gyllensten U. Temporal changes in the vaginal microbiota in self-samples and its association with persistent HPV16 infection and CIN2. Virol J 2020; 17:147. [PMID: 33028395 PMCID: PMC7541248 DOI: 10.1186/s12985-020-01420-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Accepted: 09/28/2020] [Indexed: 12/12/2022] Open
Abstract
Background The vaginal microbiota has been reported to be associated with HPV infection and cervical cancer. This study was performed to compare the vaginal microbiota at two timepoints in women performing self-sampling and had a persistent or transient HPV16 infection. The women were tested for 12 high-risk HPV (hrHPV) types but only women with single type (HPV16) were included to reduce confounding variables. Methods In total 96 women were included in this study. Of these, 26 were single positive for HPV16 in the baseline test and HPV negative in the follow-up test and 38 were single positive for HPV16 in both tests and diagnosed with CIN2+ in histology. In addition, 32 women that were negative for all 12 HPV tested were included. The samples of vaginal fluid were analyzed with the Ion 16S™ Metagenomics Kit and Ion 16S™ metagenomics module within the Ion Reporter™ software. Results K-means clustering resulted in two Lactobacillus-dominated groups, one with Lactobacillus sp. and the other specifically with Lactobacillus iners. The two remaining clusters were dominated by a mixed non-Lactobacillus microbiota. HPV negative women had lower prevalence (28%) of the non-Lactobacill dominant cluster in the baseline test, as compared to women with HPV16 infection (42%) (p value = 0.0173). Transition between clusters were more frequent in women with persistent HPV16 infection (34%) as compared in women who cleared the HPV16 infection (19%) (p value = 0.036). Conclusions The vaginal microbiota showed a higher rate of transitioning between bacterial profiles in women with persistent HPV16 infection as compared to women with transient infection. This indicate an instability in the microenvironment in women with persistent HPV infection and development of CIN2+.
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Affiliation(s)
- Malin Berggrund
- Department of Immunology, Genetics, and Pathology, Biomedical Center, Science for Life Laboratory (SciLifeLab) Uppsala, Uppsala University, Box 815, 75108, Uppsala, Sweden
| | - Inger Gustavsson
- Department of Immunology, Genetics, and Pathology, Biomedical Center, Science for Life Laboratory (SciLifeLab) Uppsala, Uppsala University, Box 815, 75108, Uppsala, Sweden
| | - Riina Aarnio
- Department of Women's and Children's Health, Uppsala University, 75185, Uppsala, Sweden
| | - Julia Hedlund Lindberg
- Department of Immunology, Genetics, and Pathology, Biomedical Center, Science for Life Laboratory (SciLifeLab) Uppsala, Uppsala University, Box 815, 75108, Uppsala, Sweden
| | - Karin Sanner
- Department of Women's and Children's Health, Uppsala University, 75185, Uppsala, Sweden
| | - Ingrid Wikström
- Department of Women's and Children's Health, Uppsala University, 75185, Uppsala, Sweden
| | - Stefan Enroth
- Department of Immunology, Genetics, and Pathology, Biomedical Center, Science for Life Laboratory (SciLifeLab) Uppsala, Uppsala University, Box 815, 75108, Uppsala, Sweden
| | - Ignas Bunikis
- Uppsala Genome Center, Science for Life Laboratory, Department of Immunology, Genetics, and Pathology, Uppsala University, BMC, Box 815, 752 37, Uppsala, Sweden
| | - Matts Olovsson
- Department of Women's and Children's Health, Uppsala University, 75185, Uppsala, Sweden
| | - Ulf Gyllensten
- Department of Immunology, Genetics, and Pathology, Biomedical Center, Science for Life Laboratory (SciLifeLab) Uppsala, Uppsala University, Box 815, 75108, Uppsala, Sweden.
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23
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Changes of vaginal microbiota during cervical carcinogenesis in women with human papillomavirus infection. PLoS One 2020; 15:e0238705. [PMID: 32941440 PMCID: PMC7498004 DOI: 10.1371/journal.pone.0238705] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 08/21/2020] [Indexed: 12/12/2022] Open
Abstract
Objective To evaluate the changes of vaginal microbiota during cervical carcinogenesis in women with high-risk human papillomavirus infection. Materials and methods Vaginal microbiota was analyzed using next-generation sequencing in women with normal, cervical intraepithelial neoplasia (CIN), or cervical cancer. Results A marked decrease of Lactobacillus crispatus was found in the CIN/cancer groups compared with that in the normal group. The diversity of microorganisms increased in patients with CIN or cervical cancer with HPV infection. Atopobium vaginae (OR 4.33, 95% CI 1.15–16.32), Dialister invisus (OR 4.89, 95% CI 1.20–19.94), Finegoldia magna (OR 6.00, 95% CI 1.08–33.27), Gardnerella vaginalis (OR 7.43, 95% CI 1.78–31.04), Prevotella buccalis (OR 11.00, 95% CI 2.00–60.57), and Prevotella timonensis (OR 6.00, 95% CI 1.46–24.69) were significantly associated with the risk of CIN 2/3 or cervical cancer. Conclusion Women with the CIN and cervical cancer showed a high diversity in vaginal microbiota. Depletion of Lactobacillus crispatus and increased abundance of anaerobic bacteria were detected in women with cervical disease.
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24
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Determinants of Acquisition and Clearance of Human Papillomavirus Infection in Previously Unexposed Young Women. Sex Transm Dis 2020; 46:663-669. [PMID: 31464859 PMCID: PMC6887628 DOI: 10.1097/olq.0000000000001053] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Global variation in human papillomavirus (HPV) prevalence and persistence may be explained by differences in risk factors, such as sexual activity, oral contraceptive use, and behavioral factors. We evaluated determinants of acquisition and clearance of HPV infection among young women previously unexposed to HPV. METHODS Five hundred thirty-four women aged 15 to 25 years who were cytology and HPV DNA negative, and seronegative for anti-HPV-16/18 antibodies, were recruited (July 2000-September 2001) from study centers in Brazil, the United States, and Canada (NCT00689741/NCT00120848). They were followed up for 76 months. Cervical samples were HPV genotyped via polymerase chain reaction. We used multivariable (forward stepwise, P = 0.15) Cox proportional hazards regression to estimate rate ratios (RR) and 95% confidence intervals (CI), separately according to length of follow-up time. RESULTS On short-term follow-up (0-27 months), 257 (48%; 8535.80 person-months; incidence rate = 30.11; 95% CI, 26.64-34.02) incident HPV infections were detected. Marital status, lifetime number of sex partners, history of any sexually transmitted disease, and occasional use of oral contraceptives were strongly associated with acquisition of any HPV. Having 2 or more lifetime sex partners (RR, 2.03; 95% CI, 1.37-3.02) and a history of any sexually transmitted disease (RR, 1.98; 95% CI, 1.19-3.29) were the most important determinants of high-risk HPV (hrHPV) incidence. During the entire follow-up (0-76 months), an increased hrHPV clearance was found among women in North America (RR, 1.38; 95% CI, 1.08-1.78) and black women (RR, 1.64; 95% CI, 1.04-2.60). Greater number of lifetime partners was associated with reduced clearance rates for any HPV (RR, 0.65; 95% CI, 0.43-0.98). CONCLUSIONS We identified variation in risk of HPV acquisition and clearance among women unexposed to HPV at baseline.
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25
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de Moura EL, Dos Santos ACM, da Silva DM, Dos Santos BB, Figueredo DDS, Moura AWA, da Silva AF, Tanabe ISB, de Lira Tanabe EL, Lira Neto AB, Pereira E Silva AC, de Carvalho Fraga CA, de Lima Filho JL, de Farias KF, Martins de Souza EV. Association of Polymorphisms in Cytokine genes with susceptibility to Precancerous Lesions and Cervical Cancer: A systematic review with meta-analysis. Immunol Invest 2020; 50:492-526. [PMID: 32602796 DOI: 10.1080/08820139.2020.1778023] [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] [Indexed: 01/04/2023]
Abstract
Objectives: This study investigated the relationship between single-nucleotide polymorphisms (SNPs) in cytokine genes and the susceptibility to Squamous Intraepithelial Lesions (SIL), cervical cancer and HPV infection through a systematic review with meta-analysis. To verify the effect of SNPs, we also analyzed the transcription factor binding affinity using bioinformatics tools.Methods: Seven electronic databases (MEDLINE, Scielo, BIREME, PubMed, Scopus, Web of Science and Science Direct) were searched for case-control studies.Results: A total of 35 relevant case-control studies were meta-analyzed, including 7 cytokine genes and 15 SNPs. SNPs in IL-17A (rs2275913, rs3748067); IL-17 F (rs763780); IL-12A (rs568408); IL-12B (rs3212227); TNFA (rs1800629, rs361525); IL-1B (rs16944); IL-6 (rs1800795); IL-10 (rs1800896) genes were associated with increased risk for cervical cancer. No association was observed between meta-analyzed polymorphisms and SIL. Additional bioinformatics analysis suggested a possible transcriptional regulation pathway of the TNFA and IL-10 genes through the MZF1 (TNFA -308 G > A and IL-10 - 1082A>G) and ZNF263 (TNFA -238 G > A) transcription factors binding.Conclusion: Overall, 10 SNPs in cytokine genes were associated with increased risk for cervical cancer. Therefore, in our meta-analysis, these SNPs demonstrated to be potential biomarkers for predicting or identifying cases of high risk for SIL and cervical cancer.
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Affiliation(s)
- Edilson Leite de Moura
- Laboratory of Molecular Biology and Gene Expression (LABMEG), Federal University of Alagoas (UFAL), Arapiraca, Alagoas, Brazil.,Post-graduation Program in Health Science, Institute of Biological Sciences and Health (ICBS), Federal University of Alagoas (UFAL), Maceió, Alagoas, Brazil
| | - Ana Caroline Melo Dos Santos
- Laboratory of Molecular Biology and Gene Expression (LABMEG), Federal University of Alagoas (UFAL), Arapiraca, Alagoas, Brazil.,Post-graduation Program in Health Science, Institute of Biological Sciences and Health (ICBS), Federal University of Alagoas (UFAL), Maceió, Alagoas, Brazil
| | - Denise Macedo da Silva
- Laboratory of Molecular Biology and Gene Expression (LABMEG), Federal University of Alagoas (UFAL), Arapiraca, Alagoas, Brazil.,Post-graduation Program in Health Science, Institute of Biological Sciences and Health (ICBS), Federal University of Alagoas (UFAL), Maceió, Alagoas, Brazil
| | - Bruna Brandão Dos Santos
- Laboratory of Molecular Biology and Gene Expression (LABMEG), Federal University of Alagoas (UFAL), Arapiraca, Alagoas, Brazil.,Post-graduation Program in Health Science, Institute of Biological Sciences and Health (ICBS), Federal University of Alagoas (UFAL), Maceió, Alagoas, Brazil
| | | | - Alexandre Wendell Araújo Moura
- Laboratory of Molecular Biology and Gene Expression (LABMEG), Federal University of Alagoas (UFAL), Arapiraca, Alagoas, Brazil
| | - Adriely Ferreira da Silva
- Laboratory of Molecular Biology and Gene Expression (LABMEG), Federal University of Alagoas (UFAL), Arapiraca, Alagoas, Brazil
| | - Ithallo Sathio Bessoni Tanabe
- Laboratory of Molecular Biology and Gene Expression (LABMEG), Federal University of Alagoas (UFAL), Arapiraca, Alagoas, Brazil.,Post-graduation Program in Health Science, Institute of Biological Sciences and Health (ICBS), Federal University of Alagoas (UFAL), Maceió, Alagoas, Brazil
| | - Eloiza Lopes de Lira Tanabe
- Laboratory of Molecular Biology and Gene Expression (LABMEG), Federal University of Alagoas (UFAL), Arapiraca, Alagoas, Brazil.,Post-graduation Program in Health Science, Institute of Biological Sciences and Health (ICBS), Federal University of Alagoas (UFAL), Maceió, Alagoas, Brazil
| | - Abel Barbosa Lira Neto
- Laboratory of Molecular Biology and Gene Expression (LABMEG), Federal University of Alagoas (UFAL), Arapiraca, Alagoas, Brazil.,Post-graduation Program in Health Science, Institute of Biological Sciences and Health (ICBS), Federal University of Alagoas (UFAL), Maceió, Alagoas, Brazil
| | - Aline Cristine Pereira E Silva
- Laboratory of Molecular Biology and Gene Expression (LABMEG), Federal University of Alagoas (UFAL), Arapiraca, Alagoas, Brazil
| | - Carlos Alberto de Carvalho Fraga
- Laboratory of Molecular Biology and Gene Expression (LABMEG), Federal University of Alagoas (UFAL), Arapiraca, Alagoas, Brazil.,Faculty of Medicine, Federal University of Alagoas (UFAL), Arapiraca, Alagoas, Brazil
| | - José Luiz de Lima Filho
- Laboratory Keizo Asami of Immunopathology (LIKA), Federal University of Pernambuco, Recife, Pernambuco, Brazil
| | - Karol Fireman de Farias
- Laboratory of Molecular Biology and Gene Expression (LABMEG), Federal University of Alagoas (UFAL), Arapiraca, Alagoas, Brazil
| | - Elaine Virginia Martins de Souza
- Laboratory of Molecular Biology and Gene Expression (LABMEG), Federal University of Alagoas (UFAL), Arapiraca, Alagoas, Brazil.,Post-graduation Program in Health Science, Institute of Biological Sciences and Health (ICBS), Federal University of Alagoas (UFAL), Maceió, Alagoas, Brazil
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26
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El-Bayoumy K, Christensen ND, Hu J, Viscidi R, Stairs DB, Walter V, Chen KM, Sun YW, Muscat JE, Richie JP. An Integrated Approach for Preventing Oral Cavity and Oropharyngeal Cancers: Two Etiologies with Distinct and Shared Mechanisms of Carcinogenesis. Cancer Prev Res (Phila) 2020; 13:649-660. [PMID: 32434808 DOI: 10.1158/1940-6207.capr-20-0096] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 03/30/2020] [Accepted: 05/15/2020] [Indexed: 12/27/2022]
Abstract
Head and neck squamous cell carcinoma (HNSCC) was the 7th most common malignancy worldwide in 2018 and despite therapeutic advances, the overall survival rate for oral squamous cell carcinoma (OSCC; ∼50%) has remained unchanged for decades. The most common types are OSCC and oropharyngeal squamous cell carcinoma (OPSCC, survival rate ∼85%). Tobacco smoking is a major risk factor of HNSCC. In the developed world, the incidence of OSCC is declining as a result of tobacco cessation programs. However, OPSCC, which is also linked to human papillomavirus (HPV) infection, is on the rise and now ranks as the most common HPV-related cancer. The current state of knowledge indicates that HPV-associated disease differs substantially from other types of HNSCC and distinct biological differences between HPV-positive and HPV-negative HNSCC have been identified. Although risk factors have been extensively discussed in the literature, there are multiple clinically relevant questions that remain unanswered and even unexplored. Moreover, existing approaches (e.g., tobacco cessation, vaccination, and chemoprevention) to manage and control this disease remain a challenge. Thus, in this review, we discuss potential future basic research that can assist in a better understanding of disease pathogenesis which may lead to novel and more effective preventive strategies for OSCC and OPSCC.
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Affiliation(s)
- Karam El-Bayoumy
- Department of Biochemistry & Molecular Biology, Pennsylvania State University, College of Medicine, Hershey, Pennsylvania.
| | - Neil D Christensen
- The Jake Gittlen Laboratories for Cancer Research, Pennsylvania State University, College of Medicine, Hershey, Pennsylvania.,Department of Pathology, Pennsylvania State University, College of Medicine, Hershey, Pennsylvania
| | - Jiafen Hu
- The Jake Gittlen Laboratories for Cancer Research, Pennsylvania State University, College of Medicine, Hershey, Pennsylvania.,Department of Pathology, Pennsylvania State University, College of Medicine, Hershey, Pennsylvania
| | - Raphael Viscidi
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Douglas B Stairs
- Department of Pathology, Pennsylvania State University, College of Medicine, Hershey, Pennsylvania
| | - Vonn Walter
- Department of Biochemistry & Molecular Biology, Pennsylvania State University, College of Medicine, Hershey, Pennsylvania.,Department of Public Health Sciences, Pennsylvania State University, College of Medicine, Hershey, Pennsylvania
| | - Kun-Ming Chen
- Department of Biochemistry & Molecular Biology, Pennsylvania State University, College of Medicine, Hershey, Pennsylvania
| | - Yuan-Wan Sun
- Department of Biochemistry & Molecular Biology, Pennsylvania State University, College of Medicine, Hershey, Pennsylvania
| | - Joshua E Muscat
- Department of Public Health Sciences, Pennsylvania State University, College of Medicine, Hershey, Pennsylvania
| | - John P Richie
- Department of Public Health Sciences, Pennsylvania State University, College of Medicine, Hershey, Pennsylvania
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27
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New Diagnostic Approaches to Viral Sexually Transmitted Infections. Sex Transm Infect 2020. [DOI: 10.1007/978-3-030-02200-6_6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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28
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Loopik DL, IntHout J, Melchers WJG, Massuger LFAG, Bekkers RLM, Siebers AG. Oral contraceptive and intrauterine device use and the risk of cervical intraepithelial neoplasia grade III or worse: a population-based study. Eur J Cancer 2019; 124:102-109. [PMID: 31760309 DOI: 10.1016/j.ejca.2019.10.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Accepted: 10/10/2019] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Hormonal contraceptive use has been associated with the development of cervical cancer, although inconsistent results are reported on the association with intrauterine device (IUD) use. The aim of this study was to evaluate the association between the type of contraceptive use and the development of cervical intraepithelial neoplasia grade III or worse (CIN3+). METHODS A retrospective population-based cohort study including women aged 29-44 years attending the cervical cancer screening program with normal cytology between 2005 and 2009 identified from the Dutch Pathology Registry. Subgroups with at least 5 years registered use of an oral contraceptive (OC) or IUD were compared with non-users. Risk ratios of CIN3+ were estimated per contraceptive type. RESULTS 702,037 women were included with a median follow-up of 9.7 years, of which 6705 (0.96%) and 559 (0.08%) women developed CIN3 and cervical cancer, respectively. IUD use was associated with an increased risk of developing CIN3+ (risk ratio (RR) 1.51, 95% confidence interval (CI) 1.32-1.74), and OC use was associated with an increased risk of developing CIN3+ (RR 2.77, 95%CI 2.65-3.00) and cervical cancer (RR 2.06, 95%CI 1.52-2.79). The risk of developing CIN3+ and cervical cancer was higher for OC users compared with IUD users (RR 1.83, 95%CI 1.60-2.09 and RR 1.70, 95%CI 1.00-2.90, respectively). CONCLUSIONS Both OC use and IUD use were associated with an increased risk of developing CIN3+. However, for women with a contraceptive wish, an IUD seems safer than an OC as the risk of developing CIN3+ and cervical cancer was higher for OC users.
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Affiliation(s)
- Diede L Loopik
- Department of Obstetrics and Gynaecology, Radboud Institute for Molecular Life Sciences, Radboud university medical center, PO Box 9101, 6500HB, Nijmegen, the Netherlands.
| | - Joanna IntHout
- Department of Biostatistics, Radboud Institute for Health Sciences, Radboud university medical center, PO Box 9101, 6585KM, Nijmegen, the Netherlands.
| | - Willem J G Melchers
- Department of Medical Microbiology, Radboud university medical center, PO Box 9101, 6500HB, Nijmegen, the Netherlands.
| | - Leon F A G Massuger
- Department of Obstetrics and Gynaecology, Radboud university medical center, PO Box 9101, 6500HB, Nijmegen, the Netherlands.
| | - Ruud L M Bekkers
- Department of Obstetrics and Gynaecology, Catharina Hospital, PO Box 1350, 5602ZA, Eindhoven, the Netherlands.
| | - Albert G Siebers
- Department of Pathology, Radboud university medical center, PO Box 9101, 6500HB, Nijmegen, the Netherlands; PALGA, Randhoeve 225a, 3995 GA, Houten, the Netherlands.
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29
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Sandulache VC, Wilde DC, Sturgis EM, Chiao EY, Sikora AG. A Hidden Epidemic of "Intermediate Risk" Oropharynx Cancer. Laryngoscope Investig Otolaryngol 2019; 4:617-623. [PMID: 31890879 PMCID: PMC6929570 DOI: 10.1002/lio2.316] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 08/13/2019] [Accepted: 09/21/2019] [Indexed: 12/12/2022] Open
Abstract
Objectives Oropharyngeal squamous cell carcinoma (OPSCC) incidence is rapidly increasing in the United States and around the world, driven in large part by infection with the human papillomavirus (HPV). HPV associated OPSCC (HPV+OPSCC) has been shown to have improved response to treatment relative to tobacco‐associated OPSCC. However, improvement in patient survival has not been uniform. Subsets of OPSCC patients in the US and around the world continue to have poor oncologic outcomes. Although the drivers of this phenomenon remain unclear, there is increasing evidence that tobacco exposure plays an important role in modulating HPV+OPSCC clinical outcomes. Methods We conducted a review of the literature. Results We discuss the potential biological and epidemiological interplay between tobacco and HPV exposure in the context of OPSCC. Multiple retrospective and prospective cohorts show that HPV+OPSCC patients with a history of tobacco exposure have response to treatment and clinical outcomes distinct from HPV+OPSCC non‐smokers which poses clinical and scientific challenges to be addressed over the next decade. Conclusions The interaction between tobacco exposure and HPV infection in the context of OPSCC has significant implications for both standard of care treatment regimens and development of novel therapeutic approaches, in particular those which incorporate immunomodulatory agents. Level of Evidence 5
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Affiliation(s)
- Vlad C Sandulache
- Bobby R. Alford Department of Otolaryngology-Head and Neck Surgery Baylor College of Medicine Houston Texas U.S.A.,ENT Section, Operative Care Line Michael E. DeBakey Veterans Affairs Medical Center Houston Texas U.S.A
| | - David C Wilde
- Bobby R. Alford Department of Otolaryngology-Head and Neck Surgery Baylor College of Medicine Houston Texas U.S.A
| | - Erich M Sturgis
- Department of Head and Neck Surgery University of Texas MD Anderson Cancer Center Houston Texas U.S.A
| | - Elizabeth Y Chiao
- Department of Medicine Baylor College of Medicine Houston Texas U.S.A
| | - Andrew G Sikora
- Bobby R. Alford Department of Otolaryngology-Head and Neck Surgery Baylor College of Medicine Houston Texas U.S.A.,ENT Section, Operative Care Line Michael E. DeBakey Veterans Affairs Medical Center Houston Texas U.S.A
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Kops NL, Bessel M, Horvath JDC, Domingues C, de Souza FMA, Benzaken AS, Mendes Pereira GF, Maranhão AGK, Villa LL, Mello B, Wendland EM. Factors associated with HPV and other self-reported STI coinfections among sexually active Brazilian young adults: cross-sectional nationwide study. BMJ Open 2019; 9:e027438. [PMID: 31230011 PMCID: PMC6596954 DOI: 10.1136/bmjopen-2018-027438] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES To analyse factors associated with genital human papillomavirus (HPV) and other self-reported sexually transmitted infection (STI) coinfections among women and men aged 16-25 years from Brazil. DESIGN A cross-sectional, nationwide, multicentre study. SETTING 119 primary healthcare centres between September 2016 and November 2017. PARTICIPANTS 6388 sexually active young adults were enrolled by trained health professionals. PRIMARY OUTCOME MEASURE Genital HPV and other self-reported STI coinfections. RESULTS Of 3512 participants with valid data for genital HPV and (STI)-positive status, 276 (9.60%, 95% CI 7.82% to 11.36%) had HPV/STI coinfection. Among men, HPV/STI coinfection was more prevalent than HPV infection alone. Among HPV-positive participants, the percentage of subjects who reported having another STI was highest for gonorrhoea at 4.24% (95% CI 2.67% to 5.81%), followed by syphilis, herpes and HIV. Smoking, drug use and ever having a same-sex sexual experience were risk factors that were uniquely associated with HPV/STI coinfection compared with HPV infection alone. CONCLUSIONS The results identified a low prevalence of self-reported STIs, but in participants with at least one STI, the prevalence of HPV was high. These results reinforce the importance of implementing strategies to prevent risky behaviours among Brazilian young adults.
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Affiliation(s)
- Natalia Luiza Kops
- Escritório de Projetos PROADI-SUS, Hospital Moinhos de Vento, Porto Alegre, Rio Grande do Sul, Brazil
- Programa de Pós Graduação Endocrinologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Marina Bessel
- Escritório de Projetos PROADI-SUS, Hospital Moinhos de Vento, Porto Alegre, Rio Grande do Sul, Brazil
| | | | - Carla Domingues
- National Immunization Program, Ministry of Health, Brasilia, Brazil
| | | | | | | | | | - Luisa Lina Villa
- Instituto do Câncer do Estado de São Paulo, Universidade de São Paulo and Cancer Institute of the São Paulo State (ICESP), São Paulo, Brazil
| | - Barbara Mello
- Faculdade de Medicina, Universidade de São Paulo, São Paulo, São Paulo, Brazil
| | - Eliana Marcia Wendland
- Escritório de Projetos PROADI-SUS, Hospital Moinhos de Vento, Porto Alegre, Rio Grande do Sul, Brazil
- Department of Community Health, Federal University of Health Science of Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
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Aierken K, Dong Z, Abulimiti T, Zhang Y, Abuduxikuer G, Tuerxun G, Abudurexiti G, Maimaitiaishan A, Mijiti P, Abulizi G. CDK6 3'UTR polymorphisms alter the susceptibility to cervical cancer among Uyghur females. Mol Genet Genomic Med 2019; 7:e626. [PMID: 30829464 PMCID: PMC6503018 DOI: 10.1002/mgg3.626] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 01/11/2019] [Accepted: 02/11/2019] [Indexed: 12/24/2022] Open
Abstract
AIMS Cyclin dependent kinase 6 (CDK6) plays a crucial role in malignant tumor whereas less is reported in cervical cancer development. The aim of this study was to evaluate the effects of CDK6 3' untranslated region (3'UTR) polymorphisms on cervical cancer susceptibility among Uyghur females. METHODS The genotypes of the six CDK6 variants (rs8179, rs42032, rs42033, rs42034, rs42035, and rs42038) were identified among 306 cervical cancer cases and 310 healthy controls with the Agena MassARRAY platform. The associations of the candidate single nucleotide polymorphisms (SNPs) with the cervical cancer risk were evaluated under genetic models using conditional logistic regression analysis. Bioinformatics analysis was performed for SNP function prediction with the online databases. The expression differences between tumor tissues and normal cervix samples were also examined by Real-time PCR. RESULTS CDK6 rs8179 and rs42033 were correlated to the decreased risk of cervical cancer in Uyghurs under the allele model (rs8179 and rs42033: OR = 0.60, 95% CI: 0.37-0.99, p = 0.043) and log-additive model (rs8179 and rs42033: OR = 0.62, 95% CI: 0.38-1.00, p = 0.047). Rs8179, rs42032, and rs42033 were associated with susceptibility to high-grade cervical cancer in different genetic models as well (p < 0.05). Dataset-based analysis also uncovered the potential effects of these significant SNPs. In addition, aberrant expression of CDK6 were detected in cervical tumors. CONCLUSIONS Our results suggested the relationships between CDK6 3'UTR polymorphisms and cervical cancer pathogenesis, and the involvement of CDK6 in cervical cancer development among Uyghur females.
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Affiliation(s)
- Kailibinuer Aierken
- 5th Department of GynecologyAffiliated Tumor Hospital of Xinjiang Medical UniversityUrumqiChina
| | - Zhihong Dong
- Outpatient DepartmentAffiliated Tumor Hospital of Xinjiang Medical UniversityUrumqiChina
| | - Tangnuer Abulimiti
- 5th Department of GynecologyAffiliated Tumor Hospital of Xinjiang Medical UniversityUrumqiChina
| | - Yuanyuan Zhang
- 5th Department of GynecologyAffiliated Tumor Hospital of Xinjiang Medical UniversityUrumqiChina
| | - Guzhalinuer Abuduxikuer
- 5th Department of GynecologyAffiliated Tumor Hospital of Xinjiang Medical UniversityUrumqiChina
| | - Gulixian Tuerxun
- 5th Department of GynecologyAffiliated Tumor Hospital of Xinjiang Medical UniversityUrumqiChina
| | - Guligeina Abudurexiti
- 5th Department of GynecologyAffiliated Tumor Hospital of Xinjiang Medical UniversityUrumqiChina
| | - Aziguli Maimaitiaishan
- 5th Department of GynecologyAffiliated Tumor Hospital of Xinjiang Medical UniversityUrumqiChina
| | - Patiman Mijiti
- 5th Department of GynecologyAffiliated Tumor Hospital of Xinjiang Medical UniversityUrumqiChina
| | - Guzhalinuer Abulizi
- 5th Department of GynecologyAffiliated Tumor Hospital of Xinjiang Medical UniversityUrumqiChina
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Vale DB, Sauvaget C, Murillo R, Muwonge R, Zeferino LC, Sankaranarayanan R. Correlation of Cervical Cancer Mortality with Fertility, Access to Health Care and Socioeconomic Indicators. REVISTA BRASILEIRA DE GINECOLOGIA E OBSTETRÍCIA 2019; 41:249-255. [PMID: 30912091 PMCID: PMC10309279 DOI: 10.1055/s-0039-1683859] [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: 12/11/2017] [Accepted: 02/06/2019] [Indexed: 10/27/2022] Open
Abstract
OBJECTIVE The present study aimed to examine which development indicators are correlated with cervical cancer (CC) mortality rates in Brazil. METHODS This was an ecological study that correlated mortality rates and indicators, such as human development index (HDI), gross domestic product (GDP) per capita, illiteracy rate, fertility rate, screening coverage, proportion of private health insurance use, density of physicians, and density of radiotherapy centers. The mortality rates were obtained from the Brazilian national registry, while the indicators were based on official reports from the Ministry of Health. Univariate and multivariate linear regression was used. RESULTS Among the states of Brazil, the average age-specific CC mortality rate from 2008 to 2012 varied from 4.6 to 22.9 per 100,000 women/year. In the univariate analysis, HDI, proportion of private health insurance use, density of physicians, and density of radiotherapy centers were inversely correlated with the mortality rates. Fertility rate was positively correlated with the mortality rates. In the multivariate analysis, only fertility rate was significantly associated with the CC mortality rate (coefficient of correlation: 9.38; 95% confidence interval [CI]: 5.16-13.59). CONCLUSION A decrease in the fertility rate, as expected when the level of development of the regions increases, is related to a decrease in the mortality rate of CC. The results of the present study can help to better monitor the quality assessment of CC programs both among and within countries.
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Affiliation(s)
- Diama Bhadra Vale
- International Agency for Research on Cancer, Section of Early Detection and Prevention, Lyon, France
- Department of Tocoginecology, Universidade Estadual de Campinas, Campinas, SP, Brazil
| | - Catherine Sauvaget
- International Agency for Research on Cancer, Section of Early Detection and Prevention, Lyon, France
| | - Raul Murillo
- International Agency for Research on Cancer, Section of Early Detection and Prevention, Lyon, France
| | - Richard Muwonge
- International Agency for Research on Cancer, Section of Early Detection and Prevention, Lyon, France
| | - Luiz Carlos Zeferino
- Department of Tocoginecology, Universidade Estadual de Campinas, Campinas, SP, Brazil
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Chen L, Wang H. eIF4E is a critical regulator of human papillomavirus (HPV)-immortalized cervical epithelial (H8) cell growth induced by nicotine. Toxicology 2019; 419:1-10. [PMID: 30836163 DOI: 10.1016/j.tox.2019.02.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2018] [Revised: 02/18/2019] [Accepted: 02/28/2019] [Indexed: 12/19/2022]
Abstract
Tobacco smoke is known as a cofactor in the development of cervical precancer and cancer caused by human papillomavirus (HPV). The main component in cigarette smoke, nicotine, can be concentrated more strongly in cervical mucus than in blood and it has been implicated as a cocarcinogen that promotes a serial of cancers development through multiple prosurvival pathways. Although the mechanisms of nicotine-induced cell proliferation have been well studied in some epithelial cells, the molecular mechanism of its action in cervical epithelial cells is still unclear. The aims of this study were to investigate the detailed mechanism by which nicotine could induce cervical cancer growth. We found that nicotine simultaneously activates AKT/mTOR pathway in HPV-immortalized cervical epithelial (H8) cell line, followed by elevation of 4EBP1/eIF4E axis expression and its translational activity with dose-dependent and time-dependent manners. Besides, nicotine decreases eIF4E-4EBP1 binding activity in H8 cell line, which is associated with increased expression of phospho-4EBP1 at threonine 70. We therefore chose to evaluate whether this effect on eIF4E was involved in nicotine-induced proliferation. Remarkably, eIF4E knockdown by small interfering RNA diminishes its translation activity to the downstream targets including c-Myc, VEGF, CyclinD1 and Bcl-2. What is more, eIF4E knockdown inhibits cellular growth and colony formation after nicotine treatment. Note as well that eIF4E-specific siRNA could also suppress cell proliferation by decelerating the G0/G1-S transition of H8 cell treated with nicotine. Taken together, it can be concluded that nicotine promotes H8 cell proliferation by activating AKT/mTOR pathway, as well as 4EBP1/eIF4E axis and its translational activity. Furthermore, phosphorylation of 4EBP1 induced by nicotine has been shown to cause dissociation of 4EBP1/eIF4E and eIF4E may serve as a promising determinant of nicotine activity in vitro.
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Affiliation(s)
- Lu Chen
- School of Public Health, Nanchang University, 461 Ba Yi Avenue, Nanchang, Jiangxi, 330006, PR China; Jiangxi Provincial Key Laboratory of Preventive Medicine, Nanchang University, 461 Ba Yi Avenue, Nanchang, Jiangxi, 330006, PR China
| | - Huai Wang
- School of Public Health, Nanchang University, 461 Ba Yi Avenue, Nanchang, Jiangxi, 330006, PR China; Jiangxi Provincial Key Laboratory of Preventive Medicine, Nanchang University, 461 Ba Yi Avenue, Nanchang, Jiangxi, 330006, PR China.
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Abstract
OBJECTIVE(S) HIV-positive individuals have elevated rates of anal squamous cell carcinoma (SCC), and sexually transmitted infections with its causative agent, high-risk human papillomavirus, and other oncoviruses including hepatitis B virus (HBV). HBV infection can cause liver cancer, and has been associated with increased risk of some extra-hepatic cancers including biliary tract cancer, pancreatic cancer, and non-Hodgkin lymphoma. Whether HBV is associated with anal SCC risk is unknown. DESIGN Prospective study of anal SCC risk in HIV-positive and HIV-negative MSM in the Multicenter AIDS Cohort Study from 1984 to 2014. METHODS Poisson regression models were used to examine the association between past or current HBV infection (positive tests for HBV core antibodies, surface antigen, and/or DNA) and anal SCC risk. RESULTS We observed 53 cases of anal SCC among 5298 participants with 79 334 person-years follow-up. Among HIV-positive men, past or current HBV infection was associated with anal SCC risk in models adjusted for age, CD4+ cell counts, HAART use, and other risk factors [incidence rate ratio (IRR), 95% confidence interval 3.15, 1.27-7.82]. Additional risk factors included immunological parameters 1 and 6 years prior to diagnosis (IRR, 95% confidence interval 2.45, 1.31-4.58 and 2.44, 1.3-4.59 for CD4+ cell counts <500 cells/μl; 2.43, 1.34-4.42 and 2.77, 1.5-5.11 for CD4+ : CD8+ ratios <0.5, respectively). Among HIV-negative men, IRR for prior HBV and anal SCC risk was similar, but NS due to small number of cases. CONCLUSION HIV-positive MSM with prior HBV infection have increased anal SCC risk. This population may benefit from screening.
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Abstract
Human papillomavirus (HPV) is the first identified necessary cause of human cancers and is associated with nearly 100% of all cervical cancers. Compared to the general female populations, HIV+ women have higher prevalence and incidence of cervical HPV infections, higher risks of persistent HPV infections and subsequent cervical intraepithelial lesions, and a higher incidence of cervical cancer. Although the wide use of combined antiretroviral therapy (cART) has improved the immune function and the longevity of HIV+ women, the incidence of cervical cancer in HIV+ women has not declined. For HIV+ women who follow routine cervical cancer screenings, their incidence of cervical cancer is comparable to that in HIV-negative women. Thus, adherence to the recommended cervical cancer screening is still critical for HIV+ women to prevent cervical cancer. Prophylactic HPV vaccines may also benefit HIV+ women, but prospective studies are needed to determine the effectiveness of HPV vaccination on reducing cervical cancer incidence in HIV+ women.
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Affiliation(s)
- Ping Du
- Department of Medicine, Department of Public Health Sciences, Penn State Hershey College of Medicine, 90 Hope Drive, Suite 2200, A210, Hershey, PA, USA.
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Adherence to gynecological screening impacted by experienced orthodontic treatment in childhood. Arch Gynecol Obstet 2018; 299:167-171. [PMID: 30374649 DOI: 10.1007/s00404-018-4950-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Accepted: 10/19/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Dental and cervical controls are two established screening programs in Germany. Compliance to orthodontic treatment in childhood is essential for dental health and one of the first health interventions that requires adherent behavior; therefore, it may be associated with participation in further screening programs in adulthood. However, it is not yet known whether early orthodontic treatment influences long-term screening adherence. METHODS Using a questionnaire administered during a visit to a special dysplasia outpatient service, this case-control study evaluated women's personal history of orthodontic care, long-term satisfaction, and dental and gynecological screening adherence. Oral health status and dental anxiety were assessed with validated instruments. Cases were categorized as cervical dysplasia only (S2) or cervical dysplasia with conization (S1) and compared to healthy controls with a normal PAP smear. RESULTS A study population of 233 participants included 132 cases and 101 controls. The control group had had orthodontic treatment during childhood more often than our study population with abnormal PAP smears (68.3% controls versus 56.1% subjects; p < 0.005). Orthodontic treatment was not associated with attending dental appointment or gynecological check-ups. However, women with an orthodontic treatment in childhood were significantly more often vaccinated against human papillomavirus than women without orthodontic treatment (p < 0.03). CONCLUSION Data suggest that women with orthodontic treatment in childhood are more conscious about prevention strategies in adulthood; therefore, compliant behavior might be established in childhood.
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Kienka T, Varga MG, Caves J, Smith JS, Sivaraman V. Epstein-Barr virus, but not human cytomegalovirus, is associated with a high-grade human papillomavirus-associated cervical lesions among women in North Carolina. J Med Virol 2018; 91:450-456. [PMID: 30307626 DOI: 10.1002/jmv.25336] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 09/29/2018] [Indexed: 02/02/2023]
Abstract
STATEMENT OF THE PROBLEM Human papillomavirus (HPV) infection is known to contribute to cervical carcinogenesis, yet other cofactors that may contribute to oncogenesis are poorly understood. Herein, we examine whether the Epstein-Barr virus (EBV) and human cytomegalovirus (CMV), two oncomodulatory viruses, are associated with HPV-mediated cervical neoplastic progression. METHODS Sixty patient cervical brush samples from a study of North Carolina women were obtained. HPV RNA positivity was determined by Aptima testing (Hologic Corporation, Marlborough, MA). The level of viral transcripts for EBV and CMV was quantified (reverse transcription polymerase chain reaction analysis), and the coinfection status with HPV was then compared with the patient's cervical cytology grade. RESULTS Over one-third (38.3%) of the study population was CMV positive, whereas 43.3% was EBV positive. When sample data were stratified by the cytology grade, 36.5% (19/52) of normal patients, 75% (3/4) of low-grade squamous intraepithelial lesions (LSIL), and 100% (4/4) of patients with high-grade SIL (HSIL) were EBV positive. Conversely, 35.2% (18/52) of normal patients, 25% (1/4) of patients with LSIL, and 50% (2/4) of patients with HSIL were CMV positive. When examining only HPV positive-associated HSIL, 100% (4/4) were positive for both HPV and EBV detection. This suggests that co-viral detection with HPV and EBV is associated with more advanced HSIL cervical lesions, while CMV displayed no clear association with a higher grade of cervical cytology. CONCLUSIONS Co-viral detection with EBV may increase the oncogenicity and/or serve as a viral marker of progression to HPV-associated high-grade cervical dysplasia.
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Affiliation(s)
- Tamina Kienka
- Department of Biological and Biomedical Sciences, North Carolina Central University, Durham, North Carolina
| | - Matthew G Varga
- Department of Epidemiology, UNC Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina.,Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina
| | - Josie Caves
- Department of Epidemiology, UNC Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
| | - Jennifer S Smith
- Department of Epidemiology, UNC Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina.,Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina
| | - Vijay Sivaraman
- Department of Biological and Biomedical Sciences, North Carolina Central University, Durham, North Carolina
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Abreu MNS, Soares AD, Ramos DAO, Soares FV, Nunes Filho G, Valadão AF, Motta PGD. [Knowledge and perception of HPV in the population over 18 years of age in the city of Ipatinga - State of Minas Gerais, Brazil]. CIENCIA & SAUDE COLETIVA 2018. [PMID: 29538565 DOI: 10.1590/1413-81232018233.00102016] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Several studies have identified misconceptions about human papillomavirus (HPV), which can lead to negligent behavior and risk to the health of the population. This article aims to assess the knowledge of men and women about HPV in the city of Ipatinga, Minas Gerais, and evaluate socioeconomic factors and preventive measures associated with such knowledge. It involved a cross-sectional study with 591 subjects living in the city, by means of stratified sampling by quotas proportional to the number of individuals by sex and age in each of the eight administrative regions of the city. Pearson's chi-square test or the t-Student test and the binary logistic regression model were used to assess the factors associated with knowledge about HPV. Less than half (40.1%) of the respondents said they knew what HPV was. Factors associated with having knowledge about HPV were being female, having secondary or tertiary education, using the private health service, having heard about or seen a campaign about HPV and knowing of the existence of a vaccine against HPV. There is a great deficit of knowledge about HPV and vague information of what is known, favoring actions with a potential risk to personal health, including that of the partner.
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Affiliation(s)
- Mery Natali Silva Abreu
- Departamento de Enfermagem Aplicada, Escola de Enfermagem, Universidade Federal de Minas Gerais. Av. Alfredo Balena 190/336, Santa Efigênia. 31130-100 Belo Horizonte MG Brasil.
| | - Angela Deise Soares
- Curso de Medicina, Instituto Metropolitano de Ensino Superior. Ipatinga MG Brasil
| | | | | | - Gerson Nunes Filho
- Curso de Medicina, Instituto Metropolitano de Ensino Superior. Ipatinga MG Brasil
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Trugilo KP, Cebinelli GCM, Berti FCB, Okuyama NCM, Cezar-Dos-Santos F, Sena MM, Mangieri LFL, Watanabe MAE, de Oliveira KB. Polymorphisms in the TGFB1 signal peptide influence human papillomavirus infection and development of cervical lesions. Med Microbiol Immunol 2018; 208:49-58. [PMID: 30167873 DOI: 10.1007/s00430-018-0557-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 08/23/2018] [Indexed: 12/26/2022]
Abstract
The main purpose was to assess the effect of c.29C>T and c.74G>C polymorphisms in the TGFB1 signal peptide on HPV infection and development of cervical lesions. Cervical swabs and blood samples were obtained from 349 outpatient women, along with socio-demographic and sexual behavioral data. The study population was stratified by absence or presence of HPV DNA, as tested by PCR, as well as by lesion grade. TGFB1 signal peptide polymorphisms were genotyped using PCR-restriction fragment length polymorphism. HPV DNA was detected in 172 (49.3%) patients. c.74GC and the combined c.29CC+CT/c.74GC genotype were more frequent in infected patients (35.1 and 15.7%) than in uninfected women (6.2 and 14.7%). Accordingly, these genotypes were associated with a higher risk of HPV infection, with odds ratio and 95% confidence interval of 2.81 and 1.35-5.86 (P = 0.004) for c.74GC and 3.14 and 1.42-6.94 (P = 0.004) for the combined genotype, respectively. High-grade lesions were also 2.48 times more likely to occur in c.29CC patients than in c.29TT patients, with a 95% confidence interval of 1.01-6.08 (P = 0.047). The data demonstrate that c.74G>C and c.29C>T polymorphisms are significantly associated with risk of HPV infection and high-grade squamous intraepithelial lesions, respectively. Thus, TGFB1 signal peptide polymorphisms are potential susceptibility markers.
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Affiliation(s)
- Kleber Paiva Trugilo
- Department of Pathological Science, Biological Science Center, State University of Londrina, Londrina, Paraná, Brazil
| | | | - Fernanda Costa Brandão Berti
- Department of Pathological Science, Biological Science Center, State University of Londrina, Londrina, Paraná, Brazil
| | - Nádia Calvo Martins Okuyama
- Department of Pathological Science, Biological Science Center, State University of Londrina, Londrina, Paraná, Brazil
| | - Fernando Cezar-Dos-Santos
- Department of Pathological Science, Biological Science Center, State University of Londrina, Londrina, Paraná, Brazil
| | - Michelle Mota Sena
- Department of Pathological Science, Biological Science Center, State University of Londrina, Londrina, Paraná, Brazil
| | - Luis Fernando Lásaro Mangieri
- Department of Gynecology and Obstetrics, Health Science Center, State University of Londrina, Londrina, Paraná, Brazil
| | - Maria Angelica Ehara Watanabe
- Department of Pathological Science, Biological Science Center, State University of Londrina, Londrina, Paraná, Brazil
| | - Karen Brajão de Oliveira
- Department of Pathological Science, Biological Science Center, State University of Londrina, Londrina, Paraná, Brazil.
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Human papillomaviruses in Western Africa: prevalences and risk factors in Burkina Faso. Arch Gynecol Obstet 2018; 298:789-796. [PMID: 30120545 DOI: 10.1007/s00404-018-4860-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2018] [Accepted: 07/28/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE Cervical cancer is the most common cancer in women in low income countries. Certain oncogenic types of human papillomaviruses are causally associated with the cervical cancer. To ensure effective primary prevention through the introduction of a national vaccination program in Burkina Faso, information about the disease burden of HPV infection in the country is of great importance. METHODS In the present work the prevalence of 54 different HPV types and 18 other sexually transmitted infection as well as the predominant risk factors for the development of cervical cancer were investigated in Ouagadougou. A cross-sectional study on two populations without (n=471) and with known cervical dysplasia (n=39) was carried out between October 2013 and March 2014. Retrospectively, data on possible and secured risk factors of the cervical carcinoma were collected. The participants were examined gynecologically and a vaginal lavage was taken, which was molecular genetically examined for 54 different human papillomavirus genotypes and 18 other STIs. RESULTS The prevalence of human papillomavirus was 42.3% (188/444) in the first study population and 87.2% (34/39) in the second study population. The immunization coverage would be 24.5% of the HPV types and 33.9% of the high-risk HPV types with quadrivalent vaccine Gardasil®. The nonavalent vaccine Gardasil®9 (9vHPV) would cover 37.3% of all HPV types and 57.1% of high-risk HPV types. CONCLUSION The prevention of infection with human papillomaviruses by vaccination is expected to result in a drastic reduction in the morbidity and mortality of the cervical cancer in Burkina Faso.
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The impact of environmental and behavioural cofactors on the development of cervical disorders in HR-HPV-infected women in Serbia. Epidemiol Infect 2018; 146:1714-1723. [PMID: 29923470 DOI: 10.1017/s0950268818001668] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Persistent infection with one or more highly oncogenic human papillomaviruses (HPVs) or high-risk-HPV (HR-HPV) is necessary but not a sufficient aetiological agent for the development of cervical neoplasia. A number of viral, host, environmental and behavioural factors are suggested to be associated with the progression of cervical disorder. This study aimed to evaluate the impact of environmental and behavioural cofactors on the development of cervical disorders in HR-HPV-infected women in Serbia. A total of 541 women have been tested by PCR for the presence of HPV on the cervix. HPV genotypes were determined by direct DNA sequencing. Women identified as HR-HPV-positive were further classified into four subgroups according to their cytological status. All relevant information about demographical and behavioural factors was obtained by interviewer-based questionnaire. A number of analytical and descriptive statistical methods were used for processing the data. The cofactors found to be of significance for the progression of cervical disease were older age, body mass index >25, lower educational level, long-term smoking, previous genital infections and cervical interventions. On the other hand, condom use was found to have a protective role. Information about these cofactors might be very important for the development of more efficient cancer prevention programmes and promotion of anti-HPV vaccination.
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Shi X, Li B, Yuan Y, Chen L, Zhang Y, Yang M, Wang J, Qin D. The possible association between the presence of an MPO -463 G > A (rs2333227) polymorphism and cervical cancer risk. Pathol Res Pract 2018; 214:1142-1148. [PMID: 29937309 DOI: 10.1016/j.prp.2018.05.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 05/11/2018] [Accepted: 05/18/2018] [Indexed: 10/16/2022]
Abstract
PURPOSE The association between myeloperoxidase (MPO) polymorphism and the risk of cervical cancer is inconclusive. We performed a meta-analysis to clarify if a correlation exists between MPO polymorphism and the risk for developing cervical cancer. METHODS All case-control research studies that determined a relationship between MPO and cervical cancer reported up until March 1, 2018 in PubMed, Web of Science, VIP, WanFang, and the CNKI Database were accessed and included. The strength of association was evaluated with pooled odds ratios (ORs) and their corresponding 95% confidence intervals (95% CIs). We used sensitivity analysis to detect the stability of our results, conducted Q-test to evaluate heterogeneity and applied Begg's funnel plot and Egger's test to investigate any publication bias among selected studies. RESULTS In this meta-analysis, we included 5 eligible studies in the final evaluation, which included 1125 patients with cervical cancer and 1150 cancer-free control patients. A potential association between the MPO -463 G > A polymorphism and cervical cancer risk was observed (recessive model: OR = 0.65, 95%, CI: 0.43-0.98, P = 0.038; homozygous model: OR = 0.65, 95%, CI: 0.43-0.99, P = 0.045), which indicates that genotype AA reduces the risk of cervical cancer by 35% compared to GG/GA or GG genotypes in our results. A stratified analysis by ethnicity identified a significant correlation among Caucasian patients (recessive model: OR = 0.57, 95%, CI: 0.34-0.95, P = 0.029; homozygous model: OR = 0.60, 95%, CI: 0.36-0.99, P = 0.048) and a stratified analysis by source of control identified a significant correlation among population-based studies. CONCLUSIONS Our results suggest that the presence of polymorphism, -463 G > A in patients might offer them protection against cervical cancer. By implementing randomized case-control or cohort studies with larger sample sizes, the clinical significance of our results can be further strengthened and verified.
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Affiliation(s)
- Xiaoqing Shi
- Department of Clinical Laboratory, The First Affiliated Hospital of Zhengzhou University, Key Laboratory of Laboratory Medicine of Henan Province, Zhengzhou, Henan, China
| | - Bingjie Li
- Department of Clinical Laboratory, The First Affiliated Hospital of Zhengzhou University, Key Laboratory of Laboratory Medicine of Henan Province, Zhengzhou, Henan, China
| | - Yingying Yuan
- Department of Clinical Laboratory, The First Affiliated Hospital of Zhengzhou University, Key Laboratory of Laboratory Medicine of Henan Province, Zhengzhou, Henan, China
| | - Liyinghui Chen
- Department of Blood Transfusion, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yadi Zhang
- Clinical Pharmacology Base, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Meng Yang
- Clinical Pharmacology Base, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Junjie Wang
- Department of Cardiovascular Medicine, Xinyang Huaibin People's Hospital, Xinyang, Henan, China
| | - Dongchun Qin
- Department of Clinical Laboratory, The First Affiliated Hospital of Zhengzhou University, Key Laboratory of Laboratory Medicine of Henan Province, Zhengzhou, Henan, China.
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Awareness of human papilloma virus and cervical cancer prevention among Greek female healthcare workers. Eur J Cancer Prev 2018; 26:330-335. [PMID: 27254169 DOI: 10.1097/cej.0000000000000254] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
The incidence rate of cervical cancer varies by geographic region, with less developed regions showing the highest rates. All risk factors for cervical cancer are actually preventable if appropriate lifestyle changes are adopted. In addition, vaccines protecting against the majority of human papilloma virus (HPV) high-risk types have been developed. Even though cervical cancer is preventable, not all women are aware of this or how it can be prevented. Thus, it is essential for every nation to assess the level of knowledge among women of cervical cancer and HPV prevention. In this work, we assessed the level of awareness and attitudes of Greek female healthcare workers on cervical cancer and HPV prevention through the delivery of a validated questionnaire between March and June 2012 in three hospitals in Greece. Our results show that there exist gaps in the knowledge of women on this topic, especially in terms of the newest information on cervical cancer prevention through HPV testing and vaccination. In fact, only 80% of surveyed women knew about the existence of HPV testing. We propose that more information needs to be transmitted to Greek women and men on HPV testing and vaccination. Even though the incidence of cervical cancer is not extremely high in Greece, this number can easily change, especially in the face of the economic crisis and the increasing rates of migration, which can result in higher rates of HPV infection in the population if no measures for HPV prevention are implemented.
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Nikas I, Hapfelmeier A, Mollenhauer M, Angermeier D, Bettstetter M, Götz R, Schmidmayr M, Seifert-Klauss V, Muckenhuber A, Schenck U, Weirich G. Integrated morphologic and molecular analysis of Trichomonas vaginalis, Mycoplasma hominis, and human papillomavirus using cytologic smear preparations. Parasitol Res 2018; 117:1443-1451. [PMID: 29549429 DOI: 10.1007/s00436-018-5829-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Accepted: 03/06/2018] [Indexed: 01/03/2023]
Abstract
Pathogenic microbes may colonize the female genital tract via sexual transmission and cause health issues like inflammation or malignancy, summarized as sexually transmitted disease (STD). A major representative of such pathogens is Trichomonas vaginalis (T.v.), whose role in the etiology of cervical cancer remains elusive. Traditional morphologic screening of cervical smears is able to detect T.v., although its identification may be complicated by look-alikes such as degenerated granulocytes and basal cells. In addition, the parasite's endosymbiont Mycoplasma hominis (M.h.) cannot be detected in the Pap test. This investigation was aimed at designing a PCR-based method to detect specific pathogenic germs by using cervical cytology slides to overcome morphologic uncertainty and increase diagnostic accuracy. To test our molecular screening method on T.v., M.h., and HPV in archival smears, we elaborated a multiplex PCR approach based on microdissection. This assay was applied to a minute quantity of starting material which harbored or was suspected to harbor T.v.; the resulting isolated DNA was used for subsequent molecular analyses of T.v., M.h., and HPV. We clarified the diagnosis of genital T.v. infection in 88 and 1.8% of morphologically suspicious and T.v.-negative cases, respectively. We also revealed a tendency of M.h. co-infection in high-risk HPV cases. In conclusion, a microdissection-based approach to detect pathogenic microbes such as T.v., HPV, and M.h. is a molecular tool easy to implement and may help to better understand the interactivity of these germs with respect to pathogenesis.
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Affiliation(s)
- I Nikas
- Institute of Pathology, Technische Universität München, Trogerstraße 18, 81675, Munich, Germany.,School of Medicine, European University Cyprus, Nicosia, Cyprus
| | - A Hapfelmeier
- Institute of Medical Informatics, Statistics and Epidemiology, Technische Universität München, Munich, Germany
| | - M Mollenhauer
- Institute of Pathology, Technische Universität München, Trogerstraße 18, 81675, Munich, Germany
| | - D Angermeier
- Institute of Pathology, Technische Universität München, Trogerstraße 18, 81675, Munich, Germany
| | | | - R Götz
- Institute of Pathology, Technische Universität München, Trogerstraße 18, 81675, Munich, Germany
| | - M Schmidmayr
- Frauenklinik und Poliklinik, Technische Universität München, Munich, Germany
| | - V Seifert-Klauss
- Frauenklinik und Poliklinik, Technische Universität München, Munich, Germany
| | - A Muckenhuber
- Institute of Pathology, Technische Universität München, Trogerstraße 18, 81675, Munich, Germany
| | - U Schenck
- Institute of Pathology, Technische Universität München, Trogerstraße 18, 81675, Munich, Germany.,MVZ Gynäkologie & Pathologie, Munich, Germany
| | - Gregor Weirich
- Institute of Pathology, Technische Universität München, Trogerstraße 18, 81675, Munich, Germany.
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Boda D, Docea AO, Calina D, Ilie MA, Caruntu C, Zurac S, Neagu M, Constantin C, Branisteanu DE, Voiculescu V, Mamoulakis C, Tzanakakis G, Spandidos DA, Drakoulis N, Tsatsakis AM. Human papilloma virus: Apprehending the link with carcinogenesis and unveiling new research avenues (Review). Int J Oncol 2018; 52:637-655. [PMID: 29393378 PMCID: PMC5807043 DOI: 10.3892/ijo.2018.4256] [Citation(s) in RCA: 79] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2017] [Accepted: 12/28/2017] [Indexed: 12/17/2022] Open
Abstract
Human papilloma viruses (HPV) are a small group of non‑enveloped viruses belonging to the Papillomaviridae family with strong similarities to polyoma viruses. The viral particles consist of a genome in the form of a circular double‑stranded DNA, encompassing eight open reading frames, as well as a non‑enveloped icosahedral capsid. HPV infection is considered the most common sexually transmitted disease in both sexes and is strongly implicated in the pathogenesis of different types of cancer. 'High‑risk' mucosal HPV types, predominantly types 16, 18, 31, 33 and 35, are associated with most cervical, penile, vulvar, vaginal, anal, oropharyngeal cancers and pre‑cancers. Screening for HPV is necessary for the prognosis and for determining treatment strategies for cancer. Novel HPV markers, including proteomic and genomic markers, as well as anti‑papillomavirus vaccines are currently available. The aim of this comprehensive review was to thoroughly present the updated information on virus development, cancer occurrence, treatment and prevention strategies, in an attempt to shed further light into the field, including novel research avenues.
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Affiliation(s)
- Daniel Boda
- Dermatology Research Laboratory, ‘Carol Davila’ University of Medicine and Pharmacy, 030167 Bucharest
- Department of Dermatology, ‘Prof. N. Paulescu’ National Institute of Diabetes, Nutrition and Metabolic Diseases, 011233 Bucharest
| | | | - Daniela Calina
- Department of Clinical Pharmacy, University of Medicine and Pharmacy of Craiova, 200349 Craiova
| | - Mihaela Adriana Ilie
- Dermatology Research Laboratory, ‘Carol Davila’ University of Medicine and Pharmacy, 030167 Bucharest
- Department of Biochemistry
| | - Constantin Caruntu
- Dermatology Research Laboratory, ‘Carol Davila’ University of Medicine and Pharmacy, 030167 Bucharest
- Department of Dermatology, ‘Prof. N. Paulescu’ National Institute of Diabetes, Nutrition and Metabolic Diseases, 011233 Bucharest
- Department of Physiology
| | - Sabina Zurac
- Department of Pathology, ‘Carol Davila’ University of Medicine and Pharmacy, 030167 Bucharest
- Colentina University Hospital, Sector 2 19-21, Bucharest
| | - Monica Neagu
- ‘Victor Babes’ National Institute of Pathology, 050096 Bucharest
| | | | | | - Vlad Voiculescu
- Department of Dermatology and Allergology, Elias Emergency University Hospital, 011461 Bucharest, Romania
| | - Charalampos Mamoulakis
- Department of Urology, University General Hospital of Heraklion, University of Crete Medical School
| | | | - Demetrios A. Spandidos
- Laboratory of Clinical Virology, Medical School, University of Crete, 71003 Heraklion, Crete
| | - Nikolaos Drakoulis
- Research Group of Clinical Pharmacology and Pharmacogenomics, Faculty of Pharmacy, School of Health Sciences, National and Kapodistrian University of Athens, 15771 Athens
| | - Aristides M. Tsatsakis
- Laboratory of Toxicology, Medical School, University of Crete, 71003 Heraklion, Crete, Greece
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de Sanjosé S, Brotons M, Pavón MA. The natural history of human papillomavirus infection. Best Pract Res Clin Obstet Gynaecol 2018; 47:2-13. [DOI: 10.1016/j.bpobgyn.2017.08.015] [Citation(s) in RCA: 129] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Accepted: 08/01/2017] [Indexed: 01/14/2023]
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47
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Chatzistamatiou K, Moysiadis T, Vryzas D, Chatzaki E, Kaufmann AM, Koch I, Soutschek E, Boecher O, Tsertanidou A, Maglaveras N, Jansen-Duerr P, Agorastos T. Cigarette Smoking Promotes Infection of Cervical Cells by High-Risk Human Papillomaviruses, but not Subsequent E7 Oncoprotein Expression. Int J Mol Sci 2018; 19:ijms19020422. [PMID: 29385075 PMCID: PMC5855644 DOI: 10.3390/ijms19020422] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Revised: 01/28/2018] [Accepted: 01/29/2018] [Indexed: 12/21/2022] Open
Abstract
Persistent cervical infection with high-risk human papillomaviruses (hrHPVs) is a necessary, but not sufficient, condition for the development of cervical cancer. Therefore, there are other co-factors facilitating the hrHPV carcinogenic process, one of which is smoking. To assess the effect of smoking on high-risk (hr) HPV DNA positivity and on the expression of HPV E7 oncoprotein, as a surrogate of persistent hrHPV infection, we used data from women recruited for the PIPAVIR project, which examined the role of E7 protein detection in cervical cancer screening. Women were tested for hrHPV DNA, using Multiplex Genotyping (MPG), and E7 protein, using a novel sandwich ELISA method, and gave information on their smoking habits. Among 1473 women, hrHPV prevalence was 19.1%. The odds ratio (OR) for hrHPV positivity of smokers compared to non-smokers was 1.785 (95% confidence intervals (CI): 1.365–2.332, p < 0.001). The ORs for E7 positivity, concerning hrHPV positive women, ranged from 0.720 to 1.360 depending on the E7 detection assay used, but this was not statistically significant. Smoking increases the probability of hrHPV infection, and smoking intensity is positively associated to this increase. Smoking is not related to an increased probability of E7 protein positivity for hrHPV positive women.
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Affiliation(s)
- Kimon Chatzistamatiou
- 2nd Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Hippokratio General Hospital, 54642 Thessaloniki, Greece.
| | - Theodoros Moysiadis
- Institute of Applied Biosciences, Centre for Research & Technology-Hellas, 57001 Thessaloniki, Greece.
| | - Dimos Vryzas
- Medical School, Democritus University of Thrace, 68100 Alexandroupolis, Greece.
| | - Ekaterini Chatzaki
- Laboratory of Pharmacology, Medical School, Democritus University of Thrace, 68100 Alexandroupolis, Greece.
| | - Andreas M Kaufmann
- Department of Gynecology, Charité-Universitaetsmedizin Berlin, Campus Benjamin Franklin, 10117 Berlin, Germany.
| | | | | | | | - Athena Tsertanidou
- 4th Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Hippokratio General Hospital, 54642 Thessaloniki, Greece.
| | - Nikolaos Maglaveras
- Lab of Computing and Medical Informatics, Department of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece.
| | - Pidder Jansen-Duerr
- Research Institute for Biomedical Aging Research, University of Innsbruck, A-6020 Innsbruck, Austria.
| | - Theodoros Agorastos
- 4th Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Hippokratio General Hospital, 54642 Thessaloniki, Greece.
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Marchetti I, Zavaglia K, Bertacca G, Aretini P, Matteoli B, Viacava P, Prato B, De Punzio C, Genazzani AR, Bevilacqua G, Di Coscio G. HPV Testing and Pap Test: Role for a Combined Approach in a Non-Screened Population. Int J Biol Markers 2018; 21:149-56. [PMID: 17013796 DOI: 10.1177/172460080602100303] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The aim of the present study was to test the polymerase chain reaction (PCR) as a tool to identify human papillomavirus (HPV) in routine cytological samples scraped from the uterine cervix. Moreover, attention has been focused on the correlation between HPV types and early intraepithelial lesions. The study involved 586 women who had undergone conventional Pap test. Analysis of HPV infection was performed by PCR and HPV typing by dot blot. In a group of 78 cases histologically diagnosed as high-grade squamous intraepithelial lesions (HSILs), the cytological diagnosis was correct in 92.3% and the HPV test was positive in 89.8% of cases; combined positivity at Pap and/or HPV tests raised this figure to 99.0%. In a group of 67 cases histologically diagnosed as low-grade squamous intraepithelial lesions (LSILs), the cytological diagnosis was correct in 73.1% and the PCR-based HPV test was positive in 64.2%; combined positivity at Pap and/or HPV tests raised this figure to 91.0%. This study confirms the limitations of screening programs based on Pap test only. Our results suggest, in fact, that adding the HPV test to primary screening could increase the yield of preinvasive cervical lesions.
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Affiliation(s)
- I Marchetti
- Section of Cytopathology, Division of Surgical, Molecular and Ultrastructural Pathology, Department of Oncology, University of Pisa, Pisa University Hospital, Pisa, Italy.
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Karim S, Souho T, Benlemlih M, Bennani B. Cervical Cancer Induction Enhancement Potential of Chlamydia Trachomatis: A Systematic Review. Curr Microbiol 2018; 75:1667-1674. [PMID: 29356877 DOI: 10.1007/s00284-018-1439-7] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 01/16/2018] [Indexed: 01/15/2023]
Abstract
Human papillomavirus (HPV) persistent infection is the necessary but not sufficient cause of cervical cancer. Other co-factors are required to induce cell transformation that will evolve to malignant cervical cancer. These co-factors include physical elements, other sexually transmitted infections, and immune response. Chlamydia trachomatis the most common bacterial sexually transmitted infection is often asymptomatic but causes various syndromes such as cervicitis, endometritis, pelvic inflammatory disease, and infertility. It is established that this bacterium is involved in cell proliferation process and inhibit apoptosis. Furthermore, C. trachomatis may induce chronic inflammation, interfere with immune response by decreasing the number of antigen presenting cells, and reduce the cell-mediated immunity allowing the persistence of HPV. However, it is unclear whether this bacterium plays a particular role in cervical cancer induction. We therefore aimed at enlightening the actual knowledge about the relationship between C. trachomatis and cervical cancer or precursor lesions through a systematic literature review. We summarized and analyzed the epidemiological data on C. trachomatis and its co-infection with HPV and their association to cervical cancer.
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Affiliation(s)
- Safae Karim
- Laboratory of Microbiology and Molecular Biology, Faculty of Medicine and Pharmacy of Fez (FMPF), Sidi Mohammed Ben Abdellah University (USMBA), Fez, Morocco
- Laboratory of Biotechnologies, Faculty of Sciences Dhar El Mahraz, USMBA, Fez, Morocco
| | - Tiatou Souho
- Faculty of Science and Technology, University of Kara, Kara, Togo
| | - Mohamed Benlemlih
- Laboratory of Biotechnologies, Faculty of Sciences Dhar El Mahraz, USMBA, Fez, Morocco
| | - Bahia Bennani
- Laboratory of Microbiology and Molecular Biology, Faculty of Medicine and Pharmacy of Fez (FMPF), Sidi Mohammed Ben Abdellah University (USMBA), Fez, Morocco.
- Team of Microorganisms, Genomic and Oncogene Factors, Laboratory of Human Pathology, Biomedicine and Environmental, FMP, USMBA, Fez, Morocco.
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50
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Cruz-Gregorio A, Manzo-Merino J, Gonzaléz-García MC, Pedraza-Chaverri J, Medina-Campos ON, Valverde M, Rojas E, Rodríguez-Sastre MA, García-Cuellar CM, Lizano M. Human Papillomavirus Types 16 and 18 Early-expressed Proteins Differentially Modulate the Cellular Redox State and DNA Damage. Int J Biol Sci 2018; 14:21-35. [PMID: 29483822 PMCID: PMC5821046 DOI: 10.7150/ijbs.21547] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Accepted: 10/31/2017] [Indexed: 01/12/2023] Open
Abstract
Oxidative stress has been proposed as a risk factor for cervical cancer development. However, few studies have evaluated the redox state associated with human papillomavirus (HPV) infection. The aim of this work was to determine the role of the early expressed viral proteins E1, E2, E6 and E7 from HPV types 16 and 18 in the modulation of the redox state in an integral form. Therefore, generation of reactive oxygen species (ROS), concentration of reduced glutathione (GSH), levels and activity of the antioxidant enzymes catalase and superoxide dismutase (SOD) and deoxyribonucleic acid (DNA) damage, were analysed in epithelial cells ectopically expressing the viral proteins. Our research shows that E6 oncoproteins decreased GSH and catalase protein levels, as well as its enzymatic activity, which was associated with an increase in ROS production and DNA damage. In contrast, E7 oncoproteins increased GSH, as well as catalase protein levels and its activity, which correlated with a decrease in ROS without affecting DNA integrity. The co-expression of both E6 and E7 oncoproteins neutralized the effects that were independently observed for each of the viral proteins. Additionally, the combined expression of E1 and E2 proteins increased ROS levels with the subsequent increase in the marker for DNA damage phospho-histone 2AX (γH2AX). A decrease in GSH, as well as SOD2 levels and activity were also detected in the presence of E1 and E2, even though catalase activity increased. This study demonstrates that HPV early expressed proteins differentially modulate cellular redox state and DNA damage.
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Affiliation(s)
- Alfredo Cruz-Gregorio
- Programa de Maestría y Doctorado en Ciencias Bioquímicas, Facultad de Química, Universidad Nacional Autónoma de México, Ciudad Universitaria, 04510 Ciudad de México, México.,Unidad de Investigación Biomédica en Cáncer, Instituto Nacional de Cancerología, México/Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México. San Fernando No. 22, Col. Sección XVI, Tlalpan, 14080 Ciudad de México, México
| | - Joaquín Manzo-Merino
- CONACyT Research Fellow, Instituto Nacional de Cancerología, San Fernando No. 22, Col. Sección XVI, Tlalpan, México
| | - María Cecilia Gonzaléz-García
- Programa de Maestría y Doctorado en Ciencias Bioquímicas, Facultad de Química, Universidad Nacional Autónoma de México, Ciudad Universitaria, 04510 Ciudad de México, México.,Unidad de Investigación Biomédica en Cáncer, Instituto Nacional de Cancerología, México/Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México. San Fernando No. 22, Col. Sección XVI, Tlalpan, 14080 Ciudad de México, México
| | - José Pedraza-Chaverri
- Departamento de Biología, Facultad de Química, Universidad Nacional Autónoma de México, Ciudad Universitaria, 04510 Ciudad de México, México
| | - Omar Noel Medina-Campos
- Departamento de Biología, Facultad de Química, Universidad Nacional Autónoma de México, Ciudad Universitaria, 04510 Ciudad de México, México
| | - Mahara Valverde
- Departamento de Medicina Genómica y Toxicología Ambiental, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, 04510 Ciudad de México, México
| | - Emilio Rojas
- Departamento de Medicina Genómica y Toxicología Ambiental, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, 04510 Ciudad de México, México
| | - María Alexandra Rodríguez-Sastre
- Departamento de Medicina Genómica y Toxicología Ambiental, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, 04510 Ciudad de México, México
| | - Claudia María García-Cuellar
- Unidad de Investigación Biomédica en Cáncer, Instituto Nacional de Cancerología, México/Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México. San Fernando No. 22, Col. Sección XVI, Tlalpan, 14080 Ciudad de México, México
| | - Marcela Lizano
- Unidad de Investigación Biomédica en Cáncer, Instituto Nacional de Cancerología, México/Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México. San Fernando No. 22, Col. Sección XVI, Tlalpan, 14080 Ciudad de México, México.,Departamento de Medicina Genómica y Toxicología Ambiental, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, 04510 Ciudad de México, México
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