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Zhou J, Li Y, Xu K, Rong Y, Huang S, Wu H, Yi X, Liu C. Transcription factor c-Rel regulated by E5 affects the whole process after HPV16 infection through miR-133a-modulated feedback loop aim at mir-379-369 cluster. Cancer Cell Int 2022; 22:375. [PMID: 36457028 PMCID: PMC9714012 DOI: 10.1186/s12935-022-02794-6] [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: 08/07/2022] [Accepted: 11/15/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND During the development of cervical cancer, HPV infection causes a series of changes in transcription factors and microRNAs. But their relationships with pathogenic processes are not clear. METHODS Base on previous study, to analyse the relationship among HPV16 infection and the related transcription factors, related miRNAs, so as to further understand the molecular mechanism of HPV16 infection to cervical cancer, around the HPV16 related miRNAs we have reported, the methods of bioinformatics prediction, histology, cell model in vitro and molecular interaction were used for prediction and validation respectively RESULTS: The results showed that NF-κB family members(c-Rel, p65 and p50) were identified as main HPV16rmiR-transcription factors. They have different expressive characteristics in cervical lesions and play tumorigenesis or progression roles in different periods of HPV16 infection. c-Rel, p65 and p50 act as mediators which link the HPV16 E5 and HPV16 related miRNAs. Among them, c-Rel affects the occurrence and progression of cervical cancer during whole HPV16 infection stage through miR133a-3p-modulated mir-379-369 cluster with a positive feedback way which targeted c-Rel itself and its positive regulator AKT3. CONCLUSION So in the course of HPV16 infection, the E5, c-Rel, and miR-133a-3p form a positive feedback system which aim at mir-379-369 cluster for the whole process from HPV16 infection to cervical cancer.
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Affiliation(s)
- Juan Zhou
- grid.256607.00000 0004 1798 2653Department of Gynecologic Oncology, Guangxi Medical University Cancer Hospital, Nanning, 530021 Guangxi China ,grid.33199.310000 0004 0368 7223Department of Gynaecology and Obstetrics, Wuhan Children’s Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430016, Hubei, China
| | - Yongpeng Li
- grid.256607.00000 0004 1798 2653Department of Urology, Guangxi Medical University Cancer Hospital, Nanning, 530021 Guangxi China
| | - Ke Xu
- grid.256607.00000 0004 1798 2653Department of Gynecologic Oncology, Guangxi Medical University Cancer Hospital, Nanning, 530021 Guangxi China
| | - Yan Rong
- grid.256607.00000 0004 1798 2653Department of Gynecologic Oncology, Guangxi Medical University Cancer Hospital, Nanning, 530021 Guangxi China
| | - Siting Huang
- grid.256607.00000 0004 1798 2653Department of Gynecologic Oncology, Guangxi Medical University Cancer Hospital, Nanning, 530021 Guangxi China
| | - Hailun Wu
- grid.256607.00000 0004 1798 2653Department of Gynecologic Oncology, Guangxi Medical University Cancer Hospital, Nanning, 530021 Guangxi China
| | - Xianlin Yi
- grid.256607.00000 0004 1798 2653Department of Urology, Wuming Hospital of Guangxi Medical University, Nanning, 530199 GuangXi China
| | - Chanzhen Liu
- grid.256607.00000 0004 1798 2653Department of Gynecologic Oncology, Guangxi Medical University Cancer Hospital, Nanning, 530021 Guangxi China
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2
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Monteiro JC, Fonseca RRDS, Ferreira TCDS, Rodrigues LLS, da Silva ARB, Gomes ST, Silvestre RVD, Silva ANMR, Pamplona I, Vallinoto ACR, Ishak R, Machado LFA. Prevalence of High Risk HPV in HIV-Infected Women From Belém, Pará, Amazon Region of Brazil: A Cross-Sectional Study. Front Public Health 2021; 9:649152. [PMID: 33996727 PMCID: PMC8116653 DOI: 10.3389/fpubh.2021.649152] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 03/24/2021] [Indexed: 11/29/2022] Open
Abstract
Human papillomavirus (HPV) is the most common sexually transmitted infection in the world. Several studies have shown a higher prevalence of HPV infection in HIV-infected women. The aim of this study was to determine the prevalence and the genotype diversity of HPV infection in HIV-infected women. From April 2010 to December 2012 cervical specimens were collected from 169 HIV-infected women who screening for cervical cancer at Reference Unit in Belém. The detection of HPV infection was performed by nested PCR and HPV type was performed using a commercial system. The prevalence of HPV infection was 63.3%. Of the 47 genotyped samples, 40.4% was found positive for high risk-HPV 16 and 12.8% for high risk-HPV 52. HPV infection was predominant in the group of women with no incidence of cytological abnormalities and more prevalent in women of reproductive age, unmarried, low education level, and who reported use condoms during sexual intercourse. It was observed an association between HPV infection and independent variables, such as condom use, multiple sexual partners, and history of sexually transmitted diseases. High-risk types of HPV infection were prevalent in our study. Infection with multiple high-risk HPV genotypes may potentiate the development of cervical cancer in HIV-infected women.
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Affiliation(s)
- Jacqueline Cortinhas Monteiro
- Biology of Infectious and Parasitic Agents Post-Graduate Program, Federal University of Pará, Belém, Brazil.,Virology Laboratory, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
| | - Ricardo Roberto de Souza Fonseca
- Biology of Infectious and Parasitic Agents Post-Graduate Program, Federal University of Pará, Belém, Brazil.,Virology Laboratory, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
| | - Tuane Carolina de Sousa Ferreira
- Biology of Infectious and Parasitic Agents Post-Graduate Program, Federal University of Pará, Belém, Brazil.,Virology Laboratory, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
| | - Luana Lorena Silva Rodrigues
- Biology of Infectious and Parasitic Agents Post-Graduate Program, Federal University of Pará, Belém, Brazil.,Virology Laboratory, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
| | | | - Samara Tatielle Gomes
- Papillomavirus Laboratory, Evandro Chagas Institute, Health Ministry of Brazil, Ananindeua, Brazil
| | | | | | - Ilze Pamplona
- Reference Unit Specialized in Infectious and Parasitic Diseases, Belém, Brazil
| | - Antonio Carlos Rosário Vallinoto
- Biology of Infectious and Parasitic Agents Post-Graduate Program, Federal University of Pará, Belém, Brazil.,Virology Laboratory, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
| | - Ricardo Ishak
- Biology of Infectious and Parasitic Agents Post-Graduate Program, Federal University of Pará, Belém, Brazil.,Virology Laboratory, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
| | - Luiz Fernando Almeida Machado
- Biology of Infectious and Parasitic Agents Post-Graduate Program, Federal University of Pará, Belém, Brazil.,Virology Laboratory, Institute of Biological Sciences, Federal University of Pará, Belém, Brazil
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3
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Suehiro TT, Damke GMZF, Damke E, de Azevedo Ramos PLR, de Andrade Pereira Silva M, Pelloso SM, Huh WK, Franco RAF, da Silva VRS, Scarinci IC, Consolaro MEL. Cervical and oral human papillomavirus infection in women living with human immunodeficiency virus (HIV) and matched HIV-negative controls in Brazil. Infect Agent Cancer 2020; 15:31. [PMID: 32426032 PMCID: PMC7216672 DOI: 10.1186/s13027-020-00301-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 05/05/2020] [Indexed: 12/13/2022] Open
Abstract
Background Despite the demonstrated role of human Papillomavirus (HPV) in the etiology of cervical cancer and the strong evidence suggesting the importance of HPV in the development of oropharyngeal cancer, several aspects of the interrelationship between HPV infection in both body sites remain unknown, specifically in female human immunodeficiency virus (HIV)-positive (HIV+) patients. We aimed to assess the prevalence, distribution, and concordance of cervical and oral HPV in HIV+ women and matched HIV-negative (HIV-) controls in Brazil. Material and methods Cervical and endocervical samples for cytological screening and HPV detection and oral samples were collected from 115 HIV+ women using highly active antiretroviral therapy (HAART) and 139 HIV-matched controls (HIV-) in Maringá City, Brazil. Risk factors were assessed using a standardized questionnaire, and the data regarding HIV infection were obtained from the patients’ medical records. HPV detection and typing were performed using the Kit Multiplex XGEN Multi HPV Chip HS12. Results HIV infection was well controlled in this cohort, but women who exhibited detectable HIV loads were significantly associated with HPV-positive status overall (P = 0.03) and in cervical mucosa (P = 0.01). HIV+ women had significantly more abnormal cytological findings (P = 0.04) than HIV- women. Of the 115 HIV+ women, 48.7% were positive for cervical and/or oral HPV DNA; of the 139 HIV- women, 41% were positive for cervical and/or oral HPV (P = 0.25). Both HIV+ and HIV- women had a statistically higher prevalence of cervical HPV infection than oral infection. The concurrent HPV infection in two anatomical sites was similar in HIV+ and HIV- women; however, HPV type concordance was not observed. HPV type distribution was different between the anatomical sites in both groups, and HIV+ women presented less common types, mainly in oral mucosa. Conclusion Our data support the importance of testing HPV infection in HIV+ women, even when the HIV infection is well controlled. Prospective studies are required to better understand the natural history of HPV infection in both anatomical sites, specifically in HIV+ women.
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Affiliation(s)
- Tamy Taianne Suehiro
- 1Laboratory of Clinical Cytology, Department of Clinical Analysis and Biomedicine, State University of Maringá, Paraná, Brazil
| | | | - Edilson Damke
- 1Laboratory of Clinical Cytology, Department of Clinical Analysis and Biomedicine, State University of Maringá, Paraná, Brazil
| | | | | | | | - Warner K Huh
- 3School of Medicine, University of Alabama at Birmingham, Birmingham, AL USA
| | | | - Vânia Ramos Sela da Silva
- 1Laboratory of Clinical Cytology, Department of Clinical Analysis and Biomedicine, State University of Maringá, Paraná, Brazil
| | | | - Marcia Edilaine Lopes Consolaro
- 1Laboratory of Clinical Cytology, Department of Clinical Analysis and Biomedicine, State University of Maringá, Paraná, Brazil
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4
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Thorsteinsson K, Ladelund S, Storgaard M, Katzenstein TL, Johansen IS, Pedersen G, Rönsholt FF, Nielsen LN, Nilas L, Franzmann M, Obel N, Lebech AM, Bonde J. Persistence of cervical high-risk human papillomavirus in women living with HIV in Denmark - the SHADE. BMC Infect Dis 2019; 19:740. [PMID: 31438877 PMCID: PMC6706931 DOI: 10.1186/s12879-019-4377-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Accepted: 08/13/2019] [Indexed: 12/29/2022] Open
Abstract
Background Women living with HIV (WLWH) have high rates of persistent high-risk human papillomavirus (hrHPV) infections and cervical cancer. We aimed to assess the distribution of hrHPV genotypes, risk factors of type-specific hrHPV persistence, and high-grade squamous intraepithelial lesions or worse (≥HSIL) in WLWH in Denmark. Methods From the prospective Study on HIV, cervical Abnormalities and infections in women in Denmark (SHADE) we identified WLWH with a positive hrHPV test during the study period; 2011–2014. HIV demographics were retrieved from the Danish HIV Cohort Study and pathology results from the The Danish Pathology Data Bank. Logistic regression was used to identify risk factors associated with persistent hrHPV infection (positivity of the same hrHPV type in two samples one-two years after the first hrHPV positive date) and ≥ HSIL. Results Of 71 WLWH, 31 (43.7%) had persistent hrHPV infection. Predominant hrHPV genotypes were HPV58, 52, 51, and 35 and most frequently observed persistent genotypes were HPV52, 33 and 31. CD4 < 350 cells/μL predicted genotype-specific hrHPV persistence (adjusted OR 4.36 (95%CI: 1.18–16.04)) and ≥ HSIL was predicted by prior AIDS (adjusted OR 8.55 (95% CI 1.21–60.28)). Conclusions This prospective cohort study of well-treated WLWH in Denmark found a high rate of persistent hrHPV infections with predominantly non-16/18 hrHPV genotypes. CD4 count < 350 cells/μL predicted hrHPV persistence, while prior AIDS predicted ≥HSIL. Electronic supplementary material The online version of this article (10.1186/s12879-019-4377-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Kristina Thorsteinsson
- Department of Infectious Diseases, Hvidovre Hospital, Kettegaards Allé 30, 2650, Hvidovre, Denmark.
| | - Steen Ladelund
- Clinical Research Center, Copenhagen University Hospital, Hvidovre, Denmark
| | - Merete Storgaard
- Department of Infectious Diseases, Aarhus University Hospital, Skejby, Denmark
| | - Terese L Katzenstein
- Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.,Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | | | - Gitte Pedersen
- Department of Infectious Diseases, Aalborg University Hospital, Aalborg, Denmark
| | | | | | - Lisbeth Nilas
- Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.,Department of Obstetrics and Gynaecology, Copenhagen University Hospital, Hvidovre, Denmark
| | - Maria Franzmann
- Molecular Pathology Laboratory, Department of Pathology, Copenhagen University Hospital, Hvidovre, Denmark
| | - Niels Obel
- Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.,Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Anne-Mette Lebech
- Department of Infectious Diseases, Hvidovre Hospital, Kettegaards Allé 30, 2650, Hvidovre, Denmark.,Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Jesper Bonde
- Molecular Pathology Laboratory, Department of Pathology, Copenhagen University Hospital, Hvidovre, Denmark
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5
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Fitzpatrick MB, Dube Mandishora RS, Katzenstein DA, McCarty K, Weber J, Sahoo MK, Manasa J, Chirenje ZM, Pinsky BA. hrHPV prevalence and type distribution in rural Zimbabwe: A community-based self-collection study using near-point-of-care GeneXpert HPV testing. Int J Infect Dis 2019; 82:21-29. [PMID: 30807869 PMCID: PMC6538272 DOI: 10.1016/j.ijid.2019.02.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 02/18/2019] [Accepted: 02/18/2019] [Indexed: 12/02/2022] Open
Abstract
Objectives: High-risk human papilloma viruses (hrHPV) are the causative agents of cervical cancer, the leading cause of cancer deaths among Zimbabwean women. The objective of this study was to describe the hrHPV types found in Zimbabwe for consideration in cervical cancer screening and vaccination efforts. Design and methods: To determine hrHPV prevalence and type distribution in Zimbabwe we implemented a community-based cross-sectional study of self-collected cervicovaginal samples with hrHPV screening using near-point-of-care Cepheid GeneXpert HPV. Results: The hrHPV prevalence was 17% (112/643); 33% (41/123) vs. 14% (71/520) among HIV-1-positive and -negative participants, respectively (p = 2.3E-07). Typing via Xpert HPV showed very good overall agreement (77.2%, kappa = 0.698) with the Seegene Anyplex II HPV HR Detection kit. The most common types were HPV16, HPV18, HPV35, HPV52, HPV58, HPV68, HPV18, and HPV51, each of which appeared in 14–20% of infections. 37% (28/76) of women with positive cytology results (ASCUS+) had a type not included in the basic vaccine and 25% (19/76) had a type not currently in the nine-valent vaccine. Conclusions: hrHPV type distribution includes less common high-risk types in rural Zimbabwe. The distribution and carcinogenicity of hrHPV type distribution should be considered during screening assay design, program development, as well as vaccine distribution and design.
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Affiliation(s)
- Megan B Fitzpatrick
- Stanford University School of Medicine, Department of Pathology, Stanford, CA, USA
| | - Racheal S Dube Mandishora
- University of Zimbabwe College of Health Sciences, Department of Medical Microbiology, Harare, Zimbabwe
| | - David A Katzenstein
- Biomedical Research and Training Institute of Zimbabwe, Mount Pleasant, Harare, Zimbabwe; Stanford University School of Medicine, Department of Medicine, Division of Infectious Diseases and Geographic Medicine, Stanford, CA, USA
| | | | - Jenna Weber
- Stanford University School of Medicine, Department of Pathology, Stanford, CA, USA
| | - Malaya K Sahoo
- Stanford University School of Medicine, Department of Pathology, Stanford, CA, USA
| | - Justen Manasa
- University of Zimbabwe College of Health Sciences, Department of Medical Microbiology, Harare, Zimbabwe
| | - Zvavahera Mike Chirenje
- University of Zimbabwe College of Health Sciences, Department of Obstetrics and Gynecology, Harare, Zimbabwe
| | - Benjamin A Pinsky
- Stanford University School of Medicine, Department of Pathology, Stanford, CA, USA; Stanford University School of Medicine, Department of Medicine, Division of Infectious Diseases and Geographic Medicine, Stanford, CA, USA.
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6
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Orlando G, Frati ER, Fasolo MM, Bianchi S, Matteelli A, Mazza F, Rizzardini G, Amendola A, Tanzi E. Incident genital HPV infections and potential impact of HPV vaccines in adult women living with HIV/AIDS. Hum Vaccin Immunother 2018; 15:1904-1910. [PMID: 30261149 PMCID: PMC6746504 DOI: 10.1080/21645515.2018.1528834] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
This study aims to describe and characterize incident HR-HPV infections and associated diseases in HIV-infected women. 805 HIV-infected women enrolled in the VALHIDATE Study were screened and followed-up for HPV by co-testing. Social, behavioral and health data were collected. HPV-DNA positive samples were typed using a commercial kit or RFLP analysis. Conventional Pap-smears were evaluated using the 2001 Bethesda System. The participants with abnormal cytological results were referred for colposcopy. 565 HIV-infected women (median age: 43 years) were analysed, 40.9% had >5 lifetime sexual partners, 77.2% contracted HIV through sexual intercourse, 93% were receiving antiretroviral treatment and 77.3% had undetectable HIV-RNA. The women underwent 1254 follow-ups (median follow-up: 33 months) for 1430.6 PersonYear-Follow-Up. 37.4% of baseline HPV-negative women acquired incident HPV-infections, 69.6% of which were HR-HPVs. HPV-53 was the most common HPV type detected (9.3%). 18.2% of women showed incident or progressive cytological abnormalities (7.8% ASC-US, 9.7% LSIL and 0.6% HSIL) and colposcopy revealed CIN2 (N = 2), CIN1 (N = 2) and VIN3 (N = 1). The preventable fraction of incident infections was 11.3%, 16.7%, and 35.2% for the 2v-4v-9v-HPV vaccines respectively (χ2 p < 0.0001). The overall burden of incident lesions attributable to the vaccine types were 9.1% for 2v-, 14.5% for 4v- and 30.9% for 9v-vaccine. High HPV incidence rates and high percentages of multiple HR-HPV infections were observed in a cohort of HIV-infected women receiving effective antiretroviral treatment. Primary prevention strategies based on the new 9v-HPV vaccine may help to prevent incident infections and disease progression in this cohort of women.
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Affiliation(s)
- Giovanna Orlando
- a Infectious Diseases Outpatient Unit, Centro Diagnostico Italiano (CDI) , Milan , Italy
| | - Elena R Frati
- b Department of Biomedical Sciences for Health, University of Milan , Milan , Italy
| | - Michela M Fasolo
- c STD Unit, Infectious Diseases 1st, L Sacco University Hospital , Milan , Italy
| | - Silvia Bianchi
- b Department of Biomedical Sciences for Health, University of Milan , Milan , Italy
| | - Alberto Matteelli
- d Department of Infectious and Tropical Diseases, University of Brescia , Brescia , Italy
| | - Francesca Mazza
- e U.O. Laboratorio Analisi, ASST Santi Paolo e Carlo , Milan , Italy
| | | | - Antonella Amendola
- b Department of Biomedical Sciences for Health, University of Milan , Milan , Italy
| | - Elisabetta Tanzi
- b Department of Biomedical Sciences for Health, University of Milan , Milan , Italy
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7
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Involvement of the Toll-Like Receptor/Nitric Oxide Signaling Pathway in the Pathogenesis of Cervical Cancer Caused by High-Risk Human Papillomavirus Infection. BIOMED RESEARCH INTERNATIONAL 2017. [PMID: 28626766 PMCID: PMC5463171 DOI: 10.1155/2017/7830262] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Human papillomavirus (HPV) can activate Toll-like receptor (TLR)/nitric oxide (NO) signaling pathways; however, whether the TLR/NO pathway is involved in cervical cancer caused by high-risk HPV (HR-HPV) remains unclear. In this study, 43 HR-HPV-positive patients with cervical cancer (CC group), 39 HR-HPV-positive patients with a healthy cervix (HR-HPV group), and 33 HR-HPV-negative controls were recruited. NO concentration in cervical canal and expression of inducible NO synthase (iNOS) in cervical tissues were detected. Expressions of key TLR/NO pathway genes (TLR3/4/7/8, NF-κB p65, and iNOS) in cervical epithelial cells were detected by quantitative reverse transcription PCR. Expressions of TLR4, NF-κB p65, and iNOS in CaSki, HeLa, and C33a cells were determined by Western blot. NO concentration in cervical canal of CC group was significantly higher than in other groups (P < 0.05). Positive rates of iNOS in cervical tissues were 72.1%, 28.2%, and 3.1% in the CC group, HR-HPV group, and controls, respectively (P < 0.05). Levels of TLR3, TLR4, TLR7, TLR8, NF-κB p65, and iNOS in cervical epithelial cells were higher in CC group than in other groups (P < 0.05). Both mRNA and protein levels of TLR4, NF-κB p65, and iNOS were higher in HPV-positive HeLa and CaSki cells than in HPV-negative C33a cells (P < 0.05). Together, these results suggest that TLR/NO signaling pathway may be involved in pathogenesis of cervical cancer caused by HR-HPV.
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8
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Human papillomavirus 9-valent vaccine for cancer prevention: a systematic review of the available evidence. Epidemiol Infect 2017; 145:1962-1982. [PMID: 28446260 PMCID: PMC5974698 DOI: 10.1017/s0950268817000747] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
In 2014, the Food and Drug Administration approved a new human papillomavirus 9-valent vaccine (9vHPV), targeting nine HPV types: HPV types 6, 11, 16, and 18, which are also targeted by the quadrivalent HPV vaccine (qHPV), plus five additional high cancer risk HPV types (HPV types 31, 33, 45, 52, and 58). The aim of the current study was to systematically retrieve, qualitatively and quantitatively pool, as well as critically appraise all available evidence on 9vHPV from randomized controlled trials (RCTs). We conducted a systematic review of the literature on 9vHPV efficacy, immunogenicity and safety, as well as a systematic search of registered, completed, and ongoing RCTs. We retrieved and screened 227 records for eligibility. A total of 10 publications reported on RCTs’ results on 9vHPV and were included in the review. Sixteen RCTs on 9vHPV have been registered on RCT registries. There is evidence that 9vHPV generated a response to HPV types 6, 11, 16 and 18 that was non-inferior to qHPV. Vaccine efficacy against five additional HPV type-related diseases was directly assessed on females aged 16–26 years (risk reduction against high-grade cervical, vulvar or vaginal disease = 96·7%, 95% CI 80·9%–99·8%). Bridging efficacy was demonstrated for males and females aged 9–15 years and males aged 16–26 years (the lower bound of the 95% CIs of both the geometric mean titer ratio and difference in seroconversion rates meeting the criteria for non-inferiority for all HPV types). Overall, 9vHPV has been proved to be safe and well tolerated. Other RCTs addressed: 9vHPV co-administration with other vaccines, 9vHPV administration in subjects that previously received qHPV and 9vHPV efficacy in regimens containing fewer than three doses. The inclusion of additional HPV types in 9vHPV offers great potential to expand protection against HPV infection. However, the impact of 9vHPV on reducing the global burden of HPV-related disease will greatly depend on vaccine uptake, coverage, availability, and affordability.
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9
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Kelly HA, Ngou J, Chikandiwa A, Sawadogo B, Gilham C, Omar T, Lompo O, Doutre S, Meda N, Weiss HA, Delany-Moretlwe S, Segondy M, Mayaud P. Associations of Human Papillomavirus (HPV) genotypes with high-grade cervical neoplasia (CIN2+) in a cohort of women living with HIV in Burkina Faso and South Africa. PLoS One 2017; 12:e0174117. [PMID: 28333966 PMCID: PMC5363860 DOI: 10.1371/journal.pone.0174117] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Accepted: 03/04/2017] [Indexed: 12/29/2022] Open
Abstract
Objective To describe associations of high-risk human papillomavirus (HR-HPV) with high-grade cervical intraepithelial neoplasia (CIN2+) in women living with HIV (WLHIV) in Burkina Faso (BF) and South Africa (SA). Methods Prospective cohort of WLHIV attending HIV outpatient clinics and treatment centres. Recruitment was stratified by ART status. Cervical HPV genotyping using INNO-LiPA and histological assessment of 4-quadrant cervical biopsies at enrolment and 16 months later. Results Among women with CIN2+ at baseline, the prevalence of any HR-HPV genotypes included in the bi/quadrivalent (HPV16/18) or nonavalent (HPV16/18/31/35/45/52/58) HPV vaccines ranged from 37% to 90%. HPV58 was most strongly associated with CIN2+ (aOR = 5.40, 95%CI: 2.77–10.53). At 16-months follow-up, persistence of any HR-HPV was strongly associated with incident CIN2+ (aOR = 7.90, 95%CI: 3.11–20.07), as was persistence of HPV16/18 (aOR = 5.25, 95%CI: 2.14–12.91) and the additional HR types in the nonavalent vaccine (aOR = 3.23, 95%CI: 1.23–8.54). Conclusion HR-HPV persistence is very common among African WLHIV and is linked to incident CIN2+. HPV vaccines could prevent between 37–90% of CIN2+ among African WLHIV.
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Affiliation(s)
- Helen A Kelly
- Clinical Research Department, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Jean Ngou
- INSERM U1058 and University Hospital (CHRU), Montpellier, France
| | - Admire Chikandiwa
- Wits Reproductive Health and HIV Institute, University of the Witwatersrand, Johannesburg, South Africa
| | - Bernard Sawadogo
- Centre de Recherches Internationales en Santé, University of Ouagadougou, Ouagadougou, Burkina Faso
| | - Clare Gilham
- Clinical Research Department, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Tanvier Omar
- National Health Laboratory Services, Johannesburg, South Africa
| | - Olga Lompo
- Centre de Recherches Internationales en Santé, University of Ouagadougou, Ouagadougou, Burkina Faso
| | - Sylviane Doutre
- INSERM U1058 and University Hospital (CHRU), Montpellier, France
| | - Nicolas Meda
- Centre de Recherches Internationales en Santé, University of Ouagadougou, Ouagadougou, Burkina Faso
| | - Helen A Weiss
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom.,MRC Tropical Epidemiology Group, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | | | - Michel Segondy
- INSERM U1058 and University Hospital (CHRU), Montpellier, France
| | - Philippe Mayaud
- Clinical Research Department, London School of Hygiene and Tropical Medicine, London, United Kingdom.,Wits Reproductive Health and HIV Institute, University of the Witwatersrand, Johannesburg, South Africa
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