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Tosado-Rodríguez E, Mendez LB, Espino AM, Dorta-Estremera S, Aquino EE, Romaguera J, Godoy-Vitorino F. Inflammatory cytokines and a diverse cervicovaginal microbiota associate with cervical dysplasia in a cohort of Hispanics living in Puerto Rico. PLoS One 2023; 18:e0284673. [PMID: 38064478 PMCID: PMC10707696 DOI: 10.1371/journal.pone.0284673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 11/23/2023] [Indexed: 12/18/2023] Open
Abstract
Cervical cancer (CC) is women's fourth most common cancer worldwide. A worrying increase in CC rates in Hispanics suggests that besides Human papillomavirus infections, there may be other cofactors included in the epithelial microenvironment that could play a role in promoting the disease. We hypothesized that the cervical microbiome and the epithelial microenvironment favoring inflammation is conducive to disease progression in a group of Hispanics attending gynecology clinics in Puerto Rico. Few studies have focused on the joint microbiota and cytokine profile response in Hispanics outside the US, especially regarding the development of precancerous lesions. We aimed to investigate the relationship between the cervicovaginal microbiome and inflammation in Hispanic women living in PR while considering cervical dysplasia and HPV genotype risk. Cervical samples collected from 91 participants coming to gynecology clinics in San Juan, underwent 16S rRNA genes (V4 region) profiling, and cytokines were measured using Luminex MAGPIX technology. Cytokines were grouped as inflammatory (IL-1β, TNFα, IFNγ, IL-6), anti-inflammatory (IL- 4, IL-10, TGFβ1), and traffic-associated (IL-8, MIP1a, MCP1, IP10). They were related to microbes via an inflammation scoring index based on the quartile and tercile distribution of the cytokine's concentration. We found significant differences in the diversity and composition of the microbiota according to HPV type according to carcinogenic risk, cervical disease, and cytokine abundance. Community State Types (CSTs) represents a profile of microbial communities observed within the vaginal microbiome ecological niche, and Lactobacillus-depleted CST IV had ~ 90% dominance in participants with high-grade squamous intraepithelial lesions and high-risk HPV. The increasing concentration of pro-inflammatory cytokines was associated with a decrease in L. crispatus. In contrast, dysbiosis-associated bacteria such as Gardnerella, Prevotella, Atopobium concomitantly increased with pro-inflammatory cytokines. Our study highlights that the cervical microbiota of Hispanics living in Puerto Rico is composed mostly of diverse CST profiles with decreased Lactobacillus and is associated with a higher pro-inflammatory environment. The joint host-microbe interaction analyses via cytokine and microbiota profiling have very good translational potential.
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Affiliation(s)
- Eduardo Tosado-Rodríguez
- Department of Microbiology and Medical Zoology, School of Medicine, Medical Sciences Campus, University of Puerto Rico, Carolina, Puerto Rico, United States of America
| | - Loyda B. Mendez
- University Ana G. Méndez, Carolina Campus, Carolina, Puerto Rico, United States of America
| | - Ana M. Espino
- Department of Microbiology and Medical Zoology, School of Medicine, Medical Sciences Campus, University of Puerto Rico, Carolina, Puerto Rico, United States of America
| | - Stephanie Dorta-Estremera
- Department of Microbiology and Medical Zoology, School of Medicine, Medical Sciences Campus, University of Puerto Rico, Carolina, Puerto Rico, United States of America
- Cancer Biology, Comprehensive Cancer Center University of Puerto Rico, Carolina, Puerto Rico, United States of America
| | - Edna E. Aquino
- Department of Microbiology and Medical Zoology, School of Medicine, Medical Sciences Campus, University of Puerto Rico, Carolina, Puerto Rico, United States of America
| | - Josefina Romaguera
- Department of OBGYN, School of Medicine, Medical Sciences Campus, University of Puerto Rico, Carolina, Puerto Rico, United States of America
| | - Filipa Godoy-Vitorino
- Department of Microbiology and Medical Zoology, School of Medicine, Medical Sciences Campus, University of Puerto Rico, Carolina, Puerto Rico, United States of America
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Jailani AS, Balqis-Ali NZ, Tang KF, Fun WH, Samad SA, Jahaya R, Subakir NN, Ismail R, Said ZM, Sararaks S. Prevalence and sociodemographic predictors of high-risk vaginal human papillomavirus infection: findings from a public cervical cancer screening registry. BMC Public Health 2023; 23:2243. [PMID: 37964260 PMCID: PMC10644607 DOI: 10.1186/s12889-023-17132-2] [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: 01/21/2023] [Accepted: 11/01/2023] [Indexed: 11/16/2023] Open
Abstract
INTRODUCTION High-risk human papillomavirus (HPV) screening is vital for early cervical cancer detection and treatment. With the introduction of the national cervical cancer screening programme and screening registry in Malaysia, there is a need to monitor population-based HPV screening uptake and high-risk HPV prevalence as part of cervical cancer surveillance. OBJECTIVE To determine the prevalence and sociodemographic factors predicting high-risk HPV infection in Malaysia based on a public, community-based cervical cancer screening registry targeting women at risk of getting HPV infection. METHODS The study used data from the Malaysian cervical cancer screening registry established by the Family Health Development Division from 2019 to 2021. The registry recorded sociodemographic data, HPV test details and results of eligible women who underwent HPV screening at public primary healthcare facilities. A vaginal sample (via self-sampling or assisted by a healthcare provider) was used for DNA extraction for HPV detection and genotyping. Registry data were extracted and analysed to determine prevalence estimates of high-risk HPV infection. Multifactorial logistic regression analysis was conducted to determine predictors of high-risk HPV infection. All analyses were performed using Stata version 14. RESULTS The programme screened a total of 36,738 women during the study period. Women who attended the screening programme were mainly from urban areas, aged 30-39 years, and of Malay ethnicity. The prevalence of high-risk HPV infection was 4.53% among women screened, with the yearly prevalence ranging from 4.27 to 4.80%. A higher prevalence was observed among urban settling women, those aged 30-49 years, those of Indian ethnicity, and those without children. The results from logistic regression showed that women from urban areas, lower age groups, of Indian or Chinese ethnicity, and who are self-employed were more likely to be infected with high-risk HPV. CONCLUSION Targeted and robust strategies to reach identified high-risk groups are needed in Malaysia. In addition, the registry has the potential to be expanded for an improved cervical cancer elimination plan. TRIAL REGISTRATION Trial registration number: NMRR ID-22-00187-DJU.
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Affiliation(s)
- Anis-Syakira Jailani
- Centre for Health Outcomes Research, Institute for Health Systems Research, National Institutes of Health, Ministry of Health Malaysia, Block B2, No. 1, Jalan Setia Murni U13/52, Seksyen U13 Bandar Setia Alam, Shah Alam, Selangor, 40170, Malaysia
| | - Nur Zahirah Balqis-Ali
- Centre for Health Outcomes Research, Institute for Health Systems Research, National Institutes of Health, Ministry of Health Malaysia, Block B2, No. 1, Jalan Setia Murni U13/52, Seksyen U13 Bandar Setia Alam, Shah Alam, Selangor, 40170, Malaysia.
| | - Kar Foong Tang
- Centre for Health Outcomes Research, Institute for Health Systems Research, National Institutes of Health, Ministry of Health Malaysia, Block B2, No. 1, Jalan Setia Murni U13/52, Seksyen U13 Bandar Setia Alam, Shah Alam, Selangor, 40170, Malaysia
| | - Weng Hong Fun
- Centre for Health Outcomes Research, Institute for Health Systems Research, National Institutes of Health, Ministry of Health Malaysia, Block B2, No. 1, Jalan Setia Murni U13/52, Seksyen U13 Bandar Setia Alam, Shah Alam, Selangor, 40170, Malaysia
| | - Shazimah Abdul Samad
- Family Health Section, Family Health Development Division, Ministry of Health, Malaysia, Putrajaya, 62590, Malaysia
| | - Rohaidza Jahaya
- Family Health Section, Family Health Development Division, Ministry of Health, Malaysia, Putrajaya, 62590, Malaysia
| | - Nurun Najihah Subakir
- Family Health Section, Family Health Development Division, Ministry of Health, Malaysia, Putrajaya, 62590, Malaysia
| | - Roziah Ismail
- Family Health Section, Family Health Development Division, Ministry of Health, Malaysia, Putrajaya, 62590, Malaysia
| | - Zakiah Mohd Said
- Family Health Section, Family Health Development Division, Ministry of Health, Malaysia, Putrajaya, 62590, Malaysia
| | - Sondi Sararaks
- Centre for Health Outcomes Research, Institute for Health Systems Research, National Institutes of Health, Ministry of Health Malaysia, Block B2, No. 1, Jalan Setia Murni U13/52, Seksyen U13 Bandar Setia Alam, Shah Alam, Selangor, 40170, Malaysia
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3
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de Geus V, Ewing-Graham PC, de Koning W, de Koning MNC, van den Bosch TPP, Nigg AL, van Eijck CHJ, Jozwiak M, van Beekhuizen HJ, Mustafa DAM. Identifying Molecular Changes in Early Cervical Cancer Samples of Patients That Developed Metastasis. Front Oncol 2022; 11:715077. [PMID: 35087740 PMCID: PMC8787153 DOI: 10.3389/fonc.2021.715077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 12/17/2021] [Indexed: 11/13/2022] Open
Abstract
Cervical cancer is one of the most common cancers in women worldwide. Patients diagnosed with early-stage cervical cancer have a good prognosis, however, 10-20% suffer from local or distant recurrent disease after primary treatment. Treatment options for recurrent cervical cancer are limited. Therefore, it is crucial to identify factors that can predict patients with an increased risk of recurrence to optimize treatment to prevent the recurrence of cervical cancer. We aimed to identify biomarkers in early-stage primary cervical cancer which recurred after surgery. Formalin-Fixed, Paraffin-Embedded surgical specimens of 34 patients with early-stage cervical cancer (FIGO 2009 stage 1B1) and 7 healthy controls were analyzed. Targeted gene expression profiling using the PanCancer IO 360 panel of NanoString Technology was performed. The findings were confirmed by performing immunohistochemistry stainings. Various genes, namely GLS, CD36, WNT5a, HRAS, DDB2, PIK3R2, and CDH2 were found to be differentially highly expressed in primary cervical cancer samples of patients who developed distant recurrence. In addition, The relative infiltration score of CD8+ T cells, CD80+CD86+ macrophages, CD163+MRC1+ macrophages, and FOXP3+IL2RA+ regulatory T cells were significantly higher in this group of samples. In contrast, no significant differences in gene expression and relative immune infiltration were found in samples of patients who developed local recurrence. The infiltration of CD8 and FOXP3 cells were validated by immunohistochemistry using all samples included in the study. We identified molecular alterations in primary cervical cancer samples from patients who developed recurrent disease. These findings can be utilized towards developing a molecular signature for the early detection of patients with a high risk to develop metastasis.
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Affiliation(s)
- Vera de Geus
- Department of Gynaecologic Oncology, Erasmus MC Cancer Institute, Rotterdam, Netherlands.,Department of Pathology, Tumor Immuno-Pathology Laboratory, Erasmus University Medical Center Rotterdam, Rotterdam, Netherlands
| | | | - Willem de Koning
- Department of Pathology, Tumor Immuno-Pathology Laboratory, Erasmus University Medical Center Rotterdam, Rotterdam, Netherlands.,Department of Pathology, Clinical Bioinformatics Unit, Erasmus University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Maurits N C de Koning
- Department of Research & Development Services, Delft Diagnostic Laboratory (DDL) Diagnostic Laboratory, Rijswijk, Netherlands
| | | | - Alex L Nigg
- Department of Pathology, Erasmus MC Cancer Institute, Rotterdam, Netherlands
| | - Casper H J van Eijck
- Department of Surgery, Erasmus University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Marta Jozwiak
- Department of Gynaecologic Oncology, Erasmus MC Cancer Institute, Rotterdam, Netherlands
| | | | - Dana A M Mustafa
- Department of Pathology, Tumor Immuno-Pathology Laboratory, Erasmus University Medical Center Rotterdam, Rotterdam, Netherlands
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MacDonald-Ottevanger MS, Boyd A, Prins M, van der Helm JJ, Zijlmans CWR, Hindori-Mohangoo AD, Harkisoen S, Hermelijn SM, Brinkman K, Codrington J, Roosblad J, Kort SAR, Dams ETM, van de Laar TJW, Vreden SGS. Differences in prevalence of hepatitis B virus infection and genotypes between ethnic populations in Suriname, South America. Virology 2021; 564:53-61. [PMID: 34656809 DOI: 10.1016/j.virol.2021.09.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 09/21/2021] [Accepted: 09/22/2021] [Indexed: 12/24/2022]
Abstract
Epidemiological data on hepatitis B virus (HBV) are needed to benchmark HBV elimination goals. We recently assessed prevalence of HBV infection and determinants in participants attending the Emergency Department in Paramaribo, Suriname, South America. Overall, 24.5% (95%CI = 22.7-26.4%) of participants had anti-Hepatitis B core antibodies, which was associated with older age (per year, adjusted Odds Ratio [aOR] = 1.03, 95%CI = 1.02-1.04), Afro-Surinamese (aOR = 1.84, 95%CI = 1.52-2.19) and Javanese ethnicity (aOR = 1.63, 95%CI = 1.28-2.07, compared to the grand mean). 3.2% of participants were Hepatitis B surface Ag-positive, which was also associated with older age (per year, aOR = 1.02, 95%CI = 1.00-1.04), Javanese (aOR = 4.3, 95%CI = 2.66-6.95) and Afro-Surinamese ethnicity (aOR = 2.36, 95%CI = 1.51-3.71). Sex, nosocomial or culturally-related HBV transmission risk-factors were not associated with infection. Phylogenetic analysis revealed strong ethnic clustering: Indonesian subgenotype HBV/B3 among Javanese and African subgenotypes HBV/A1, HBV/QS-A3 and HBV/E among Afro-Surinamese. Testing for HBV during adulthood should be considered for individuals living in Suriname, specifically with Javanese and Afro-Surinamese ancestry.
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Affiliation(s)
- M S MacDonald-Ottevanger
- Scientific Research Center Suriname, Academic Hospital Paramaribo, Paramaribo, Suriname; Department of Medical Microbiology, Academic Medical Center, Amsterdam, the Netherlands.
| | - A Boyd
- Department of Infectious Diseases, Public Health Service Amsterdam (GGD), Amsterdam, the Netherlands; Stichting HIV Monitoring, Amsterdam, the Netherlands
| | - M Prins
- Department of Infectious Diseases, Public Health Service Amsterdam (GGD), Amsterdam, the Netherlands
| | - J J van der Helm
- Department of Infectious Diseases, Public Health Service Amsterdam (GGD), Amsterdam, the Netherlands
| | - C W R Zijlmans
- Faculty of Medical Sciences, Anton de Kom University of Suriname, Paramaribo, Suriname; Department of Environmental Health Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA; Foundation for Perinatal Interventions and Research in Suriname (Perisur), Paramaribo, Suriname
| | - A D Hindori-Mohangoo
- Department of Environmental Health Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA; Foundation for Perinatal Interventions and Research in Suriname (Perisur), Paramaribo, Suriname
| | - S Harkisoen
- Department of Infectious Diseases, Academic Hospital Paramaribo, Suriname
| | - S M Hermelijn
- Department of Medical Microbiology, Academic Hospital Paramaribo, Suriname
| | - K Brinkman
- Department of Infectious Diseases, Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands
| | - J Codrington
- Department of Clinical Chemistry, Academic Hospital Paramaribo, Suriname
| | - J Roosblad
- Department of Clinical Chemistry, Academic Hospital Paramaribo, Suriname
| | | | - E Th M Dams
- Department of Internal Medicine, Diakonessenhuis, Paramaribo, Suriname
| | - T J W van de Laar
- Department of Medical Microbiology, Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands; Sanquin Research, Department of Donor Medicine Research, Amsterdam, the Netherlands
| | - S G S Vreden
- Department of Infectious Diseases, Academic Hospital Paramaribo, Suriname; Foundation for Scientific Research Suriname, Paramaribo, Suriname
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Leeman A, Del Pino M, Molijn A, Rodriguez A, Torné A, de Koning M, Ordi J, van Kemenade F, Jenkins D, Quint W. HPV testing in first-void urine provides sensitivity for CIN2+ detection comparable with a smear taken by a clinician or a brush-based self-sample: cross-sectional data from a triage population. BJOG 2018; 124:1356-1363. [PMID: 28391609 DOI: 10.1111/1471-0528.14682] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/06/2017] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To compare the sensitivity of high-risk human papillomavirus (hrHPV) and genotype detection in self-collected urine samples in the morning (U1), and later on (U2), brush-based self-samples (SS), and clinician-taken smears (CTS) for detecting cervical intraepithelial neoplasia grade 2+ (CIN2+) in a colposcopic referral population. DESIGN Cross-sectional single-centre study. SETTING A colposcopy clinic in Spain. POPULATION A cohort of 113 women referred for colposcopy after an abnormal Pap smear. METHODS Women undergoing colposcopy with biopsy for abnormal Pap smears were sent a device (Colli-Pee™, Novosanis, Wijnegem, Belgium) to collect U1 on the morning of colposcopy. U2, CTS, and SS (Evalyn brush™, Rovers Medical Devices B.V., Oss, the Netherlands) were also analysed. All samples were tested for HPV DNA using the analytically sensitive SPF10-DEIA-LiPA25 assay and the clinically validated GP5+/6+-EIA-LMNX. MAIN OUTCOME MEASURES Histologically confirmed CIN2+ and hrHPV positivity for 14 high-risk HPV types. RESULTS Samples from 91 patients were analysed. All CIN3 cases (n = 6) tested positive for hrHPV in CTS, SS, U1, and U2 with both HPV assays. Sensitivity for CIN2+ with the SPF10 system was 100, 100, 95, and 100%, respectively. With the GP5+/6+ assay, sensitivity was 95% in all sample types. The sensitivities and specificities for both tests on each of the sample types did not significantly differ. There was 10-14% discordance on hrHPV genotype. CONCLUSIONS CIN2+ detection using HPV testing of U1 shows a sensitivity similar to that of CTS or brush-based SS, and is convenient. There was substantial to almost excellent agreement between all samples on genotype with both hrHPV assays. There was no advantage in testing U1 compared with U2 samples. TWEETABLE ABSTRACT Similar CIN2+ sensitivity for HPV testing in first-void urine, physician-taken smear and brush-based self-sample.
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Affiliation(s)
- A Leeman
- DDL Diagnostic Laboratory, ER Rijswijk, the Netherlands
| | - M Del Pino
- Faculty of Medicine-University 9 of Barcelona, Institute of Gynaecology, Obstetrics and Neonatology, Hospital Clínic-Institut d'Investigacions Biomèdiques August Pi I 8 Sunyer (IDIBAPS), Barcelona, Spain
| | - A Molijn
- DDL Diagnostic Laboratory, ER Rijswijk, the Netherlands
| | - A Rodriguez
- Faculty of Medicine-University 9 of Barcelona, Institute of Gynaecology, Obstetrics and Neonatology, Hospital Clínic-Institut d'Investigacions Biomèdiques August Pi I 8 Sunyer (IDIBAPS), Barcelona, Spain
| | - A Torné
- Faculty of Medicine-University 9 of Barcelona, Institute of Gynaecology, Obstetrics and Neonatology, Hospital Clínic-Institut d'Investigacions Biomèdiques August Pi I 8 Sunyer (IDIBAPS), Barcelona, Spain
| | - M de Koning
- DDL Diagnostic Laboratory, ER Rijswijk, the Netherlands
| | - J Ordi
- Department of Pathology, ISGLobal 11 (Institut de Salit Global de Barcelona)-Hospital Clínic, Barcelona, Spain
| | - F van Kemenade
- Department of Pathology, Erasmus Medical Centre, CA Rotterdam, the Netherlands
| | - D Jenkins
- DDL Diagnostic Laboratory, ER Rijswijk, the Netherlands
| | - W Quint
- DDL Diagnostic Laboratory, ER Rijswijk, the Netherlands
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Godoy-Vitorino F, Romaguera J, Zhao C, Vargas-Robles D, Ortiz-Morales G, Vázquez-Sánchez F, Sanchez-Vázquez M, de la Garza-Casillas M, Martinez-Ferrer M, White JR, Bittinger K, Dominguez-Bello MG, Blaser MJ. Cervicovaginal Fungi and Bacteria Associated With Cervical Intraepithelial Neoplasia and High-Risk Human Papillomavirus Infections in a Hispanic Population. Front Microbiol 2018; 9:2533. [PMID: 30405584 PMCID: PMC6208322 DOI: 10.3389/fmicb.2018.02533] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Accepted: 10/04/2018] [Indexed: 01/28/2023] Open
Abstract
The human cervicovaginal microbiota resides at an interface between the host and the environment and may affect susceptibility to disease. Puerto Rican women have high human papillomavirus (HPV) infection and cervical cancer rates. We hypothesized that the population structure of the cervicovaginal bacterial and fungal biota changed with cervical squamous intraepithelial lesions and HPV infections. DNA was extracted from cervix, introitus, and anal sites of 62 patients attending high-risk San Juan clinics. The 16S rRNA V4 region and ITS-2 fungal regions were amplified and sequenced using Illumina technology. HPV genotyping was determined by reverse hybridization with the HPV SPF10-LiPA25 kit. HPV prevalence was 84% of which ∼44% subjects were infected with high-risk HPV, ∼35% were co-infected with as many as 9 HPV types and ∼5% were infected with exclusively low-risk HPV types. HPV diversity did not change with cervical dysplasia. Cervical bacteria were more diverse in patients with CIN3 pre-cancerous lesions. We found enrichment of Atopobium vaginae and Gardnerella vaginalis in patients with CIN3 lesions. We found no significant bacterial biomarkers associated with HPV infections. Fungal diversity was significantly higher in cervical samples with high-risk HPV and introitus samples of patients with Atypical Squamous Cells of Undetermined Significance (ASCUS). Fungal biomarker signatures for vagina and cervix include Sporidiobolaceae and Sacharomyces for ASCUS, and Malassezia for high-risk HPV infections. Our combined data suggests that specific cervicovaginal bacterial and fungal populations are related to the host epithelial microenvironment, and could play roles in cervical dysplasia.
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Affiliation(s)
- Filipa Godoy-Vitorino
- Microbiome Lab, Department of Microbiology and Medical Zoology, School of Medicine, Medical Sciences Campus, University of Puerto Rico, San Juan, PR, United States
- Microbial Ecology and Genomics Laboratory, Department of Natural Sciences, Inter American University of Puerto Rico, San Juan, PR, United States
| | - Josefina Romaguera
- Department of Obstetrics and Gynecology, School of Medicine, Medical Sciences Campus, University of Puerto Rico, San Juan, PR, United States
| | - Chunyu Zhao
- Division of Gastroenterology, Hepatology, and Nutrition, Children’s Hospital of Philadelphia, Philadelphia, PA, United States
| | - Daniela Vargas-Robles
- Department of Biology, University of Puerto Rico, San Juan, PR, Puerto Rico
- Servicio Autónomo Centro Amazónico de Investigación y Control de Enfermedades Tropicales Simón Bolívar, MPPS, Puerto Ayacucho, Venezuela
| | - Gilmary Ortiz-Morales
- Microbial Ecology and Genomics Laboratory, Department of Natural Sciences, Inter American University of Puerto Rico, San Juan, PR, United States
| | - Frances Vázquez-Sánchez
- Microbial Ecology and Genomics Laboratory, Department of Natural Sciences, Inter American University of Puerto Rico, San Juan, PR, United States
| | | | - Manuel de la Garza-Casillas
- Microbial Ecology and Genomics Laboratory, Department of Natural Sciences, Inter American University of Puerto Rico, San Juan, PR, United States
| | - Magaly Martinez-Ferrer
- Comprehensive Cancer Center, University of Puerto Rico, San Juan, PR, United States
- Department of Pharmaceutical Sciences, Medical Sciences Campus, University of Puerto Rico, San Juan, PR, United States
| | | | - Kyle Bittinger
- Division of Gastroenterology, Hepatology, and Nutrition, Children’s Hospital of Philadelphia, Philadelphia, PA, United States
| | - Maria Gloria Dominguez-Bello
- Department of Biochemistry and Microbiology and of Anthropology, Rutgers University, New Brunswick, NJ, United States
| | - Martin J. Blaser
- Department of Medicine and Department of Microbiology, School of Medicine, New York University, New York, NY, United States
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High Rate of Infection by Only Oncogenic Human Papillomavirus in Amerindians. mSphere 2018; 3:3/3/e00176-18. [PMID: 29720524 PMCID: PMC5932372 DOI: 10.1128/msphere.00176-18] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Accepted: 04/12/2018] [Indexed: 01/01/2023] Open
Abstract
The role of HPV type distribution on the disparity of cervical cancer (CC) incidence between human populations remains unknown. The incidence of CC in the Amazonas State of Venezuela is higher than the national average. In this study, we determined the diversity of known HPV types (the viral agent of CC) in Amerindian and mestizo women living in the Venezuelan Amazonas State. Understanding the ecological diversity of HPV in populations undergoing lifestyle transformations has important implication on public health measures for cervical cancer prevention. Human papillomavirus (HPV), an etiological agent of cervical cancer (CC), has infected humans since ancient times. Amerindians are the furthest migrants out of Africa, and they reached the Americas more than 14,000 years ago. Some groups still remain isolated, and some migrate to towns, forming a gradient spanning urbanization. We hypothesized that, by virtue of their history, lifestyle, and isolation from the global society, remote Amerindian women have lower HPV diversity than do urban women (Amerindian or mestizo). Here we determined the diversity of the 25 most relevant cervical HPV types in 82 Amerindians spanning urbanization (low, medium, and high, consistent with the exposure to urban lifestyles of the town of Puerto Ayacucho in the Venezuelan Amazonas State), and in 29 urban mestizos from the town. Cervical, anal, oral, and introitus samples were taken, and HPVs were typed using reverse DNA hybridization. A total of 23 HPV types were detected, including 11 oncogenic or high-risk types, most associated with CC. Cervical HPV prevalence was 75%, with no differences by group, but Amerindians from low and medium urbanization level had significantly lower HPV diversity than mestizos did. In Amerindians, but not in mestizos, infections by only high-risk HPVs were higher than coinfections or by exclusively low-risk HPVs. Cervical abnormalities only were observed in Amerindians (9/82), consistent with their high HPV infection. The lower cervical HPV diversity in more isolated Amerindians is consistent with their lower exposure to the global pool, and transculturation to urban lifestyles could have implications on HPV ecology, infection, and virulence. IMPORTANCE The role of HPV type distribution on the disparity of cervical cancer (CC) incidence between human populations remains unknown. The incidence of CC in the Amazonas State of Venezuela is higher than the national average. In this study, we determined the diversity of known HPV types (the viral agent of CC) in Amerindian and mestizo women living in the Venezuelan Amazonas State. Understanding the ecological diversity of HPV in populations undergoing lifestyle transformations has important implication on public health measures for CC prevention.
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Hooi DJ, Lissenberg-Witte BI, de Koning MNC, Pinedo HM, Kenter GG, Meijer CJ, Quint WG. High prevalence of high-risk HPV genotypes other than 16 and 18 in cervical cancers of Curaçao: implications for choice of prophylactic HPV vaccine. Sex Transm Infect 2017; 94:263-267. [PMID: 29021405 PMCID: PMC5969325 DOI: 10.1136/sextrans-2017-053109] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Revised: 07/21/2017] [Accepted: 08/08/2017] [Indexed: 12/14/2022] Open
Abstract
Background Curaçao is a Dutch-Caribbean Island located in a high-risk area for cervical cancer. Prior to introduction of a prophylactic human papillomavirus (HPV) vaccine, knowledge of the prevalence of high-risk HPV vaccine genotypes (HPV16, 18, 31, 33, 45, 52 and 58) in cervical (pre)cancer is required. Objective To investigate the prevalence of HPV genotypes in invasive cervical cancers (ICC) and cervical intraepithelial neoplasia (CIN) grade 1, 2 and 3 in Curaçao. Methods Paraffin-embedded blocks of 104 cervical cancers (89 squamous, 15 adenocarcinoma), 41 CIN3, 39 CIN2 and 40 CIN1 lesions were analysed for the presence of HPV. Sections were stained by H&E for histopathological evaluation, and DNA was extracted using proteinase K. HPV genotypes were detected using Short PCR Fragment (SPF10) PCR DNA enzyme immunoassay and a Line Probe Assay (LiPA25). Results HPV was found in 92 (88.5%) ICC; 87 (94.6%) had a single HPV infection and 86 (93.5%) were high-risk human papillomavirus (hrHPV)-type positive. The three most common HPV types in ICC were 16 (38.5%), 18 (13.5%) and 45 (6.7%), covering 58.7%. HrHPV vaccine genotypes 16, 18, 31, 35, 45, 52 and 58 were responsible for 73.1% of ICC. For precancerous lesions, the HPV attribution was 85.4% for CIN3, 66.7% for CIN2% and 42.5% for CIN1. Conclusions Our study, the largest in the Caribbean region in (pre)cancer, shows that the prevalence of HPV-type 16 and 18 in cervical cancer is lower compared with the world population but no differences in prevalence of these two HPV types are seen in precancerous lesions. When considering HPV vaccination in Curaçao, the relatively high contribution of non-HPV 16/18 genotypes in ICC should be taken into account.
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Affiliation(s)
- Desiree J Hooi
- Fundashon Prevenshon, Willemstad, Curaçao.,Department of Pathology, VU University Medical Centre, Amsterdam, the Netherlands
| | - Birgit I Lissenberg-Witte
- Department of Epidemiology and Biostatistics, VU University Medical Centre, Amsterdam, the Netherlands
| | | | | | - Gemma G Kenter
- Department of Gynaecology and Oncology, VU University Medical Centre, Amsterdam, the Netherlands
| | - Chris Jlm Meijer
- Department of Pathology, VU University Medical Centre, Amsterdam, the Netherlands
| | - Wim G Quint
- DDL Diagnostic Laboratory, Rijswijk, the Netherlands
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9
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Distinctive distribution of HPV genotypes in cervical cancers in multi-ethnic Suriname: implications for prevention and vaccination. Epidemiol Infect 2016; 145:245-253. [DOI: 10.1017/s0950268816002132] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
SUMMARYSuriname is ranked as high-risk country for cervical cancer, but recent national data of HPV prevalence and distribution in cervical cancer is scarce. In a retrospective cross-sectional study, cervical cancer incidence, HPV prevalence and HPV-type-specific distribution were investigated in all cervical cancer cases (n = 111), diagnosed in two consecutive years. HPV presence and type-specific prevalence were determined in paraffin-embedded biopsies utilizing master-nested multiplex PCR assays, targeting 14 HPV types. The age-standardized incidence rate of cervical cancer was 22·4/100 000 women, justifying revision of the current international ranking of Suriname. Eleven HPV types were detected, with the most common types in descending order of frequency: 16, 18, 45, 66, 58/52/35. HPV16 was predominant, although with markedly low presence (25%). HPV16 or 18 infections were detected in 43% of the cases, while 28% were untyped, implicating a divergent HPV-type distribution in Suriname with significant variation in the prevalence of less common high-risk virus types and/or presence of HPV16 variants. HPV-type distribution differed between ethnic groups. A vaccination efficacy of just 28–30% was anticipated, next to an uneven vaccination impact in different ethnic groups, cautioning Suriname and other multi-ethnic countries to tailor the information presented to different ethnic communities.
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10
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Goeijenbier M, Aron G, Anfasa F, Lundkvist Å, Verner-Carlsson J, Reusken CBEM, Martina BEE, van Gorp ECM, Resida L. Emerging Viruses in the Republic of Suriname: Retrospective and Prospective Study into Chikungunya Circulation and Suspicion of Human Hantavirus Infections, 2008-2012 and 2014. Vector Borne Zoonotic Dis 2015; 15:611-8. [PMID: 26393384 DOI: 10.1089/vbz.2015.1798] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Suriname is a country on the northeastern Atlantic coast of South America. It is unique in the sense that different ethnic cultures live together within the country, resulting in high levels of transport of both humans and products between the Asian, African, and European continents as well as the Caribbean. Travel is only one of the many factors present in Suriname contributing to the risk for the emergence or introduction of any infectious disease. Recently, circulation of both chikungunya virus (CHIKV) and hantavirus was reported in areas neighboring Suriname. Here we report a retrospective and prospective study into chikungunya and hantavirus circulation. METHODS A chikungunya and hantavirus retrospective serological study was conducted on samples submitted for dengue, leptospirosis, and/or influenza virus diagnostics between 2008 and 2012 to the Bureau of Public Health in Suriname. This was followed by a prospective CHIKV serological and molecular surveillance study until the detection of the first autochthonous CHIKV cases in Suriname in May and June of 2014. RESULTS None of the tested samples showed the presence of CHIKV antibodies in the retrospective serological study. Prospective testing of CHIKV-suspected patients resulted in the detection of the first autochthonous CHIKV cases in Suriname in May, 2015. In one sample, we were able to isolate and sequence the virus. Retrospective testing for the presence of hantavirus antibodies showed a relative high response in both pan-hantavirus enzyme-linked immunosorbent assay (ELISA) and immunofluorescence assay (IFA). However, neutralization tests did not yield any evidence for infection with either Seoul or Andes hantavirus. CONCLUSION Here we report the presence of CHIKV in the republic of Suriname and the first serological indication of hantavirus infections in symptomatic patients.
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Affiliation(s)
| | - Georgina Aron
- 1 Erasmus MC , Viroscience department, Rotterdam, The Netherlands
| | - Fatih Anfasa
- 1 Erasmus MC , Viroscience department, Rotterdam, The Netherlands .,2 Faculty of Medicine, University of Indonesia , Jakarta, Indonesia
| | - Åke Lundkvist
- 3 Department of Medical Biochemistry and Microbiology, Zoonoses Science Centre, Uppsala University , Sweden .,4 Public Health Agency of Sweden , Solna, Sweden
| | - Jenny Verner-Carlsson
- 3 Department of Medical Biochemistry and Microbiology, Zoonoses Science Centre, Uppsala University , Sweden .,4 Public Health Agency of Sweden , Solna, Sweden
| | | | - Byron E E Martina
- 1 Erasmus MC , Viroscience department, Rotterdam, The Netherlands .,5 ARTEMIS One Health Research Institute , Utrecht, The Netherlands
| | | | - Lesley Resida
- 6 Bureau of Public Health (BOG) , Paramaribo, Suriname
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11
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Geraets DT, Struijk L, Kleter B, Molijn A, van Doorn LJ, Quint WGV, Colau B. The original SPF10 LiPA25 algorithm is more sensitive and suitable for epidemiologic HPV research than the SPF10 INNO-LiPA Extra. J Virol Methods 2015; 215-216:22-9. [PMID: 25698462 DOI: 10.1016/j.jviromet.2015.01.001] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Two commercial HPV tests target the same 65 bp fragment of the human papillomavirus genome (designated SPF10): the original HPV SPF10 PCR-DEIA-LiPA25 system, version 1, (LiPA25) and the INNO-LiPA HPV Genotyping Extra (INNO-LiPA). The original SPF10 LiPA25 system was designed to have high analytical sensitivity and applied in HPV vaccine and epidemiology studies worldwide. But due to apparent similarities, this test can be easily confused with INNO-LiPA, a more recent assay of which the intended use, i.e., epidemiological or clinical, is currently unclear. The aim was to compare the analytical sensitivity of SPF10 LiPA25 to that of INNO-LiPA on the level of general HPV detection and genotyping. HPV testing by both assays was performed on the same DNA isolated from cervical swab (n = 365) and biopsy (n = 42) specimens. In cervical swabs, SPF10 LiPA25 and INNO-LiPA identified 35.3% and 29.3% multiple infections, 52.6% and 51.5% single infections, and no HPV type in 12.1% and 19.2%, respectively. Genotyping results were 64.7% identical, 26.0% compatible and 9.3% discordant between both methods. SPF10 LiPA25 detected significantly more genotypes (p < 0.001). The higher analytical sensitivity of SPF10 LiPA25 was confirmed by the MPTS123 genotyping assay. HPV positivity by the general probes in SPF10 DEIA was significantly higher (87.9%) than by those on INNO-LiPA (77.0%) (kappa = 0.592, p < 0.001). In cervical biopsies, SPF10 LiPA25 and INNO-LiPA identified 21.4% and 9.5% multiple types, 76.2% and 81.0% single types, and no type in 2.4% and 9.5%, respectively. Between both tests, the identification of genotypes was 76.3% identical, 14.3% compatible and 9.5% discordant. Overall, significantly more genotypes were detected by SPF10 LiPA25 (kappa = 0.853, p = 0.022). HPV positivity was higher by the SPF10 DEIA (97.6%) than by the INNO-LiPA strip (92.9%). These results demonstrate that SPF10 LiPA25 is more suitable for HPV genotyping in epidemiologic and vaccine-related studies, due to its higher analytical sensitivity.
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Affiliation(s)
- Daan T Geraets
- DDL Diagnostic Laboratory, Visseringlaan 25, 2288 ER Rijswijk, The Netherlands.
| | - Linda Struijk
- DDL Diagnostic Laboratory, Visseringlaan 25, 2288 ER Rijswijk, The Netherlands
| | - Bernhard Kleter
- DDL Diagnostic Laboratory, Visseringlaan 25, 2288 ER Rijswijk, The Netherlands
| | - Anco Molijn
- DDL Diagnostic Laboratory, Visseringlaan 25, 2288 ER Rijswijk, The Netherlands
| | - Leen-Jan van Doorn
- DDL Diagnostic Laboratory, Visseringlaan 25, 2288 ER Rijswijk, The Netherlands
| | - Wim G V Quint
- DDL Diagnostic Laboratory, Visseringlaan 25, 2288 ER Rijswijk, The Netherlands
| | - Brigitte Colau
- GSK Vaccines, Rue de l'Institut 89, B-1330 Rixensart, Belgium
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12
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Geraets DT, Struijk L, Kleter B, Molijn A, van Doorn LJ, Quint WGV, Colau B. TEMPORARY REMOVAL: The original SPF 10 LiPA 25 algorithm is more sensitive and suitable for epidemiologic HPV research than the SPF 10 INNO-LiPA Extra. J Virol Methods 2014; 213C:1. [PMID: 25476446 DOI: 10.1016/j.jviromet.2014.11.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2014] [Revised: 10/27/2014] [Accepted: 11/11/2014] [Indexed: 11/24/2022]
Abstract
The publisher regrets that this article has been temporarily removed. A replacement will appear as soon as possible in which the reason for the removal of the article will be specified, or the article will be reinstated. The full Elsevier Policy on Article Withdrawal can be found at http://www.elsevier.com/locate/withdrawalpolicy.
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Affiliation(s)
- Daan T Geraets
- DDL Diagnostic Laboratory, Visseringlaan 25, 2288 ER Rijswijk, The Netherlands.
| | - Linda Struijk
- DDL Diagnostic Laboratory, Visseringlaan 25, 2288 ER Rijswijk, The Netherlands
| | - Bernhard Kleter
- DDL Diagnostic Laboratory, Visseringlaan 25, 2288 ER Rijswijk, The Netherlands
| | - Anco Molijn
- DDL Diagnostic Laboratory, Visseringlaan 25, 2288 ER Rijswijk, The Netherlands
| | - Leen-Jan van Doorn
- DDL Diagnostic Laboratory, Visseringlaan 25, 2288 ER Rijswijk, The Netherlands
| | - Wim G V Quint
- DDL Diagnostic Laboratory, Visseringlaan 25, 2288 ER Rijswijk, The Netherlands
| | - Brigitte Colau
- GlaxoSmithKline Vaccines, Rue de l'Institut 89, B-1330 Rixensart, Belgium
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