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Liu J, Hu N, Zheng X, Li H, Zhao K, Wang J, Zhang M, Zhang L, Song L, Lyu Y, Cui M, Ding L, Wang J. Vaginal micro-environment disorder promotes malignant prognosis of low-grade cervical intraepithelial neoplasia: a prospective community cohort study in Shanxi Province, China. Clin Transl Oncol 2024:10.1007/s12094-024-03524-2. [PMID: 38769216 DOI: 10.1007/s12094-024-03524-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2024] [Accepted: 05/07/2024] [Indexed: 05/22/2024]
Abstract
PURPOSE Emerging evidence suggests that vaginal micro-environment disorder is closely related to the development of cervical lesions. Low-grade cervical intraepithelial neoplasia (CIN1), as an early stage of cervical lesions, exhibits a high risk of progressing to high-grade lesions or even cervical cancer. However, the effect of vaginal micro-environment on the malignant prognosis of CIN1 remains uncertain. METHODS A total of 504 patients diagnosed with CIN1 by pathology, who were from the population-based cohorts established in Shanxi Province, China, were enrolled and followed up for 2 years. Micro-environmental factors such as vaginal pH, cleanliness, hydrogen peroxide (H2O2), β-glucuronidase (GUSB), leucocyte esterase (LE), and sialidase (SNA) were detected to evaluate their effect on the malignant prognosis of CIN1. RESULTS Abnormal vaginal pH (HR = 1.472, 95%CI 1.071-2.022), cleanliness (HR = 1.446, 95%CI 1.067-1.960), H2O2 (HR = 1.525, 95%CI 1.155-2.013), GUSB (HR = 1.739, 95%CI 1.235-2.448), LE (HR = 1.434, 95%CI 1.038-1.981), and SNA (HR = 1.411, 95%CI 1.065-1.870) could promote a higher incidence of CIN1 malignant prognosis, and the combined effects of these micro-environmental factors resulted in a nearly twofold increased risk (HR = 2.492, 95%CI 1.773-3.504) compared to any single factor alone, especially under the high-risk human papillomavirus (HR-HPV) infection. Notably, the cumulative incidence of malignant prognosis for CIN1 gradually increased during the early follow-up period, reaching its peak at approximately 8 months, and then stabilizing. CONCLUSION Vaginal micro-environment disorder could promote CIN1 malignant prognosis, particularly in HR-HPV-infected women. Taking micro-environmental factors as the breakthrough, our study provides a feasible vision for preventing early stage cervical lesions.
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Affiliation(s)
- Jiamin Liu
- Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan, 030001, China
| | - Nan Hu
- Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan, 030001, China
| | - Xiao Zheng
- Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan, 030001, China
| | - Huimin Li
- Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan, 030001, China
| | - Kailu Zhao
- Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan, 030001, China
| | - Jiahao Wang
- Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan, 030001, China
| | - Mingxuan Zhang
- Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan, 030001, China
| | - Le Zhang
- Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan, 030001, China
| | - Li Song
- Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan, 030001, China
| | - Yuanjing Lyu
- Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan, 030001, China
| | - Meng Cui
- Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan, 030001, China
| | - Ling Ding
- Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan, 030001, China
| | - Jintao Wang
- Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan, 030001, China.
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Sawaya M, Cordina‐Duverger E, Lamy P, Rébillard X, Trétarre B, Menegaux F. Sexually and non-sexually transmitted infections and the risk of prostate cancer: Results from the EPICAP study. Cancer Med 2024; 13:e6841. [PMID: 38174802 PMCID: PMC10807638 DOI: 10.1002/cam4.6841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 11/01/2023] [Accepted: 11/27/2023] [Indexed: 01/05/2024] Open
Abstract
INTRODUCTION Prostate cancer (PCa) is by far the most common type of cancer among men in western countries. However, relatively little is known about its etiology despite the high morbidity and mortality. It has been suggested that chronic inflammation may be involved in prostate carcinogenesis. We investigated the role of sexually and non-sexually transmitted infections in prostate cancer risk with a specific interest in the aggressive types. METHODS We used data from epidemiological study of prostate cancer (EPICAP), a population-based case-control study. A total of 819 incident cases and 879 controls were interviewed face-to-face using a standardized questionnaire gathering information on known or suspected risk factors of prostate cancer and personal history of specific sexually and non-sexually transmitted infections: gonorrhea, syphilis, trichomonas, herpes, mononucleosis, Epstein-Barr virus, varicella-zoster, and dengue. Odds ratios (OR) and their 95% confidence interval were estimated using multivariate unconditional logistic regression. RESULTS There was no significant association between gonorrhea (OR: 0.90, 95% CI: 0.61-1.33), trichomonas (OR: 0.74, 95% CI: 0.27-2.07), genital herpes (OR: 0.69, 95% CI: 0.38-1.27), and the risk of prostate cancer. No association emerged for overall sexually transmitted bacterial and viral infections (OR 1.05, 95% CI: 0.86-1.29) and overall non-sexually transmitted viral infections (OR 1.11, 95% CI: 0.90-1.35) and the risk of prostate cancer. CONCLUSION Our results showed that sexually or non-sexually transmitted infections, either bacterial or viral, were not associated to prostate cancer. Therefore, further investigation is needed to help advance our understanding of the role of chronic inflammation in the etiology of prostate cancer, with a particular focus on its most aggressive types.
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Affiliation(s)
- Melissa Sawaya
- Université Paris‐Saclay, UVSQ, Inserm, Gustave Roussy, CESPVillejuifFrance
| | | | - Pierre‐Jean Lamy
- Service de recherche clinique, Clinique Beau SoleilMontpellierFrance
- Service Urologie, Clinique Beau SoleilMontpellierFrance
| | | | - Brigitte Trétarre
- Registre des Tumeurs de l'Hérault, EA 2415, ICMMontpellierFrance
- Center for Epidemiology and Research in Population Health (CERPOP)ToulouseFrance
| | - Florence Menegaux
- Université Paris‐Saclay, UVSQ, Inserm, Gustave Roussy, CESPVillejuifFrance
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Nagata M, Tome A, White K, Wilkens LR, Park SY, Le Marchand L, Haiman C, Hernandez BY. No Association of Trichomonas vaginalis Seropositivity with Advanced Prostate Cancer Risk in the Multiethnic Cohort: A Nested Case-Control Study. Cancers (Basel) 2023; 15:5194. [PMID: 37958367 PMCID: PMC10648031 DOI: 10.3390/cancers15215194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 10/20/2023] [Accepted: 10/25/2023] [Indexed: 11/15/2023] Open
Abstract
The potential involvement of a sexually transmitted agent has been suggested to contribute to the high number of prostate cancers in the United States and worldwide. We investigated the relationship of Trichomonas vaginalis seropositivity with prostate cancer risk in a nested case-control study within the Multiethnic Cohort in Hawaii and California using blood samples collected prior to cancer diagnoses. Incident cases of advanced prostate cancer (intermediate- to high-grade based on Gleason score ≥ 7 and/or disease spread outside the prostate) were matched to controls by age, ethnicity, and the date of blood collection. T. vaginalis serostatus was measured using an ELISA detecting IgG antibodies against a recombinant T. vaginalis α-actinin protein. Seropositivity to T. vaginalis was observed in 35 of 470 (7.4%) cases and 26 of 470 (5.5%) controls (unadjusted OR = 1.47, 95% CI 0.82-2.64; adjusted OR = 1.31, 95% CI 0.67-2.53). The association was similarly not significant when cases were confined to extraprostatic tumors having regional or distant spread (n = 121) regardless of grade (unadjusted OR = 1.37, 95% CI 0.63-3.01; adjusted OR = 1.20, 95% CI 0.46-3.11). The association of T. vaginalis with prostate cancer risk did not vary by aspirin use. Our findings do not support a role for T. vaginalis in the etiology of advanced prostate cancer.
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Affiliation(s)
- Michelle Nagata
- Population Sciences in the Pacific Program, University of Hawaii Cancer Center, 701 Ilalo Street, Honolulu, HI 96813, USA; (A.T.); (K.W.); (L.R.W.); (S.-Y.P.); (L.L.M.); (B.Y.H.)
| | - Anne Tome
- Population Sciences in the Pacific Program, University of Hawaii Cancer Center, 701 Ilalo Street, Honolulu, HI 96813, USA; (A.T.); (K.W.); (L.R.W.); (S.-Y.P.); (L.L.M.); (B.Y.H.)
| | - Kami White
- Population Sciences in the Pacific Program, University of Hawaii Cancer Center, 701 Ilalo Street, Honolulu, HI 96813, USA; (A.T.); (K.W.); (L.R.W.); (S.-Y.P.); (L.L.M.); (B.Y.H.)
| | - Lynne R. Wilkens
- Population Sciences in the Pacific Program, University of Hawaii Cancer Center, 701 Ilalo Street, Honolulu, HI 96813, USA; (A.T.); (K.W.); (L.R.W.); (S.-Y.P.); (L.L.M.); (B.Y.H.)
| | - Song-Yi Park
- Population Sciences in the Pacific Program, University of Hawaii Cancer Center, 701 Ilalo Street, Honolulu, HI 96813, USA; (A.T.); (K.W.); (L.R.W.); (S.-Y.P.); (L.L.M.); (B.Y.H.)
| | - Loïc Le Marchand
- Population Sciences in the Pacific Program, University of Hawaii Cancer Center, 701 Ilalo Street, Honolulu, HI 96813, USA; (A.T.); (K.W.); (L.R.W.); (S.-Y.P.); (L.L.M.); (B.Y.H.)
| | - Christopher Haiman
- Center for Genetic Epidemiology, Keck School of Medicine, University of Southern California, 1975 Zonal Ave., Los Angeles, CA 90033, USA;
| | - Brenda Y. Hernandez
- Population Sciences in the Pacific Program, University of Hawaii Cancer Center, 701 Ilalo Street, Honolulu, HI 96813, USA; (A.T.); (K.W.); (L.R.W.); (S.-Y.P.); (L.L.M.); (B.Y.H.)
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Lawson JS, Glenn WK. Multiple pathogens and prostate cancer. Infect Agent Cancer 2022; 17:23. [PMID: 35637508 PMCID: PMC9150368 DOI: 10.1186/s13027-022-00427-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 03/18/2022] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND The aim of this review is to consider whether multiple pathogens have roles in prostate cancer. METHODS We have reviewed case control studies in which infectious pathogens in prostate cancer were compared to normal and benign prostate tissues. We also reviewed additional evidence from relevant published articles. RESULTS We confirmed that high risk human papilloma viruses are a probable cause of prostate cancer. We judged Escherichia coli, Cutibacterium acnes, Neisseria gonorrhoea, Herpes simplex, Epstein Barr virus and Mycoplasmas as each having possible but unproven roles in chronic prostatic inflammation and prostate cancer. We judged Cytomegalovirus, Chlamydia trachomatis, Trichomonas vaginalis and the Polyoma viruses as possible but unlikely to have a role in prostate cancer. CONCLUSIONS AND ACTIONS The most influential cause of prostate cancer appears to be infection induced chronic inflammation. Given the high prevalence of prostate cancer it is important for action to can be taken without waiting for additional conclusive evidence. These include: 1. Encouragement of all boys (as well as girls) to have HPV vaccines 2. The vigorous use of antibiotics to treat all bacterial pathogens identified in the urogenital tract 3. The use of antiviral medications to control herpes infections 4. Education about safe sexual practices.
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Affiliation(s)
- James S. Lawson
- School of Biotechnology and Biomolecular Sciences, University of New South Wales, Sydney, 2052 Australia
| | - Wendy K. Glenn
- School of Biotechnology and Biomolecular Sciences, University of New South Wales, Sydney, 2052 Australia
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Inflammation and Prostate Cancer: A Multidisciplinary Approach to Identifying Opportunities for Treatment and Prevention. Cancers (Basel) 2022; 14:cancers14061367. [PMID: 35326519 PMCID: PMC8946208 DOI: 10.3390/cancers14061367] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 03/03/2022] [Accepted: 03/06/2022] [Indexed: 02/06/2023] Open
Abstract
Prostate cancer is a major cause of disease for men globally. Inflammation, an established hallmark of cancer, is frequently observed in the prostate, though its contribution to prostate cancer risks and outcomes is not fully understood. Prostate cancer is biologically and clinically heterogeneous, and there is now evidence that inflammation and immunological characteristics vary by the genomic and mutational landscape of the tumor. Moreover, it is now recognized that risk factor profiles vary between tumor subgroups, as defined by histopathological and molecular features. Here, we provide a review centered around the relationship between inflammation and prostate cancer, with a consideration of molecular tumor features and a particular focus on the advanced and lethal stages of disease. We summarize findings from epidemiological studies of the etiology and role of inflammation in prostate cancer. We discuss the pathology of prostate inflammation, and consider approaches for assessing the tumor immune microenvironment in epidemiological studies. We review emerging clinical therapies targeting immune biology within the context of prostate cancer. Finally, we consider potentially modifiable risk factors and corresponding lifestyle interventions that may affect prostate inflammation, impacting outcomes. These emerging insights will provide some hints for the development of treatment and prevention strategies for advanced and lethal prostate cancer.
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Kamarkhani Z, Rafiei-Sefiddashti R, Haghighi L, Badirzadeh A, Hadighi R. Molecular Examination of Trichomonas vaginalis Infection and Risk of Prostate Cancer in the Biopsy of Patients with Different Prostate Lesions. Ethiop J Health Sci 2021; 31:237-240. [PMID: 34158774 PMCID: PMC8188072 DOI: 10.4314/ejhs.v31i2.5] [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] [Indexed: 11/17/2022] Open
Abstract
Background Trichomoniasis is a sexually transmitted infectious disease caused by a flagellated protozoa, Trichomonas vaginalis (T.vaginalis) and is often asymptomatic in men. Benign prostatic hyperplasia (BPH) and prostate cancer (PCA) are the most common urological diseases in the elderly. Scientists have proposed various factors which trigger prostate cancer, including sexually transmitted diseases. Thus, this study aimed to evaluate the potential role of T. vaginalis as a risk factor for various prostate lesions such as hyperplasia and prostate cancer. Methods A total of 250 paraffin-embedded of different prostate lesion biopsies were analyzed by Polymerase Chain Reaction (PCR) using the beta-tubulin gene for identifying T. vaginalis. Result All 250 pathologic specimens were negative for this parasite by using PCR technique. Conclusion It seems that T. vaginalis may have not had a causative role for different prostate lesions and it seems proposed PCR technique is an insufficient method to find the parasite in paraffin-embedded tissues. Therefore, other diagnostic techniques to identify the parasite in biopsy samples are suggested.
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Affiliation(s)
- Zeinab Kamarkhani
- Department of Parasitology and Mycology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Raheleh Rafiei-Sefiddashti
- Department of Parasitology and Mycology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Leila Haghighi
- Department of Parasitology and Mycology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Alireza Badirzadeh
- Department of Parasitology and Mycology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Ramtin Hadighi
- Department of Parasitology and Mycology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
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Zheng JJ, Miao JR, Wu Q, Yu CX, Mu L, Song JH. Correlation between HPV-negative cervical lesions and cervical microenvironment. Taiwan J Obstet Gynecol 2021; 59:855-861. [PMID: 33218401 DOI: 10.1016/j.tjog.2020.08.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/13/2020] [Indexed: 10/23/2022] Open
Abstract
OBJECTIVE To investigate the correlation between high-risk human papillomavirus (HR HPV)-negative cervical lesions and cervical microenvironment in Inner Mongolia, China, and to find the pathogenic factors of HR HPV-negative cervical lesions. MATERIALS AND METHODS 74 cases of HR HPV-negative healthy women and 80 cases of patients with cervical lesions (28 cases of LSIL, 49 cases of HSIL and 3 cases of CSCC) were selected as the study group; 26 cases of HPV-positive women and 352 cases of patients with cervical lesions (108 cases of LSIL, 214 cases of HSIL and 30 cases of CSCC) were control group. Questionnaires were collected from the study group and the control group and specimens were collected. Gram staining, hematoxylin and eosin staining microscopy, and substrate colorimetry method were used to detect vaginal micro-ecological indicators; ELISA was used to detect the concentration of SIgA, IgG, IL-2 and IL-10 in vaginal lavage fluid. Genetic testing was used to detect HPV, mycoplasma, and chlamydia infection. The changes of vaginal micro-ecology evaluation index and local immune factor concentration in healthy women and cervical lesions of all grades in the study group and the control group were compared. RESULTS Patients with cervical lesions, compared with healthy women, had a decrease in dominant lactobacilli and dysbacteriosis (P < 0.05), and this trend became more apparent as the disease progressed. The diversity and concentration of the flora in the HPV-negative group increased, the abnormal composition ratio decreased, and the HPV-positive group showed the opposite trend. As the lesion progressed, H2O2 decreased first and then increased, and the overall trend of SNa, LE, GUS, and GADP increased. The infection rate of trichomoniasis, BV and chlamydia increased and infection rate of Candida decreased. Also, compared with healthy women, patients with cervical lesions showed changes in immune factor concentration (P < 0.05). As the lesion progressed, IL-2 decreased, IL-10 increased, and IL-2/IL-10 decreased. However, IL-2 expression in HPV-negative group was higher than HSIL. SIgA was significantly lower in patients with cervical lesions than in healthy women. IgG had an upward trend in the HPV positive group. CONCLUSION This study showed that vaginal micro-ecological imbalance and weakening of local cervical immune function are important reasons for the development of cervical lesions. It is expected to inhibit the development of cervical lesions by regulating the balance of vaginal micro-ecology and enhancing local immune function. By detecting Lactobacillus vaginalis, pre-enzyme, IL-2, IL-10, SIgA, it can guide the further diversion of HPV-positive women and predict the development direction of cervical lesions after HPV infection.
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Affiliation(s)
- Jing-Jing Zheng
- Department of Obstetrics and Gynecology, The Affiliated Hospital of Inner Mongolia Medical University, Inner Mongolia 010059, China
| | - Jing-Rui Miao
- Department of Obstetrics and Gynecology, The Affiliated Hospital of Inner Mongolia Medical University, Inner Mongolia 010059, China
| | - Qiang Wu
- Department of Neurosurgery, The Affiliated Hospital of Inner Mongolia Medical University, Inner Mongolia 010059, China
| | - Cong-Xiang Yu
- Department of Obstetrics and Gynecology, The Affiliated Hospital of Inner Mongolia Medical University, Inner Mongolia 010059, China
| | - Lin Mu
- Department of Obstetrics and Gynecology, The Affiliated Hospital of Inner Mongolia Medical University, Inner Mongolia 010059, China
| | - Jing-Hui Song
- Department of Obstetrics and Gynecology, The Affiliated Hospital of Inner Mongolia Medical University, Inner Mongolia 010059, China.
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Saleh NE, Alhusseiny SM, El-Zayady WM, Aboelnaga EM, El-Beshbishi WN, Saleh YM, Abou-ElWafa HS, El-Beshbishi SN. Trichomonas vaginalis serostatus and prostate cancer risk in Egypt: a case-control study. Parasitol Res 2020; 120:1379-1388. [PMID: 33159459 DOI: 10.1007/s00436-020-06942-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 10/21/2020] [Indexed: 10/23/2022]
Abstract
Trichomonas vaginalis is one of the most common non-viral sexually transmitted infections (STIs) that has been associated with prostate cancer in some countries. This study aims to investigate if T. vaginalis infection can be a risk factor for prostate cancer in Egypt and its possible relationship with cancer prognostic factors and overall survival. Serum samples were collected from a total of 445 age-matched males; 126 with prostate cancer, 108 with bladder cancer, 91 with different types of cancers, and 120 healthy controls, and then analyzed by ELISA for detection of anti-Trichomonas IgG and prostate-specific antigen (PSA). The results revealed that only 8.3% of controls were seropositive for trichomoniasis, compared with 19% of prostate cancer patients (P = 0.015). There were positive associations between the levels of PSA and tumor stage with T. vaginalis IgG optical density scores among the seropositive cases (P < 0.001 and < 0.05, respectively). However, no significant correlations were detected between seropositivity of T. vaginalis and other prognostic factors or overall survival in those patients. In conclusion, chronic T. vaginalis infection may be associated with prostate cancer, but it does not seem that this STI aggravates the cancer status.
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Affiliation(s)
- Nora E Saleh
- Department of Medical Parasitology, Faculty of Medicine, Mansoura University, 2 El-Gomhouria Street, Mansoura, 35516, Egypt
| | - Samar M Alhusseiny
- Department of Medical Parasitology, Faculty of Medicine, Mansoura University, 2 El-Gomhouria Street, Mansoura, 35516, Egypt
| | - Wafaa M El-Zayady
- Department of Medical Parasitology, Faculty of Medicine, Mansoura University, 2 El-Gomhouria Street, Mansoura, 35516, Egypt
| | - Engy M Aboelnaga
- Department of Clinical Oncology and Nuclear Medicine, Mansoura University Hospital, Faculty of Medicine, Mansoura University, Mansoura, 35516, Egypt
| | - Wafaa N El-Beshbishi
- Department of Clinical Oncology and Nuclear Medicine, Mansoura University Hospital, Faculty of Medicine, Mansoura University, Mansoura, 35516, Egypt
| | - Yasser M Saleh
- Department of Clinical Oncology and Nuclear Medicine, Mansoura University Hospital, Faculty of Medicine, Mansoura University, Mansoura, 35516, Egypt
| | - Hala S Abou-ElWafa
- Department of Public Health and Community Medicine, Faculty of Medicine, Mansoura University, Mansoura, 35516, Egypt
| | - Samar N El-Beshbishi
- Department of Medical Parasitology, Faculty of Medicine, Mansoura University, 2 El-Gomhouria Street, Mansoura, 35516, Egypt.
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Is there association between Trichomonas vaginalis infection and prostate cancer risk?: A systematic review and meta-analysis. Microb Pathog 2019; 137:103752. [DOI: 10.1016/j.micpath.2019.103752] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 09/15/2019] [Indexed: 12/21/2022]
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10
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Langston ME, Bhalla A, Alderete JF, Nevin RL, Pakpahan R, Hansen J, Elliott D, De Marzo AM, Gaydos CA, Isaacs WB, Nelson WG, Sokoll LJ, Zenilman JM, Platz EA, Sutcliffe S. Trichomonas vaginalis infection and prostate-specific antigen concentration: Insights into prostate involvement and prostate disease risk. Prostate 2019; 79:1622-1628. [PMID: 31376187 PMCID: PMC6715535 DOI: 10.1002/pros.23886] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 07/08/2019] [Indexed: 01/10/2023]
Abstract
BACKGROUND The protist Trichomonas vaginalis causes a common, sexually transmitted infection and has been proposed to contribute to the development of chronic prostate conditions, including benign prostatic hyperplasia and prostate cancer. However, few studies have investigated the extent to which it involves the prostate in the current antimicrobial era. We addressed this question by investigating the relation between T. vaginalis antibody serostatus and serum prostate-specific antigen (PSA) concentration, a marker of prostate infection, inflammation, and/or cell damage, in young, male, US military members. METHODS We measured T. vaginalis serum IgG antibodies and serum total PSA concentration in a random sample of 732 young, male US active duty military members. Associations between T. vaginalis serostatus and PSA were investigated by linear regression. RESULTS Of the 732 participants, 341 (46.6%) had a low T. vaginalis seropositive score and 198 (27.0%) had a high score, with the remainder seronegative. No significant differences were observed in the distribution of PSA by T. vaginalis serostatus. However, slightly greater, nonsignificant differences were observed when men with high T. vaginalis seropositive scores were compared with seronegative men, and when higher PSA concentrations were examined (≥0.70 ng/mL). Specifically, 42.5% of men with high seropositive scores had a PSA concentration greater than or equal to 0.70 ng/mL compared with 33.2% of seronegative men (adjusted P = .125). CONCLUSIONS Overall, our findings do not provide strong support for prostate involvement during T. vaginalis infection, although our suggestive positive findings for higher PSA concentrations do not rule out this possibility entirely. These suggestive findings may be relevant for prostate condition development because higher early- to mid-life PSA concentrations have been found to predict greater prostate cancer risk later in life.
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Affiliation(s)
- Marvin E. Langston
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO
| | - Ankita Bhalla
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO
- School of Dentistry, University of California, San Francisco, San Francisco, CA
| | - John F. Alderete
- School of Molecular Biosciences, College of Veterinary Medicine, Washington State University, Pullman, WA
| | - Remington L. Nevin
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
- The Quinism Foundation, White River Junction, VT
| | - Ratna Pakpahan
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO
| | - Johannah Hansen
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO
- Los Angeles County Department of Public Health, Los Angeles, CA
| | - Debra Elliott
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Angelo M. De Marzo
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD
- Department of Urology and the James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine
- Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD
| | - Charlotte A. Gaydos
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
| | - William B. Isaacs
- Department of Urology and the James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine
- Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD
| | - William G. Nelson
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD
- Department of Urology and the James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine
- Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD
- Department of Pharmacology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Lori J. Sokoll
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD
- Department of Urology and the James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine
- Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD
| | - Jonathan M. Zenilman
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Elizabeth A. Platz
- Department of Urology and the James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine
- Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Siobhan Sutcliffe
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO
- Alvin J. Siteman Cancer Center and the Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO
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Adjei C, Boateng R, Dompreh A, Okyere B, Owiredu EW. Prevalence and the evaluation of culture, wet mount, and ELISA methods for the diagnosis of Trichomonas vaginalis infection among Ghanaian women using urine and vaginal specimens. Trop Med Health 2019; 47:33. [PMID: 31130814 PMCID: PMC6521517 DOI: 10.1186/s41182-019-0162-9] [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: 03/25/2019] [Accepted: 05/03/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The services of most clinical laboratories in Africa regarding the diagnosis of Trichomonas vaginalis are largely dependent on the urine direct wet-mount method. However, the exclusive use of urine-based detection may not be appropriate. The culture method is considered the "gold standard" for the diagnosis of T. vaginalis. However, this method has a relatively longer turn-around time and is limited by non-viable organisms in the specimen. This study assessed the prevalence of T. vaginalis and its associated risk factors and evaluated its diagnosis using urine and vaginal samples from symptomatic female out-patients by culture, direct wet-mount, and ELISA method respectively. METHODS This cross-sectional study was conducted at the Obstetrics and Gynaecology department of the Manhyia District hospital (MDH) and Komfo Anokye Teaching Hospital (KATH), Ghana. Ghanaian sexually active female adults between the ages of 18 and 50 years old were recruited for this study. Vaginal (HVS) and urine samples were collected from each participant, and T. vaginalis infection was assessed based on culture, direct wet mount, and ELISA methods. RESULTS The prevalence of T. vaginalis infection based on the ELISA method, HVS culture, and HVS wet mount were 7.2%, 5.0%, and 1.7%, respectively. Urine culture presented with a 0.6% prevalence rate while urine direct wet mount detected no positive case. There was no statistically significant association between demographic and clinical characteristics and T. vaginalis infection, except for subjects presenting with abdominal pain [OR = 5.42, 95% CI (1.35-21.73), p = 0.017]. Using HVS culture as the reference, ELISA performed best compared to the other methods assessed in this study, presenting with the highest sensitivity [88.9%, 95% CI (54.0-99.8)], specificity [97.1%, 95% CI (93.1-98.9)], AUC (93.0%), and accuracy (96.7%). CONCLUSION The prevalence of T. vaginalis infection is high among women in Ghana. With the exception of abdominal pain, there is no significant association between demographic and clinical characteristics and T. vaginalis infection. In the event where the culture method is unavailable or when rapid diagnosis is required, antigenic detection using ELISA is the most accurate for the diagnosis of T. vaginalis infection in women compared to urine wet-mount/culture and the HVS wet-mount method.
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Affiliation(s)
- Collins Adjei
- Department of Clinical Microbiology, School of Medical Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Richard Boateng
- Department of Clinical Microbiology, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Albert Dompreh
- Department of Clinical Microbiology, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Bismark Okyere
- Department of Clinical Microbiology, School of Medical Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Eddie-Williams Owiredu
- Department of Molecular Medicine, School of Medical Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Tsang SH, Peisch SF, Rowan B, Markt SC, Gonzalez-Feliciano AG, Sutcliffe S, Platz EA, Mucci LA, Ebot EM. Association between Trichomonas vaginalis and prostate cancer mortality. Int J Cancer 2018; 144:2377-2380. [PMID: 30242839 DOI: 10.1002/ijc.31885] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 08/27/2018] [Accepted: 08/29/2018] [Indexed: 11/05/2022]
Abstract
We previously observed a positive association between seropositivity for the parasite Trichomonas vaginalis and risk of clinically significant prostate cancer at diagnosis. Here, we examined whether T. vaginalis seropositivity was associated with increased prostate cancer-specific or all-cause mortality among prostate cancer patients. We studied 736 men with prostate cancer from the Physicians' Health Study (PHS) and 749 men with prostate cancer from the Health Professionals Follow-Up Study (HPFS). We used Cox proportional hazards regression models to estimate multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of the association between T. vaginalis serostatus and progression to death from prostate cancer and from all causes. In PHS, 423 men died of any cause during a median follow-up of 13.8 years from the date of cancer diagnosis, among whom 131 died of prostate cancer. In HPFS, there were 287 deaths, including 77 deaths from prostate cancer, during a median follow-up of 12.8 years. We found no association between T. vaginalis serostatus and either prostate cancer mortality or all-cause mortality in either the PHS or HPFS. While previous studies suggest a possible role for T. vaginalis in the development of clinically significant prostate cancer, our findings do not support the hypothesis that T. vaginalis serostatus is associated with mortality among prostate cancer patients.
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Affiliation(s)
- Sabrina H Tsang
- Cancer Prevention Fellowship Program, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | - Samuel F Peisch
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Brendan Rowan
- UCD School of Medicine, University College Dublin, Belfield, Dublin
| | - Sarah C Markt
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
| | | | - Siobhan Sutcliffe
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, Saint Louis, MO
| | - Elizabeth A Platz
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Lorelei A Mucci
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Ericka M Ebot
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
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Yang S, Zhao W, Wang H, Wang Y, Li J, Wu X. Trichomonas vaginalis infection-associated risk of cervical cancer: A meta-analysis. Eur J Obstet Gynecol Reprod Biol 2018; 228:166-173. [DOI: 10.1016/j.ejogrb.2018.06.031] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2017] [Revised: 06/07/2018] [Accepted: 06/14/2018] [Indexed: 10/28/2022]
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de Waaij DJ, Dubbink JH, Ouburg S, Peters RPH, Morré SA. Prevalence of Trichomonas vaginalis infection and protozoan load in South African women: a cross-sectional study. BMJ Open 2017; 7:e016959. [PMID: 28993385 PMCID: PMC5640031 DOI: 10.1136/bmjopen-2017-016959] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVES Trichomonas vaginalis is thought to be the most common non-viral sexually transmitted infection worldwide. We investigated the prevalence, risk factors and protozoan load of T. vaginalis infection in South African women. METHODS A cross-sectional study of 604 women was conducted at 25 primary healthcare facilities in rural South Africa (Mopani district). T. vaginalis DNA was detected in vaginal and rectal swabs. In univariate and multivariate analyses, the T. vaginalis infection was investigated in relation to demographic characteristics, medical history and behavioural factors. The T. vaginalis load was determined as the logarithm of DNA copies per microlitre sample solution. RESULTS Collected vaginal and rectal swabs were tested for T. vaginalis DNA. Prevalence of vaginal T. vaginalis was 20% (95% CI 17.0% to 23.4%) and rectal 1.2% (95% CI 0.6% to 2.4%). Most women (66%) with a vaginal infection were asymptomatic. Factors associated with T. vaginalis infection were a relationship status of single (OR 2.4; 95% CI 1.5 to 4.0; p<0.001) and HIV positive infection (OR 1.6; 95% CI 1.0 to 2.6; p=0.041). Women with vaginal T. vaginalis infection were more likely to have concurrent Chlamydia trachomatis rectal infection than those without vaginal infection (12%vs3%; p<0.001; OR 4.1). A higher median T. vaginalis load was observed among women with observed vaginal discharge compared with those without vaginal discharge (p=0.025). CONCLUSIONS Vaginal trichomoniasis is highly prevalent in rural South Africa, especially among single women and those with HIV infection, and often presents without symptoms.
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Affiliation(s)
- Dewi J de Waaij
- Department of Medical Microbiology and Infection Control, Laboratory of Immunogenetics, VU University Medical Centre, Amsterdam, The Netherlands
- Department of Genetics and Cell Biology, Faculty of Health, Medicine & Life Sciences, Institute for Public Health Genomics, Research School GROW (School for Oncology & Developmental Biology), University of Maastricht, Maastricht, The Netherlands
| | - Jan Henk Dubbink
- Department of Medical Microbiology and Infection Control, Laboratory of Immunogenetics, VU University Medical Centre, Amsterdam, The Netherlands
- Department of Genetics and Cell Biology, Faculty of Health, Medicine & Life Sciences, Institute for Public Health Genomics, Research School GROW (School for Oncology & Developmental Biology), University of Maastricht, Maastricht, The Netherlands
| | - Sander Ouburg
- Department of Medical Microbiology and Infection Control, Laboratory of Immunogenetics, VU University Medical Centre, Amsterdam, The Netherlands
| | - Remco P H Peters
- Anova Health Institute, Johannesburg and Tzaneen, South Africa
- Department of Medical Microbiology, University of Maastricht, Maastricht, The Netherlands
| | - Servaas A Morré
- Department of Medical Microbiology and Infection Control, Laboratory of Immunogenetics, VU University Medical Centre, Amsterdam, The Netherlands
- Department of Genetics and Cell Biology, Faculty of Health, Medicine & Life Sciences, Institute for Public Health Genomics, Research School GROW (School for Oncology & Developmental Biology), University of Maastricht, Maastricht, The Netherlands
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Trichomonas vaginalis infection and risk of prostate cancer: associations by disease aggressiveness and race/ethnicity in the PLCO Trial. Cancer Causes Control 2017; 28:889-898. [PMID: 28669054 DOI: 10.1007/s10552-017-0919-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Accepted: 06/24/2017] [Indexed: 12/13/2022]
Abstract
PURPOSE Results from previous sero-epidemiologic studies of Trichomonas vaginalis infection and prostate cancer (PCa) support a positive association between this sexually transmitted infection and aggressive PCa. However, findings from previous studies are not entirely consistent, and only one has investigated the possible relation between T. vaginalis seropositivity and PCa in African-American men who are at highest risk of both infection and PCa. Therefore, we examined this possible relation in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial, including separate analyses for aggressive PCa and African-American men. METHODS We included a sample of participants from a previous nested case-control study of PCa, as well as all additional Caucasian, aggressive, and African-American cases diagnosed since the previous study (total n = 438 Gleason 7 Caucasian cases, 487 more advanced Caucasian cases (≥Gleason 8 or stage III/IV), 201 African-American cases, and 1216 controls). We tested baseline sera for T. vaginalis antibodies. RESULTS No associations were observed for risk of Gleason 7 (odds ratio (OR) = 0.87, 95% confidence interval (CI) 0.55-1.37) or more advanced (OR = 0.90, 95% CI 0.58-1.38) PCa in Caucasian men, or for risk of any PCa (OR = 1.06, 95% CI 0.67-1.68) in African-American men. CONCLUSIONS Our findings do not support an association between T. vaginalis infection and PCa.
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