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Bhatavdekar JM, Ghosh N, Shukla MK, Balar DB, Bhaduri A, Karelia NH, Shah NG, Trivedi SN. Prognostic Value of Squamous Cell Carcinoma Antigen in Patients with Uterine Cervical Carcinoma. Tumori 2018; 74:221-5. [PMID: 3368976 DOI: 10.1177/030089168807400218] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Squamous cell carcinoma antigen (SCC Ag) was estimated in 30 controls, in 16 patients with benign lesions of the uterine cervix, and in 51 patients with uterine cervical carcinoma. The rate of positivity of the antigen among the cancer patients was 87% (N = 49). SCC Ag estimations were of no diagnostic value, since 37% of patients with bening lesions had elevated levels compared to controls. SCC Ag was highly correlated to histologic subtype. The highest values were obtained in keratinizing tumors, followed by large cell nonkeratinizing and small cell nonkeratinizing types. Moreover, elevation of SCC Ag was statistically significant (p < 0.001) among all the three histologic subtypes compared to controls. However, SCC Ag levels were not consistently correlated to the stage of the disease. Patients with pretherapeutic SCC Ag levels above 30 ng/ml had a faster recurrence rate and shorter survival than those who exhibited antigen values below 2.0 ng/ml. From our results, it is suggested that SCC Ag has limited use as a parameter for early diagnosis of cervical carcinoma, but it seems to reflect advancement of the disease. These findings indicate that SCC Ag elevation may prove to be a valuable marker in predicting subclinical disease.
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Affiliation(s)
- J M Bhatavdekar
- Department of Cancer Biology, Gujarat Cancer & Research Institute, Asarwa, Ahmedabad, India
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Safaeian M, Sampson JN, Pan Y, Porras C, Kemp TJ, Herrero R, Quint W, van Doorn LJ, Schussler J, Lowy DR, Schiller J, Schiffman MT, Rodriguez AC, Gail MH, Hildesheim A, Gonzalez P, Pinto LA, Kreimer AR. Durability of Protection Afforded by Fewer Doses of the HPV16/18 Vaccine: The CVT Trial. J Natl Cancer Inst 2018; 110:4096545. [PMID: 28954299 PMCID: PMC6075614 DOI: 10.1093/jnci/djx158] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 05/02/2017] [Accepted: 06/30/2017] [Indexed: 01/16/2023] Open
Abstract
Background Previously, we demonstrated similar human papillomavirus (HPV)16/18 vaccine efficacy estimates and stable HPV16/18 antibody levels four years postvaccination in a nonrandomized analysis of women who received a varying number of doses of the bivalent HPV16/18 vaccine. Here we extend data to seven years following initial vaccination. Methods We evaluated HPV16/18-vaccinated women who received one (n = 134), two (n 0/1 = 193, n 0/6 = 79), or three doses (n = 2043) to a median of 6.9 years postvaccination. Cervical HPV DNA was measured with the SPF10- DEIA-LiPA PCR system; HPV16/18-specific antibody levels were measured using enzyme-linked immunosorbent assays (n = 486). Infection and immunological measures were compared across vaccine dose groups. Prevalent HPV infection at year 7 was also compared with an unvaccinated control group (UCG). All statistical tests were two-sided. Results Among women in the three-dose, two-dose 0/6 , two-dose 0/1 , and one-dose groups, cumulative incident HPV16/18 infection rates (No. of events/No. of individuals) were 4.3% (88/2036, 95% confidence interval [CI] = 3.5% to 5.3%), 3.8% (3/78, 95% CI = 1.0% to 10.1%), 3.6% (7/192, 95% CI = 1.6% to 7.1%), and 1.5% (2/133, 95% CI = 0.3% to 4.9%; P = 1.00, .85, .17 comparing the two-dose 0/6 , two-dose 0/1 , and one-dose groups to the three-dose group, respectively). The prevalence of other carcinogenic and noncarcinogenic HPV types, excluding HPV16/18/31/33/45, were high and not statistically different among all dose groups, indicating that the low incidence of HPV16/18 in the one- and two-dose groups was not due to lack of exposure. At seven years, 100% of participants in all dose groups remained HPV16 and HPV18 seropositive. A non-statistically significant decrease in the geometric mean of the HPV16 antibody levels between years 4 and 7 was observed among women in the three-dose group: -10.8% (95% CI = -25.3% to 6.6%); two-dose (0/6 months) group: -17.3% (95% CI = -39.3% to 12.8%), two-dose (0/1 month) group: -6.9% (95% CI = -22.1% to 11.2%), and one-dose group: -5.5% (95% CI = -29.7% to 27.0%); results were similar for HPV18. Conclusions At an average of seven years of follow-up, we observed similar low rates of HPV16/18 infections and slight, if any, decreases in HPV16/18 antibody levels by dose group.
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Affiliation(s)
| | - Joshua N. Sampson
- National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Yuanji Pan
- HPV Immunology Laboratory, Leidos Biomedical Research, Inc., Frederick National Laboratory for Cancer Research, Frederick, MD
| | - Carolina Porras
- Agencia Costarricense de Investigaciones Biomédicas (ACIB), formerly Proyecto Epidemiológico Guanacaste, Fundación INCIENSA, San José, Costa Rica
| | - Troy J. Kemp
- HPV Immunology Laboratory, Leidos Biomedical Research, Inc., Frederick National Laboratory for Cancer Research, Frederick, MD
| | - Rolando Herrero
- Prevention and Implementation Group, International Agency for Research on Cancer, Lyon, France
| | - Wim Quint
- DDL, Diagnostic Laboratory, Rijswijk, the Netherlands
| | | | | | - Douglas R. Lowy
- National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - John Schiller
- National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Mark T. Schiffman
- National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Ana Cecilia Rodriguez
- Agencia Costarricense de Investigaciones Biomédicas (ACIB), formerly Proyecto Epidemiológico Guanacaste, Fundación INCIENSA, San José, Costa Rica
- Independent Consultant, San José, Costa Rica
| | - Mitchell H. Gail
- National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Allan Hildesheim
- National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Paula Gonzalez
- Agencia Costarricense de Investigaciones Biomédicas (ACIB), formerly Proyecto Epidemiológico Guanacaste, Fundación INCIENSA, San José, Costa Rica
| | - Ligia A. Pinto
- HPV Immunology Laboratory, Leidos Biomedical Research, Inc., Frederick National Laboratory for Cancer Research, Frederick, MD
| | - Aimée R. Kreimer
- National Cancer Institute, National Institutes of Health, Bethesda, MD
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Donnelly SM, Nguyen BT, Rhyne S, Estes J, Jesmin S, Mowa CN. Vascular endothelial growth factor induces growth of uterine cervix and immune cell recruitment in mice. J Endocrinol 2013; 217:83-94. [PMID: 23386058 DOI: 10.1530/joe-12-0469] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Knowledge of uterine cervical epithelial biology and factors that influence its events may be critical in understanding the process of cervical remodeling (CR). Here, we examine the impact of exogenous vascular endothelial growth factor (VEGF) on uterine cervical epithelial growth in mice (nonpregnant and pregnant) treated with VEGF agents (recombinant and inhibitor) using a variety of morphological and molecular techniques. Exogenous VEGF altered various uterine cervical epithelial cellular events, including marked induction of growth, edema, increase in inter-epithelial paracellular space, and recruitment of immune cells to the outer surface of epithelial cells (cervical lumen). We conclude that VEGF induces multiple alterations in the uterine cervical epithelial tissues that may play a role in local immune surveillance and uterine cervical growth during CR.
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Affiliation(s)
- Siobhan M Donnelly
- Department of Biology, Appalachian State University, Rankin Science North Building N219, 572 River Street, Boone, North Carolina 28608, USA
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Kim JH, Bae SN, Lee CW, Song MJ, Lee SJ, Yoon JH, Lee KH, Hur SY, Park TC, Park JS. A pilot study to investigate the treatment of cervical human papillomavirus infection with zinc-citrate compound (CIZAR®). Gynecol Oncol 2011; 122:303-6. [PMID: 21605892 DOI: 10.1016/j.ygyno.2011.04.026] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2011] [Revised: 04/15/2011] [Accepted: 04/17/2011] [Indexed: 01/19/2023]
Abstract
OBJECTIVE In the present study the potential therapeutic effects of zinc-citrate compound (CIZAR®) in women infected with high-risk human papillomavirus (HR-HPV) was investigated. METHODS A total of 194 women diagnosed with HR-HPV infection using the Hybrid capture (HC) II assay with no evidence of high grade squamous intraepithelial lesions (HSIL) or worse by Pap smear and colposcopy were enrolled. Among them, 76 women were treated by twice weekly self administered intra-vaginal infusion of 0.5 mM zinc citrate solution containing CIZAR® for 12 weeks and were evaluated for clearance of the HR-HPV infection compared to 118 women without treatment (Control group). RESULTS The 12 weeks zinc citrate solution treatment resulted in the elimination of HR-HPV in 49/76 (64.47%) patients compared to the spontaneous clearance of 15.25% (18/118) in the control group (p=0.000). By logistic regression analysis, the 12 week zinc citrate solution treatment reduced the risk of persistent HR-HPV infection significantly (OR 0.079; 95% CI 0.039-0.165; p=0.000). CONCLUSION The results of this study showed for the first time that treatment with intra-vaginal infusion of a zinc-citrate compound (CIZAR®) can result in elimination of HR-HPV infection from the uterine cervix.
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Affiliation(s)
- Jin Hwi Kim
- Department of Obstetrics Gynecology, School of Medicine, Catholic University, Seoul, Republic of Korea
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Harris TG, Burk RD, Xue X, Anastos K, Minkoff H, Massad LS, Young MA, Levine AM, Gange SJ, Watts DH, Palefsky JM, Strickler HD. Association of cutaneous anergy with human papillomavirus and cervical neoplasia in HIV-seropositive and seronegative women. AIDS 2007; 21:1933-41. [PMID: 17721101 DOI: 10.1097/qad.0b013e3282c3a945] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Cutaneous anergy testing evaluates delayed type hypersensitivity responses and is, in essence, an in-vivo measure of cell-mediated immune function at an epithelial surface. This study assessed the relationship of anergy test results with cervical infection by human papillomavirus (HPV) and cervical neoplasia in HIV-seropositive and seronegative women. METHODS HIV-seropositive (n = 1029) and HIV-seronegative (n = 272) women enrolled in a long-term cohort study were followed semi-annually with HPV-DNA testing and cytology. Anergy was defined as unresponsiveness to Candida albicans, tetanus toxoid, and mumps antigen. RESULTS Anergy was associated with the prevalent detection of squamous intraepithelial lesions [SIL; adjusted odds ratio 1.70; 95% confidence interval (CI) 1.16-2.48] in multivariable logistic regression models, and with the incident detection of oncogenic HPV (adjusted hazard ratio 1.24; 95% CI 0.99-1.56) in multivariable Cox regression models. These models adjusted for HIV infection, combined CD4 T-cell and HIV-RNA strata (13 separate strata to control optimally for their interactive effects), as well as other variables. CONCLUSION Cutaneous anergy testing may measure aspects of local cellular immune function in epithelial tissues that are important for the control of HPV and development of SIL, and that in HIV-seropositive women are not fully accounted for by circulating CD4 T-cell counts and HIV-RNA levels.
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Behbahani H, Walther-Jallow L, Klareskog E, Baum L, French AL, Patterson BK, Garcia P, Spetz AL, Landay A, Andersson J. Proinflammatory and type 1 cytokine expression in cervical mucosa during HIV-1 and human papillomavirus infection. J Acquir Immune Defic Syndr 2007; 45:9-19. [PMID: 17356467 DOI: 10.1097/qai.0b013e3180415da7] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Suppression of immune activation and increased inflammation are prevalent during viral infection. To investigate the role of inflammation in HIV transmission, we studied the infectious and inflammatory milieu in cervical mucosa from HIV-1- and human papillomavirus (HPV)-coinfected and HPV-monoinfected women. The numbers of cytokine-, chemokine-, and p24-expressing cells were determined using in situ imaging analysis and intracellular staining of p24 antigen. Significantly higher expression of the proinflammatory cytokines, interleukin (IL)-1alpha/beta, was seen in cervical tissue from HIV/HPV-coinfected as compared with HPV-monoinfected tissues, whereas IL-2- and interferon (IFN)-gamma-expressing cells were higher in HPV-monoinfected tissues. IL-10 was low in both groups, whereas IL-4 was significantly higher in HPV-monoinfected and HIV/HPV-coinfected tissues than in HIV/HPV-negative controls. RANTES and macrophage inflammatory protein (MIP)-1beta but not MIP-1alpha were significantly higher in the genital tract of HIV/HPV-coinfected as compared with HPV-monoinfected individuals and controls. HIV/HPV-coinfected tissues had a higher level of human leukocyte antigen D-related (HLA-DR)-expressing dendritic cells (DCs). There was a positive correlation between the number of CD4(+) and CD8(+) T cells as well as CD1a, IL-1alpha, and RANTES expression and p24 antigen-expressing cells in the HIV/HPV-coinfected tissues. These findings suggest the persistence of immune activation and inflammation in the genital tract of women with HPV monoinfection and in HIV-infected women coinfected with HPV.
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Affiliation(s)
- Homira Behbahani
- Center for Infectious Medicine, Department of Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
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Agrawal T, Vats V, Salhan S, Mittal A. Local Markers for Prediction of Women at Higher Risk of Developing Sequelae to Chlamydia trachomatis Infection. Am J Reprod Immunol 2007; 57:153-9. [PMID: 17217370 DOI: 10.1111/j.1600-0897.2006.00459.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
PROBLEM Chlamydial infections are often associated with various fertility-related disorders. Serological prediction of these has limitations, as they do not differentiate between past and current infections. Thus, we looked for local markers that could predict more precisely women at higher risk of developing severe complications. METHOD OF STUDY A total of 320 Chlamydia trachomatis positive women with or without fertility disorders were tested for the prevalence of immunoglobulin A antibodies to synthetic peptides of chlamydial heat-shock protein 60 (cHSP60) and cHSP10 along with cervical interferon-gamma (IFN-gamma) and serum C-reactive protein (CRP) levels. RESULTS Positive IFN-gamma level was the single best predictor for fertility disorder [odds ratio (OR) 15.4]. The predictive value of IFN-gamma could be significantly improved only by the addition of CRP test (OR 37.9). CONCLUSION Positive IFN-gamma levels in cervical washes along with elevated CRP levels could be used to predict women who are at higher risk of developing fertility disorders.
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Affiliation(s)
- Tanvi Agrawal
- Institute of Pathology-ICMR, Safdarjung Hospital Campus, New Delhi, India
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Freund P, Schmidlin E, Wannier T, Bloch J, Mir A, Schwab ME, Rouiller EM. Nogo-A-specific antibody treatment enhances sprouting and functional recovery after cervical lesion in adult primates. Nat Med 2006; 12:790-2. [PMID: 16819551 DOI: 10.1038/nm1436] [Citation(s) in RCA: 228] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2006] [Accepted: 05/19/2006] [Indexed: 11/09/2022]
Abstract
In rodents, after spinal lesion, neutralizing the neurite growth inhibitor Nogo-A promotes axonal sprouting and functional recovery. To evaluate this treatment in primates, 12 monkeys were subjected to cervical lesion. Recovery of manual dexterity and sprouting of corticospinal axons were enhanced in monkeys treated with Nogo-A-specific antibody as compared to monkeys treated with control antibody.
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Affiliation(s)
- Patrick Freund
- Unit of Physiology and Program in Neurosciences, Department of Medicine, Faculty of Sciences, University of Fribourg, Chemin du Musée 5, CH-1700 Fribourg, Switzerland
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Kayikcioglu F, Bulbul D, Celiker S, Kucukali T. Ligneous inflammation of the cervix: a case report. J Reprod Med 2005; 50:801-4. [PMID: 16320561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
BACKGROUND Ligneous change of the genital tract is a very rare condition and may result in infertility. CASE A 27-year-old woman presented with primary infertility and ligneous changes of the genital tract. Cervical and endometrial samples revealed subepithelial deposition of dense, amorphous, eosinophilic material associated with intensive inflammatory cell infiltration. Plasminogen functional activity was 16%. CONCLUSION The clinician must be aware of the systemic nature of this disorder and the multisystem complications.
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Affiliation(s)
- Fulya Kayikcioglu
- Departments of Gynecology and Obstetrics, Pathology and Ophthalmology, SSK Ankara Maternity Hospital, Ankara, Turkey.
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Dolgushin II, Gizinger OA, Letiaeva OI. [Local immunity factors in the reproductive system of women with Chlamydia infection]. Zh Mikrobiol Epidemiol Immunobiol 2005:65-9. [PMID: 16146231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
A total of 50 healthy women and 184 women of reproductive age with Chlamidia infection, complicated by candidiasis, mycoplasmosis and bacterial vaginosis were under examination. The local infectious immunity indices of cervical mucous were detected. The investigation of cell-mediated and humoral factors of cervical secretions revealed the dysfunction of local infectious protection in women with Chlamydia infection.
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Nicol AF, Fernandes ATG, Grinsztejn B, Russomano F, E Silva JRL, Tristão A, Pérez MDA, Nuovo GJ, Martínez-Maza O, Bonecini-Almeida MDG. Distribution of Immune Cell Subsets and Cytokine-Producing Cells in the Uterine Cervix of Human Papillomavirus (HPV)-Infected Women. ACTA ACUST UNITED AC 2005; 14:39-47. [PMID: 15714063 DOI: 10.1097/01.pas.0000143309.81183.6c] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The aim of this study was to characterize the immune system profile in the uterine cervix of 17 human papillomavirus (HPV)-infected women, compared with 17 whom were coinfected with HIV-1. Five histologically normal cervices in immunocompetent women were used as controls. HPV infection was associated with a marked increase in cells expressing interleukin (IL)-6, interferon gamma (IFN-gamma), and tumor necrosis factor alpha (TNF-alpha). Coinfection by HPV and HIV-1 led to decreased expression of IL-6, TNF-alpha, and IFN-gamma. However, coinfection led to increased numbers of cells expressing IL-4, IL-10, and IL-8. Compared with the histologically normal cervices, increased numbers of macrophages (CD68, RFD7) and T lymphocytes (CD4, CD8) were seen in HPV-infected cervices; coinfection with HIV-1 was associated with a higher number of CD8 cells and lower number of CD68 cells. HPV DNA localized exclusively to the dysplastic squamous cells, whereas HIV-1 RNA was detected mainly in CD68-positive stromal cells. In conclusion, this study shows differential expression of various cytokines and classes of inflammatory cells, relative to HIV-1 infection and HPV coinfection, which may relate to the risk of transmission of HIV-1 and increased risk of cervical cancer in these women.
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Affiliation(s)
- Alcina Frederica Nicol
- Immunology Service, Chagas Research Institute, Oswaldo Cruz Foundation, Avenida Brasil, Rio de Janeiro, RJ, Brazil
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Harper DM, Franco EL, Wheeler C, Ferris DG, Jenkins D, Schuind A, Zahaf T, Innis B, Naud P, De Carvalho NS, Roteli-Martins CM, Teixeira J, Blatter MM, Korn AP, Quint W, Dubin G. Efficacy of a bivalent L1 virus-like particle vaccine in prevention of infection with human papillomavirus types 16 and 18 in young women: a randomised controlled trial. Lancet 2004; 364:1757-65. [PMID: 15541448 DOI: 10.1016/s0140-6736(04)17398-4] [Citation(s) in RCA: 1059] [Impact Index Per Article: 53.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Vaccination against the most common oncogenic human papillomavirus (HPV) types, HPV-16 and HPV-18, could prevent development of up to 70% of cervical cancers worldwide. We did a randomised, double-blind, controlled trial to assess the efficacy, safety, and immunogenicity of a bivalent HPV-16/18 L1 virus-like particle vaccine for the prevention of incident and persistent infection with these two virus types, associated cervical cytological abnormalities, and precancerous lesions. METHODS We randomised 1113 women between 15-25 years of age to receive three doses of either the vaccine formulated with AS04 adjuvant or placebo on a 0 month, 1 month, and 6 month schedule in North America and Brazil. Women were assessed for HPV infection by cervical cytology and self-obtained cervicovaginal samples for up to 27 months, and for vaccine safety and immunogenicity. FINDINGS In the according-to-protocol analyses, vaccine efficacy was 91.6% (95% CI 64.5-98.0) against incident infection and 100% against persistent infection (47.0-100) with HPV-16/18. In the intention-to-treat analyses, vaccine efficacy was 95.1% (63.5-99.3) against persistent cervical infection with HPV-16/18 and 92.9% (70.0-98.3) against cytological abnormalities associated with HPV-16/18 infection. The vaccine was generally safe, well tolerated, and highly immunogenic. INTERPRETATION The bivalent HPV vaccine was efficacious in prevention of incident and persistent cervical infections with HPV-16 and HPV-18, and associated cytological abnormalities and lesions. Vaccination against such infections could substantially reduce incidence of cervical cancer.
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Affiliation(s)
- Diane M Harper
- Department of Obstetrics and Gynecology, Norris Cotton Cancer Center, Dartmouth Medical School, Hanover, NH, USA.
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Affiliation(s)
- Matti Lehtinen
- National Public Health Institute, Department of Infectious Disease Epidemiology, 00300 Helsinki, Finland.
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Castle PE, Rodriguez AC, Bowman FP, Herrero R, Schiffman M, Bratti MC, Morera LA, Schust D, Crowley-Nowick P, Hildesheim A. Comparison of ophthalmic sponges for measurements of immune markers from cervical secretions. Clin Diagn Lab Immunol 2004; 11:399-405. [PMID: 15013994 PMCID: PMC371211 DOI: 10.1128/cdli.11.2.399-405.2004] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Measurements of cervical immunity are important for evaluating immune responses to infections of the cervix and to vaccines for preventing those infections. Three ophthalmic sponges, Weck-Cel, Ultracell, and Merocel, were loaded in vitro with interleukin-1 beta (IL-1 beta), IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, IL-12, IL-15, IL-18, gamma interferon (IFN-gamma), granulocyte-macrophage colony-stimulating factor (GM-CSF), immunoglobulin A (IgA), or IgG, and sponges were extracted and evaluated for total recovery by enzyme-linked immunosorbent assay (ELISA). There was excellent (>75%) recovery for all immune markers from all three devices except for IL-6, which was poorly recovered (<60%) for all sponge types, IFN-gamma, which was poorly recovered from both Weck-Cel and Ultracell sponges but was completely recovered from Merocel sponges, and IL-4, which was poorly recovered from Weck-Cel sponges but was completely recovered from Ultracell or Merocel sponges. We then compared the absolute recovery of selected markers (IL-10, IL-12, IgG, and IgA) from cervical secretion specimens collected from women using each type of sponge. There were no significant differences in the recoveries of IL-10, IL-12, and IgG from cervical specimens collected by any type of ophthalmic sponge, but there was reduced IgA recovery from Merocel sponges. However, the variability in these measurements attributable to sponge types (1 to 3%) was much less than was attributable to individuals (45 to 72%), suggesting that differences in sponge type contribute only in a minor way to these measurements. We infer from our data that the three collection devices are adequate for the measurements of IL-1 beta, IL-2, IL-5, IL-12, IL-15, IL-18, and IgG. Merocel may be a better ophthalmic sponge for the collection of cervical secretions and measurements of IL-4, IL-8, IL-10, GM-CSF, and IFN-gamma, but our data from clinical specimens, not in vitro-loaded sponges, suggested the possibility of reduced recovery of IgA. These findings require confirmation.
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Affiliation(s)
- Philip E Castle
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland 20892-7234, USA.
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Szkaradkiewicz A, Wal M, Kuch A, Pieta P. Human papillomavirus (HPV) and Epstein-Barr virus (EBV) cervical infections in women with normal and abnormal cytology. Pol J Microbiol 2004; 53:95-9. [PMID: 15478354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023] Open
Abstract
In 48 adult women, subdivided into group 1 with no cervical intraepithelial neoplasia (CIN-negative) and group 2 (CIN-positive), endocervical scrapes were tested for the presence EBV DNA and HPV DNA using PCR-ELISA. In addition, attempts were made to detect HPV 16 and HPV 18 using other PCR amplification techniques. In parallel, in biopsies of uterine cervix obtained from group 2 patients, presence of EBER was documented by RNA in situ hybridization (ISH). Sera of all patients were tested for anti-EBV antibodies. In group 1, presence of EBV DNA was noted in the material obtained from 8 women (30.8%), while HPV DNA was detected in 2 women (7.7%). In group 2, EBV DNA was present in the material obtained from 11 patients (50%), including 7 (31.8%) with HPV DNA also identified. In 5 women (22.7%) of group 2 only HPV DNA was detected. The identifical HPV DNA in all cases belonged to HPV 16 type. Both in group 1 and in group 2, all patients were found to carry serum IgG-anti-VCA and IgG-anti-EBNA antibodies. The results allow to conclude that, co-infection with EBV and HPV 16 may be of cervical significance in etiopathogenesis of uterine cervical cancer.
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Rocha-Zavaleta L, Pereira-Suarez AL, Yescas G, Cruz-Mimiaga RM, Garcia-Carranca A, Cruz-Talonia F. Mucosal IgG and IgA responses to human papillomavirus type 16 capsid proteins in HPV16-infected women without visible pathology. Viral Immunol 2003; 16:159-68. [PMID: 12828867 DOI: 10.1089/088282403322017893] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Human papillomavirus type 16 (HPV16) may infect the cervical epithelium without producing pathological changes for a long time. To investigate if mucosal antibodies are induced in HPV16-infected women without visible pathology, cervical mucus from HPV16-infected patients with and without evident pathology, along with mucus from uninfected women were analyzed for the presence of mucosal IgG and secretory IgA (sIgA) antibodies to HPV16 capsid proteins by ELISA. sIgA and IgG antibodies were found in a significantly higher proportion of infected patients compared with uninfected women (p < 0.0001). sIgA antibodies were present in 13.1% of infected patients without visible pathology, the proportion of positivity increased to 27.0% in patients with visible pathology (p = 0.001). Mucosal IgG response was observed in 6.5% of patients without and 27.5% of patients with visible pathology (p = 0.00005). The antibody mean signal strength was significantly higher in patients with than in patients without pathological evidence (p < 0.005). In conclusion, both sIgA and IgG are found in patients without pathological signs of infection, however, the response increases significantly in patients with pathological evidence, suggesting that the appearance of these changes might be associated with a more vigorous antibody-mediated mucosal reaction.
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Affiliation(s)
- L Rocha-Zavaleta
- Department of Molecular Biology and Biotechnology, General Hospital of Mexico, Mexico City, Mexico
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17
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Pahuja S, Choudhury M, Gupta U. Ki-67 labelling as a proliferation marker in pre-invasive squamous epithelial lesions of cervix. INDIAN J PATHOL MICR 2003; 46:402-4. [PMID: 15025284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023] Open
Abstract
Study was conducted to evaluate proliferation in squamous intraepithelial lesions of cervix. 36 cases of cervical biopsies were chosen including unremarkable cervix, basal cell hyperplasia, cervical intraepithelial neoplasia (CIN I, CIN II, CIN III). Ki-67 immunostaining was performed by peroxidase-antiperoxidase method. Ki-67 labelling index in basal and parabasal layers of cervix showed progressive rise with increasing grade of lesion but may not be helpful in classification of individual lesion. Also extent of staining from the basement membrane increases with increasing grade. High basal Ki-67 reactivity might be of greater biological significance than surface differentiation.
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Affiliation(s)
- Sangeeta Pahuja
- Department of Pathology, Lady Hardinge Medical College, New Delhi.
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18
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Luxton JC, Nath R, Derias N, Herbert A, Shepherd PS. Human papillomavirus type 16-specific T cell responses and their association with recurrence of cervical disease following treatment. J Gen Virol 2003; 84:1063-1070. [PMID: 12692269 DOI: 10.1099/vir.0.18931-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Human papillomavirus type 16 (HPV-16) L1- and E7-specific T cell responses were measured in 58 women with abnormal cervical cytology in a prospective study. On recruitment, patients responded most frequently and with the highest numbers of responding cells to the L1 region aa 311-345 and this response was significantly associated with the presence of cervical disease (P=0.041). Responses to the L1 peptide aa 281-295 were significantly higher in patients with CIN III than in those with HPV/CIN I or CIN II lesions (P=0.027). The E7 region aa 70-98 was the most immunogenic in patients with squamous intraepithelial lesions of the cervix (SIL) but the responses detected were not significantly higher than in patients without SIL. Following treatment, the T cell response profiles of patient groups did not change significantly. However, on analysis of the responses of individual patients with and without recurrent disease on follow-up, significant differences were found. Recurrence of disease was associated with T cell responses to the E7 region aa 70-98 at the patient's first clinic visit (P=0.017). Recurrence of disease was also accompanied by an increase in the total number of L1-specific short-term T cell lines (STLs) at follow-up, whereas absence of disease was accompanied by a decrease in L1-specific STLs. The data also suggested a possible link between E7 70-98-specific responses and acquisition of disease by patients who were previously disease-free. Further studies are warranted to determine whether this response could be useful as a marker of recurrent disease in some patients.
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Affiliation(s)
- Jenny C Luxton
- Peter Gorer Department of Immunobiology, GKT, 3rd Floor New Guy's House, Guy's Hospital, London SE1 9RT, UK
| | - Rahul Nath
- Department of Obstetrics and Gynaecology, Birmingham Women's Hospital, Metchley Park Road, Edgbaston, Birmingham B15 2TG, UK
| | - Nawal Derias
- Department of Histopathology, St Thomas' Hospital, London SE1 7EH, UK
| | - Amanda Herbert
- Department of Histopathology, St Thomas' Hospital, London SE1 7EH, UK
| | - Philip S Shepherd
- Peter Gorer Department of Immunobiology, GKT, 3rd Floor New Guy's House, Guy's Hospital, London SE1 9RT, UK
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19
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20
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Lillo FB, Ferrari D, Veglia F, Origoni M, Grasso MA, Lodini S, Mastrorilli E, Taccagni G, Lazzarin A, Uberti-Foppa C. Human papillomavirus infection and associated cervical disease in human immunodeficiency virus-infected women: effect of highly active antiretroviral therapy. J Infect Dis 2001; 184:547-51. [PMID: 11494160 DOI: 10.1086/322856] [Citation(s) in RCA: 129] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2000] [Revised: 05/24/2001] [Indexed: 11/04/2022] Open
Abstract
To determine the effect of highly active antiretroviral therapy (HAART) on high-risk human papillomavirus (HR-HPV) infections and related cervical lesions, the virologic and cytologic markers of HPV infection were prospectively studied in 163 human immunodeficiency virus (HIV)-infected women, including 27 untreated, 62 treated with reverse transcriptase inhibitors, and 74 treated with HAART. A high prevalence of both infections with HR-HPV types (68%) and squamous intraepithelial lesions (SILs; low grade, 20.2%; high grade, 6.2%) was observed. The risks of infection and disease were inversely correlated with CD4 cell counts (P=.015 and P=.022, respectively). During the observation period (mean, 15.4 months; range, 6-24 months), CD4 cell counts increased significantly only in subjects receiving HAART (P<.001). Persistence of HR-HPV infection and progression of SILs were comparable in the 3 groups. These results indicate that, even in the era of HAART, HIV-infected women should be monitored carefully for the emergence of high-grade SILs and cervical cancer.
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Affiliation(s)
- F B Lillo
- Laboratory of Virology, San Raffaele Hospital, 20127 Milan, Italy.
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21
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Abstract
OBJECTIVE To investigate the effects of stopping smoking on cervical Langerhans' cells and lymphocytes. DESIGN Prospective intervention study. SETTING A large family planning clinic in central London. POPULATION Women volunteers prepared to attempt to give up smoking for six months. Their most recent cervical smear showed no abnormality greater than mild dyskaryosis. METHODS The women were seen at three-month intervals for six months. Reduction in smoking was assessed by self-reporting and validated by salivary cotinine concentrations. Colposcopy and a biopsy of a normal area were performed at the first and last visits. Any area of abnormality was also biopsied at the final visit. Langerhans' cells and lymphocytes were counted. MAIN OUTCOME MEASURES Proportional changes in counts of Langerhans' cells and lymphocytes with reduction in smoking. RESULTS Reduction in smoking by 20 to 40 cigarettes per day was significantly associated with a reduction of between 6% and 16% in counts of Langerhans cells, CD8 and total lymphocytes. Heavy smoking was significantly associated (P = 0.02) with an increased chance of persistent human papillomavirus infection. The presence of candida was associated with significantly higher counts of between 41% and 47% in total lymphocytes and CD8 lymphocytes. In contrast, the presence of anaerobic vaginosis was associated with significantly lower counts of between 16% and 30% in Langerhans cells, CD4 and CD8 lymphocytes. CONCLUSIONS This large intervention study has demonstrated a clear relationship between reduction in smoking and changes in cervical immune cell counts. Future studies need to take into account cytokine interactions, which recent studies suggest may be significant in the immune response to both human papillomavirus and cervical intraepithelial neoplasia and the ever-increasing complexity of the cell-mediated immune system of the cervix.
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22
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Ville Y. [Premature delivery and inflammation]. J Gynecol Obstet Biol Reprod (Paris) 2001; 30:12-6. [PMID: 11240512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
Premature delivery results from multiple closely interdependent factors. Inflammation is most generally caused by cervicovaginal infection that may progress to intra-uterine infection or inflammation. Severe chorioamniotitis is found in 75% of all premature deliveries compared with 15% in term deliveries. Premature rupture of the membranes is the cause of premature delivery in 30-40% of premature deliveries although the diagnosis of chorioamniotitis can also be established with intact membranes, sometimes on the basis of histological findings alone. The degree of prematurity is correlated with the severity of the histological chorioamniotitis. The severity and the duration of the lesions is often the cause of antibiotic failure for the treatment of threatening premature delivery. Inflammation mediators, mainly proinflammatory cytokines (IL1, TNF-alpha), chemokines (IL6, IL8 and MIP-1alpha) and immunomodulator cytokines (IL6) and immunosuppressive cytokines (IL10, IL4) are produced by the amniotic and decidual membranes and are found in the fetal circulation and amniotic fluid. This reaction triggers a cascade of events leading to the production of prostaglandins and cyclooxygenase (COX2) activity, that cause uterine contractions. The inflammation may be initiated locally, even from an extrapelvic location, This leads to a fetal and/or maternal systemic inflammatory reaction. Systemic fetal expression of deregulated inflammatory phenomena can lead to neonatal lesions of lung and brain white matter tissue. This explains the failure of tocolysis and antibiotics in uncontrolled situations and suggests new avenues for therapy using selective inhibitors of COX2.
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Affiliation(s)
- Y Ville
- Département de Gynécologie-Obstétrique, Université Paris-Ouest, CHI Poissy-St-Germain.
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23
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Lakatosh VP, Lazarenko LM, Lianenko LO, Iurachkivs'kyĭ IP, Iatsenko VO. [Mathematical modelling and the prognosis of treatment efficacy in papillomavirus infection of the cervix uteri]. Lik Sprava 2000:65-71. [PMID: 11031455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
In this paper, consideration is given to the problem of mathematical modelling, diagnosis and effects of treatment options on the condition of a patient exposed to papillomavirus infection. The problem is tackled of identifying the most prominent signs of degree of severity of the disease course and of therapy efficiency on the basis of parameters characterizing the immunologic vigor with making use of the covariation matrix eigenvalues algorithm, namely the modelling manifolds algorithm. Such an approach allows the central problem of classification of indices for the immunologic vigor to be settled. A mathematical model as discrimination surface to be used for prediction of results of the treatments administered is constructed.
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24
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Lawn SD, Subbarao S, Wright TC, Evans-Strickfaden T, Ellerbrock TV, Lennox JL, Butera ST, Hart CE. Correlation between human immunodeficiency virus type 1 RNA levels in the female genital tract and immune activation associated with ulceration of the cervix. J Infect Dis 2000; 181:1950-6. [PMID: 10837174 DOI: 10.1086/315514] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/1999] [Revised: 02/16/2000] [Indexed: 11/03/2022] Open
Abstract
To address the hypothesis that local immune activation resulting from genital ulceration enhances human immunodeficiency virus type 1 (HIV-1) replication and shedding into the genital tract, paired plasma and cervicovaginal lavage (CVL) samples were obtained from 12 HIV-infected women before and after treatment of cervical intraepithelial lesions. Two weeks after treatment, inflammation and ulceration of the cervix were accompanied by major increases in mean concentrations of HIV-1 RNA (200-fold), tumor necrosis factor-alpha, interleukin 6, and soluble markers shed by activated lymphocytes and macrophages (sCD25 and sCD14, respectively) in CVL samples (P<.01 for each), but not plasma. Strong temporal and quantitative correlations were observed between concentrations of immunological markers and HIV-1 load in this compartment during a 10-week follow-up. Furthermore, in the presence of genital ulceration, HIV-1 in CVL samples was more readily captured by antibodies directed against virion-associated HLA-DR, a marker of host-cell activation, compared with virus in plasma. We suggest that local immune activation increases HIV-1 load in genital secretions, potentially increasing the risk of HIV-1 transmission.
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Affiliation(s)
- S D Lawn
- Tuberculosis and Mycobacteriology Branch, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
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25
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Dolgushin II, Telesheva LF, Dolgushina VF. [Local anti-infective protection of the reproductive tract in women of different ages]. Zh Mikrobiol Epidemiol Immunobiol 2000:86-9. [PMID: 10808583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
Healthy girls and women of the reproductive age, as well as women immediately before and after menopause, were examined. Neutrophils and immunoglobulins of cervical and vaginal secretions were studied and, as a result, age-dependent differences in the activity of the anti-infectious protection of the reproductive tract of women were found.
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26
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Franco EL, Villa LL, Sobrinho JP, Prado JM, Rousseau MC, Désy M, Rohan TE. Epidemiology of acquisition and clearance of cervical human papillomavirus infection in women from a high-risk area for cervical cancer. J Infect Dis 1999; 180:1415-23. [PMID: 10515798 DOI: 10.1086/315086] [Citation(s) in RCA: 387] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Acquisition and clearance of cervical human papillomavirus (HPV) infection were analyzed among 1425 low-income women attending a maternal and child health program in São Paulo, Brazil. Specimens collected every 4 months were tested by a polymerase chain reaction protocol (MY09/11). In all, 357 subjects were positive at least once. There were 1.3% new infections per month, with 38% cumulative positivity after 18 months. Of 177 positive subjects at enrollment, only 35% remained infected after 12 months. The monthly clearance rate was higher for nononcogenic types (12.2%; 95% confidence interval [CI], 9.6-15.4) than for oncogenic HPV infections (9.5%; 95% CI, 7.5-11.9). Median retention times were 8.1 months (95% CI, 7.8-8.3) for oncogenic types and 4.8 months (95% CI, 3.9-5.6) for nononcogenic HPV infections. The mean infection durations were 8.2 and 13.5 months for nononcogenic and oncogenic types, respectively. Although a woman's age did not affect mean duration for oncogenic types (13-14 months), nononcogenic-type infections lasted longer (10. 2 months) among younger (<35 years old) than in older women (5.6 months).
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Affiliation(s)
- E L Franco
- Department of Oncology, McGill University, Montreal, QC, Canada H2W 1S6.
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27
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Vassilakos P. Management of suboptimal cytologic smears: persistent inflammatory smears. Acta Cytol 1998; 42:1481. [PMID: 9850666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
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28
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Hildesheim A, Bratti MC, Edwards RP, Schiffman M, Rodriguez AC, Herrero R, Alfaro M, Morera LA, Ermatinger SV, Miller BT, Crowley-Nowick PA. Collection of cervical secretions does not adversely affect Pap smears taken immediately afterward. Clin Diagn Lab Immunol 1998; 5:491-3. [PMID: 9665954 PMCID: PMC95605 DOI: 10.1128/cdli.5.4.491-493.1998] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Collection of cervical secretions for local immunological assessment requires that the secretions be collected prior to the Pap smear to avoid contamination with blood. The objective of the present study was to determine whether gentle collection of cervical secretions prior to a Pap smear collection influences the quality of the Pap smear. A total of 266 women were recruited. Half of the participants were assigned to collection of cervical secretions prior to Pap smear collection with Weck-cel sponges. The remaining half had only the Pap smear collection performed. Pap smear slides were reviewed and evaluated for quality by the Bethesda System adequacy criteria without knowledge of randomization. The proportions of limited or inadequate slides in the two study groups were compared by using the Pearson chi-square test. No significant differences were observed between the two study groups when overall Pap smear quality was evaluated (P = 0.29). Comparison of the two study groups with respect to individual adequacy criteria, including presence of air drying artifact, presence of obscuring blood, absence of metaplastic or endocervical cells from the transformation zone, scant cellularity, and presence of obscuring inflammatory cells, also revealed no significant differences between the two study groups. Results from the present study suggest that the collection of cervical secretions with Weck-cel sponges does not adversely impact the quality of subsequently obtained Pap smears.
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Affiliation(s)
- A Hildesheim
- Interdisciplinary Studies Section, Environmental Epidemiology Branch, National Cancer Institute, Bethesda, Maryland 20892-7374, USA.
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29
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Spizhenko NI. [The level of immunoglobulins and antispermatic antibodies in the cervical mucus of infertile women with cervix uteri pathology]. Lik Sprava 1997:151-4. [PMID: 9589964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
This article is about determination of local immunity indices, immunoglobulins of A, M, G, sIgA classes and antispermal immunity of the cervical mucus in infertile women with pathology of cervix uteri. It is shown that usage of complex tests with local immunity as well as identification antispermal antibody should be a reliable basis to diagnose infertile women with benign and precancerous diseases of cervix uteri.
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30
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Abstract
Venereal infection with equine arteritis virus (EAV) was established in each of seven mares by inoculation via the cervix with 20 ml of viral suspension (> or = 8 x 10(6) plaque-forming units; PFU), following treatment with prostaglandin and oestradiol. A dose of < or = 8 x 10(5) PFU produced infection in only five of eight mares. Serum neutralizing antibody developed in mares manifesting clinical signs of equine viral arteritis (EVA), and a weak antibody was detectable in one apparently healthy mare inoculated with 8 x 10(5) PFU. Virus isolation was demonstrated not only in the buffy coat but also in nasal swabs of infected mares. EAV was isolated frequently from the body tissues of the mares (killed 10 to 34 days post-inoculation) up to day 12, but rarely from the reproductive tissues later than day 12. The virus persisted longest in the splenic and deep inguinal lymph nodes, followed by the spleen and internal iliac lymph nodes. Four mares immunized with a killed vaccine for EVA showed no clinical disease after venereal challenge with EAV; the virus was recovered from the buffy coat of three mares and from the nasal swab of one of them, but not from the remaining animal.
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Affiliation(s)
- Y Fukunaga
- Epizootic Research Station, Japan Racing Association, Tochigi
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31
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Vinatier D, Dufour P. [Anti-papillomavirus immunologic response and natural history of cervical lesions]. Contracept Fertil Sex 1997; 25:339-47. [PMID: 9273102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- D Vinatier
- Hôpital Jeanne de Flandre, Service Chirurgie Gynécologie, Lille
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32
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Viscidi RP, Kotloff KL, Clayman B, Russ K, Shapiro S, Shah KV. Prevalence of antibodies to human papillomavirus (HPV) type 16 virus-like particles in relation to cervical HPV infection among college women. Clin Diagn Lab Immunol 1997; 4:122-6. [PMID: 9067643 PMCID: PMC170489 DOI: 10.1128/cdli.4.2.122-126.1997] [Citation(s) in RCA: 75] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
A human papillomavirus type 16 (HPV-16) virus-like particle (VLP)-based enzyme-linked immunosorbent assay (ELISA) was used to measure serum antibody to capsid proteins in 376 sexually active college women who were also screened for the presence of genital HPVs by PCR and interviewed for demographic and behavioral risk factors for HPV infection. The seroprevalence was 46% in women with HPV-16 DNA in the genital tract. The corresponding values for women who harbored other HPV types or no HPV in the genital tract were 30 and 19%, respectively (HPV-16 group versus no-HPV group; odds ratio [OR], 3.7; 95% confidence interval [CI], 1.5 to 8.9). The antibody response was significantly higher among women with a high viral load than among those with a low viral load (median optical density value, 0.838 versus 0.137, P = 0.009). Comparable levels of seroreactivity were observed among women infected with HPV types distantly or closely related genetically to HPV-16. Seroreactivity was significantly associated with an age of 25 to 30 years (OR, 2.3; 95% CI, 1.2 to 4.4), three or more lifetime sexual partners (OR, 2.9; 95% CI, 1.1 to 10), and history of a sexually transmitted disease other than HPV (OR, 3.1; 95% CI, 1.5 to 6.3). The percent seropositivity increased linearly with number of lifetime sexual partners until reaching a plateau at 35% for women with more than six partners (chi for linear trend, P < 0.001). The low sensitivity of HPV-16 VLP-based ELISA may limit the usefulness of the assay as a diagnostic test for HPV-16 infection. However, the assay appears to have adequate specificity and should be useful as an epidemiological marker of HPV-16 infection and sexual behavior.
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Affiliation(s)
- R P Viscidi
- Eudowood Division of Infectious Diseases, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
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33
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Frank GA, Minkina GN, Kulagina LA, Simonova TV, Petrov AN. [Proliferating cell nuclear antigen in precancerous cervical disease]. Arkh Patol 1997; 59:30-3. [PMID: 9139604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Monoclonal antibodies PC-10 were used to study the expression of PCNA in precancerous pathology of the uterine cervix in 50 biopsies in the presence of papilloma virus infection (PVI). Positive reaction was in 100% PVI before treatment; weak proliferative activity was in 40% and strong reaction in 15%. If PVI was complicated with degree III dysplasia, there was an increase of proliferative activity. The positive reaction was retained after the therapy in 4 cases of the recurrent PVI. Positivity with PC-10 may be an unfavourable prognostic criterium.
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McCluggage G, McBride H, Maxwell P, Bharucha H. Immunohistochemical detection of p53 and bcl-2 proteins in neoplastic and non-neoplastic endocervical glandular lesions. Int J Gynecol Pathol 1997; 16:22-7. [PMID: 8986528 DOI: 10.1097/00004347-199701000-00004] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The study examines p53 and bcl-2 protein expression in a variety of neoplastic and non-neoplastic endocervical glandular lesions. Immunohistochemical staining, using monoclonal antibodies against p53 (DO-7) and bcl-2, was performed on archival paraffin-embedded tissue following microwave antigen retrieval. With DO-7 there was positive nuclear staining in 23/33 cases of adenocarcinoma, 2/10 adenocarcinoma in situ, 2/10 tubo-endometrial metaplasia, 1/10 microglandular hyperplasia, and 1/17 normal endocervix. With adenocarcinoma in situ and non-neoplastic lesions, positive staining was confined to scattered cells. Nine of 23 positive cases of adenocarcinoma showed widespread staining. With anti-bcl-2 antibody, there was positive cytoplasmic staining in 9/33 cases of adenocarcinoma, 0/10 adenocarcinoma in situ, 7/10 tubo-endometrial metaplasia, 1/10 microglandular hyperplasia, and 0/17 normal endocervix. Five of nine positive adenocarcinomas showed widespread staining. There was widespread positive staining for bcl-2 in six of seven positive cases of tubo-endometrial metaplasia. The results indicate that p53 protein expression is frequent in endocervical adenocarcinoma and suggest that mutation of the p53 gene may be important in the evolution of some cases of endocervical adenocarcinoma. Scattered p53-positive cells may be seen in endocervical adenocarcinoma in situ and in non-neoplastic endocervical glandular lesions, the significance of which is uncertain. Bcl-2 protein expression is seen in a proportion of endocervical adenocarcinomas and may play a role in the evolution of these tumors through inhibition of apoptosis. Widespread positivity for bcl-2 protein is seen in most cases of tubo-endometrial metaplasia, suggesting that this type of metaplastic epithelium may represent an unusually stable population of cells.
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Affiliation(s)
- G McCluggage
- Department of Pathology, Royal Group of Hospitals Trust, Belfast, Northern Ireland
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35
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Casamassima A, Marinaccio L, Fanciullo F, Correale M, Petroni S, Wiesel S, Simone G, Marzullo A, Caponio MA, Falco G. [Secretory IgA of the cervical mucus in neoplastic and nonneoplastic conditions of the uterine cervix]. Minerva Ginecol 1997; 49:7-12. [PMID: 9162888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
In 39 women affected by cervical intraepithelial neoplasia (CIN) concentration of the cervical mucus secretory IgA (sIgA) was significantly higher than in 414 controls matched for age, reproductive status and smoking habit (196 healthy women; 109 with "specific" and "aspecific" cervicitis or cervico-vaginitis; 51 with benign epithelial disorders of the cervix; 40 with adenomatous cervical polyp and 18 with early invasive exocervical squamous carcinoma). CIN carried the highest proportion of cases with sIgA detectable or beyond the cut-off value and sIgA concentration was inversely related to CIN grade. Present data confirm our preliminary investigation on the cervical total IgA and explain that any increased levels of these IgA are induced by the secretory and not serum fraction of this immunoglobulin. We still don't know the exact meaning and value of the present results. It is only possible to suppose that they are the expression of a vigorous local immune activation adverse to CIN, which is elevated for as long as the architecture of cervical glandular epithelia is preserved.
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Affiliation(s)
- A Casamassima
- Unità di Laboratorio Analisi, IRCCS Oncologico, Bari
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Syrjänen K, Nurmi T, Mäntyjärvi R, Ilonen J, Syrjänen S, Surcel HM, Yliskoski M, Väyrynen M, Chang F, Saarikoski S. HLA types in women with cervical human papillomavirus (HPV) lesions prospectively followed up for 10 years. Cytopathology 1996; 7:99-107. [PMID: 9074659 DOI: 10.1046/j.1365-2303.1996.38882388.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Certain genotypes of HPV have been recently implicated in the etiology of carcinoma of the uterine cervix. In order to determine whether HLA antigen-controlled immunoregulatory functions have a role in the pathogenesis of HPV infections, class I and II HLA antigen typing was carried out on a series of 96 randomly selected women who were part of a cohort of 530 women prospectively followed up for cervical HPV infections in our clinic since 1981. The frequency of the DQ3 antigen, which has previously been reported to be increased among cervical cancer patients, was decreased in our HPV patients compared with the control group of Finnish women, but it was slightly increased in HPV16-infected women (P = 0.0812). However, we were able to demonstrate that HLA-DR5 antigen is significantly increased (i) in patients with high grade cervical intraepithelial neoplasia (CIN) (P < 0.02), and (ii) in women harbouring the high risk HPV type 16 (P = 0.0003), thus confirming earlier reports of an association of this HLA antigen and cervical cancer. Such a close association between the high risk HPV type 16 with an HLA antigen might have important implications in the possible immunogenetic basis of the increased risk for squamous cell carcinoma of the uterine cervix.
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Affiliation(s)
- K Syrjänen
- Department of Pathology, University of Kuopio, Finland
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37
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Quéreux C, Hourdequin P, Saniez D, Rémy G. [Cervical pathology and immunodepression]. Contracept Fertil Sex 1994; 22:771-6. [PMID: 7827639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
The Human Papilloma Virus is often involved in the pathogenesis of cervical lesions. A local or systemic immunodeficiency allows neoplasia outbreaks. We do not know if immunodepression only allows the virus to persist, or if the HPV induces a local immunodeficiency. Large warts are often associated with pregnancy, but cervical cancers are not increased in pregnant women. Induced immunodeficiency (among transplanted patients), or AIDS increase the rate of CIN and cervical cancers. The more serious the immunodeficiency is, the more multifocal and recurrent the lesions are. We have to look for an immunodepression and for AIDS when we observe multifocal or recurrent lesions of the cervix, specially when the lesions do not regress under correct treatment. Immunodeficient women would benefit from closer care of their cervix. We think that combine therapy (e.g. laser and local interferon) would be more efficient in case of immunodeficiency.
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Affiliation(s)
- C Quéreux
- Service de gynécologie-obstétrique, Hôpital Maison Blanche, CHU, Reims
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38
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Abstract
The role of CD8+ T cells in antichlamydial immunity was investigated in a murine model of chlamydial genital infection by using T-cell clones generated against the Chlamydia trachomatis agent of mouse pneumonitis (MoPn). Two CD8+ T-cell clones tested (2.1F and 2.14-9) were chlamydia antigen specific and MHC restricted and reacted against MoPn as well as the Chlamydia psittaci agent of guinea pig inclusion conjunctivitis and C. trachomatis serovar E, suggesting the recognition of a genus-specific antigen. Upon adoptive transfer into persistently MoPn-infected nu/nu mice, 55.6% of the recipients of clone 2.1F (15 of 27) resolved the infection but recipients of clone 2.14-9 did not. The ability to resolve the MoPn infection correlated with the capacity of clone 2.1F to elaborate a combination of gamma interferon and tumor necrosis factor alpha. The results suggested that in addition to CD4+ T cells, CD8+ T cells may also contribute to antichlamydial T-cell immunity in vivo.
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Affiliation(s)
- J U Igietseme
- Department of Microbiology and Immunology, University of Arkansas for Medical Sciences, Little Rock 72205
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39
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Gocze PM, Vahrson HW, Freeman DA. Serum levels of squamous cell carcinoma antigen and ovarian carcinoma antigen (CA 125) in patients with benign and malignant diseases of the uterine cervix. Oncology 1994; 51:430-4. [PMID: 8052484 DOI: 10.1159/000227378] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
In the present study we evaluated the clinical usefulness of the tumor antigens, squamous cell carcinoma antigen (SCC) and ovarian carcinoma antigen (CA 125), in populations of patients with benign and malignant cervical disease. SCC and CA 125 levels were determined in the serum of 59 patients with invasive carcinoma of the uterine cervix and in 21 patients with benign cervical diseases. Before treatment of cervical cancer, SCC levels were elevated in 63% of the patients with squamous cell cancer while all 5 patients with adenocarcinoma had normal levels. CA 125 levels were elevated in 21% of the patients with cervical squamous cell cancer and in 3 of the 5 cases of adenocarcinoma of the cervix. In patients with benign cervical diseases, only 1 had a positive SCC level and none were positive for CA 125. No correlation was found between SCC levels and histological differentiation or clinical stage. In positive patients, serial SCC determinations correlated with the clinical course in 72.2%. Increasing levels were always associated with progression and increased on average 3 months before there was clinical evidence for disease progression. It is concluded from these studies that SCC levels are a useful marker for cervical cancer progression and recurrence. Levels of CA 125 were more likely to be elevated in patients with adenocarcinoma than squamous cell carcinoma, but when elevated in these latter patients, it also tended to predict tumor recurrence.
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Affiliation(s)
- P M Gocze
- University of Oklahoma Health Sciences Center, Oklahoma City
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40
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Ghinsberg RC, Nitzan Y. Chlamydia trachomatis direct isolation, antibody prevalence and clinical symptoms in women attending outpatient clinics. New Microbiol 1994; 17:231-42. [PMID: 7968658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Two hundred and ninety-seven women with complaints of vaginal or urethral discharge and 100 women attending outpatient clinics for contraceptive or other advice (enrolled as controls) were studied and compared. A meticulous sampling for Chlamydia trachomatis was taken from one hundred and seventy-seven women enrolled in the study group (A1). Technical difficulties were encountered with the remaining 120 cases--study group (A2). It was found that ninety-three out of the 177 women (of group A1) were infected with either Chlamydia trachomatis or Neisseria gonorrhoeae (52.5%) compared to four out of 120 (3.4%) in the A2 subgroup. The overall prevalence of C. trachomatis antibodies was found to be 171/397 (43.1%) when all three groups studied were tested by immunoperoxidase (IPA). In comparison, by direct culture alone 92/397 (23.2%) were positive. The most significant clinical symptoms for chlamydial infection were purulent or mucoid discharge, bleeding and vaginitis (p = 0.005). This study demonstrates that immunoperoxidase (IPA) and ELISA techniques for C. trachomatis serology are helpful for the identification of infection by this agent. The possibility of using these serological methods in screening tests for vaginal infections in addition to C. trachomatis direct culture and clinical symptoms in outpatient clinics should be considered.
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Affiliation(s)
- R C Ghinsberg
- Dr. D. Rappaport Regional and Central Public Health Laboratory, Tel Aviv, Israel
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41
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Clad A, Freidank H, Plünnecke J, Jung B, Petersen EE. Chlamydia trachomatis species specific serology: ImmunoComb Chlamydia bivalent versus microimmunofluorescence (MIF). Infection 1994; 22:165-73. [PMID: 7927811 DOI: 10.1007/bf01716696] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
The ImmunoComb Chlamydia Bivalent IgG/IgA (Orgenics, Israel) is a new quantitative serologic test that employs LPS extracted Chlamydia trachomatis L2 and LPS extracted Chlamydia pneumoniae elementary bodies on two separate antigenic spots. The Bivalent C. trachomatis specific test results were compared with microimmunofluorescence (MIF), the gold standard of chlamydial species specific serology. For C. trachomatis IgG the Bivalent was highly concordant with the MIF: the rate of positive titres (IgG > or = 1:8) was 10% vs. 11% in 100 blood donors, 18% vs. 16% in 111 obstetric patients (6% antigen prevalence), 26% vs. 22% in sterile women with open (n = 54) and 86% vs. 84% with occluded (n = 51) tubes, and 88% vs. 85% in 103 women with C. trachomatis positive cervical smears. Surprisingly, the Bivalent differed considerably from the MIF in IgA prevalence: in obstetric patients (8% vs. 4%), sterile women with open (13% vs. 6%) and occluded (71% vs. 20%) tubes, and women with positive cervical smears (78% vs. 24%). Bivalent IgA appeared to be more sensitive than MIF IgA and showed a stronger correlation with positive cervical smears in obstetric patients (sensitivity 67% vs. 0%, specificity 95% vs. 96%, positive prediction 44% vs. 0%, negative prediction 98% vs. 94%) and with tubal occlusion in sterile women (sensitivity 71% vs. 20%, specificity 87% vs. 94%, positive prediction 84% vs. 77%, negative prediction 76% vs. 55%). MIF IgM was of little diagnostic help. Supplemental to the often difficult C. trachomatis antigen detection, the easily performed Bivalent IgG/IgA appears to be of great value in routine diagnosis of genital chlamydial infections.
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Affiliation(s)
- A Clad
- Universitäts-Frauenklinik, Freiburg, Germany
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42
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Ghosh AK, Smith NK, Stacey SN, Glew SS, Connor ME, Arrand JR, Stern PL. Serological response to HPV 16 in cervical dysplasia and neoplasia: correlation of antibodies to E6 with cervical cancer. Int J Cancer 1993; 53:591-6. [PMID: 8382193 DOI: 10.1002/ijc.2910530411] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Sera from patients with cervical cancer, cervical intraepithelial neoplasia (CIN) and non-genital cancers, and from healthy individuals, were investigated for antibodies to human papilloma virus (HPV) early proteins E4, E6 and E7 and the major capsid protein LI by Western blot analysis of recombinant HPV proteins. There was a significantly higher prevalence of sera with antibodies to E6 in cervical cancer patients than in healthy individuals or in CIN or non-genital-cancer patients. Antibodies to E7 were detected in 25% of cervical-cancer patients, which is significantly higher than in HPV-associated cervical lesions or in control populations, but not significantly different from the incidence in patients with non-genital cancers. Antibodies to LI were found more frequently in CIN, while antibodies to E4 had a similar prevalence in cervical-cancer, cervical-dysplasia and non-genital-cancer groups, with 24% in the controls. The inability to detect antibodies to E6 and E7 in the majority of cervical-cancer patients limits the application of this methodology to the monitoring of HPV infection and the development of cervical cancer. However, the latter approach may be useful in combination with other assay systems which allow detection of different, including conformational, epitopes of HPV E6 and/or E7 recombinant proteins.
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Affiliation(s)
- A K Ghosh
- Cancer Research Campaign Department of Immunology, Paterson Institute for Cancer Research, Christie Hospital NHS Trust, Manchester, UK
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43
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Zemskov AM, Kozachenko VP, Bychkov VI, Chursanova DN. [The immunocorrective therapy of cervix uteri diseases]. Akush Ginekol (Mosk) 1993:40-42. [PMID: 8250117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Analyzes the results of comprehensive clinical and immunologic examinations of women with inflammatory and tumorous diseases of the cervix uteri. Demonstrates a reduction of the immunologic reactions in such diseases and in traditional antibiotic therapy thereof. Presents methods of immunocorrective therapy with vitamin E, thymactin, and sodium nucleinate to be carried out on an inpatient basis.
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44
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Abstract
Human papillomavirus type-16 (HPV-16) is strongly associated with cervical carcinoma and cervical intraepithelial neoplasia. It may soon be possible to develop prophylactic vaccines designed to induce neutralizing antibodies to HPV-16 virions in genital secretions and therapeutic vaccines to induce cytotoxic T-cell responses against HPV-16 early proteins in cervical intraepithelial neoplasia and cervical cancers. Although significant advances have been achieved, problems remain before such vaccines can be used routinely.
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Affiliation(s)
- J Cason
- Richard DimbleBy Laboratory of Cancer Virology, United Medical and Dental Schools, Rayne Institute, London, UK
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45
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Kadish AS, Hagan RJ, Ritter DB, Goldberg GL, Romney SL, Kanetsky PA, Beiss BK, Burk RD. Biologic characteristics of specific human papillomavirus types predicted from morphology of cervical lesions. Hum Pathol 1992; 23:1262-9. [PMID: 1330876 DOI: 10.1016/0046-8177(92)90294-d] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Human papillomavirus (HPV) DNA was detected by Southern blot hybridization in cervicovaginal lavage samples from 199 of 329 (60.5%) women attending a municipal hospital colposcopy clinic. Human papillomavirus was identified in 195 of 264 (73.9%) patients with a squamous intraepithelial lesion or cancer on biopsy or Papanicolaou smear (Bethesda system) compared with 11 of 65 (16.9%) without squamous intraepithelial lesion (P < .0001). The most common HPV type identified was HPV 16 (20.6% of positive samples), and 36.7% of isolates contained uncharacterized HPVs. Of women with cervical intraepithelial neoplasia (CIN) grade III or cancer, 23.4% were infected with HPV 16 compared with less than 4% with any other single HPV type. Based on biopsy diagnosis in patients infected with specific HPV types, HPVs 6 and 11 had low oncogenic potential; HPVs 18, 31, 35, and 45 had intermediate oncogenic potential; and HPVs 16 and 33 had high oncogenic potential. Hyperchromatic, unusually enlarged nuclei ("meganuclei"), and/or abnormal mitoses were found significantly more often in lesions infected with HPVs 16, 33, and 35 than in those infected with HPVs 6, 11, 18, 31, and 45, even in low-grade lesions, and may represent a histologic marker for HPVs with significant oncogenic potential. Human papillomavirus capsid protein was detected significantly less often by immunocytochemical staining in CIN I and CIN II lesions infected with HPVs 16 and 33 (8.3%) than in those infected with HPVs 6, 11, 18, and 31 (60%; P = .007), suggesting early abnormalities in cellular differentiation in lesions infected with highly oncogenic HPVs.
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Affiliation(s)
- A S Kadish
- Department of Pathology, Albert Einstein College of Medicine, Bronx, NY 10461
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46
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Johnson JC, Burnett AF, Willet GD, Young MA, Doniger J. High frequency of latent and clinical human papillomavirus cervical infections in immunocompromised human immunodeficiency virus-infected women. Obstet Gynecol 1992; 79:321-7. [PMID: 1310804 DOI: 10.1097/00006250-199203000-00001] [Citation(s) in RCA: 81] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
In 32 human immunodeficiency virus (HIV)-infected women, routine gynecologic examination was performed with colposcopy and Papanicolaou smear; cervical swabs were collected for human papillomavirus (HPV) DNA screening and typing; and immune status was assessed by CD4 T-cell count. Dot blot analysis was specifically chosen for HPV DNA screening to detect only relatively substantial HPV DNA infections. Polymerase chain reaction analysis was used for precise DNA typing of dot blot-positive samples. The HPV data were assessed for immune status; a subject with a CD4 T-cell count below 200/microL was considered functionally immunosuppressed. The frequency of dot blot positivity was fivefold higher among immunocompromised (nine of ten) than relatively immunocompetent (four of 22) HIV-infected women. Moreover, four immunosuppressed women, compared with no immunocompetent subjects, had evidence of HPV DNA without signs of HPV-associated lesions by cytology or histology (ie, latent HPV infection). Furthermore, four of nine of the immunocompromised, compared with four of 21 immunocompetent, subjects had cervical intraepithelial neoplasia. These frequencies are high compared with those reported in the general population. Finally, HPV 18 was detected in five of the ten women with CD4 T-cell counts below 200/microL and in only one of the 22 with CD4 T-cell counts above that level. These results suggest that the normal immune system suppresses latent and clinical HPV cervical infections and that the efficiency of suppression may be HPV type-specific. Furthermore, impaired immune status, as reflected by CD4 T-cell count, is an important factor increasing the severity of HPV-induced cervical infections in this population.
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Affiliation(s)
- J C Johnson
- Department of Obstetrics and Gynecology, Georgetown University Medical Center, Washington, DC
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47
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Ishi K, Shimota H, Kawashima T, Kawahata S, Kubota T, Takada M. [Significance of determination of the blood antibody level in Chlamydia trachomatis infection of the uterine cervix]. Rinsho Byori 1991; 39:1215-9. [PMID: 1762201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Kits for measurement of C. trachomatis specific antibody are not commercially available, but of the significance of determination of the serum antibody level has not been clarified. In this study, we first determined the C. trachomatis antibody level in patients considered to be free of C. trachomatis infection. Then, we evaluated the relationship between the presence or absence of antigen with the antibody level in patients at our department who were available for antigen examination. Anti-C. trachomatis IgA and IgG antibodies were detected in all age groups with a peak frequency in the 20's expect that IgA antibody was absent in the umbilical blood (IgG antibody was detected also in the umbilical blood). Concerning the relationship between the presence or absence of C. trachomatis antigen and the serum antibody levels, both IgA and IgG antibodies were significantly different (chi 2 test, p less than 0.01) between the antigen-positive group and the antigen-negative group. Because females infected by C. trachomatis were more often asymptomatic than infected males, and because antigen tests may produce false negative results, determination of the antibody level must be included in the clinical tests. Determination of the antibody level is considered to be valuable also in screening for mother-child infection and asymptomatic infection.
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Affiliation(s)
- K Ishi
- Department of Clinical Laboratory, Juntendo Urayasu Hospital, Juntendo University, School of Medicine, Urayasu
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48
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Köchel HG, Sievert K, Monazahian M, Mittelstädt-Deterding A, Teichmann A, Thomssen R. Antibodies to human papillomavirus type-16 in human sera as revealed by the use of prokaryotically expressed viral gene products. Virology 1991; 182:644-54. [PMID: 1850922 DOI: 10.1016/0042-6822(91)90605-b] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Open reading frames of human papillomaviruses were expressed in Escherichia coli as beta-galactosidase fusion proteins. These bacterially derived papillomaviral gene products were used to examine sera from 67 women (63 healthy subjects, 4 patients with genital carcinoma) for antibodies to papillomavirus type-16 antigens (E1, E2, E4, E5, E6, E7, L1, L2) and the L2 proteins of HPV-6b and HPV-18 by Western-blot analysis. The serologic data were compared with cytological findings classified according to Papanicolaou and with nucleic acid hybridization data from cervical smears of the same individuals. Twenty-three of the normal individuals showed antibodies exclusively directed against L2 gene products; whereas in the sera from the four genital cancer patients, antibodies to the early gene products E4 and/or E7 could be detected. In one case these antibodies were found to be combined with antibodies to L2 of HPV-16 and -18 and in another case with those to E1 and E2 of HPV-16. In none of the sera examined could antibodies to L1, E5 or E6 be identified. Three of the antibody positive normal women were found to be also positive for HPV-16/18 DNA, while all of the 40 seronegative women were HPV-16/18 DNA negative. These data indicate that serology may be a valuable means to study the epidemiology of genital human papillomavirus infection.
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Affiliation(s)
- H G Köchel
- Centre of Hygiene and Human Genetics of the University, Department of Medical Microbiology, Göttingen, Germany
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49
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Fais S, Delle Fratte F, Mancini F, Cioni V, Guadagno M, Vetrano G, Pallone F. Human cervical epithelial cells that express HLA-DR associated with viral infection and activated mononuclear cell infiltrate. J Clin Pathol 1991; 44:290-2. [PMID: 2030146 PMCID: PMC496900 DOI: 10.1136/jcp.44.4.290] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The association between the expression of HLA-DR antigens on cervical epithelium and the local immune state of activation in colposcopically obtained biopsy specimens from patients with histologically documented wart virus infection was investigated. In normal cervical epithelium no HLA-DR staining was detected. No or few IL-2R positive cells were found in the contiguous sections. HLA-DR was expressed by epithelial cells in six out of the 14 samples of wart virus infection. The pattern of fluorescence was focal, but strong and diffuse, to the whole epithelial layer. In the six samples with HLA-DR positive epithelium the numbers of IL-2R positive cells in the lamina propria were strongly increased, ranging between 75 and 90%. HLA-DR expression by cervical epithelium was observed in only two of 12 samples from patients with mixed epithelial non-virus related abnormalities. No increase in the numbers of IL-2R positive cells was observed in this group of patients. Additionally, no significant differences in terms of T lymphocyte infiltrate were found among the three groups. The results indicate that wart virus infection is associated with enhanced HLA-DR epithelial expression and they lend support to the concept that in the human cervix the epithelium actively participates in the local immune response.
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Affiliation(s)
- S Fais
- Cattedra di Gastroenterologia 1, Policlinico Umberto 1, Rome, Italy
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50
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Pinon JM, Toubas D, Marx C, Mougeot G, Bonnin A, Bonhomme A, Villaume M, Foudrinier F, Lepan H. Detection of specific immunoglobulin E in patients with toxoplasmosis. J Clin Microbiol 1990; 28:1739-43. [PMID: 2203811 PMCID: PMC268039 DOI: 10.1128/jcm.28.8.1739-1743.1990] [Citation(s) in RCA: 73] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
An immunocapture assay was developed to detect Toxoplasma gondii-specific immunoglobulin E (IgE) in sera from adults with acute acquired infection or reactivation and from babies with congenital toxoplasmosis. The components of this assay were monoclonal antibody to human IgE, samples from patients, and T. gondii tachyzoites treated with Formalin. When T. gondii-specific IgE antibodies were present, visually detectable agglutination occurred. Sera, umbilical cord blood, fetal blood, cerebrospinal fluid, and amniotic fluid were tested by this method. Specific IgE antibodies were detected in sera from 25 (86%) of 29 adults who developed specific IgG antibody during pregnancy or had specific IgA and IgM antibodies. Specific IgE was present early during infection, at the time that IgM antibodies were present, and slightly preceding the presence of specific IgA antibodies. In 23 patients tested serially, IgE antibodies never persisted for longer than 4 months. No nonspecific anti-T. gondii IgE was detected in sera from uninfected individuals. Maternal IgE antibodies did not cross the placenta. In sera of patients with congenital toxoplasmosis, specific IgE antibodies were found at birth, during the first year of life, and during immunologic recrudescence following discontinuation of pyrimethamine-sulfonamide therapy. The IgE immunocapture assay is simple to perform. It is especially useful for determining when T. gondii was acquired by recently infected pregnant women.
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Affiliation(s)
- J M Pinon
- Laboratoire de Parasitologie, CHRU, Hôpital Maison Blanche, Reims, France
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