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Nuralieva N, Yukina M, Sozaeva L, Donnikov M, Kovalenko L, Troshina E, Orlova E, Gryadunov D, Savvateeva E, Dedov I. Diagnostic Accuracy of Methods for Detection of Antibodies against Type I Interferons in Patients with Endocrine Disorders. J Pers Med 2022; 12:jpm12121948. [PMID: 36556169 PMCID: PMC9783777 DOI: 10.3390/jpm12121948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 11/21/2022] [Accepted: 11/22/2022] [Indexed: 11/25/2022] Open
Abstract
Autoantibodies against type 1 interferons (IFN-I) are a highly specific marker for type 1 autoimmune polyglandular syndrome (APS-1). Moreover, determination of antibodies to omega-interferon (IFN-ω) and alpha2-interferon (IFN-α2) allows a short-term diagnosis in patients with isolated and atypical forms of APS-1. In this study, a comparison of three different methods, namely multiplex microarray-based, cell-based and enzyme-linked immunosorbent assays for detection of antibodies against omega-interferon and alpha2-interferon, was carried out. A total of 206 serum samples from adult patients with APS-1, APS-2, isolated autoimmune endocrine pathologies or non-autoimmune endocrine disorders, and healthy individuals were analyzed. In the APS-1 patient cohort (n = 18), there was good agreement between the results of anti-IFN-I antibody tests performed by three methods, with 100% specificity and sensitivity for microarray-based assay. Although only the cell-based assay can determine the neutralizing activity of autoantibodies, the microarray-based assay can serve as a highly specific and sensitive screening test to identify anti-IFN-I antibody positive patients.
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Affiliation(s)
- Nurana Nuralieva
- Endocrinology Research Centre, Ministry of Health of Russia, 117036 Moscow, Russia
| | - Marina Yukina
- Endocrinology Research Centre, Ministry of Health of Russia, 117036 Moscow, Russia
| | - Leila Sozaeva
- Endocrinology Research Centre, Ministry of Health of Russia, 117036 Moscow, Russia
| | - Maxim Donnikov
- Medical Institute, Surgut State University, 628416 Surgut, Russia
| | | | - Ekaterina Troshina
- Endocrinology Research Centre, Ministry of Health of Russia, 117036 Moscow, Russia
| | - Elizaveta Orlova
- Endocrinology Research Centre, Ministry of Health of Russia, 117036 Moscow, Russia
| | - Dmitry Gryadunov
- Center for Precision Genome Editing and Genetic Technologies for Biomedicine, Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, 119991 Moscow, Russia
| | - Elena Savvateeva
- Center for Precision Genome Editing and Genetic Technologies for Biomedicine, Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, 119991 Moscow, Russia
- Correspondence:
| | - Ivan Dedov
- Endocrinology Research Centre, Ministry of Health of Russia, 117036 Moscow, Russia
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Kulebyakin K, Tyurin-Kuzmin P, Sozaeva L, Voloshin N, Nikolaev M, Chechekhin V, Vigovskiy M, Sysoeva V, Korchagina E, Naida D, Vorontsova M. Dynamic Balance between PTH1R-Dependent Signal Cascades Determines Its Pro- or Anti-Osteogenic Effects on MSC. Cells 2022; 11:3519. [PMID: 36359914 PMCID: PMC9656268 DOI: 10.3390/cells11213519] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 10/29/2022] [Accepted: 11/02/2022] [Indexed: 03/14/2024] Open
Abstract
Parathyroid hormone (PTH) is one of the key regulators of calcium and phosphate metabolism in the body, controlling bone metabolism and ion excretion by the kidneys. At present, attempts to use PTH as a therapeutic agent have been associated with side-effects, the nature of which is not always clear and predictable. In addition, it is known that in vivo impairment of PTH post-receptor signaling is associated with atypical differentiation behavior not only of bone cells, but also of connective tissues, including adipose tissue. In this work, we studied the functional responses of multipotent mesenchymal stromal cells (MSCs) to the action of PTH at the level of single cells. We used MSCs isolated from the periosteum and subcutaneous adipose tissue to compare characteristics of cell responses to PTH. We found that the hormone can activate three key responses via its receptor located on the surface of MSCs: single transients of calcium, calcium oscillations, and hormone-activated smooth increase in intracellular calcium. These types of calcium responses led to principally different cellular responses of MSCs. The cAMP-dependent smooth increase of intracellular calcium was associated with pro-osteogenic action of PTH, whereas phospholipase C dependent calcium oscillations led to a decrease in osteogenic differentiation intensity. Different variants of calcium responses are in dynamic equilibrium. Suppression of one type of response leads to increased activation of another type and, accordingly, to a change in the effect of PTH on cell differentiation.
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Affiliation(s)
- Konstantin Kulebyakin
- Faculty of Medicine, Lomonosov Moscow State University, 119991 Moscow, Russia
- Institute for Regenerative Medicine, Medical Research and Education Center, Lomonosov Moscow State University, 119234 Moscow, Russia
| | - Pyotr Tyurin-Kuzmin
- Faculty of Medicine, Lomonosov Moscow State University, 119991 Moscow, Russia
| | - Leila Sozaeva
- Endocrinology Research Center, 115478 Moscow, Russia
| | - Nikita Voloshin
- Faculty of Medicine, Lomonosov Moscow State University, 119991 Moscow, Russia
| | - Mikhail Nikolaev
- Faculty of Medicine, Lomonosov Moscow State University, 119991 Moscow, Russia
| | - Vadim Chechekhin
- Faculty of Medicine, Lomonosov Moscow State University, 119991 Moscow, Russia
| | - Maxim Vigovskiy
- Institute for Regenerative Medicine, Medical Research and Education Center, Lomonosov Moscow State University, 119234 Moscow, Russia
| | - Veronika Sysoeva
- Faculty of Medicine, Lomonosov Moscow State University, 119991 Moscow, Russia
| | | | - Daria Naida
- Burdenko Main Military Clinical Hospital, 105094 Moscow, Russia
| | - Maria Vorontsova
- Institute for Regenerative Medicine, Medical Research and Education Center, Lomonosov Moscow State University, 119234 Moscow, Russia
- Endocrinology Research Center, 115478 Moscow, Russia
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3
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Bastard P, Orlova E, Sozaeva L, Lévy R, James A, Schmitt MM, Ochoa S, Kareva M, Rodina Y, Gervais A, Le Voyer T, Rosain J, Philippot Q, Neehus AL, Shaw E, Migaud M, Bizien L, Ekwall O, Berg S, Beccuti G, Ghizzoni L, Thiriez G, Pavot A, Goujard C, Frémond ML, Carter E, Rothenbuhler A, Linglart A, Mignot B, Comte A, Cheikh N, Hermine O, Breivik L, Husebye ES, Humbert S, Rohrlich P, Coaquette A, Vuoto F, Faure K, Mahlaoui N, Kotnik P, Battelino T, Trebušak Podkrajšek K, Kisand K, Ferré EM, DiMaggio T, Rosen LB, Burbelo PD, McIntyre M, Kann NY, Shcherbina A, Pavlova M, Kolodkina A, Holland SM, Zhang SY, Crow YJ, Notarangelo LD, Su HC, Abel L, Anderson MS, Jouanguy E, Neven B, Puel A, Casanova JL, Lionakis MS. Preexisting autoantibodies to type I IFNs underlie critical COVID-19 pneumonia in patients with APS-1. J Exp Med 2021; 218:e20210554. [PMID: 33890986 PMCID: PMC8077172 DOI: 10.1084/jem.20210554] [Citation(s) in RCA: 160] [Impact Index Per Article: 53.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 04/01/2021] [Accepted: 04/07/2021] [Indexed: 12/15/2022] Open
Abstract
Patients with biallelic loss-of-function variants of AIRE suffer from autoimmune polyendocrine syndrome type-1 (APS-1) and produce a broad range of autoantibodies (auto-Abs), including circulating auto-Abs neutralizing most type I interferons (IFNs). These auto-Abs were recently reported to account for at least 10% of cases of life-threatening COVID-19 pneumonia in the general population. We report 22 APS-1 patients from 21 kindreds in seven countries, aged between 8 and 48 yr and infected with SARS-CoV-2 since February 2020. The 21 patients tested had auto-Abs neutralizing IFN-α subtypes and/or IFN-ω; one had anti-IFN-β and another anti-IFN-ε, but none had anti-IFN-κ. Strikingly, 19 patients (86%) were hospitalized for COVID-19 pneumonia, including 15 (68%) admitted to an intensive care unit, 11 (50%) who required mechanical ventilation, and four (18%) who died. Ambulatory disease in three patients (14%) was possibly accounted for by prior or early specific interventions. Preexisting auto-Abs neutralizing type I IFNs in APS-1 patients confer a very high risk of life-threatening COVID-19 pneumonia at any age.
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Affiliation(s)
- Paul Bastard
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Institut National de la Santé et de la Recherche Médicale U1163, Necker Hospital for Sick Children, Paris, France
- University of Paris, Imagine Institute, Paris, France
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY
| | | | | | - Romain Lévy
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Institut National de la Santé et de la Recherche Médicale U1163, Necker Hospital for Sick Children, Paris, France
- University of Paris, Imagine Institute, Paris, France
- Pediatric Immunology, Hematology and Rheumatology Unit, Necker Hospital for Sick Children, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Alyssa James
- Laboratory of Clinical Immunology and Microbiology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD
| | - Monica M. Schmitt
- Laboratory of Clinical Immunology and Microbiology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD
| | - Sebastian Ochoa
- Laboratory of Clinical Immunology and Microbiology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD
| | | | - Yulia Rodina
- Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russia
| | - Adrian Gervais
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Institut National de la Santé et de la Recherche Médicale U1163, Necker Hospital for Sick Children, Paris, France
- University of Paris, Imagine Institute, Paris, France
| | - Tom Le Voyer
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Institut National de la Santé et de la Recherche Médicale U1163, Necker Hospital for Sick Children, Paris, France
- University of Paris, Imagine Institute, Paris, France
| | - Jérémie Rosain
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Institut National de la Santé et de la Recherche Médicale U1163, Necker Hospital for Sick Children, Paris, France
- University of Paris, Imagine Institute, Paris, France
| | - Quentin Philippot
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Institut National de la Santé et de la Recherche Médicale U1163, Necker Hospital for Sick Children, Paris, France
- University of Paris, Imagine Institute, Paris, France
| | - Anna-Lena Neehus
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Institut National de la Santé et de la Recherche Médicale U1163, Necker Hospital for Sick Children, Paris, France
- University of Paris, Imagine Institute, Paris, France
| | - Elana Shaw
- Laboratory of Clinical Immunology and Microbiology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD
| | - Mélanie Migaud
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Institut National de la Santé et de la Recherche Médicale U1163, Necker Hospital for Sick Children, Paris, France
| | - Lucy Bizien
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Institut National de la Santé et de la Recherche Médicale U1163, Necker Hospital for Sick Children, Paris, France
| | - Olov Ekwall
- Department of Pediatrics, Institute of Clinical Sciences, The Sahlgrenska Academy, University of Gothenburg, Sweden
- Department of Rheumatology and Inflammation Research, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Stefan Berg
- Department of Pediatrics, Institute of Clinical Sciences, The Sahlgrenska Academy, University of Gothenburg, Sweden
| | | | - Lucia Ghizzoni
- Department of Medical Sciences, University of Turin, Turin, Italy
| | - Gérard Thiriez
- Intensive Care Unit, Besançon Hospital, Besançon, France
| | - Arthur Pavot
- Intensive Care Unit, Kremlin-Bicêtre Hospital, Kremlin-Bicêtre, France
| | - Cécile Goujard
- Internal Medicine Department, Bicêtre Hospital, Assistance Publique Hôpitaux de Paris, Paris Saclay University, Institut National de la Santé et de la Recherche Médicale U1018, Le Kremlin-Bicêtre, France
| | - Marie-Louise Frémond
- Pediatric Immunology, Hematology and Rheumatology Unit, Necker Hospital for Sick Children, Assistance Publique Hôpitaux de Paris, Paris, France
- Laboratory of Neurogenetics and Neuroinflammation, Université de Paris, Imagine Institute, Paris, France
| | - Edwin Carter
- Centre for Genomic and Experimental Medicine, Medical Research Council Institute of Genetics and Molecular Medicine, Edinburgh, UK
| | - Anya Rothenbuhler
- Pediatric Endocrinology Department, Bicêtre Hospital, Assistance Publique Hôpitaux de Paris, Paris Saclay University, Le Kremlin-Bicêtre, France
| | - Agnès Linglart
- Pediatric Endocrinology Department, Bicêtre Hospital, Assistance Publique Hôpitaux de Paris, Paris Saclay University, Le Kremlin-Bicêtre, France
| | - Brigite Mignot
- Pediatric Medicine Unit, University Hospital of Besançon, Besançon, France
| | - Aurélie Comte
- Pediatric Medicine Unit, University Hospital of Besançon, Besançon, France
| | - Nathalie Cheikh
- Pediatric Hematology Unit, University Hospital of Besançon, Besançon, France
| | - Olivier Hermine
- University of Paris, Imagine Institute, Paris, France
- Hematology department, University of Paris, Necker Hospital for Sick Children, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Lars Breivik
- Department of Clinical Science and K.G. Jebsen Center for Autoimmune Disorders, University of Bergen, Bergen, Norway
| | - Eystein S. Husebye
- Department of Clinical Science and K.G. Jebsen Center for Autoimmune Disorders, University of Bergen, Bergen, Norway
- Department of Medicine, Haukeland University Hospital, Bergen, Norway
- Department of Medicine (Solna), Karolinska Institutet, Stockholm, Sweden
| | | | - Pierre Rohrlich
- Pediatric Hematology and Oncology unit, Centre Hospitalier Universitaire de Nice, Nice, France
| | | | - Fanny Vuoto
- Infectious Disease Unit, Lille Hospital, Lille, France
| | - Karine Faure
- Infectious Disease Unit, Lille Hospital, Lille, France
| | - Nizar Mahlaoui
- Pediatric Immunology, Hematology and Rheumatology Unit, Necker Hospital for Sick Children, Assistance Publique Hôpitaux de Paris, Paris, France
- Centre de Référence Déficits Immunitaires Héréditaires, Hôpital Universitaire Necker-Enfants Malades, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Primož Kotnik
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
- University Medical Centre Ljubljana, University Children's Hospital, Ljubljana, Slovenia
| | - Tadej Battelino
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
- University Medical Centre Ljubljana, University Children's Hospital, Ljubljana, Slovenia
| | - Katarina Trebušak Podkrajšek
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
- University Medical Centre Ljubljana, University Children's Hospital, Ljubljana, Slovenia
| | - Kai Kisand
- Institute of Biomedicine and Translational Medicine, University of Tartu, Tartu, Estonia
| | - Elise M.N. Ferré
- Laboratory of Clinical Immunology and Microbiology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD
| | - Thomas DiMaggio
- Laboratory of Clinical Immunology and Microbiology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD
| | - Lindsey B. Rosen
- Laboratory of Clinical Immunology and Microbiology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD
| | - Peter D. Burbelo
- National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD
| | | | - Nelli Y. Kann
- Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russia
| | - Anna Shcherbina
- Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russia
| | - Maria Pavlova
- Department of Endocrinology N°1, Sechenov University, Moscow, Russia
| | | | - Steven M. Holland
- Laboratory of Clinical Immunology and Microbiology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD
| | - Shen-Ying Zhang
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Institut National de la Santé et de la Recherche Médicale U1163, Necker Hospital for Sick Children, Paris, France
- University of Paris, Imagine Institute, Paris, France
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY
| | - Yanick J. Crow
- Laboratory of Neurogenetics and Neuroinflammation, Université de Paris, Imagine Institute, Paris, France
- Centre for Genomic and Experimental Medicine, Medical Research Council Institute of Genetics and Molecular Medicine, Edinburgh, UK
| | - Luigi D. Notarangelo
- Laboratory of Clinical Immunology and Microbiology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD
| | - Helen C. Su
- Laboratory of Clinical Immunology and Microbiology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD
| | - Laurent Abel
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Institut National de la Santé et de la Recherche Médicale U1163, Necker Hospital for Sick Children, Paris, France
- University of Paris, Imagine Institute, Paris, France
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY
| | - Mark S. Anderson
- Diabetes Center, University of California, San Francisco, San Francisco, CA
| | - Emmanuelle Jouanguy
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Institut National de la Santé et de la Recherche Médicale U1163, Necker Hospital for Sick Children, Paris, France
- University of Paris, Imagine Institute, Paris, France
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY
| | - Bénédicte Neven
- University of Paris, Imagine Institute, Paris, France
- Pediatric Immunology, Hematology and Rheumatology Unit, Necker Hospital for Sick Children, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Anne Puel
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Institut National de la Santé et de la Recherche Médicale U1163, Necker Hospital for Sick Children, Paris, France
- University of Paris, Imagine Institute, Paris, France
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY
| | - Jean-Laurent Casanova
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Institut National de la Santé et de la Recherche Médicale U1163, Necker Hospital for Sick Children, Paris, France
- University of Paris, Imagine Institute, Paris, France
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, NY
- Howard Hughes Medical Institute, New York, NY
| | - Michail S. Lionakis
- Laboratory of Clinical Immunology and Microbiology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD
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4
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Syrjänen K, Shabalova I, Naud P, Kozachenko V, Derchain S, Zakharchenko S, Roteli-Martins C, Nerovjna R, Longatto-Filho A, Kljukina L, Tatti S, Branovskaja M, Hammes LS, Branca M, Grunjberga V, Eržen M, Juschenko A, Costa S, Sarian L, Podistov J, Syrjäen S, Syrjänen K, Syrjänen S, Shabalova I, Petrovichev N, Kozachenko V, Zakharova T, Pajanidi J, Podistov J, Chemeris G, Sozaeva L, Lipova E, Tsidaeva I, Ivanchenko O, Pshepurko A, Zakharenko S, Nerovjna R, Kljukina L, Erokhina O, Branovskaja M, Nikitina M, Grunjberga V, Grunjberg A, Juschenko A, Santopietro R, Cintorino M, Tosi P, Syrjänen K, Naud P, Derchain S, Roteli-Martins C, Longatto-Filho A, Tatti S, Branca M, Eržen M, Hammes LS, Matos J, Gontijo R, Sarian L, Braganća J, Arlindo FC, Maeda MYS, Lörincz A, Dores GB, Costa S, Syrjänen S. Risk estimates for persistent high-risk human papillomavirus infections as surrogate endpoints of progressive cervical disease critically depend on reference category: analysis of the combined prospective cohort of the New Independent States of the Former Soviet Union and Latin American Screening Studies. Int J STD AIDS 2011; 22:315-23. [DOI: 10.1258/ijsa.2009.009365] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Summary To make feasible future clinical trials with new-generation human papillomavirus (HPV) vaccines, novel virological surrogate endpoints of progressive disease have been proposed, including high-risk HPV (HR-HPV) persistence for six months (6M+) or 12 months (12M+). The risk estimates (relative risks [RRs]) of these ‘virological endpoints’ are influenced by several variables, not yet validated adequately. We compared the impact of three referent groups: (i) HPV-negative, (ii) HPV-transient, (iii) HPV-mixed outcome on the risk estimates for 6M+ or 12M+ HR-HPV persistence as predictors of progressive disease. Generalized estimating equation models were used to estimate the strength of 6M+ and 12M+ HR-HPV persistence with disease progression to squamous intraepithelial lesions (SILs), cervical intraepithelial neoplasia (CIN) grade 1 +, CIN2+, CIN/SIL endpoints, comparing three optional reference categories (i)-(iii) in a prospective sub-cohort of 1865 women from the combined New Independent States of the Former Soviet Union (NIS) and Latin American Screening (LAMS) studies cohort ( n = 15,301). The RRs of these viral endpoints as predictors of progressive disease are affected by the length of viral persistence (6M+ or 12M+) and the surrogate endpoint (SIL, CIN1, CIN2, CIN/SIL). Most dramatic is the effect of the referent group used in risk estimates, with the HPV-negative referent group giving the highest and most consistent RRs for both 6M+ and 12M+ viral persistence, irrespective of which surrogate is used. In addition to deciding on whether to use 6M+ or 12M+ persistence criteria, and cytological, histological or combined surrogate endpoints, one should adopt the HPV-negative referent group as the gold standard in all future studies using viral persistence as the surrogate endpoint of progressive disease.
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Affiliation(s)
- K Syrjänen
- Department of Oncology and Radiotherapy, Turku University Hospital, Turku, Finland
| | - I Shabalova
- Russian Academy of Post-Graduate Medical Education. Moscow, Russia
| | - P Naud
- Hospital de Clinicas de Porto Alegre, and Department of Gynecology and Obstetrics, Federal University of Rio Grande do Sul. Porto Alegre
| | - V Kozachenko
- Russian Academy of Post-Graduate Medical Education. Moscow, Russia
| | - S Derchain
- Universidade Estadual de Campinas, Campinas, Brazil
| | - S Zakharchenko
- Novgorod Municipal Dermato-venereological Dispensary, Department of Gynaecology, Novgorod, Russia
| | | | - R Nerovjna
- Novgorod Female Consultative Outpatient Hospital. Department of Gynaecology, Novgorod, Russia
| | - A Longatto-Filho
- lnstituto Adolfo Lutz, Sao Paulo, Brazil and Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal
| | - L Kljukina
- Research Institute of Oncology and Medical Radiology, Republican Centre of Clinical Cytology, Minsk, Belarus
| | - S Tatti
- First Chair Gynecology Hospital de Clinicas, Buenos Aires, Argentina
| | - M Branovskaja
- Minsk State Medical Institute. Department of Gynaecology and Obstetrics, Minsk, Belarus
| | - L S Hammes
- Hospital de Clinicas de Porto Alegre, and Department of Gynecology and Obstetrics, Federal University of Rio Grande do Sul. Porto Alegre
| | - M Branca
- Unit of Cytopathology, National Centre of Epidemiology, Surveillance and Promotion of Health, National Institute of Health (ISS), Rome, Italy
| | - V Grunjberga
- Latvian Cancer Centre, Department of Gynaecology, and Laboratory of Cytology, Riga, Latvia
| | - M Eržen
- SIZE Diagnostic Center, Ljubljana, Slovenia
| | - A Juschenko
- Latvian Cancer Centre, Department of Gynaecology, and Laboratory of Cytology, Riga, Latvia
| | - S Costa
- Department of Obstetrics and Gynecology, S. Orsola-Malpighi Hospital, Bologna, Italy
| | - L Sarian
- Universidade Estadual de Campinas, Campinas, Brazil
| | - J Podistov
- NN Blokhin Cancer Research Centre of Russian Academy of Medical Sciences (RAMS), Moscow, Russia
| | - S Syrjäen
- Department of Oral Pathology, Institute of Dentistry, University of Turku, Turku, Finland
| | - K Syrjänen
- Department of Oncology and Radiotherapy, Turku University Hospital, Turku, Finland
| | - S Syrjänen
- Department of Oral Pathology, Institute of Dentistry, and MediCity Research Laboratory, University of Turku, Finland
| | - I Shabalova
- NN Blokhin Cancer Research Centre of Russian Academy of Medical Sciences (RAMS), Moscow, Russia
- Russian Academy of Post-Graduate Medical Education, Moscow, Russia
| | - N Petrovichev
- NN Blokhin Cancer Research Centre of Russian Academy of Medical Sciences (RAMS), Moscow, Russia
| | - V Kozachenko
- NN Blokhin Cancer Research Centre of Russian Academy of Medical Sciences (RAMS), Moscow, Russia
| | - T Zakharova
- NN Blokhin Cancer Research Centre of Russian Academy of Medical Sciences (RAMS), Moscow, Russia
| | - J Pajanidi
- NN Blokhin Cancer Research Centre of Russian Academy of Medical Sciences (RAMS), Moscow, Russia
| | - J Podistov
- NN Blokhin Cancer Research Centre of Russian Academy of Medical Sciences (RAMS), Moscow, Russia
| | - G Chemeris
- NN Blokhin Cancer Research Centre of Russian Academy of Medical Sciences (RAMS), Moscow, Russia
| | - L Sozaeva
- Russian Academy of Post-Graduate Medical Education, Moscow, Russia
| | - E Lipova
- Russian Academy of Post-Graduate Medical Education, Moscow, Russia
| | - I Tsidaeva
- Russian Academy of Post-Graduate Medical Education, Moscow, Russia
| | - O Ivanchenko
- Novgorod Clinical Regional Hospital, Centralised Cytology Laboratory, Novgorod, Russia
| | - A Pshepurko
- Novgorod Clinical Regional Hospital, Centralised Cytology Laboratory, Novgorod, Russia
| | - S Zakharenko
- Novgorod Municipal Dermato-venereological Dispensary, Department of Gynaecology, Novgorod, Russia
| | - R Nerovjna
- Novgorod Female Consultative Outpatient Hospital, Department of Gynaecology, Novgorod, Russia
| | - L Kljukina
- Research Institute of Oncology and Medical Radiology, Republican Centre of Clinical Cytology, Minsk, Belarus
| | - O Erokhina
- Research Institute of Oncology and Medical Radiology, Republican Centre of Clinical Cytology, Minsk, Belarus
| | - M Branovskaja
- Minsk State Medical Institute, Department of Gynaecology and Obstetrics, Minsk, Belarus
| | - M Nikitina
- Latvian Cancer Centre, Department of Gynaecology, and Laboratory of Cytology, Riga, Latvia
| | - V Grunjberga
- Latvian Cancer Centre, Department of Gynaecology, and Laboratory of Cytology, Riga, Latvia
| | - A Grunjberg
- Latvian Cancer Centre, Department of Gynaecology, and Laboratory of Cytology, Riga, Latvia
| | - A Juschenko
- Latvian Cancer Centre, Department of Gynaecology, and Laboratory of Cytology, Riga, Latvia
| | - R Santopietro
- Department of Human Pathology and Oncology, University of Siena, Italy
| | - M Cintorino
- Department of Human Pathology and Oncology, University of Siena, Italy
| | - P Tosi
- Department of Human Pathology and Oncology, University of Siena, Italy
| | - K Syrjänen
- Department of Oncology and Radiotherapy, Turku University Hospital, Turku, Finland
| | - P Naud
- Hospital de Clinicas de Porto Alegre, Brazil
| | - S Derchain
- Universidade Estadual de Campinas, Campinas, Brazil
| | | | - A Longatto-Filho
- Instituto Adolfo Lutz, Sao Paulo, Brazil and (ALF) Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal
| | - S Tatti
- First Chair Gynecology Hospital de Clinicas, Buenos Aires, Argentina
| | - M Branca
- Unit of Cytopathology, National Centre of Epidemiology, Surveillance and Promotion of Health, National Institute of Health (ISS), Rome, Italy
| | - M Eržen
- SIZE Diagnostic Center, Ljubljana, Slovenia
| | - LS Hammes
- Hospital de Clinicas de Porto Alegre, Brazil
| | - J Matos
- Hospital de Clinicas de Porto Alegre, Brazil
| | - R Gontijo
- Universidade Estadual de Campinas, Campinas, Brazil
| | - L Sarian
- Universidade Estadual de Campinas, Campinas, Brazil
| | - J Braganća
- Universidade Estadual de Campinas, Campinas, Brazil
| | - FC Arlindo
- Hospital Leonor M de Barros, Sao Paulo, Brazil
| | - MYS Maeda
- Instituto Adolfo Lutz, Sao Paulo, Brazil and (ALF) Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal
| | | | - GB Dores
- Di gene Brazil, Sao Paulo, Brazil
| | - S Costa
- Department of Obstetrics and Gynecology, S. Orsola-Malpighi Hospital, Bologna, Italy
| | - S Syrjänen
- Department of Oral Pathology, Institute of Dentistry, University of Turku, Finland
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5
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Syrjänen K, Kulmala SM, Shabalova I, Petrovichev N, Kozachenko V, Zakharova T, Pajanidi J, Podistov J, Chemeris G, Sozaeva L, Lipova E, Tsidaeva I, Ivanchenko O, Pshepurko A, Zakharenko S, Nerovjna R, Kljukina L, Erokhina O, Branovskaja M, Nikitina M, Grunjberga V, Grunjberg A, Juschenko A, Santopietro R, Cintorino M, Tosi P, Syrjänen S. Epidemiological, clinical and viral determinants of the increased prevalence of high-risk human papillomavirus (HPV) infections in elderly women. EUR J GYNAECOL ONCOL 2008; 29:114-122. [PMID: 18459542] [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: 05/26/2023]
Abstract
BACKGROUND Population-based studies have reported a second peak of human papillomavirus (HPV) prevalence among women > 55 years, but reasons for this U-shaped HPV prevalence curve are poorly understood. OBJECTIVES To analyse determinants of high-risk HPV (HR-HPV) infections among postmenopausal women. STUDY DESIGN AND METHODS A cohort of 3,187 women was stratified into three age categories: i) youngest age group < 25 years (n = 1.103); ii) women between 26-55 years (n = 2.004), and iii) women > 55 years (n = 80), analysed for epidemiological, clinical and virological determinants of their HR-HPV infections. Real-time PCR was used for HPV genotyping, analysis of viral loads for HPV16, 18/45, 31, 33/52/58, 35 and 39, and load of integrated HPV16. RESULTS Age-standardised prevalence of HR-HPV infections showed a second peak among women > 55 years, with a perfect U-shaped curve (R2 = 0.966). The factors explaining this increased HR-HPV prevalence among older women include: i) cohort effect, ii) higher viral loads for HR-HPV types with cubic model curve (R2 = 0.714) for HPV 16, iii) distinct shift (p = 0.0001) from multiple-type infections to single HR-HPV types, iv) transition from episomal to integrated HPV16 (p = 0.009), v) higher load of integrated HPV16 (p = 0.009), and, vi) higher proportion of incident infections, higher rate of viral persistence, and lower rate of HR-HPV clearance. CONCLUSIONS These data suggest that in women who fail to eradicate their HR-HPV infection until menopause, selection of integrated viral clone has taken place, driving the process towards progressing disease. Consequent to this, most of the HR-HPV infections in women > 55 years were associated with high-grade CIN or invasive carcinoma.
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Affiliation(s)
- K Syrjänen
- Department of Oncology and Radiotherapy, Turku University Hospital, Turku, Finland.
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6
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Syrjänen S, Shabalova I, Petrovichev N, Kozachenko V, Zakharova T, Pajanidi J, Podistov J, Chemeris G, Sozaeva L, Lipova E, Tsidaeva I, Ivanchenko O, Pshepurko A, Zakharenko S, Nerovjna R, Kljukina L, Erokhina O, Branovskaja M, Nikitina M, Grunberga V, Grunberg A, Juschenko A, Cintorino M, Santopietro R, Tosi P, Syrjänen K. Factors predicting persistence of high-risk human papillomavirus (HPV) infections in women prospectively followed-up in three New Independent States (NIS) of the former Soviet Union. EUR J GYNAECOL ONCOL 2005; 26:491-8. [PMID: 16285563] [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: 05/05/2023]
Abstract
BACKGROUND We completed an analysis of the factors predicting the persistence of high risk (HR) HPV infections in women participating in a multicenter screening trial in three NIS countries. METHODS The 543 baseline HR HPV-positive women included in this analysis are derived from a sub-cohort of 887 women who were prospectively followed-up for a mean of 21.6 months (range: 0.5-42.9) as a part of a multi-center screening study in three NIS countries (the NIS cohort study; n = 3,187 women). Of these 543 women, 273 showed persistent HR-HPV in serial Hybrid Capture II (HCII) testing during the follow-up (Group 1), whereas 270 women cleared their infection (Group 2). These two groups were compared with their epidemiological, clinical, and virological data (HCII, PCR) to disclose the factors predicting persistent HR-HPV infection. RESULTS Women with persistent HR-HPV infections were significantly younger (27.3 yrs) than those who cleared their infection (29.1 yrs) (p = 0.006), and their follow-up time was shorter; 14.1 and 21 months, respectively (p = 0.0001). Both variables were treated as confounders in the multivariate analyses. Of the 66 recorded epidemiological variables, only being a current smoker proved to be an independent predictor (OR 1.693; 95% CI 1.114-2.573; p=0.014). Baseline colposcopy, biopsy or Pap smear did not predict HPV persistence, whereas an incident or persistent abnormal Pap during the follow-up were independent predictors in a multivariate model (p = 0.005), together with the high viral load (HCII RLU/CO at 100 pg/ml cut-off), and HR HPV positive PCR test (p = 0.0001). When all significant variables were entered in the regression model, only the follow-up time (OR 0.950, 95% CI 0.924-0.976; p = 0.0001) and HR-HPV positive PCR (OR 4.169, 95% CI 1.741-9.987; p = 0.001), remained independent predictors. CONCLUSIONS While several factors were related to HR-HPV persistence in univariate analysis and when adjusted for age and follow-up time as confounders, the only independent predictors in the multivariate regression model were follow-up time and HR-HPV positive PCR. Clearly more data are needed on type-specific persistence and HPV integration as its predictors.
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Affiliation(s)
- S Syrjänen
- Department of Oral Pathology, Institute of Dentistry, University of Turku, Finland
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