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Le VN, Le VNB, Hoang XS, Le VD. Distribution of human papillomavirus among Vietnamese women with cervical cancer and unusual genetic variability of HPV16. Virology 2024; 594:110058. [PMID: 38520797 DOI: 10.1016/j.virol.2024.110058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 01/21/2024] [Accepted: 03/11/2024] [Indexed: 03/25/2024]
Abstract
HPV16, with typical mutations that differ in geographical distribution and carcinogenic potency, has implications for cervical cancer screening, clinical diagnosis, and treatment. DNASTAR and MEGA were used to identify HPV16 variants and construct a phylogenetic tree. The most prevalent HPV genotypes were HPV16 (63.9%), HPV18 (26.7%), and other HPV (6.9%). HPV16 alterations were found in all E6, E7, and L1 genes, including 15 missense and 18 synonymous mutations. Missense mutations include R10G, Q14H, D25E, H78Y, L83V (E6); M29V, R35K, L78R, L95P (E7); H73Y, T176 N, N178T, T317P, T386S, L472F/I (L1). HPV16 sublineages include A1 (17.2%), A2 (0.9%), A3 (56.0%), A4 (19.0%), D1 (4.3%), and D3 (2.6%). Although several mutations in the oncoproteins E6, E7, and L1 have been detected, mutations known to be associated with cervical cancer risk, such as D25E and L83V, occur at a relatively low frequency. This suggests that HPV16 mutations are associated with cervical cancer through a complicated mechanism.
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Affiliation(s)
- Van Nam Le
- Departments of Infectious Disease, Military Hospital 103, 261 Phung Hung, Ha Dong, Hanoi, Viet Nam
| | - Van Nguyen Bang Le
- Luong the Vinh High School, 35 Dinh Nup, Trung Hoa, Cau Giay, Hanoi, Viet Nam
| | - Xuan Son Hoang
- Departments of Obstetrics and Gynecology, Cho Moi District General Hospital, Na Mo Village, Dong Tam Town, Cho Moi District, Bac Kan Province, Viet Nam
| | - Van Duyet Le
- Micobiology and Moclecular Biology Department, National Hospital for Tropical Diseases, 78 Giai Phong, Dong Da, Hanoi, Viet Nam.
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Hermansson RS, Lillsunde-Larsson G, Helenius G, Karlsson MG, Kaliff M, Olovsson M, Lindström AK. History of HPV in HPV-positive elderly women. Eur J Obstet Gynecol Reprod Biol X 2024; 22:100297. [PMID: 38496379 PMCID: PMC10944087 DOI: 10.1016/j.eurox.2024.100297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 01/29/2024] [Accepted: 03/06/2024] [Indexed: 03/19/2024] Open
Abstract
Background The aim of this study was to examine the natural course of HPV infection in women of 60 years and older who were HPV positive at inclusion, and any association between HPV positivity in historical samples and dysplasia outcome. Methods Eighty-nine women aged 60-82 years, who tested positive for HPV between 2012 and 2016 were included. Sampling for cytology and/or histology was also performed. HPV genotyping was carried out on archived material back to 1999. Results Of the 89 HPV-positive women 16 had HSIL, 34 had LSIL and 39 were benign at inclusion. Of the women with HSIL, 50.0% had the same HPV type in the archive samples, 12.5% had another type, and 37.5% were HPV negative. Among the 34 women with LSIL, 47.1% had the same HPV type in archive samples, 5.8% had another type, and 47.1% were HPV negative. Of the 39 women without dysplasia at inclusion, 25.6% had the same HPV type in archive samples, 5.1% had another HPV type and 69.2% were HPV negative. Conclusion Surprisingly few of the elderly women thus seem to have a history with the same or any HPV infection the years before being diagnosed with an HPV infection and dysplasia. The significance of an HPV infection for dysplasia development in elderly women is still not fully understood.
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Affiliation(s)
- Ruth S. Hermansson
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
- Department of Oncology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Gabriella Lillsunde-Larsson
- Department of Laboratory Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
- School of Health Sciences, Örebro University, Örebro, Sweden
| | - Gisela Helenius
- Department of Laboratory Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Mats G. Karlsson
- Department of Laboratory Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Malin Kaliff
- Department of Laboratory Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Matts Olovsson
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
| | - Annika K. Lindström
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
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Del Prete R, Nesta D, Triggiano F, Lorusso M, Garzone S, Vitulano L, Denicolò S, Indraccolo F, Mastria M, Ronga L, Inchingolo F, Aityan SK, Nguyen KCD, Tran TC, Gargiulo Isacco C, Santacroce L. Human Papillomavirus Carcinogenicity and the Need of New Perspectives: Thoughts from a Retrospective Analysis on Human Papillomavirus Outcomes Conducted at the Hospital University of Bari, Apulia, Italy, between 2011 and 2022. Diagnostics (Basel) 2024; 14:968. [PMID: 38732382 PMCID: PMC11083870 DOI: 10.3390/diagnostics14090968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 04/26/2024] [Accepted: 04/28/2024] [Indexed: 05/13/2024] Open
Abstract
BACKGROUND The current manuscript's aim was to determine the human papillomavirus (HPV) genotype-specific prevalence and distribution among individuals, males, and females, of different ages in the region of Apulia, Italy, highlighting the possible variables involved in the carcinogenicity mechanism. In addition, we proposed two hypothetical models of HPV's molecular dynamics, intending to clarify the impact of prevention and therapeutic strategies, explicitly modeled by recent survey data. METHODS We presented clinical data from 9647 participants tested for either high-risk (HR) or low-risk (LR) HPV at the affiliated Bari Policlinic University Hospital of Bari from 2011 to 2022. HPV DNA detection was performed using nested-polymerase chain reaction (PCR) and multiplex real-time PCR assay. Statistical analysis showed significant associations for all genders and ages and both HR- and LR-HPV types. A major number of significant pairwise associations were detected for the higher-risk types and females and lower-risk types and males. RESULTS The overall prevalence of HPV was 50.5% (n-4.869) vs. 49.5% (n-4.778) of the study population, of which 74.4% (n-3621) were found to be HPV high-risk (HR-HPV) genotypes and 57.7% (n-2.807) low-risk HPV (LR-HPV) genotypes, of which males were 58% and females 49%; the three most prevalent HR-HPV genotypes were HPV 53 (n707-15%), 16 (n704-14%), and 31 (n589-12%), and for LR-HPV, they were 42 (19%), 6 (16%), and 54 (13%); 56% of patients screened for HPV were ≤ 30 years old, 53% were between 31 and 40 years old, 46% were 41-50 and 51-60 years old, and finally, 44% of subjects were >60 years old. CONCLUSIONS Our study provided comprehensive epidemiological data on HPV prevalence and genotype distribution among 9647 participants, which could serve as a significant reference for clinical practice, and it implied the necessity for more effective screening methods for HPV carcinogenesis covering the use of more specific molecular investigations. Although this is a predominantly descriptive and epidemiological study, the data obtained offer not only a fairly unique trend compared to other studies of different realities and latitudes but also lead us to focus on the HPV infection within two groups of young people and adults and hypothesize the possible involvement of dysbiosis, stem cells, and the retrotransposition mechanism.
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Affiliation(s)
- Raffaele Del Prete
- Department of Interdisciplinary Medicine (DIM), U.O.C. Microbiology and Virology, University-Hospital of Bari, 70100 Bari, Italy; (R.D.P.); (D.N.); (F.T.); (M.L.); (S.G.); (L.V.); (S.D.); (F.I.); (M.M.); (L.R.); (F.I.); (K.C.D.N.); (L.S.)
| | - Daniela Nesta
- Department of Interdisciplinary Medicine (DIM), U.O.C. Microbiology and Virology, University-Hospital of Bari, 70100 Bari, Italy; (R.D.P.); (D.N.); (F.T.); (M.L.); (S.G.); (L.V.); (S.D.); (F.I.); (M.M.); (L.R.); (F.I.); (K.C.D.N.); (L.S.)
| | - Francesco Triggiano
- Department of Interdisciplinary Medicine (DIM), U.O.C. Microbiology and Virology, University-Hospital of Bari, 70100 Bari, Italy; (R.D.P.); (D.N.); (F.T.); (M.L.); (S.G.); (L.V.); (S.D.); (F.I.); (M.M.); (L.R.); (F.I.); (K.C.D.N.); (L.S.)
| | - Mara Lorusso
- Department of Interdisciplinary Medicine (DIM), U.O.C. Microbiology and Virology, University-Hospital of Bari, 70100 Bari, Italy; (R.D.P.); (D.N.); (F.T.); (M.L.); (S.G.); (L.V.); (S.D.); (F.I.); (M.M.); (L.R.); (F.I.); (K.C.D.N.); (L.S.)
| | - Stefania Garzone
- Department of Interdisciplinary Medicine (DIM), U.O.C. Microbiology and Virology, University-Hospital of Bari, 70100 Bari, Italy; (R.D.P.); (D.N.); (F.T.); (M.L.); (S.G.); (L.V.); (S.D.); (F.I.); (M.M.); (L.R.); (F.I.); (K.C.D.N.); (L.S.)
| | - Lorenzo Vitulano
- Department of Interdisciplinary Medicine (DIM), U.O.C. Microbiology and Virology, University-Hospital of Bari, 70100 Bari, Italy; (R.D.P.); (D.N.); (F.T.); (M.L.); (S.G.); (L.V.); (S.D.); (F.I.); (M.M.); (L.R.); (F.I.); (K.C.D.N.); (L.S.)
| | - Sofia Denicolò
- Department of Interdisciplinary Medicine (DIM), U.O.C. Microbiology and Virology, University-Hospital of Bari, 70100 Bari, Italy; (R.D.P.); (D.N.); (F.T.); (M.L.); (S.G.); (L.V.); (S.D.); (F.I.); (M.M.); (L.R.); (F.I.); (K.C.D.N.); (L.S.)
| | - Francesca Indraccolo
- Department of Interdisciplinary Medicine (DIM), U.O.C. Microbiology and Virology, University-Hospital of Bari, 70100 Bari, Italy; (R.D.P.); (D.N.); (F.T.); (M.L.); (S.G.); (L.V.); (S.D.); (F.I.); (M.M.); (L.R.); (F.I.); (K.C.D.N.); (L.S.)
| | - Michele Mastria
- Department of Interdisciplinary Medicine (DIM), U.O.C. Microbiology and Virology, University-Hospital of Bari, 70100 Bari, Italy; (R.D.P.); (D.N.); (F.T.); (M.L.); (S.G.); (L.V.); (S.D.); (F.I.); (M.M.); (L.R.); (F.I.); (K.C.D.N.); (L.S.)
| | - Luigi Ronga
- Department of Interdisciplinary Medicine (DIM), U.O.C. Microbiology and Virology, University-Hospital of Bari, 70100 Bari, Italy; (R.D.P.); (D.N.); (F.T.); (M.L.); (S.G.); (L.V.); (S.D.); (F.I.); (M.M.); (L.R.); (F.I.); (K.C.D.N.); (L.S.)
| | - Francesco Inchingolo
- Department of Interdisciplinary Medicine (DIM), U.O.C. Microbiology and Virology, University-Hospital of Bari, 70100 Bari, Italy; (R.D.P.); (D.N.); (F.T.); (M.L.); (S.G.); (L.V.); (S.D.); (F.I.); (M.M.); (L.R.); (F.I.); (K.C.D.N.); (L.S.)
| | - Sergey K. Aityan
- College of Engineering, Northeastern University, 5000 MacArthur Blvd., Oakland, CA 94613, USA;
| | - Kieu C. D. Nguyen
- Department of Interdisciplinary Medicine (DIM), U.O.C. Microbiology and Virology, University-Hospital of Bari, 70100 Bari, Italy; (R.D.P.); (D.N.); (F.T.); (M.L.); (S.G.); (L.V.); (S.D.); (F.I.); (M.M.); (L.R.); (F.I.); (K.C.D.N.); (L.S.)
| | - Toai Cong Tran
- Department of Basic Medical Sciences and Biomedical Research Center, Pham Ngoc Thach University of Medicine, Ho Chi Minh City 700100, Vietnam;
| | - Ciro Gargiulo Isacco
- Department of Interdisciplinary Medicine (DIM), U.O.C. Microbiology and Virology, University-Hospital of Bari, 70100 Bari, Italy; (R.D.P.); (D.N.); (F.T.); (M.L.); (S.G.); (L.V.); (S.D.); (F.I.); (M.M.); (L.R.); (F.I.); (K.C.D.N.); (L.S.)
| | - Luigi Santacroce
- Department of Interdisciplinary Medicine (DIM), U.O.C. Microbiology and Virology, University-Hospital of Bari, 70100 Bari, Italy; (R.D.P.); (D.N.); (F.T.); (M.L.); (S.G.); (L.V.); (S.D.); (F.I.); (M.M.); (L.R.); (F.I.); (K.C.D.N.); (L.S.)
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Mikalsen MP, Simonsen GS, Sørbye SW. Impact of HPV Vaccination on the Incidence of High-Grade Cervical Intraepithelial Neoplasia (CIN2+) in Women Aged 20-25 in the Northern Part of Norway: A 15-Year Study. Vaccines (Basel) 2024; 12:421. [PMID: 38675803 PMCID: PMC11054067 DOI: 10.3390/vaccines12040421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 04/03/2024] [Accepted: 04/12/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Human papillomavirus (HPV), the most prevalent sexually transmitted infection globally, is a key risk factor for high-grade cervical lesions and cervical cancer. Since 2009, HPV vaccination has been part of the national immunization program for girls in 7th grade in Norway (women born 1997 and later). This study aimed to assess the impact of HPV vaccination on the incidence of high-grade cervical precursors (CIN2+) among women aged 20-25 in Troms and Finnmark over a 15-year period. MATERIALS AND METHODS In this time series study, we analyzed cervical screening data from 15,328 women aged 20-25 in Troms and Finnmark, collected between 2008 and 2022. Statistical methods, including linear and logistic regression, were employed to evaluate changes in cervical intraepithelial neoplasia grade 2 and worse (CIN2+) incidence and compare risks between vaccine-offered cohorts and pre-vaccine cohorts. RESULTS The incidence of CIN2+ initially increased from 31 cases per year in 2008 to 110 cases in 2018, then significantly decreased to 44 cases per year by 2022 (p < 0.01). Women in pre-vaccine cohorts had a substantially higher risk of CIN2+ (OR 9.02, 95% CI 5.9-13.8) and CIN3+ (OR 19.6, 95% CI 7.3-52.6). Notably, no vaccinated women with CIN2+ tested positive for HPV types 16 or 18. Furthermore, none of the 13 cervical cancer cases recorded during the study were from the vaccinated cohorts. INTERPRETATION The findings suggest a significant reduction in the incidence of high-grade cervical precursors following the introduction of the HPV vaccine in Norway's national immunization program, highlighting its effectiveness in cervical cancer prevention among young women in Northern Norway.
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Affiliation(s)
- Marte Pettersen Mikalsen
- Department of Medical Biology, UiT The Arctic University of Norway, 9019 Tromsø, Norway; (M.P.M.); (G.S.S.)
| | - Gunnar Skov Simonsen
- Department of Medical Biology, UiT The Arctic University of Norway, 9019 Tromsø, Norway; (M.P.M.); (G.S.S.)
- Department of Microbiology and Infection Control, University Hospital of North Norway, 9019 Tromsø, Norway
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Li M, Zhao C, Zhang X, Li J, Zhao Y, Zhang W, Ren L, Wei L. PAX1/JAM3 Methylation and HPV Viral Load in Women with Persistent HPV Infection. Cancers (Basel) 2024; 16:1430. [PMID: 38611108 PMCID: PMC11010937 DOI: 10.3390/cancers16071430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Revised: 04/03/2024] [Accepted: 04/04/2024] [Indexed: 04/14/2024] Open
Abstract
The relationship of PAX1/JAM3 methylation as well as HPV viral load (VL) with cervical lesions has been reported, but their role in persistent HPV infection without cervical high-grade lesions has not been fully elucidated. A total of 231 females diagnosed with persistent HPV infection and pathologically confirmed absence of high-grade cervical lesions were selected from the Colposcopy Outpatient Clinic of Peking University People's Hospital, from March 2023 to December 2023. They were categorized into two groups based on the duration of HPV infection: the HPV persistent less than 3 years group and the more than 3 years group. PAX1/JAM3 methylation and HPV VL were determined by real-time PCR and BioPerfectus Multiplex Real-Time (BMRT)-HPV reports type-specific VL/10,000 cells, respectively. The average age of individuals with HPV infection lasting more than 3 years was higher compared to those with less than 3 years (48.9 vs. 45.1 years), with a statistically significant difference. Among the participants, 81.8% (189/231) had no previous screening. The methylation levels of JAM3 and PAX1 were significantly higher in individuals with HPV infection persisting for more than 3 years compared to those with less than 3 years, with a statistically significant difference (p < 0.05). There was a significant correlation between PAX1 and JAM3 methylation (p < 0.001), which could be used as cumulative evidence of HPV infection duration before the occurrence of precancerous lesions. The incidence of vaginal intraepithelial lesions was higher in individuals with HPV infection persisting for more than 3 years compared to those with less than 3 years, and HPV VL can be used as an indicative biomarker for concurrent cervical-vaginal lesions, especially for HPV other than 16/18 genotypes.
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Affiliation(s)
| | | | | | | | | | | | | | - Lihui Wei
- Department of Obstetrics and Gynecology, Peking University People’s Hospital, No. 11 Xizhimen South Street, Beijing 100044, China; (M.L.); (C.Z.); (X.Z.); (J.L.); (Y.Z.); (W.Z.); (L.R.)
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Jacques C, Marchand F, Chatelais M, Albinet V, Coustal C, Floris I. The Micro-Immunotherapy Medicine 2LPAPI ® Displays Immune-Modulatory Effects in a Model of Human Papillomavirus Type-16 L1-Protein Capsid-Treated Human Peripheral Blood Mononuclear Cells and Antiproliferative Effects in a Model of Cervical Cancer Cells. Cancers (Basel) 2024; 16:1421. [PMID: 38611099 PMCID: PMC11010933 DOI: 10.3390/cancers16071421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 03/28/2024] [Accepted: 04/03/2024] [Indexed: 04/14/2024] Open
Abstract
Human papillomavirus (HPV) is the second most common infectious agent causing cancer. Persistent infection with high-risk (HR)-HPV can lead to cervical intra-epithelial neoplasia and cervical carcinomas (CC). While host immune response is necessary for viral clearance, chronic immune activation contributes to a low-grade inflammation that can ultimately lead to carcinogenesis. The micro-immunotherapy medicine (MIM) 2LPAPI® could be a valuable tool to manage the clearance of the virus and reduce the risk of developing CC. In this in vitro study, we aimed to investigate its mode of action. We showed that actives from the MIM increased the IL-6, IFN-γ, and IP-10 secretion in human peripheral blood mononuclear cells (PBMCs) exposed to peptides derived from the HPV-16 capsid (HPV16(L1)). This could reflect an increase in the immune activity toward HPV-16. At the same time, some active substances reduced the lympho-proliferation and the expression of T-cell activation markers. Finally, some of the MIM actives displayed antiproliferative effects in CC-derived HeLa cells under serum-starvation conditions. Altogether, this body of data highlighted for the first time the dual effect of MIM in the framework of HR-HPV infections as a potential (i) immune modulator of HPV16(L1)-treated PBMCs and (ii) antiproliferative agent of HPV-positive CC cells.
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Affiliation(s)
- Camille Jacques
- Preclinical Research Department, Labo’Life France, Pescalis-Les Magnys, 79320 Moncoutant-sur-Sevre, France;
| | - Flora Marchand
- ProfileHIT, 7 rue du Buisson, 44680 Sainte-Pazanne, France; (F.M.); (M.C.)
| | - Mathias Chatelais
- ProfileHIT, 7 rue du Buisson, 44680 Sainte-Pazanne, France; (F.M.); (M.C.)
| | - Virginie Albinet
- Imavita S.A.S., Canal Biotech 1&2, 3 rue des Satellites, Parc Technologique du Canal, 31400 Toulouse, France; (V.A.); (C.C.)
| | - Claire Coustal
- Imavita S.A.S., Canal Biotech 1&2, 3 rue des Satellites, Parc Technologique du Canal, 31400 Toulouse, France; (V.A.); (C.C.)
| | - Ilaria Floris
- Preclinical Research Department, Labo’Life France, Pescalis-Les Magnys, 79320 Moncoutant-sur-Sevre, France;
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Arthur AW, El-Zein M, Burchell AN, Tellier PP, Coutlée F, Franco EL. Detection and Clearance of Type-Specific and Phylogenetically Related Genital Human Papillomavirus Infections in Young Women in New Heterosexual Relationships. J Infect Dis 2024; 229:691-706. [PMID: 37824429 PMCID: PMC10938200 DOI: 10.1093/infdis/jiad450] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 09/30/2023] [Accepted: 10/10/2023] [Indexed: 10/14/2023] Open
Abstract
BACKGROUND Understanding the natural history of human papillomavirus (HPV) infections is essential to cervical cancer prevention planning. We estimated HPV type-specific infection detection and clearance in young women. METHODS The HPV Infection and Transmission among Couples through Heterosexual activity (HITCH) study is a prospective cohort of 502 college-age women who recently initiated a heterosexual relationship. We tested vaginal samples collected at 6 clinical visits over 24 months for 36 HPV types. Using rates and Kaplan-Meier analysis, we estimated time-to-event statistics with 95% confidence intervals (CIs) for detection of incident infections and clearance of incident and present-at-baseline infections (separately). We conducted analyses at the woman- and HPV-levels, with HPV types grouped by phylogenetic relatedness. RESULTS By 24 months, we detected incident infections in 40.4% (CI, 33.4%-48.4%) of women. Incident subgenus 1 (43.4; CI, 33.6-56.4), 2 (47.1; CI, 39.9-55.5), and 3 (46.6; CI, 37.7-57.7) infections cleared at similar rates per 1000 infection-months. We observed similar homogeny in HPV-level clearance rates among present-at-baseline infections. CONCLUSIONS Our analyses provide type-specific infection natural history estimates for cervical cancer prevention planning. HPV-level analyses did not clearly indicate that high oncogenic risk subgenus 2 infections persist longer than their low oncogenic risk subgenera 1 and 3 counterparts.
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Affiliation(s)
- Andrew W Arthur
- Division of Cancer Epidemiology, McGill University, Montréal, Québec, Canada
| | - Mariam El-Zein
- Division of Cancer Epidemiology, McGill University, Montréal, Québec, Canada
| | - Ann N Burchell
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St.Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | | | - François Coutlée
- Département Clinique de Médecine de Laboratoire, Service de Diagnostique Moléculaire, Centre Hospitalier de l’Université de Montréal, Montréal, Québec, Canada
| | - Eduardo L Franco
- Division of Cancer Epidemiology, McGill University, Montréal, Québec, Canada
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Ring LL, Larsen HK, Frederiksen K, Hædersdal M, Sørensen SS, Bonde JH, Thomsen LT, Kjær SK. Incidence and clearance of cervical and anal high-risk human papillomavirus in kidney transplant recipients: Results from a Danish prospective clinical study. Am J Transplant 2024:S1600-6135(24)00200-4. [PMID: 38458364 DOI: 10.1016/j.ajt.2024.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 02/28/2024] [Accepted: 03/04/2024] [Indexed: 03/10/2024]
Abstract
This study investigates the incidence and clearance of cervical and anal high-risk human papillomavirus (hrHPV) infection in kidney transplant recipients (KTRs) compared to immunocompetent controls. During 2016-2017, we enrolled 125 female KTRs and 125 female controls. Liquid-based cervical and anal cytology samples collected at enrollment and follow-up were tested for human papillomavirus (HPV) DNA using the CLART HPV2 test. All participants answered a questionnaire on lifestyle and sexual behavior at both examinations. KTRs had an increased age-adjusted risk of incident cervical hrHPV infection compared to controls (hazard ratio [HR] = 3.6, 95% CI = 1.2-11.2). Probability of cervical hrHPV clearance at 18 months was lower among KTRs (8.3%) than controls (66.7%). There was no statistically significant difference in anal hrHPV incidence between KTRs and controls (HR = 0.9, 95% CI = 0.4-2.0). Clearance of anal hrHPV was similar between KTRs and controls at 18 months. During the total follow-up, a lower anal hrHPV clearance, although not statistically significant, was observed among KTRs (HR = 0.3, 95% CI = 0.06-1.2). KTRs had higher incidence of cervical hrHPV and lower probability of clearance, especially of cervical hrHPV infections, than controls. Our findings support that KTRs are at increased risk of HPV infection and point to the need for targeted HPV prevention strategies, such as cervical cancer screening.
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Affiliation(s)
- Linea Landgrebe Ring
- Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Helle Kiellberg Larsen
- Department of Dermatology and Venereology, Copenhagen University Hospital, Bispebjerg Hospital, Copenhagen, Denmark
| | | | - Merete Hædersdal
- Department of Dermatology and Venereology, Copenhagen University Hospital, Bispebjerg Hospital, Copenhagen, Denmark
| | - Søren Schwartz Sørensen
- Department of Nephrology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Jesper Hansen Bonde
- Department of Pathology, Copenhagen University Hospital, Hvidovre Hospital, Hvidovre, Denmark
| | | | - Susanne K Kjær
- Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark; Department of Gynecology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
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Zhang Y, Wang Y, Guo S, Cui H. METTL3-mediated HPV vaccine enhances the effect of anti PD-1 immunotherapy to alleviate the development of cutaneous squamous cell carcinoma. An Bras Dermatol 2024; 99:210-222. [PMID: 38030537 PMCID: PMC10943324 DOI: 10.1016/j.abd.2023.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 04/28/2023] [Accepted: 05/02/2023] [Indexed: 12/01/2023] Open
Abstract
BACKGROUND Cutaneous squamous cell carcinoma (cSCC) develops from epithelial keratinocytes by dysregulation of self-renewal and differentiation. Recent studies have found that the size and number of cSCC tumors gradually decrease or even disappear after HPV vaccination. However, the role of the HPV vaccine in the cSCC mechanism is poorly understood. OBJECTIVE The aim of this study is to investigate the effect and mechanism of the HPV vaccine in cSCC. METHODS Immunofluorescence was used to study the immune infiltrating cells in the tumor tissues of patients with cSCC. The effects of the HPV vaccine on cSCC cells and tissues were studied by Cell Culture, Real-time PCR, Western Blot, Cytotoxicity Assay, Enzyme-linked Immunosorbent Assay, m6A Blotting, CCK-8 Assay, m6A Ribonucleic acid Methylation Quantification and tumor transplantation. RESULTS The HPV vaccine enhanced the toxic effect of CD8+T cells on cSCC cells and promoted the secretion of multiple cytokines by CD8+T cells. In addition, HPV vaccines can increase tumor sensitivity to anti-PD-1 therapy by downregulating METTL3 in tumor tissue, with the combination of HPV vaccine and PD-1 monoclonal antibodies producing enhanced immune cell infiltration compared to PD-1 blockade alone. STUDY LIMITATIONS It is important to note the limitations of this study, including the small sample size, the construction of the mouse model, and the choice of HPV vaccine and PD-1 monoclonal antibody, which may limit the generalization of our findings to a wider population. CONCLUSIONS It is hoped that this research will contribute to a deeper understanding of the role of the HPV vaccine in the treatment of cSCC. HPV vaccine is expected to become an important approach to alleviate the development of cSCC.
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Affiliation(s)
- Yingjie Zhang
- Department of Dermatology, First Hospital of Shanxi Medical University, Taiyuan, China; The First Clinical Medical College, Shanxi Medical University, Taiyuan, China
| | - Yiru Wang
- Department of Dermatology, Taiyuan Maternity and Child Health Care Hospital, Taiyuan, China
| | - Shuping Guo
- Department of Dermatology, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Hongzhou Cui
- Department of Dermatology, First Hospital of Shanxi Medical University, Taiyuan, China; The First Clinical Medical College, Shanxi Medical University, Taiyuan, China.
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Tsoneva E, Dimitrova P, Metodiev M, Shivarov V, Vasileva-Slaveva M, Yordanov A, Kostov S. Utility of expression of 4-hydroxynonenal tested by immunohistochemistry for cervical cancer. PRZEGLAD MENOPAUZALNY = MENOPAUSE REVIEW 2024; 23:6-13. [PMID: 38690070 PMCID: PMC11056727 DOI: 10.5114/pm.2024.136356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 11/17/2023] [Indexed: 05/02/2024]
Abstract
Introduction Cervical cancer (CC) is a leading cause of mortality in women around the world, with the highest incidence rate still being in developing countries. The most common aetiological factor is infection with high-risk human papilloma virus viral strains. Oxidative stress through generation of reactive oxygen species leads to lipid peroxidation and DNA damage. Studies show that reactive lipid electrophiles such as 4-hydroxynonenal (4-HNE) produced in the process play an important role in cancer signalling pathways and are a good biomarker for oxidative stress. We aim to investigate the prognostic role of 4-HNE as a biomarker for oxidative stress in patients in early and advanced stages of CC measured by immunohistochemistry. Material and methods This is a retrospective study of 69 patients treated at our Department of Oncogynaecology. Paraffin embedded tumour tissues were immunohistochemically tested for the levels of expression of 4-HNE. The results for H-score, Allred score, and combined score were investigated for association with tumour size, lymph node status, andInternational Federation of Gynaecology and Obstetrics stage. Results 4-hydroxynonenal showed higher expression in more advanced stages of CC and in cases with involved lymph nodes. Tumour size was not associated with the levels of 4-HNE. Conclusions To best of our knowledge, this is the first study to use immunohistochemistry to examine the expression of 4-HNE as a prognostic factor in CC. The 3 score systems showed similar results. The pattern of 4-HNE histological appearance is dependent on the histological origin of cancer and is not universal.
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Affiliation(s)
| | - Polina Dimitrova
- Department of Pathology, Medical University Pleven, Pleven, Bulgaria
| | | | | | | | - Angel Yordanov
- Department of Gynaecological Oncology, Medical University Pleven, Pleven, Bulgaria
| | - Stoyan Kostov
- Department of Gynaecology, Medical University Varna “Prof. Dr. Paraskev Stoyanov”, Varna, Bulgaria
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11
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Thasneem P, Sudhager A, Nalini C, Rani J SS, Bharathipriya R, Sridharan V, Balasubramani L. Out-reach Colposcopy Clinics and HPV Self-Sampling Decreases Loss to Follow up in a Community based Cervical Cancer Screening Programme. Asian Pac J Cancer Prev 2024; 25:419-424. [PMID: 38415526 PMCID: PMC11077114 DOI: 10.31557/apjcp.2024.25.2.419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 02/18/2024] [Indexed: 02/29/2024] Open
Abstract
OBJECTIVE To introduce HPV self-sampling and out-reach colposcopy clinic as interventions to improve the follow-up of HPV positive women in a community based cervical cancer screening programme. METHODS This was a prospective observational study conducted during October 2017 to August 2019 and 2977 women underwent cervical cancer screening using CareHPV test. Follow up colposcopy for HPV positive women were conducted at the rural health center and alternatively as out-reach clinics in their own villages and default rates were compared. HPV positive women were followed up at one-year. They were given an option of either having a follow-up HPV test performed by a health care worker (HCW) or by self-sampling. Compliance to follow up in these two modalities were compared. A validated questionnaire was given to women who had given an HPV self-sample to assess their awareness about HPV and cervical cancer. RESULTS During our initial round of cervical cancer screening using HPV as a primary screening modality, our HPV screen positive rate was 7.05% (210 out of 2977 women screened). Our colposcopy rates following an initial invitation at the rural health centre was only 28.5%. Following this, we initiated out-reach colposcopy clinics at their own villages for HPV positive women and this increased colposcopy rates from 28.5% to 45.2%. The participation rate at one-year follow-up was increased from 40.5% to 60% by the introduction of self-sampling as a follow up option and 16.2% of women who were initially positive remained HPV positive at 12-14 months follow up. All women who were offered the option of self-sampling preferred it over a HCW collected sample. CONCLUSION Our study showed that self-sampling could also be used effectively in the follow up of HPV positive women in the community. Outreach colposcopy clinics in their own villages enabled better follow up of HPV positive women.
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Affiliation(s)
- P Thasneem
- Department of Obstetrics and Gynaecology, GKNM Hospital, Coimbatore, India.
| | - Aishwarya Sudhager
- Department of Obstetrics and Gynaecology, GKNM Hospital, Coimbatore, India.
| | - C Nalini
- VN Cancer Centre, GKNM Hospital, Coimbatore, India.
| | | | | | - V Sridharan
- VN Cancer Centre, GKNM Hospital, Coimbatore, India.
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Hung TM, Son HX, Bang LVN, Van Duyet L. Characteristics of Cervical Cancer Caused by the Human Papillomavirus 18 and Its Genetic Variations in Vietnamese Women. INFECTION, GENETICS AND EVOLUTION : JOURNAL OF MOLECULAR EPIDEMIOLOGY AND EVOLUTIONARY GENETICS IN INFECTIOUS DISEASES 2024; 117:105546. [PMID: 38176603 DOI: 10.1016/j.meegid.2023.105546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 12/21/2023] [Accepted: 12/26/2023] [Indexed: 01/06/2024]
Abstract
BACKGROUND The involvement of HPV18 in cervical cancer pathogenesis, as well as its high oncogenic potential and influence on the variation of cervical cancer distribution in different geographical regions, makes assessing the characteristics of cervical cancer and its variants the basis for considering potential carcinogenic HPV18 sequence variations and vaccine strategies. METHODS A prospective study was conducted at Vietnam Central Obstetrics Hospital from January 1, 2019 to December 31, 2020. HPV18 infection was confirmed in cervical cancer patients using molecular diagnostics. Nucleotide sequences of the HPV18 E6, E7, and L1 genes were used to analyze genetic variations. The demographic, clinical, and laboratory data of the patients were collected and statistically analyzed. RESULTS Among 48 patients with HPV18-infected cervical cancer, 79.2% were between the ages of 35-54; while only 20.8% were < 35 and > 54 years old. 100% of patients have been pregnant at some point in their lives, with ≥3 pregnancies accounting for 83.3%. Patients with cervical cancer caused by HPV18 infection were predominantly in stages 0 and I, with no patients in stages II, III, or IV. A single HPV18 infection generates much more cervical cancer cases than multiple HPV18 infections. Symptoms such as lower abdomen pain, unusual anginal discharge, and vaginal bleeding were observed in both stages 0 and I; however, vaginal bleeding after sex was only detected in women with stage I cervical cancer. Cervicitis, cervical ectropion, and ulcers are reported in cervical status stages 0 and I; however, warts and ulcers were only present in stage I. Magnetic resonance imaging produces far superior outcomes than ultrasound. All cytology and pathology tests confirmed L/HSIL, SCC, AC, and CIS. On the other hand, a single HPV18 infection was associated with a significantly higher risk of L/HSIL, SCC, AC, and CIS than multiple HPV18 infections. Nulceotide sequences of the E6, E7, and L1 genes revealed 20 mutations, including three (E6), five (E7), and twelve (L1) mutations. High-frequency mutations (95.8%-100% of HPV18 samples had mutations) occur at the following positions: C287G - P61P (E6 gene), G5503A - R25Q, C5701G - P91R, C6460G - P344R, C6625G - P399R, and C6842G - P471R (L1 gene). A phylogenetic tree based on the E6/E7/L1 gene sequence revealed that 100% belonged to A lineage, with 97.9% belonging AA (Asian Amerindian - A1) and 2.1% belonging to the E (European - A5). CONCLUSION Patients with a single HPV18 infection have a higher risk of cervical cancer than those infected with HPV18 and other high-risk strains simultaneously. HPV18 single-infection, on the other hand, had considerably higher incidences of L/HSIL, SCC, AC, and CIS than HPV18 co-infection. The HPV18 strain that was found in Vietnam belonged to lineage A (A1 and A5), which contains several oncogene mutations.
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Affiliation(s)
- Than Manh Hung
- Emergency Department, National Hospital for Tropical Diseases, 78 Giai Phong, Dong Da, Hanoi, Viet Nam; Infectious Department, University of Medicine and Pharmacy, Vietnam National University, 144 Xuan Thuy, Cau Giay, Hanoi, Viet Nam
| | - Hoang Xuan Son
- Departments of obstetrics and gynecology, Cho Moi District General Hospital, Na Mo village, Dong Tam town, Cho Moi district, Bac Kan province, Viet Nam
| | - Le Van Nguyen Bang
- Luong The Vinh High School, 35 Dinh Nup, Trung Hoa, Cau Giay, Hanoi, Viet Nam
| | - Le Van Duyet
- Micobiology and Moclecular Biology Department, National Hospital for Tropical Diseases, 78 Giai Phong, Dong Da, Hanoi, Viet Nam.
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13
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Pogere A, Costa AF, Pasinato APBF, Machado MJ, de Miranda Onofre FB, Onofre ASC. Role of DNA ploidy in diagnosis and prognosis of high-grade cervical intraepithelial neoplasia: A prospective cohort study. Cytopathology 2024; 35:122-130. [PMID: 37872834 DOI: 10.1111/cyt.13320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 09/26/2023] [Accepted: 10/10/2023] [Indexed: 10/25/2023]
Abstract
OBJECTIVE To compare the sensitivity and specificity of DNA ploidy with cytology, human papillomavirus (HPV) testing and colposcopy in diagnosis of high-grade cervical intraepithelial neoplasia (CIN) and to assess the role of aneuploidy in cervical lesions with the worst prognosis. A prospective observational cohort study was conducted on 254 women with altered colpocytology. METHODS Colposcopy, biopsy, DNA-ICM and HPV examinations were applied to cervical cytological and histological samples. Participants were evaluated every 6 months and divided into two groups: 'Harm' and 'No-harm'. Logistic regression and multivariate COX model were used to identify independent risk factors for diagnosis and prognosis of high-grade CIN, and ROC curve to assess the sensitivity and specificity of methods. RESULTS Variables 'age greater than or equal to 30 years', 'lesion size greater than 20%', 'aneuploidy' and 'HPV 16' were associated with diagnosis of high-grade CIN and 'aneuploidy' and 'women living with HIV', with a worse prognosis. Agreement for colposcopy was good, with a sensitivity of 79.3% and specificity of 94.4%; DNA-ICM and cytology were moderate, with sensitivity of 74.6% and 72.3% and specificity of 85.3% and 76.1%, respectively. High-risk HPV and HPV 16 tests were weak, with sensitivity of 75.0% and 43.75% and specificity of 50.0% and 88.64%, respectively. CONCLUSIONS In relation to high-grade CIN diagnosis, DNA-ICM presented similar sensitivity and specificity to cytology and high-risk HPV test when associated with HPV 16. Regarding prognosis, this research certifies that aneuploidy is considered a predictor of more severe cervical injury.
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Affiliation(s)
- Adriane Pogere
- Department of Obstetrics and Gynecology, Professor Polydoro Ernani of Sao Thiago University Hospital of the Federal University of Santa Catarina, Florianópolis, Florianópolis, Brazil
| | - Ane Francyne Costa
- Department of Clinical Analysis, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Ana Paula Beltrame Farina Pasinato
- Department of Pathology, Professor Polydoro Ernani of Sao Thiago University Hospital of the Federal University of Santa Catarina, Florianópolis, Florianópolis, Brazil
| | - Marcos José Machado
- Department of Clinical Analysis, Federal University of Santa Catarina, Florianópolis, Brazil
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Ferreira MT, Mendoza López RV, Gonçalves MG, Ferreira S, Sirak B, Baggio ML, Lazcano-Ponce E, Nyitray AG, Giuliano AR, Villa LL, Sichero L. Human Papillomavirus 16 Lineage A Variants Associated With Persistent Genital Infections in Men: The HPV Infection in Men (HIM) Study. J Infect Dis 2023; 228:1748-1757. [PMID: 37279655 PMCID: PMC10733738 DOI: 10.1093/infdis/jiad204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 05/04/2023] [Accepted: 06/01/2023] [Indexed: 06/08/2023] Open
Abstract
BACKGROUND Human papillomavirus (HPV) 16 non-A lineage variants have higher carcinogenic potential for cervical cancer. HPV-16 variants natural history among males is not established. We evaluated HPV-16 variants prevalence and persistence in the external genitalia of men enrolled in the prospective HPV Infection in Men (HIM) Study. METHODS The HIM Study included men from the United States, Brazil, and Mexico. HPV-16 variants were distinguished using polymerase chain reaction sequencing. The prevalence of HPV-16 variants was assessed, and associations with infection persistence were estimated. RESULTS We characterized the HPV-16 variants for 1700 genital swab samples from 753 men and 22 external genital lesions in 17 men. The prevalence of HPV-16 lineages differed by country and marital status (P < .001). Overall, 90.9% of participants harbored lineage A variants. The prevalence of non-A lineages was heterogenous among countries. HPV-16 lineage A variants were associated with a 2.69-fold increased risk of long-term persistent infections compared with non-A lineages. All high-grade penile intraepithelial neoplasia harbored lineage A variants and occurred in the context of long-term persistent infections with the same variants. CONCLUSIONS The prevalence and persistence of HPV-16 variants observed at the male external genitalia suggest differences in the natural history of these variants between men and women, which may be associated with intrinsic differences in the infected genital epithelia.
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Affiliation(s)
- Matthew Thomas Ferreira
- Instituto do Cancer do Estado de Sao Paulo, Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, Brazil
| | - Rossana Veronica Mendoza López
- Instituto do Cancer do Estado de Sao Paulo, Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, Brazil
- Comprehensive Center for Precision Oncology, Universidade de Sao Paulo, São Paulo, Brazil
| | - Milena Giulia Gonçalves
- Instituto do Cancer do Estado de Sao Paulo, Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, Brazil
- Comprehensive Center for Precision Oncology, Universidade de Sao Paulo, São Paulo, Brazil
| | - Silvaneide Ferreira
- Instituto do Cancer do Estado de Sao Paulo, Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, Brazil
| | - Bradley Sirak
- Center for Immunization and Infection Research in Cancer, and Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | - Maria Luizai Baggio
- Instituto do Cancer do Estado de Sao Paulo, Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, Brazil
| | - Eduardo Lazcano-Ponce
- Center for Population Health Research, Instituto Nacional de Salud Pública, Instituto Mexicano del Seguro Social, Cuernavaca, Mexico
| | - Alan G Nyitray
- Health Intervention Sciences Group/Center for AIDS Intervention Research, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
- Clinical Cancer Center, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Anna R Giuliano
- Center for Immunization and Infection Research in Cancer, and Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | - Luisa L Villa
- Instituto do Cancer do Estado de Sao Paulo, Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, Brazil
- Comprehensive Center for Precision Oncology, Universidade de Sao Paulo, São Paulo, Brazil
- Department of Radiology and Oncology, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Laura Sichero
- Instituto do Cancer do Estado de Sao Paulo, Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, Brazil
- Comprehensive Center for Precision Oncology, Universidade de Sao Paulo, São Paulo, Brazil
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15
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Saldaña F, Kebir A, Camacho-Gutiérrez JA, Aguiar M. Optimal vaccination strategies for a heterogeneous population using multiple objectives: The case of L 1- and L 2-formulations. Math Biosci 2023; 366:109103. [PMID: 37918477 DOI: 10.1016/j.mbs.2023.109103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 09/29/2023] [Accepted: 10/28/2023] [Indexed: 11/04/2023]
Abstract
The choice of the objective functional in optimization problems coming from biomedical and epidemiological applications plays a key role in optimal control outcomes. In this study, we investigate the role of the objective functional on the structure of the optimal control solution for an epidemic model for sexually transmitted infections that includes a core group with higher sexual activity levels than the rest of the population. An optimal control problem is formulated to find a targeted vaccination program able to control the spread of the infection with minimum vaccine deployment. Both L1- and L2-objectives are considered as an attempt to explore the trade-offs between control dynamics and the functional form characterizing optimality. The results show that the optimal vaccination policies for both the L1- and the L2-formulation share one important qualitative property, that is, immunization of the core group should be prioritized by policymakers to achieve a fast reduction of the epidemic. However, quantitative aspects of this result can be significantly affected depending on the choice of the control weights between formulations. Overall, the results suggest that with appropriate weight constants, the optimal control outcomes are reasonably robust with respect to the L1- or L2-formulation. This is particularly true when the monetary cost of the control policy is substantially lower than the cost associated with the disease burden. Under these conditions, even if the L1-formulation is more realistic from a modeling perspective, the L2-formulation can be used as an approximation and yield qualitatively comparable outcomes.
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Affiliation(s)
| | - Amira Kebir
- Basque Center for Applied Mathematics (BCAM), Bilbao, Spain; IPEIT, Tunis University, Tunis, Tunisia; BIMS-IPT, Tunis El Manar University, Tunis, Tunisia
| | | | - Maíra Aguiar
- Basque Center for Applied Mathematics (BCAM), Bilbao, Spain; Ikerbasque, Basque Foundation for Science, Bilbao, Spain; Dipartimento di Matematica, Università degli Studi di Trento, Trento, Italy
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16
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Zhao M, Zhou D, Zhang M, Kang P, Cui M, Zhu L, Luo L. Characteristic of persistent human papillomavirus infection in women worldwide: a meta-analysis. PeerJ 2023; 11:e16247. [PMID: 38025679 PMCID: PMC10655709 DOI: 10.7717/peerj.16247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 09/14/2023] [Indexed: 12/01/2023] Open
Abstract
Objectives We aimed to estimate the genotype distribution of persistent human papillomavirus (HPV) infection in females worldwide, and provided a scientific basis for the prevention strategies of cervical cancer (CC) and the development of HPV vaccines. Methods Both English and Chinese databases were researched from the inception to July 2023. The pooled persistent HPV infection prevalence was calculated using a random effects model. The subgroup analysis was performed to explore the heterogeneity. Publication bias was evaluated using funnel plot, Egger's and Begg's test. Results Twenty-eight studies with 27,335 participants were included. The pooled prevalence of persistent HPV infection was 29.37% (95% CI [24.05%∼35.31%]), and the genotypes with the persistent infection prevalence were HPV16 (35.01%), HPV52 (28.19%), HPV58 (27.06%), HPV18 (25.99%), HPV33 (24.37%), HPV31 (23.35%), HPV59 (21.87%), HPV39 (19.54%), HPV68 (16.61%) and HPV45 (15.05%). The prevalence of multiple and single HPV persistent infection were 48.66% and 36.71%, respectively; the prevalence of persistent HPV infection in different age groups (<30, 30∼39, 40∼49, >50) were 29.83%, 28.39%, 22.24% and 30.22%, respectively. The follow-up time was significantly associated with heterogeneity by subgroup analysis (P < 0.05), and the prevalence of persistent infection decreased with longer follow-up time. Conclusions Multiple infections were more likely to occur persistent HPV infection than single infection. In addition to HPV vaccination, we should emphasize the follow-up management for women under 30 and over 50 years old, those with high-risk HPV infection (HPV59, 39, 68) and multiple infections.
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Affiliation(s)
- Ming Zhao
- School of Public Health, Jiamusi University, Jiamusi, Heilongjiang, China
- Maternal and Child Health Development Research Center, Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Qingdao University, Jinan, Shandong, China
| | - Dan Zhou
- School of Public Health, Jiamusi University, Jiamusi, Heilongjiang, China
- Maternal and Child Health Development Research Center, Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Qingdao University, Jinan, Shandong, China
| | - Min Zhang
- School of Public Health, Jiamusi University, Jiamusi, Heilongjiang, China
- Maternal and Child Health Development Research Center, Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Qingdao University, Jinan, Shandong, China
| | - Peipei Kang
- Shandong Mental Health Center, Shandong University, Jinan, Shandong, China
| | - Meimei Cui
- Maternal and Child Health Development Research Center, Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Qingdao University, Jinan, Shandong, China
- School of Basic Medical, Weifang Medical College, Weifang, Shandong, China
| | - Liling Zhu
- School of Public Health, Jiamusi University, Jiamusi, Heilongjiang, China
| | - Limei Luo
- Maternal and Child Health Development Research Center, Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Qingdao University, Jinan, Shandong, China
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Xu J, Abudurusuli G, Rui J, Li Z, Zhao Z, Xia Y, Guo X, Abudunaibi B, Zhao B, Guo Q, Cui JA, Zhou Y, Chen T. Epidemiological characteristics and transmissibility of HPV infection: A long-term retrospective study in Hokkien Golden Triangle, China, 2013-2021. Epidemics 2023; 44:100707. [PMID: 37480747 DOI: 10.1016/j.epidem.2023.100707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 06/29/2023] [Accepted: 07/11/2023] [Indexed: 07/24/2023] Open
Abstract
OBJECTIVE Multiple human papillomavirus (HPV)-associated diseases have put a significant disease burden on the world. Therefore, we conducted a study to explore the epidemiological characteristics of HPV and the transmissibility of its genotypes. METHODS HPV testing data was collected from Hospital. A transmission dynamics model of HPV was constructed to simulate and compare the transmissibility of different HPV genotypes, which was quantitatively described by the basic reproduction number (R0). RESULTS The collected HPV subjects were mainly from Xiamen City, Zhangzhou City and Quanzhou City, together, they are known as the Hokkien golden triangle. There were variations in the distribution of HPV infections by age groups. Among all HPV genotypes, 13 of them had R0 > 1, with 10 of them being high-risk types. The top five were HPV56, 18, 58, 52 and 53, among which, HPV56, 18, 58 and 42 were of high risk, whereas HPV53 was not, and the R0 values for the five were 3.35 (CI: 0.00-9.99), 3.20 (CI: 0.00-6.46), 3.19 (CI: 1.27-6.94), 3.19 (CI: 1.01-8.42) and 2.99 (CI: 0.00-9.39), respectively. In addition, HPV52 had R0 > 1 for about 51 months, which had the longest duration. CONCLUSION Most high-risk HPV types in the Hokkien golden triangle could transmit among the population. Therefore, there is a need of further optimization for developing HPV vaccines and better detection methods in the region.
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Affiliation(s)
- Jingwen Xu
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, School of Public Health, Xiamen University; Health Emergency Office, Hefei Center for Disease Control and Prevention, Hefei City, Anhui Province, People's Republic of China
| | - Guzainuer Abudurusuli
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, School of Public Health, Xiamen University
| | - Jia Rui
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, School of Public Health, Xiamen University
| | - Zhuoyang Li
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, School of Public Health, Xiamen University
| | - Zeyu Zhao
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, School of Public Health, Xiamen University
| | - Yilan Xia
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, School of Public Health, Xiamen University
| | - Xiaohao Guo
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, School of Public Health, Xiamen University
| | - Buasiyamu Abudunaibi
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, School of Public Health, Xiamen University
| | - Benhua Zhao
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, School of Public Health, Xiamen University
| | - Qiwei Guo
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, School of Public Health, Xiamen University
| | - Jing-An Cui
- Department of Mathematics, School of Science, Beijing University of Civil Engineering and Architecture, Beijing 102616, People's Republic of China
| | - Yulin Zhou
- United Diagnostic and Research Center for Clinical Genetics, Women and Children's Hospital, School of Medicine & School of Public Health, Xiamen University, Xiamen, Fujian 361102, People's Republic of China.
| | - Tianmu Chen
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, School of Public Health, Xiamen University.
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Tuerxun G, Abudurexiti G, Abulizi G. Prevalence, persistence, clearance and risk factors for HPV infection in rural Uyghur women in China. BMC Womens Health 2023; 23:433. [PMID: 37582764 PMCID: PMC10426228 DOI: 10.1186/s12905-023-02558-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 07/19/2023] [Indexed: 08/17/2023] Open
Abstract
BACKGROUND The incidence of cervical cancer in Uyghur women ranks first among those in Han and other ethnic minority groups. We aimed to understand the natural history of HPV in Uyghur women. METHODS A longitudinal cohort study on the natural history of HPV infection in rural Uyghur women in China was conducted between May 2013 and May 2014. A total of 11000 women from South Xinjiang underwent HPV screening by careHPV and liquid-based cytology. Ultimately, a total of 298 women with positive HPV and normal biopsy results or CIN1 were enrolled to participate in a study including follow-up HPV testing for two years. RESULTS The HPV infection rate in Uyghur women was 9.15%. Among the participants, the careHPV test showed that 298 women were HPV-positive, and histology showed CIN1 or normal results for these women at baseline. Among these patients, after 24 months of initial recruitment, 92 (30.87%) patients had persistent HPV infections, and 206 (69.13%) had cleared HPV infection. Univariate analysis showed that persistent HPV infection was associated with age and shower frequency (P < 0.001 and P = 0.047, respectively). CONCLUSIONS Our results suggest that women over the age of 50 years who have been infected with HR-HPV for more than 1 year should be regularly screened and monitored for HPV. In addition, education should be strengthened to improve poor health habits in these women.
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Affiliation(s)
- Gulixian Tuerxun
- Fifth Department of Gynecologic Surgery, Xinjiang Medical University Affiliated Tumor Hospital, Urumqi, 830000, China
| | - Guligeina Abudurexiti
- Fifth Department of Gynecologic Surgery, Xinjiang Medical University Affiliated Tumor Hospital, Urumqi, 830000, China
| | - Guzalinuer Abulizi
- Fifth Department of Gynecologic Surgery, Xinjiang Medical University Affiliated Tumor Hospital, Urumqi, 830000, China.
- Xinjiang Key Laboratory of Oncology, No. 789 East Suzhou Street, Xinshi District, Urumqi, 830000, China.
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Fesahat F, Firouzabadi AM, Zare-Zardini H, Imani M. Roles of Different β-Defensins in the Human Reproductive System: A Review Study. Am J Mens Health 2023; 17:15579883231182673. [PMID: 37381627 PMCID: PMC10334010 DOI: 10.1177/15579883231182673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 05/21/2023] [Accepted: 05/30/2023] [Indexed: 06/30/2023] Open
Abstract
Human β-defensins (hBDs) are cationic peptides with an amphipathic spatial shape and a high cysteine content. The members of this peptide family have been found in the human body with various functions, including the human reproductive system. Of among β-defensins in the human body, β-defensin 1, β-defensin 2, and β-defensin 126 are known in the human reproductive system. Human β-defensin 1 interacts with chemokine receptor 6 (CCR6) in the male reproductive system to prevent bacterial infections. This peptide has a positive function in antitumor immunity by recruiting dendritic cells and memory T cells in prostate cancer. It is necessary for fertilization via facilitating capacitation and acrosome reaction in the female reproductive system. Human β-defensin 2 is another peptide with antibacterial action which can minimize infection in different parts of the female reproductive system such as the vagina by interacting with CCR6. Human β-defensin 2 could play a role in preventing cervical cancer via interactions with dendritic cells. Human β-defensin 126 is required for sperm motility and protecting the sperm against immune system factors. This study attempted to review the updated knowledge about the roles of β-defensin 1, β-defensin 2, and β-defensin 126 in both the male and female reproductive systems.
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Affiliation(s)
- Farzaneh Fesahat
- Reproductive Immunology Research
Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Amir Masoud Firouzabadi
- Reproductive Immunology Research
Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Hadi Zare-Zardini
- Hematology and Oncology Research
Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Maryam Imani
- Reproductive Immunology Research
Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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20
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Øvestad IT, Dalen I, Andersland MS, Vintermyr OK, Moltu P, Berland JM, Janssen EAM, Haugland HK. Triaging HPV-Positive Cervical Samples with p16 and Ki-67 Dual Stained Cytology within an Organized Screening Program-A Prospective Observational Study from Western Norway. Int J Mol Sci 2023; 24:ijms24087158. [PMID: 37108319 PMCID: PMC10138375 DOI: 10.3390/ijms24087158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 03/31/2023] [Accepted: 03/31/2023] [Indexed: 04/29/2023] Open
Abstract
The implementation of high-risk human papillomavirus testing (hrHPV testing) as a screening method in substitute for cytology has evoked the need for more sensitive and less objective tests for the triage of HPV-positive women. In a cohort of 1763 HPV-positive women, the potential of immunocytochemical p16 and Ki-67 dual staining as compared to cytology, alone or in combination with HPV partial genotyping, was tested for triage of women attending a cervical cancer screening program. Performance was measured using sensitivity, specificity, and positive and negative predictive values. Comparisons were assessed using logistic regression models and the McNemar test. Dual staining was evaluated in a prospectively collected study cohort of 1763 HPV-screened women. For triage of CIN2+ and CIN3+, NPV and sensitivity, 91.8% and 94.2% versus 87.9% and 89.7%, respectively, were significantly higher using dual staining together with HPV 16/18 positive, as compared to cytology (p < 0.001). The specificities, however, were lower for dual staining as compared to cytology. Conclusions: Dual staining is safer for decision-making regarding HPV-positive women's need for follow-up with colposcopy and biopsy, as compared to cytology.
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Affiliation(s)
| | - Ingvild Dalen
- Department of Research, Stavanger University Hospital, 4011 Stavanger, Norway
| | - Marie S Andersland
- Department of Pathology, Haukeland University Hospital, 5053 Bergen, Norway
| | - Olav K Vintermyr
- Department of Pathology, Haukeland University Hospital, 5053 Bergen, Norway
- Gade Laboratory for Pathology, Department of Clinical Medicine, University of Bergen, 5020 Bergen, Norway
| | - Pia Moltu
- Department of Pathology, Stavanger University Hospital, 4011 Stavanger, Norway
| | - Jannicke M Berland
- Department of Pathology, Stavanger University Hospital, 4011 Stavanger, Norway
| | - Emilius A M Janssen
- Department of Pathology, Stavanger University Hospital, 4011 Stavanger, Norway
- Department of Chemistry, Bioscience and Environmental Technology, University of Stavanger, 4021 Stavanger, Norway
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21
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Zhang C, Yang Z, Luo P, Li T, Wang S, Sun F, Gong P, Mei B. Association of TLR4 and TLR9 gene polymorphisms with cervical HR-HPV infection status in Chinese Han population. BMC Infect Dis 2023; 23:152. [PMID: 36915050 PMCID: PMC10012518 DOI: 10.1186/s12879-023-08116-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 02/23/2023] [Indexed: 03/14/2023] Open
Abstract
BACKGROUND Toll-like receptors (TLRs) may be involved in the natural history of human papillomavirus (HPV) infection. In our study, we aimed to investigate the association of TLR4 (rs10116253, rs1927911, rs10759931) and TLR9 (rs187084, rs352140) gene polymorphisms with cervical persistent high-risk HPV (HR-HPV) infection, as well as multiple HR-HPV infections. METHODS A total of 269 study subjects were enrolled and grouped by retrospectively analyzing the HR-HPV testing results and other clinical data of 2647 gynecological outpatients from Jingzhou Hospital Affiliated to Yangtze University. We conducted a case-control study to compare the role of TLR4/TLR9 gene polymorphisms between HR-HPV transient and persistent infections, as well as between HR-HPV single and multiple infections. HR-HPV genotypes were detected using Real-time polymerase chain reaction (RT-PCR). PCR-restriction fragment length polymorphism (PCR-RFLP) was used to determine TLR4 and TLR9 gene polymorphisms. Analyses of the different outcome variables (HR-HPV infection status and time for HR-HPV clearance) with respect to TLR4/TLR9 polymorphisms were carried out. Logistic regression analysis was used to determine the association of TLR4/TLR9 genotypes and alleles with HR-HPV infection status. The Kaplan-Meier method with the log-rank test was used to analyze the relationship between TLR4/TLR9 genotypes and the time for HR-HPV clearance. RESULTS The mutant genotypes of TLR9 rs187084 and rs352140 were associated with persistent (rs187084: CT and CT+CC; rs352140: CT and CT+TT) and multiple (rs187084: CT and CT+CC; rs352140: CT+TT) (all P < 0.05) HR-HPV infection. However, no association was found between TLR4 polymorphisms and HR-HPV infection status. Kaplan-Meier time to HR-HPV clearance analysis demonstrated that women carrying rs187084 and rs352140 mutant genotypes take longer duration to clear HR-HPV infection compared with wild-type genotype carriers (P1 = 0.012; P2 = 0.031). CONCLUSION Our results suggested that TLR9 polymorphisms, but not TLR4, were associated with cervical persistent and multiple HR-HPV infections, which could be useful as a potential predictor of HR-HPV infection status.
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Affiliation(s)
- Chunlin Zhang
- Department of Laboratory Medicine, Jingzhou Hospital Affiliated to Yangtze University, Jingzhou, 434020, Hubei, China
| | - Zhiping Yang
- Department of Laboratory Medicine, Jingzhou Hospital Affiliated to Yangtze University, Jingzhou, 434020, Hubei, China
| | - Ping Luo
- Department of Laboratory Medicine, Jingzhou Hospital Affiliated to Yangtze University, Jingzhou, 434020, Hubei, China
| | - Ting Li
- Department of Laboratory Medicine, Jingzhou Hospital Affiliated to Yangtze University, Jingzhou, 434020, Hubei, China
| | - Sutong Wang
- Department of Laboratory Medicine, Jingzhou Hospital Affiliated to Yangtze University, Jingzhou, 434020, Hubei, China
| | - Fenglan Sun
- Department of Laboratory Medicine, Jingzhou Hospital Affiliated to Yangtze University, Jingzhou, 434020, Hubei, China
| | - Ping Gong
- Department of Pathology, Jingzhou Hospital Affiliated to Yangtze University, Jingzhou, 434020, Hubei, China
| | - Bing Mei
- Department of Laboratory Medicine, Jingzhou Hospital Affiliated to Yangtze University, Jingzhou, 434020, Hubei, China.
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Preventing Persistence of HPV Infection with Natural Molecules. Pathogens 2023; 12:pathogens12030416. [PMID: 36986338 PMCID: PMC10056139 DOI: 10.3390/pathogens12030416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 02/26/2023] [Accepted: 03/03/2023] [Indexed: 03/09/2023] Open
Abstract
Human papillomavirus (HPV) infection is one the most common sexually transmitted infections worldwide. In most cases, the infection is temporary and asymptomatic; however, when persistent, it may lead to lesions that can evolve into cancer in both women and men. Nowadays, prophylactic vaccination is the primary preventive strategy for HPV infections, but vaccines do not cover all types of HPV strains. Scientific research has uncovered the beneficial role of some natural supplements in preventing persistent HPV infections or treating HPV-related lesions. We review the current insight into the roles of natural molecules in HPV infection with a special focus on epigallocatechin gallate (EGCG), folic acid, vitamin B12, and hyaluronic acid (HA). Specifically, EGCG from green tea extracts plays a critical role in suppressing HPV oncogenes and oncoproteins (E6/E7), which are responsible for HPV oncogenic activity and cancer development. Folic acid and vitamin B12 are essential vitamins for multiple functions in the body, and accumulating evidence suggests their importance in maintaining a high degree of methylation of the HPV genome, thus decreasing the likelihood of causing malignant lesions. HA, due to its re-epithelizing property, may prevent HPV virus entry in damaged mucosa and epithelia. Thereby, based on these premises, the combination of EGCG, folic acid, vitamin B12, and HA may be a very promising therapeutic approach to prevent HPV persistence.
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23
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Arthur AW, El-Zein M, Burchell AN, Tellier PP, Coutlée F, Franco EL. Detection and clearance of type-specific and phylogenetically related genital human papillomavirus infections in young women in new heterosexual relationships. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.02.24.23286387. [PMID: 36865299 PMCID: PMC9980228 DOI: 10.1101/2023.02.24.23286387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
Background Understanding the natural history of human papillomavirus (HPV) infections is essential to effective cervical cancer prevention planning. We examined these outcomes in-depth among young women. Methods The HPV Infection and Transmission among Couples through Heterosexual Activity (HITCH) study is a prospective cohort of 501 college-age women who recently initiated a heterosexual relationship. We tested vaginal samples collected at six clinical visits over 24 months for 36 HPV types. Using rates and Kaplan-Meier analysis, we estimated time-to-event statistics with 95% confidence intervals (CIs) for detection of incident infections and liberal clearance of incident and present-at-baseline infections (separately). We conducted analyses at the woman- and HPV-levels, with HPV types grouped by phylogenetic relatedness. Results By 24 months, we detected incident infections in 40.4%, CI:33.4-48.4 of women. Incident subgenus 1 (43.4, CI:33.6-56.4), 2 (47.1, CI:39.9-55.5) and 3 (46.6, CI:37.7-57.7) infections cleared at similar rates per 1000 infection-months. We observed similar homogeny in HPV-level clearance rates among present-at-baseline infections. Conclusions Our woman-level analyses of infection detection and clearance agreed with similar studies. However, our HPV-level analyses did not clearly indicate that high oncogenic risk subgenus 2 infections take longer to clear than their low oncogenic risk and commensal subgenera 1 and 3 counterparts.
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Affiliation(s)
- Andrew W Arthur
- Division of Cancer Epidemiology, McGill University, Montréal, Québec, H4A 3T2, Canada
| | - Mariam El-Zein
- Division of Cancer Epidemiology, McGill University, Montréal, Québec, H4A 3T2, Canada
| | - Ann N Burchell
- Department of Family and Community Medicine and MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, M5B 1W8, Canada
| | - Pierre-Paul Tellier
- Department of Family Medicine, McGill University, Montréal, Québec, H3S 1Z1, Canada
| | - Francois Coutlée
- Départements de Clinique de Médecine de Laboratoire et de Médecine, Services de Biologie Moléculaire et d'Infectiologie, Centre Hospitalier de l'Université de Montréal, Montréal, Québec, H2X 0C1, Canada
| | - Eduardo L Franco
- Division of Cancer Epidemiology, McGill University, Montréal, Québec, H4A 3T2, Canada
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24
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Rousset-Jablonski C, Mekki Y, Denis A, Reynaud Q, Nove-Josserand R, Durupt S, Touzet S, Perceval M, Ray-Coquard I, Golfier F, Durieu I. Human papillomavirus prevalence, persistence and cervical dysplasia in females with cystic fibrosis. J Cyst Fibros 2022:S1569-1993(22)01415-1. [DOI: 10.1016/j.jcf.2022.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Revised: 11/14/2022] [Accepted: 11/27/2022] [Indexed: 12/15/2022]
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25
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Castro-Muñoz LJ, Rocha-Zavaleta L, Lizano M, Ramírez-Alcántara KM, Madrid-Marina V, Manzo-Merino J. Alteration of the IFN-Pathway by Human Papillomavirus Proteins: Antiviral Immune Response Evasion Mechanism. Biomedicines 2022; 10:biomedicines10112965. [PMID: 36428532 PMCID: PMC9687819 DOI: 10.3390/biomedicines10112965] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 11/14/2022] [Accepted: 11/15/2022] [Indexed: 11/19/2022] Open
Abstract
A persistent infection with the so-called high-risk Human Papillomaviruses (hr-HPVs) plays a fundamental role in the development of different neoplasms. The expression of the HPV proteins throughout the different steps of the viral life cycle produce a disruption of several cellular processes, including immune response, which can lead to cell transformation. The interferon-mediated response plays an important role in eliminating HPV-infected and -transformed cells. The ability of HPV to disrupt the proper function of the interferon response is based on a series of molecular mechanisms coordinated by HPV proteins intended to prevent clearance of infection, ultimately producing an immunotolerant environment that facilitates the establishment of persistence and cancer. In this review, we focus on the molecular actions performed by HPV E1, E2, E5, E6 and E7 proteins on IFN signaling elements and their contribution to the establishment of infection, viral persistence and the progression to cancer.
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Affiliation(s)
- Leonardo Josué Castro-Muñoz
- The Wistar Institute, 3601 Spruce Street, Philadelphia, PA 19104, USA
- Unidad de Investigación Biomédica en Cáncer, Instituto Nacional de Cancerología, México/Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Av. San Fernando No. 22, Col. Sección XVI, Tlalpan, Mexico City 14080, Mexico
| | - Leticia Rocha-Zavaleta
- Departamento de Biología Molecular y Biotecnología, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Circuito Escolar S/N, Ciudad Universitaria, Delegación Coyoacán, Mexico City 04500, Mexico
| | - Marcela Lizano
- Unidad de Investigación Biomédica en Cáncer, Instituto Nacional de Cancerología, México/Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Av. San Fernando No. 22, Col. Sección XVI, Tlalpan, Mexico City 14080, Mexico
- Departamento de Medicina Genómica y Toxicología Ambiental, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Mexico City 04510, Mexico
| | - Katia Montserrat Ramírez-Alcántara
- Unidad de Investigación Biomédica en Cáncer, Instituto Nacional de Cancerología, México/Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Av. San Fernando No. 22, Col. Sección XVI, Tlalpan, Mexico City 14080, Mexico
| | - Vicente Madrid-Marina
- Dirección de Infecciones Crónicas y Cáncer, Centro de Investigación sobre Enfermedades Infecciosas (CISEI), Instituto Nacional de Salud Pública, Av. Universidad 655, Santa María Ahuacatitlán, Cuernavaca, Morelos 62100, Mexico
| | - Joaquín Manzo-Merino
- Unidad de Investigación Biomédica en Cáncer, Instituto Nacional de Cancerología, México/Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Av. San Fernando No. 22, Col. Sección XVI, Tlalpan, Mexico City 14080, Mexico
- Cátedras CONACyT-Instituto Nacional de Cancerología, San Fernando No. 22, Col. Sección XVI, Tlalpan, Mexico City 14080, Mexico
- Correspondence:
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Amorrortu RP, Zhao Y, Fenske NA, Cherpelis BS, Messina JL, Giuliano AR, Sondak VK, Schell MJ, Mckay-Chopin S, Gheit T, Waterboer T, Tommasino M, Rollison DE. Natural History of Incident and Persistent Cutaneous Human Papillomavirus and Human Polyomavirus Infections. J Infect Dis 2022; 226:1162-1174. [PMID: 35022780 PMCID: PMC9518839 DOI: 10.1093/infdis/jiac004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 01/07/2022] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Cutaneous human papillomaviruses (cuHPV) and polyomaviruses (HPyV) have been implicated in skin cancers; however, interpretation of findings across studies is complicated by limited understanding of the natural history of these infections across normal tissue types. METHODS In total, 675 eyebrow hair (EBH) and skin swab (SSW) samples were collected from 71 skin cancer screening patients every 6 months over 2 years and measured for presence of β-HPV, γ-HPV, and HPyV. Incidence, persistence, and clearance of cuHPV/HPyV were estimated, and risk factors associated with infection were examined. RESULTS Prevalence, incidence, and persistence of β-HPV, γ-HPV, and HPyV were consistently higher in SSW than in EBH, with types 5, 24, 49, 76 and Merkel cell polyomavirus (MCPyV) having incidence rates greater than 20 per 1000 person-months. Prevalent γ-HPV EBH infections persisted more often in women (P = .024), incident β-HPV EBH infections persisted less often among individuals with history of blistering sunburn (P = .019), and prevalent MCPyV SSW infections persisted more often in those with a history of skin cancer (P = .033). CONCLUSIONS Incidence and persistence of cuHPV/HPyV were observed in SSW and EBH; however, none of the risk factors examined were commonly associated with cuHPV/HPyV infections across normal tissue types.
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Affiliation(s)
| | - Yayi Zhao
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida, USA
| | - Neil A Fenske
- Department of Dermatology and Cutaneous Surgery, University of South Florida College of Medicine, Tampa, Florida, USA
| | - Basil S Cherpelis
- Department of Dermatology and Cutaneous Surgery, University of South Florida College of Medicine, Tampa, Florida, USA
| | - Jane L Messina
- Department of Anatomic Pathology, Moffitt Cancer Center, Tampa, Florida, USA
- Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, Florida, USA
| | - Anna R Giuliano
- Center for Immunization and Infection Research in Cancer, Moffitt Cancer Center, Tampa, Florida, USA
| | - Vernon K Sondak
- Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, Florida, USA
| | - Michael J Schell
- Biostatistics and Bioinformatics Shared Resource, Moffitt Cancer Center, Tampa, Florida, USA
| | - Sandrine Mckay-Chopin
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Tarik Gheit
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Tim Waterboer
- Infections and Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany
| | - Massimo Tommasino
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Dana E Rollison
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida, USA
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Lintao RCV, Cando LFT, Perias GAS, Tantengco OAG, Tabios IKB, Velayo CL, de Paz-Silava SLM. Current Status of Human Papillomavirus Infection and Cervical Cancer in the Philippines. Front Med (Lausanne) 2022; 9:929062. [PMID: 35795639 PMCID: PMC9251542 DOI: 10.3389/fmed.2022.929062] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 05/30/2022] [Indexed: 11/13/2022] Open
Abstract
Cervical cancer is estimated to cause 341,831 deaths each year, with 9 of 10 deaths occurring in developing countries. Over the past decade, there has been a significant increase in cervical cancer incidence among women in the Philippines. Persistent infection with high-risk human papillomavirus (HPV) is the well-established necessary cause of cervical cancer. Based on limited studies conducted in the Philippines, the prevalence of infection with any HPV genotype was 93.8% for cervical squamous cell carcinoma and 90.9% for cervical adenocarcinomas. HPV types 16 and 18 were the most common HPV genotypes among Filipino patients with cervical cancer. On the other hand, the incidence of HPV infection among Filipino women with normal cervices was 9.2%. The World Health Organization has launched a global agenda of eliminating HPV infection by 2030. One of its key milestones is to vaccinate 90% of girls with the HPV vaccine by 15 years. However, the HPV vaccination rate among Filipino women remains to be unsatisfactory. HPV vaccination has only been included in the Philippine Department of Health's community-based National Immunization Program in 2015. Despite these efforts, the Philippines currently ranks last on HPV program coverage among low-middle income countries, with coverage of only 23% of the target female population for the first dose and 5% for the final dose. The principal reason for the non-acceptance of HPV vaccines was the perceived high cost of vaccination. The low utilization of available cervical cancer screening tests such as Pap smear and visual inspection with acetic acid hampered the Philippines' control and prevention of HPV infection and cervical cancer. Among those diagnosed with cervical cancer in the Philippines, only an estimated 50% to 60% receive some form of treatment. To this end, we summarize the burden of HPV infection and cervical cancer on Filipinos and the risk factors associated with the disease. We present the current screening, diagnostics, treatment, and prevention of HPV-related diseases in the Philippines. Lastly, we also propose solutions on how each building block in health systems can be improved to eliminate HPV infection and reduce the burden of cervical cancer in the Philippines.
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Affiliation(s)
- Ryan C. V. Lintao
- Multi-Omics Research Program for Health, College of Medicine, University of the Philippines Manila, Manila, Philippines
| | - Leslie Faye T. Cando
- Multi-Omics Research Program for Health, College of Medicine, University of the Philippines Manila, Manila, Philippines
| | - Glenmarie Angelica S. Perias
- Multi-Omics Research Program for Health, College of Medicine, University of the Philippines Manila, Manila, Philippines
| | - Ourlad Alzeus G. Tantengco
- Multi-Omics Research Program for Health, College of Medicine, University of the Philippines Manila, Manila, Philippines
| | - Ian Kim B. Tabios
- Multi-Omics Research Program for Health, College of Medicine, University of the Philippines Manila, Manila, Philippines
- Institute of Biology, College of Science, University of the Philippines Diliman, Quezon City, Philippines
- Institute of Human Genetics, National Institutes of Health, University of the Philippines Manila, Manila, Philippines
| | - Clarissa L. Velayo
- Department of Physiology, College of Medicine, University of the Philippines Manila, Manila, Philippines
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
| | - Sheriah Laine M. de Paz-Silava
- Multi-Omics Research Program for Health, College of Medicine, University of the Philippines Manila, Manila, Philippines
- Department of Medical Microbiology, College of Public Health, University of the Philippines Manila, Manila, Philippines
- *Correspondence: Sheriah Laine M. de Paz-Silava
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Wu L, Wang W, Zhang J, Wu X, Chen Y, Gu X, Shao H, Li H, Liu W. Detection of Five Types of HPV Genotypes Causing Anogenital Warts (Condyloma Acuminatum) Using PCR-Tm Analysis Technology. Front Microbiol 2022; 13:857410. [PMID: 35655998 PMCID: PMC9152731 DOI: 10.3389/fmicb.2022.857410] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 04/20/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives Condyloma acuminatum (CA) is a common sexually transmitted disease caused by human papillomavirus (HPV) infection. We established a high-throughput, simple, low-cost, and accurate HPV-typing assay (polymerase chain reaction-melting temperature [PCR-Tm] analysis) to detect HPV in CA. Materials and Methods We detected 280 cervical scraping samples, including positive samples of HPV-6 (26), HPV-11 (12), HPV-16 (22), HPV-42 (18), HPV-43 (25), HPV-multiple (19), HPV- other type (58), and HPV-negative samples (100). All samples were compared by PCR-Tm analysis and a flow fluorescence hybridization assay. Sequencing was used to confirm the results of the PCR-Tm analysis. Results PCR-Tm analysis was specific for each genotype (HPV-6, HPV-11, HPV-16, HPV-42, and HPV-43). The sensitivity of the PCR-Tm analysis assay for each genotype was 103, 103, 103, 103, and 102 copies/reaction, respectively. Most of the 158 samples, including 58 HPV-other type positive and 100 HPV-negative samples tested by the flow fluorescence hybridization assay, were tested negative by PCR-Tm analysis. For the 122 remaining samples, 26 HPV-6, 12 HPV-11, 22 HPV-16, 18 HPV-42, 25 HPV-43, and 19 multiple HPV infections were detected through PCR-Tm analysis. In total, 25 HPV-6, 12 HPV-11, 21 HPV-16, 18 HPV-42, 25 HPV-43, and only 10 multiple HPV infections were detected by the flow fluorescence hybridization assay. The kappa coefficient for the analysis of PCR-Tm analysis and flow fluorescence hybridization assay was 0.940 (P < 0.0001), and the 95% confidence interval of the kappa coefficient was 90.3–97.7%. Conclusion PCR-Tm analysis enabled the detection of HPV-6, HPV-11, HPV-16, HPV-42, and HPV-43, including single and multiple infections.
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Affiliation(s)
- Lixia Wu
- Department of Laboratory Medicine, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China.,Department of Laboratory Medicine, Children's Hospital of Soochow University, Medical College of Soochow University, Soochow, China
| | - Weifeng Wang
- Department of Laboratory Medicine, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China.,Department of Laboratory Medicine, Central Laboratory, Shanghai Tenth People's Hospital, Tongji University of Medicine, Shanghai, China
| | - Jie Zhang
- Department of Laboratory Medicine, Central Laboratory, Shanghai Tenth People's Hospital, Tongji University of Medicine, Shanghai, China
| | - Xuan Wu
- Department of Laboratory Medicine, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China.,Department of Laboratory Medicine, Central Laboratory, Shanghai Tenth People's Hospital, Tongji University of Medicine, Shanghai, China
| | - Yan Chen
- Department of Laboratory Medicine, Central Laboratory, Shanghai Tenth People's Hospital, Tongji University of Medicine, Shanghai, China
| | - Xiaoping Gu
- Department of Laboratory Medicine, Shanghai Skin Disease Hospital, Tongji University of Medicine, Shanghai, China
| | - Huaqing Shao
- Department of Laboratory Medicine, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Hongsheng Li
- Department of Laboratory Medicine, The Second Affiliated Hospital of Jiaxing University, Jiaxing, China
| | - Weiwei Liu
- Department of Laboratory Medicine, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China.,Department of Laboratory Medicine, Central Laboratory, Shanghai Tenth People's Hospital, Tongji University of Medicine, Shanghai, China.,Department of Laboratory Medicine, Shanghai Skin Disease Hospital, Tongji University of Medicine, Shanghai, China
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Yu R, Wei Y, He C, Zhou P, Yang H, Deng C, Liu R, Wu P, Gao Q, Cao C. Integrative Analyses of m6A Regulators Identify that METTL3 is Associated with HPV Status and Immunosuppressive Microenvironment in HPV-related Cancers. Int J Biol Sci 2022; 18:3874-3887. [PMID: 35813476 PMCID: PMC9254478 DOI: 10.7150/ijbs.70674] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Accepted: 03/31/2022] [Indexed: 01/09/2023] Open
Abstract
Although m6A modifications are associated with tumor progression, and anti-tumor immune responses, the role of m6A regulators in HPV-related carcinogenesis has not been well resolved. To provide evidence for the role of m6A regulators in HPV-related carcinogenesis and identify potential therapeutic targets for HPV-related cancers, integrative analyses of m6A regulators in 1,485 head and neck squamous cell carcinoma (HNSC) patients and 507 cervical squamous cell carcinoma (CESC) patients was performed and identified that an m6A regulator, METTL3, was highly expressed in tumors and was related to the poor prognosis in HNSC and CESC. In HPV-positive tumors, METTL3 was positively associated with tumor HPV status, such as HPV integration status, E6 and unspliced-E6 expression, and p16 expression. Further analysis demonstrated that METTL3 high status was negatively correlated with tumor immune cell infiltrations and facilitated the expression of immunosuppressive immune checkpoint molecules (i.e., PD-L1). Cell-derived xenograft models demonstrated that METTL3 inhibitor combined with anti-PD1 therapy promoted immunotherapy of CESC in vivo. Overall, this study identified that METTL3 high status, is associated with poor prognosis and HPV status, and serves as a mediator of the immunosuppressive tumor microenvironment in HPV-associated cancer, which provides a promising therapeutic target for anti-cancer immunotherapy.
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Affiliation(s)
- Ruidi Yu
- Department of Gynecology and Obstetrics, Cancer Biology Research Center (Key Laboratory of the Ministry of Education), Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Ye Wei
- Department of Gynecology and Obstetrics, Cancer Biology Research Center (Key Laboratory of the Ministry of Education), Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Chao He
- Department of Gynecology and Obstetrics, Cancer Biology Research Center (Key Laboratory of the Ministry of Education), Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Ping Zhou
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Shenzhen Peking University-The Hong Kong University of Science and Technology Medical Center, Guangdong, 518036, China.,Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, 100191, China
| | - Hong Yang
- Department of Gynecology and Obstetrics, Cancer Biology Research Center (Key Laboratory of the Ministry of Education), Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Chang Deng
- Department of Gynecology and Obstetrics, Cancer Biology Research Center (Key Laboratory of the Ministry of Education), Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Rang Liu
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Shenzhen Peking University-The Hong Kong University of Science and Technology Medical Center, Guangdong, 518036, China.,Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, 100191, China
| | - Peng Wu
- Department of Gynecology and Obstetrics, Cancer Biology Research Center (Key Laboratory of the Ministry of Education), Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.,✉ Corresponding authors: Peng Wu (), Canhui Cao () and Qinglei Gao (), 1095 Jiefang Ave, Wuhan, Hubei, China. Tel: 86-27-83663351; Fax: 86-27-83662681
| | - Qinglei Gao
- Department of Gynecology and Obstetrics, Cancer Biology Research Center (Key Laboratory of the Ministry of Education), Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.,✉ Corresponding authors: Peng Wu (), Canhui Cao () and Qinglei Gao (), 1095 Jiefang Ave, Wuhan, Hubei, China. Tel: 86-27-83663351; Fax: 86-27-83662681
| | - Canhui Cao
- Department of Gynecology and Obstetrics, Cancer Biology Research Center (Key Laboratory of the Ministry of Education), Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.,Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Shenzhen Peking University-The Hong Kong University of Science and Technology Medical Center, Guangdong, 518036, China.,Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, 100191, China.,✉ Corresponding authors: Peng Wu (), Canhui Cao () and Qinglei Gao (), 1095 Jiefang Ave, Wuhan, Hubei, China. Tel: 86-27-83663351; Fax: 86-27-83662681
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30
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Zhang Z, Ling X, Liu L, Xi M, Zhang G, Dai J. Natural History of Anal Papillomavirus Infection in HIV-Negative Men Who Have Sex With Men Based on a Markov Model: A 5-Year Prospective Cohort Study. Front Public Health 2022; 10:891991. [PMID: 35646789 PMCID: PMC9130828 DOI: 10.3389/fpubh.2022.891991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 04/20/2022] [Indexed: 12/03/2022] Open
Abstract
Objective Men who have sex with men (MSM) are at increased risk for Human papillomavirus (HPV) infection compared to women and heterosexual men. We aimed to assess the incidence, clearance and duration of anal human papillomavirus (HPV) infection in HIV-negative MSM and the influencing factors in a 5-year prospective cohort study. Methods From April 2016 to April 2021, HIV-negative MSM were recruited and followed every 6 months in Urumqi, Xinjiang, China. Questionnaires and anal swabs were collected at baseline and every 6 months. We detected 37 anal HPV genotypes using the HPV Geno Array Diagnostic Kit Test. Incidence and clearance rates of anal HPV infection and the influencing factors were estimated using a two-state Markov model. Results A total of 585 MSM were included with a median age of 37 years [interquartile range (IQR): 31–43 years] and were followed for a median 2.8 years (IQR: 1.8–3.6 years). Incidence rates for any HPV and high-risk HPV (Hr-HPV) were 53.4 [95% confidence interval (CI): 49.1–58.0] and 39.0 (95% CI: 35.7–42.5)/1,000 person-months. Median duration of infection was 9.67 (95% CI: 8.67–10.86) and 8.51 (95% CI: 7.57–9.50) months, respectively. Clearance rates for any HPV and Hr-HPV were 50.9 (95% CI: 46.7–55.3) and 62.1 (95% CI: 56.8–66.7)/1,000 person-months, respectively. HPV16 and HPV6 had the highest incidence, lowest clearance rate and longest duration of infection among Hr-HPV and low-risk HPV (Lr-HPV) types, respectively. Receptive anal sex is a risk factor for any HPV [hazard ratio (HR) = 1.66, 95% CI: 1.16–2.38] and Hr-HPV infection (HR = 1.99, 95% CI:1.39–2.85). Recent anal sex without condom use was significantly associated with any HPV (HR = 1.80, 95% CI: 1.10–2.94) and Hr-HPV infection (HR = 2.60, 95% CI: 1.42–4.77). Age ≥35 years was significantly associated with Lr-HPV HPV infection only (HR = 1.40, 95% CI: 1.02–1.93). Both inserted and receptive anal sex (HR = 0.60, 95% CI: 0.40–0.89) and anal sex ≥2 times per week (HR = 0.61, 95% CI: 0.43–0.87) were associated with reduced Hr-HPV clearance. Six of the nine-valent vaccine types (HPV6, 11, 16, 18, 52 and 58) occurred most frequently, which indicates the need for high vaccination coverage in MSM. Conclusions In this cohort study, high incidence and low clearance of any HPV, Hr-HPV and individual HPV infections emphasize the importance of MSM vaccination. Modifiable behavioral factors such as condoms and drug use should be incorporated into HPV prevention strategies.
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31
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Pan S, Wei W, Du X, Li Z, Tuo J, Zhang M, Liu Q. Factors associated with persistence and clearance of HPV16/18 among rural Chinese women: a cohort study in Wufeng, Hubei province. Women Health 2022; 62:276-286. [DOI: 10.1080/03630242.2022.2056283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Shuqi Pan
- Department of Epidemiology, School of Public Health, Wuhan University, Wuhan, Hubei, China
| | - Wenshuang Wei
- Department of Epidemiology, School of Public Health, Wuhan University, Wuhan, Hubei, China
| | - Xueying Du
- Shandong Center for Disease Control and Prevention, Jinan, Shandong, China
| | - Zhi Li
- Department of Public Health, University of Massachusetts Amherst, Amherst, Massachusetts, USA
| | - Jiyu Tuo
- Office of Cancer Prevention and Treatment, Institute of Cancer Prevention and Control, Wuhan, China
| | - Min Zhang
- Office of Cancer Prevention and Treatment, Institute of Cancer Prevention and Control, Wuhan, China
| | - Qing Liu
- Department of Epidemiology, School of Public Health, Wuhan University, Wuhan, Hubei, China
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Louvanto K, Baral P, Burchell A, Ramanakumar A, El-Zein M, Tellier PP, Coutlée F, Roger M, Franco EL. Role of Human Leukocyte Antigen Allele Sharing in Human Papillomavirus Infection Transmission Among Heterosexual Couples: Findings From the Hitch Cohort Study. J Infect Dis 2022; 226:1175-1183. [PMID: 35363864 PMCID: PMC9518836 DOI: 10.1093/infdis/jiac115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 03/29/2022] [Indexed: 11/12/2022] Open
Abstract
Background Human leukocyte antigen (HLA) polymorphism influences innate and adaptive immune responses. Among heterosexual couples in the HPV Infection and Transmission Among Couples Through Heterosexual Activity (HITCH) cohort study, we examined whether allele sharing in a couple predicted the partners’ infections with the same human papillomavirus (HPV) type. Methods We tested genital samples from 271 couples for 36 HPV genotypes by polymerase chain reaction. We used direct DNA sequencing to type HLA-B07, -DRB1, -DQB1 and -G. Generalized estimating equations were used to examine the associations between the extent of allele sharing and HPV type concordance in which at least 1 of the partners was HPV positive. Results We identified 106 different HLA alleles. The most common HLA alleles among couples were G*01:01:01 (95.6%), G*01:01:02 (60.1%), DQB1*03:01 (57.2%), and DRB1*07:01 (46.9%). Allele sharing was as follows: 19.6% shared none, 43.2% shared 1 only, 25.1% shared 2, and 12.5% shared 3–5. Irrespective of HLA class, grouped or in combination, the extent of allele sharing was not a significant predictor of type-specific HPV concordance in a couple (odds ratio, 1.1 [95% confidence interval, .5–2.1], for 3–5 vs none). Conclusions We found no evidence that the extent of HLA allele concordance influences the likelihood of HPV transmission in newly formed heterosexual couples.
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Affiliation(s)
- Karolina Louvanto
- Division of Cancer Epidemiology, McGill University, Montreal, Quebec, Canada.,Department of Obstetrics and Gynaecology, Faculty of Medicine and Health Technology, Tampere, Finland.,Department of Obstetrics and Gynaecology, Tampere University Hospital, Tampere, Finland
| | - Prativa Baral
- Division of Cancer Epidemiology, McGill University, Montreal, Quebec, Canada
| | - Ann Burchell
- Ontario HIV Treatment Network, Toronto, Ontario, Canada
| | | | - Mariam El-Zein
- Division of Cancer Epidemiology, McGill University, Montreal, Quebec, Canada
| | | | - Francois Coutlée
- Division of Cancer Epidemiology, McGill University, Montreal, Quebec, Canada.,Centre de recherche du CHUM et Département de microbiologie, infectiologie et immunologie, Université de Montréal, Montréal, Quebec, Canada
| | - Michel Roger
- Centre de recherche du CHUM et Département de microbiologie, infectiologie et immunologie, Université de Montréal, Montréal, Quebec, Canada
| | - Eduardo L Franco
- Division of Cancer Epidemiology, McGill University, Montreal, Quebec, Canada
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Hatterschide J, Castagnino P, Kim HW, Sperry SM, Montone KT, Basu D, White EA. YAP1 activation by human papillomavirus E7 promotes basal cell identity in squamous epithelia. eLife 2022; 11:75466. [PMID: 35170430 PMCID: PMC8959598 DOI: 10.7554/elife.75466] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 02/15/2022] [Indexed: 11/27/2022] Open
Abstract
Persistent human papillomavirus (HPV) infection of stratified squamous epithelial cells causes nearly 5% of cancer cases worldwide. HPV-positive oropharyngeal cancers harbor few mutations in the Hippo signaling pathway compared to HPV-negative cancers at the same anatomical site, prompting the hypothesis that an HPV-encoded protein inactivates the Hippo pathway and activates the Hippo effector yes-associated protein (YAP1). The HPV E7 oncoprotein is required for HPV infection and for HPV-mediated oncogenic transformation. We investigated the effects of HPV oncoproteins on YAP1 and found that E7 activates YAP1, promoting YAP1 nuclear localization in basal epithelial cells. YAP1 activation by HPV E7 required that E7 binds and degrades the tumor suppressor protein tyrosine phosphatase non-receptor type 14 (PTPN14). E7 required YAP1 transcriptional activity to extend the lifespan of primary keratinocytes, indicating that YAP1 activation contributes to E7 carcinogenic activity. Maintaining infection in basal cells is critical for HPV persistence, and here we demonstrate that YAP1 activation causes HPV E7 expressing cells to be retained in the basal compartment of stratified epithelia. We propose that YAP1 activation resulting from PTPN14 inactivation is an essential, targetable activity of the HPV E7 oncoprotein relevant to HPV infection and carcinogenesis. The ‘epithelial’ cells that cover our bodies are in a constant state of turnover. Every few weeks, the outermost layers die and are replaced by new cells from the layers below. For scientists, this raises a difficult question. Cells infected by human papillomaviruses, often known as HPV, can become cancerous over years or even decades. How do infected cells survive while the healthy cells around them mature and get replaced? One clue could lie in PTPN14, a human protein which many papillomaviruses eliminate using their viral E7 protein; this mechanism could be essential for the virus to replicate and cause cancer. To find out the impact of losing PTPN14, Hatterschide et al. used human epithelial cells to make three-dimensional models of infected tissues. These experiments showed that, when papillomaviruses destroy PTPN14, a human protein called YAP1 turns on in the lowest, most long-lived layer of the tissue. Cells in which YAP1 is activated survive while those that carry the inactive version mature and die. This suggests that papillomaviruses turn on YAP1 to remain in tissues for long periods. Papillomaviruses cause about five percent of all human cancers. Finding ways to stop them from activating YAP1 has the potential to prevent disease. Overall, the research by Hatterschide et al. also sheds light on other epithelial cancers which are not caused by viruses.
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Affiliation(s)
- Joshua Hatterschide
- Department of Otorhinolaryngology, University of Pennsylvania, Philadelphia, United States
| | - Paola Castagnino
- Department of Otorhinolaryngology, University of Pennsylvania, Philadelphia, United States
| | - Hee Won Kim
- Department of Otorhinolaryngology, University of Pennsylvania, Philadelphia, United States
| | - Steven M Sperry
- Department of Otolaryngology-Head and Neck Surgery, Aurora St. Luke's Medical Center, Milwaukee, United States
| | - Kathleen T Montone
- Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, United States
| | - Devraj Basu
- Department of Otorhinolaryngology, University of Pennsylvania, Philadelphia, United States
| | - Elizabeth A White
- Department of Otorhinolaryngology, University of Pennsylvania, Philadelphia, United States
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Advances in HPV Screening Tests for Cervical Cancer-A Review. J Obstet Gynaecol India 2022; 72:13-18. [PMID: 35125734 PMCID: PMC8804131 DOI: 10.1007/s13224-021-01569-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 09/08/2021] [Indexed: 02/03/2023] Open
Abstract
HPV is responsible for almost all cases of cervical cancer which in turn is one of the common causes of death among female genital malignancies. Cervical cancer being a preventable disease, screening plays a vital role in its reduction. In this era of advanced health care system and technologies this cancer is still in the increasing trend, especially in the Low and Middle Income Countries, which reflects the poor coverage of women for screening. Advances in screening tests and techniques for better and larger coverage of women is the need of the hour globally. Clinicians also need to be aware of the various promising technologies available for screening of cervical cancer precursors, application of which in general practice can be of immense help in cervical cancer reduction.
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Prabhu VS, Roberts CS, Kothari S, Niccolai L. Median Age at HPV Infection Among Women in the United States: A Model-Based Analysis Informed by Real-world Data. Open Forum Infect Dis 2021; 8:ofab111. [PMID: 34888404 PMCID: PMC8653628 DOI: 10.1093/ofid/ofab111] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 03/11/2021] [Indexed: 11/25/2022] Open
Abstract
Background The US Advisory Committee for Immunization Practices (ACIP) recommended
shared clinical decision-making for human papillomavirus (HPV) vaccination
of individuals aged 27 to 45 years (mid-adults) in June 2019. Determining
the median age at causal HPV infection and CIN2+ diagnosis based on the
natural history of HPV disease can help elucidate the incidence of HPV
infections and the potential benefits of vaccination in mid-adults. Methods Real-world data on CIN2+ diagnosis from the prevaccine era were sourced
from a statewide surveillance registry in Connecticut. Age distribution of
CIN2+ diagnosis in 2008 and 2009 was estimated. A discrete event
simulation model was developed to predict the age distribution of causal HPV
infection. The optimal age distribution of causal HPV infection provided the
best goodness-of-fit statistic to compare the predicted vs real-world age
distribution of CIN2+ diagnosis. Results The median age at CIN2+ diagnosis from 2008 through 2009 in Connecticut
was 28 years. The predicted median age at causal HPV infection was estimated
to be 23.9 years. There was a difference of 5.2 years in the median age at
acquisition of causal HPV infection and the median age at CIN2+
diagnosis. Conclusions Real-world data on CIN2+ diagnosis and model-based analysis indicate a
substantial burden of infection and disease among women aged 27 years or
older, which supports the ACIP recommendation to vaccinate some mid-adults.
When natural history is known, this novel approach can also help determine
the timing of causal infections for other commonly asymptomatic infectious
diseases.
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Affiliation(s)
| | | | | | - Linda Niccolai
- Yale School of Public Health and Connecticut Emerging Infections Program, New Haven, Connecticut, USA
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Nahand JS, Khanaliha K, Mirzaei H, Moghoofei M, Baghi HB, Esghaei M, Khatami AR, Fatemipour M, Bokharaei-Salim F. Possible role of HPV/EBV coinfection in anoikis resistance and development in prostate cancer. BMC Cancer 2021; 21:926. [PMID: 34399719 PMCID: PMC8369687 DOI: 10.1186/s12885-021-08658-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 08/08/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND This study aimed to evaluate the possible role of human papillomavirus (HPV) and Epstein-Barr virus (EBV) coinfection as an etiological factor for prostate cancer (PCa) development. METHODS This case-control study was conducted on 67 patients with PCa and 40 control subjects. The expression levels of cellular and viral factors involved in inflammation, tumor progression, and metastasis were quantified, using the enzyme-linked immunosorbent assay (ELISA) and quantitative real-time polymerase chain reaction (qRT-PCR) assay. RESULTS The EBV/HPV coinfection was reported in 14.9% of patients in the case group and 7.5% of the control subjects. The high-risk types of HPV, that is, HPV 16 and HPV 18, were responsible for 50 and 30% of HPV/EBV-coinfected PCa cases (n = 10), respectively. No significant relationship was observed between PCa and HPV/EBV coinfection (OR = 2.9, 95% CI: 0.18-45.2, P = 0.31). However, the highest percentage of HPV genome integration was found in the HPV/EBV-coinfected PCa group (8/10; 80%). Also, the mean expression levels of inflammatory factors (IL-17, IL-6, TNF-α, NF-κB, VEGF, ROS, and RNS), anti-apoptotic mediators (Bcl-2 and survivin), and anti-anoikis factors (Twist and N-cadherin) were significantly higher in the HPV/EBV-coinfected PCa group, compared to the non-coinfected PCa cases. Nevertheless, the tumor-suppressor proteins (p53 and pRb) and E-cadherin (inhibitor of anoikis resistance) showed significant downregulations in the HPV/EBV-coinfected PCa group, compared to the non-coinfected PCa cases. CONCLUSION The HPV/EBV coinfection may be an etiological factor for PCa through modulation of cellular behaviors.
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Affiliation(s)
- Javid Sadri Nahand
- Department of Virology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Khadijeh Khanaliha
- Research Center of Pediatric Infectious Diseases, Institute of Immunology and Infectious Diseases, Iran University of Medical Sciences, Tehran, Iran
| | - Hamed Mirzaei
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran
- Student Research Committee, Kashan University of Medical Sciences, Kashan, Iran
| | - Mohsen Moghoofei
- Infectious Diseases Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Hossein Bannazadeh Baghi
- Infectious and Tropical Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Maryam Esghaei
- Department of Virology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Ali Reza Khatami
- Department of Virology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Maryam Fatemipour
- Department of Virology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Farah Bokharaei-Salim
- Department of Virology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
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Madhivanan P, Krupp K, Coudray M, Colbert B, Ruiz-Perez D, Cui H, Bokulich N, Narasimhan G, Mathee K, Cook RL, Schwebke J, Roe D. Longitudinal assessment of nonavalent vaccine HPV types in a sample of sexually active African American women from ten U.S. Cities. Vaccine 2021; 39:4810-4816. [PMID: 34294478 DOI: 10.1016/j.vaccine.2021.07.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Accepted: 07/11/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Chronic infection with high-risk human papillomavirus is a necessary cause for cervical carcinogenesis. This study examined prevalence of nonavalent vaccine preventable HPV types over four months among sexually active women in the United States. METHODS This sub-study obtained meta-data for 80 of the 1,365 women (18-25 years), enrolled in the BRAVO study, a randomized, open-label trial of home screening and treatment of asymptomatic bacterial vaginosis at high-risk for sexually transmitted infections conducted between 2008 and 2013. Participants were randomized to treatment or standard-of-care, and followed every 2-months for 12 months. Stored vaginal swabs from the first three visits were tested for the nine vaccine preventable HPV types using quantitative PCR. Prevalence and associated 95% confidence intervals for the HPV types were assessed using R (version 3.6.1). RESULTS The average age of the participants was 21.5 (SD ± 2.11) years, with 60% having ever been pregnant and all were African-American. Majority (71%) reported ≥ two sex partners in the prior year with 89% having unprotected vaginal sex and 45% having a new sex partner in the prior year. About 30% had ≥ one of the nine nonavalent vaccine HPV types at all three time points over a period of four months, 15% at two of any three visits, 19% at one of the three visits and 36% were negative for all nine vaccine HPV types at all time points. The most frequently detected HPV vaccine types were 52, 58, 16, and 18. The prevalence of any vaccine HPV types, and high-risk HPV types was 63.8% and 58.8%, respectively. CONCLUSIONS Our findings suggest that HPV vaccination which is currently recommended for all unvaccinated persons through age 26 years, is likely to be more beneficial than previously thought as nonavalent HPV vaccine was not available during the time these data were collected.
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Affiliation(s)
- P Madhivanan
- Mel & Enid Zuckerman College of Public Health, University of Arizona, Tucson, USA; College of Medicine, University of Arizona, Tucson, USA; University of Arizona Comprehensive Cancer Center, Tucson, USA.
| | - K Krupp
- Mel & Enid Zuckerman College of Public Health, University of Arizona, Tucson, USA; University of Arizona Comprehensive Cancer Center, Tucson, USA.
| | - M Coudray
- Robert Stempel College of Public Health and Social Work, Florida International University, Miami, USA; College of Medicine, University of Central Florida, Orlando, USA.
| | - B Colbert
- Herbert Wertheim College of Medicine, Florida International University, Miami, USA.
| | - D Ruiz-Perez
- Bioinformatic Research Group (BioRG), School of Computing and Information Sciences, Florida International University, Miami, USA.
| | - H Cui
- University of Arizona Comprehensive Cancer Center, Tucson, USA.
| | - N Bokulich
- Laboratory of Food Systems Biotechnology, Institute of Food, Nutrition and Health, ETH Zurich, Switzerland.
| | - G Narasimhan
- Herbert Wertheim College of Medicine, Florida International University, Miami, USA.
| | - K Mathee
- Herbert Wertheim College of Medicine, Florida International University, Miami, USA.
| | - R L Cook
- College of Public Health and Health Professions, University of Florida, Gainesville, USA.
| | - J Schwebke
- College of Medicine, University of Birmingham, Alabama, USA.
| | - D Roe
- Mel & Enid Zuckerman College of Public Health, University of Arizona, Tucson, USA; University of Arizona Comprehensive Cancer Center, Tucson, USA.
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Kovachev SM. A Review on Inosine Pranobex Immunotherapy for Cervical HPV-Positive Patients. Infect Drug Resist 2021; 14:2039-2049. [PMID: 34103950 PMCID: PMC8180272 DOI: 10.2147/idr.s296709] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 05/28/2021] [Indexed: 11/23/2022] Open
Abstract
The purpose of this review was to examine and summarize data for inosine pranobex (IP) immunotherapy in cervical HPV-positive patients. Persistent or recurring cervical human papillomavirus (HPV) infection is a major cause of cervical cancer. Self-clearance and blocking of cervical HPV infection depend on the status of the host immune system. Immunotherapy helps accelerate elimination of the infection. Host immunity is involved in the development of HPV infection. Several mechanisms of interaction between the virus and the immune system have been revealed; however, the mechanisms have not been completely elucidated. A properly functioning immune system impedes HPV progress and helps clear the pathogen from the body. IP has antiviral efficacy because it modulates both cellular and humoral immunities. IP has been on the market since 1971. Nevertheless, it has seldom been administered to treat cervical HPV infections. In this review, Google Scholar, PubMed/MEDLINE, Scopus, Cochrane Library, and Research Gate were searched for the period 1971–2021. Prospective controlled trials, observational and retrospective studies, and meta-analysis and reviews on immunotherapy against HPV cervical infection were explored. Prior studies showed strong clinical efficacy of combined and standalone IP therapy in reversing HPV-induced changes in the cervix, preventing disease progression, and clearing the pathogen. IP treatment enhanced host antiviral activity against HPV, delayed or stopped cervical oncogenesis, and rapidly removed HPV from the body.
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Værnesbranden MR, Wiik J, Sjøborg K, Staff AC, Carlsen KCL, Haugen G, Hedlin G, Hilde K, Nordlund B, Nystrand CF, Rangberg A, Rehbinder EM, Rudi K, Rueegg CS, Sandberg Y, Sjelmo S, Skjerven HO, Söderhäll C, Vettukattil R, Jonassen CM. Maternal human papillomavirus infections at mid-pregnancy and delivery in a Scandinavian mother-child cohort study. Int J Infect Dis 2021; 108:574-581. [PMID: 34077798 DOI: 10.1016/j.ijid.2021.05.064] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 05/21/2021] [Accepted: 05/26/2021] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES Human papillomavirus (HPV) infections are common, especially during women's reproductive years, with unclear obstetrical impact. This study aimed to identify HPV prevalence at mid-gestation and delivery, type-specific persistence from mid-gestation to delivery, and risk factors for HPV infection and persistence. METHODS In 757 women from a Scandinavian prospective mother-child cohort, HPV was analyzed in first-void urine samples at mid-gestation and delivery. We used Seegene Anyplex II HPV28 PCR assay for genotyping and semi-quantifying 28 genital HPV genotypes, including 12 high-risk HPVs (HR-HPV). Socio-demographic and health data were collected through e-questionnaires. RESULTS Any-HPV genotype (any of 28 assessed) was detected in 38% of the study cohort at mid-gestation and 28% at delivery, and HR-HPVs in 24% and 16%, respectively. The most prevalent genotype was HPV16: 6% at mid-gestation and 4% at delivery. Persistence of Any-HPV genotype was 52%, as was HR-HPV genotype-specific persistence. A short pre-conception relationship with the child's father and alcohol intake during pregnancy increased HPV infection risk at both time points. Low viral load at mid-gestation was associated with clearance of HPV infections at delivery. CONCLUSION HPV prevalence was higher at mid-gestation compared with delivery, and low viral load was associated with clearance of HPV at delivery.
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Affiliation(s)
- Magdalena R Værnesbranden
- Department of Obstetrics and Gynecology, Østfold Hospital Trust, Kalnes, Norway; University of Oslo, Faculty of Medicine, Institute of Clinical Medicine, Oslo, Norway.
| | - Johanna Wiik
- Department of Obstetrics and Gynecology, Østfold Hospital Trust, Kalnes, Norway; Department of Obstetrics and Gynecology, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
| | - Katrine Sjøborg
- Department of Obstetrics and Gynecology, Østfold Hospital Trust, Kalnes, Norway
| | - Anne Cathrine Staff
- University of Oslo, Faculty of Medicine, Institute of Clinical Medicine, Oslo, Norway; Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
| | - Karin C Lødrup Carlsen
- University of Oslo, Faculty of Medicine, Institute of Clinical Medicine, Oslo, Norway; Division of Pediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Guttorm Haugen
- University of Oslo, Faculty of Medicine, Institute of Clinical Medicine, Oslo, Norway; Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
| | - Gunilla Hedlin
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden; Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Katarina Hilde
- University of Oslo, Faculty of Medicine, Institute of Clinical Medicine, Oslo, Norway; Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
| | - Björn Nordlund
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden; Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Camilla F Nystrand
- Genetic Unit, Centre for Laboratory Medicine, Østfold Hospital Trust, Kalnes, Norway
| | - Anbjørg Rangberg
- Genetic Unit, Centre for Laboratory Medicine, Østfold Hospital Trust, Kalnes, Norway
| | - Eva Maria Rehbinder
- University of Oslo, Faculty of Medicine, Institute of Clinical Medicine, Oslo, Norway; Department of Dermatology and Venereology, Oslo University Hospital, Oslo, Norway
| | - Knut Rudi
- Faculty of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences, Ås, Norway
| | - Corina Silvia Rueegg
- Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway
| | - Yvonne Sandberg
- Genetic Unit, Centre for Laboratory Medicine, Østfold Hospital Trust, Kalnes, Norway
| | - Sigrid Sjelmo
- Department of Obstetrics and Gynecology, Østfold Hospital Trust, Kalnes, Norway
| | - Håvard O Skjerven
- University of Oslo, Faculty of Medicine, Institute of Clinical Medicine, Oslo, Norway; Division of Pediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Cilla Söderhäll
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden; Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Riyas Vettukattil
- University of Oslo, Faculty of Medicine, Institute of Clinical Medicine, Oslo, Norway; Division of Pediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Christine M Jonassen
- Faculty of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences, Ås, Norway; Genetic Unit, Centre for Laboratory Medicine, Østfold Hospital Trust, Kalnes, Norway
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Jia H, Ding L, Han Y, Lyu Y, Hao M, Tian Z, Wang J. Genotype-specific Distribution and Change of High-risk Human Papillomavirus Infection and the Association with Cervical Progression Risk in Women with Normal Pathology and Abnormal Cytology in a Population-based Cohort Study in China. J Cancer 2021; 12:4379-4388. [PMID: 34093838 PMCID: PMC8176416 DOI: 10.7150/jca.57993] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Accepted: 04/27/2021] [Indexed: 12/29/2022] Open
Abstract
Objectives: Women with normal pathology screened from abnormal cervical cytology are a special population with higher progression risk than women with normal cytology. However, the associations between genotype distribution and changes of high-risk human papillomavirus (HR-HPV) infection and cervical progression risk in this special population remain unclear. Methods: A total of 1232 women with normal pathology screened from abnormal cervical cytology were enrolled into this cohort with 2-year follow-up. HPV genotyping detection was performed through flow-through hybridization. Hazard ratios (HRs) and Odds ratios (ORs) were calculated using Cox proportional hazard regression and logistic regression models, respectively. Results: Overall HR-HPV prevalence at baseline was 29.0%, with HPV16, 52, 58, 53 and 51 the top five genotypes. The 2-year persistence rate of HR-HPV infection was 31.9%. Compared with HR-HPV negative, the adjusted HRs of overall HR-HPV, HPV16, 31/33, 58, 51, and 53 infections for the progression risk of normal cervix were 5.31, 7.10, 6.95, 5.74, 5.04, and 4.88, respectively. Multiple HR-HPV infection cannot lead to an additional risk of progression relative to single HR-HPV infection. In comparison with HR-HPV persistently negative, same-type HR-HPV persistence was positively associated with progression risk of normal cervix (adjusted OR: 22.26), but different-type HR-HPV persistence was not linked to cervical progression. Conclusion: Genotypes and persistence of HR-HPV infection could stratify the cervical progression risk in women with normal cervical pathology and abnormal cytology and provide evidence for development of next generation of vaccines. HPV51 and 53 deserved attention apart from HPV16, 31, 33, and 58.
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Affiliation(s)
- Haixia Jia
- Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Ling Ding
- Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Yang Han
- Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Yuanjing Lyu
- Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Min Hao
- Department of Obstetrics and Gynecology, The Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Zhiqiang Tian
- Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Jintao Wang
- Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan, China
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Parra SG, López-Orellana LM, Molina Duque AR, Carns JL, Schwarz RA, Smith CA, Ortiz Silvestre M, Diaz Bazan S, Escobar PA, Felix JC, Ramalingam P, Castle PE, Cremer ML, Maza M, Schmeler KM, Richards-Kortum RR. Cervical cancer prevention in El Salvador: A prospective evaluation of screening and triage strategies incorporating high-resolution microendoscopy to detect cervical precancer. Int J Cancer 2021; 148:2571-2578. [PMID: 33368249 PMCID: PMC10568648 DOI: 10.1002/ijc.33454] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 11/16/2020] [Accepted: 11/27/2020] [Indexed: 01/28/2023]
Abstract
Cervical cancer remains a leading cause of cancer death for women in low- and middle-income countries. The goal of our study was to evaluate screening and triage strategies, including high-resolution microendoscopy (HRME), to detect cervical abnormalities concerning for precancer at the point of care. Women (n = 1824) were enrolled at the Instituto de Cáncer de El Salvador. All underwent screening by both human papillomavirus (HPV) testing using careHPV and visual inspection with acetic acid (VIA). Screen-positives, along with 10% of screen-negatives, were invited to return for a follow-up examination that included triage with VIA, colposcopy and HRME imaging. Biopsies were taken of any abnormalities identified. If no abnormalities were identified, then the worst scoring site by HRME was biopsied. The sensitivities of HPV testing and VIA to screen for cervical intraepithelial neoplasia Grade 2 or more severe diagnoses (CIN2+) were 82.1% and 75% (P = .77), while the specificities were 90.4% and 80.9% (P < .001), respectively. The sensitivities of VIA, colposcopy and HRME as triage tests for CIN2+ were 82.1%, 82.1% and 71.4%, respectively (P ≥ .38). HRME had a significantly higher specificity (66.7%) than VIA (51.9%) (P < .001) and colposcopy (53.3%) (P < .001). When evaluating different theoretical screening and triage strategies, screening with HPV testing followed by triage with HRME would result in more women receiving appropriate care (97%) compared to screening with VIA (75%) or HPV alone (90%). Our findings demonstrate that screening with HPV is superior to VIA, and that triage with HRME imaging increases the specificity of detecting CIN2+ at the point of care in a low-resource setting.
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Affiliation(s)
- Sonia G Parra
- Department of Bioengineering, Rice University, Houston, Texas, USA
| | | | | | - Jennifer L Carns
- Department of Bioengineering, Rice University, Houston, Texas, USA
| | | | - Chelsey A Smith
- Department of Bioengineering, Rice University, Houston, Texas, USA
| | | | | | - Pablo A Escobar
- Liga Contra el Cáncer de El Salvador, San Salvador, El Salvador
| | - Juan C Felix
- Department of Pathology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Preetha Ramalingam
- Division of Pathology and Laboratory Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Philip E Castle
- Divisions of Cancer Prevention and Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland, USA
| | - Miriam L Cremer
- Basic Health International, San Salvador, El Salvador
- Women's Health Institute, Department of Obstetrics and Gynecology, Cleveland Clinic, Cleveland, Ohio, USA
| | - Mauricio Maza
- Basic Health International, San Salvador, El Salvador
| | - Kathleen M Schmeler
- Department of Gynecological Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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Osmani V, Klug SJ. [HPV vaccination and the prevention of genital warts and precancerous lesions-current evidence and evaluation]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2021; 64:590-599. [PMID: 33851224 PMCID: PMC8087596 DOI: 10.1007/s00103-021-03316-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 03/16/2021] [Indexed: 01/22/2023]
Abstract
Human papillomaviruses (HPVs) can cause both benign and malignant tumors. To date, more than 200 HPV types have been discovered, of which 12 are currently classified as high risk for cervical cancer. HPV types that affect the anogenital tract are sexually transmitted. Since 2006, prophylactic HPV vaccines have been available and should be administered before first sexual contact.HPVs infect epithelial cells and are worldwide the most common sexually transmitted viruses. Apart from cervical cancer, HPVs cause other anogenital cancers such as vulvar, vaginal, and anal cancer but also oropharyngeal cancer (or head and neck cancers). HPV types 16 and 18 are also found at these sites. HPV types 6 and 11 are associated with genital warts; other HPV types can cause harmless skin warts.HPV vaccines are safe and highly effective, if they are administered before exposure to HPV. Systematic reviews and meta-analyses have shown that HPV vaccination effectively prevents HPV infection, but also precancerous lesions of the anogenital tract and genital warts. Recent vaccination data also demonstrate reductions in cervical cancer incidence.The uptake rates of HPV vaccination vary worldwide by program and acceptance. In comparison to other European countries, Germany has a low uptake rate. The Standing Committee on Vaccination (STIKO) recommends HPV vaccinations for all girls and boys ages 9 to 14 years in Germany. In 2018, only half of all 18-year-old girls in Germany were completely immunized against HPV.Organized vaccination programs, whether population-based or school-based, are necessary in order to increase vaccination uptake rates.
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Affiliation(s)
- Vanesa Osmani
- Lehrstuhl für Epidemiologie, Fakultät für Sport- und Gesundheitswissenschaften, Technische Universität München, Georg-Brauchle-Ring 56, 80992, München, Deutschland
| | - Stefanie J Klug
- Lehrstuhl für Epidemiologie, Fakultät für Sport- und Gesundheitswissenschaften, Technische Universität München, Georg-Brauchle-Ring 56, 80992, München, Deutschland.
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Cao CH, Liu R, Lin XR, Luo JQ, Cao LJ, Zhang QJ, Lin SR, Geng L, Sun ZY, Ye SK, Yu ZY, Shi Y, Xia X. LRP1B mutation is associated with tumor HPV status and promotes poor disease outcomes with a higher mutation count in HPV-related cervical carcinoma and head & neck squamous cell carcinoma. Int J Biol Sci 2021; 17:1744-1756. [PMID: 33994859 PMCID: PMC8120457 DOI: 10.7150/ijbs.56970] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 04/05/2021] [Indexed: 12/11/2022] Open
Abstract
Human papillomavirus (HPV) infection and gene mutations were reputed as key factors in cervical carcinoma (CC) and head and neck squamous cell carcinoma (HNSCC). However, the associations of HPV status and gene mutations remain to be determined. This study aims to identify molecular patterns of LRP1B mutation and HPV status via rewiring tumor samples of HNSCC (n=1478) and CC (n=178) from the TCGA dataset. Here, we found that LRP1B mutation was associated with HPV status in CC (P=0.040) and HNSCC (P=0.044), especially in HPV 16 integrated CC (P=0.036). Cancer survival analysis demonstrated that samples with LRP1B mutation showed poor disease outcomes in CC (P=0.013) and HNSCC (P=0.0124). In addition, the expression status of LPR1B was more favorable for prediction than TP53 or RB1 in CC and HNSCC. Mutation clustering analysis showed that samples with LRP1B mutation showed higher mutation count in CC (P=1.76e-67) and HNSCC (P<10e-10). Further analysis identified 289 co-occurrence genes in these two cancer types, which were enriched in PI3K signaling, cell division process, and chromosome segregation process, et al. The 289-co-occurrence gene signature identified a cluster of patients with a higher portion of copy number variation (CNV) lost in the genome, different tumor HPV status (P<10e-10), higher mutation count (P<10e-10), higher fraction genome altered value (P=2.078e-4), higher aneuploidy score (P=3.362e-4), and earlier started the smoking year (P=2.572e-4), which were associated with shorter overall survival (P=0.0103) in CC and HNSCC samples. Overall, LRP1B mutation was associated with tumor HPV status and was an unfavorable prognostic biomarker for CC and HNSCC.
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Affiliation(s)
- Can-Hui Cao
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Shenzhen Peking University-The Hong Kong University of Science and Technology Medical Center, Guangdong, 518036, China
| | - Rang Liu
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Shenzhen Peking University-The Hong Kong University of Science and Technology Medical Center, Guangdong, 518036, China
| | - Xin-Ran Lin
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Shenzhen Peking University-The Hong Kong University of Science and Technology Medical Center, Guangdong, 518036, China
| | - Jia-Qi Luo
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Shenzhen Peking University-The Hong Kong University of Science and Technology Medical Center, Guangdong, 518036, China
| | - Li-Juan Cao
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Shenzhen Peking University-The Hong Kong University of Science and Technology Medical Center, Guangdong, 518036, China
| | - Qiu-Ju Zhang
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Shenzhen Peking University-The Hong Kong University of Science and Technology Medical Center, Guangdong, 518036, China
| | - Shou-Ren Lin
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Shenzhen Peking University-The Hong Kong University of Science and Technology Medical Center, Guangdong, 518036, China
| | - Lan Geng
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Shenzhen Peking University-The Hong Kong University of Science and Technology Medical Center, Guangdong, 518036, China
| | - Zhong-Yi Sun
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Shenzhen Peking University-The Hong Kong University of Science and Technology Medical Center, Guangdong, 518036, China
| | - Si-Kang Ye
- Department of Critical Care Medicine, The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Zhi-Ying Yu
- Department of Gynecology, The First Affiliated Hospital of Shenzhen University, Health Science Center, Shenzhen Second People's Hospital, Shenzhen, Guangdong, China
| | - Yu Shi
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Shenzhen Peking University-The Hong Kong University of Science and Technology Medical Center, Guangdong, 518036, China
| | - Xi Xia
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Shenzhen Hospital, Shenzhen Peking University-The Hong Kong University of Science and Technology Medical Center, Guangdong, 518036, China
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Tounkara FK, Téguété I, Guédou FA, Talbot D, Traoré CB, Béhanzin L, Traoré S, Goma-Matsétsé E, Aza-Gnandji M, Keita B, Guenoun J, Coutlée F, Alary M. Type-specific incidence, persistence and factors associated with human papillomavirus infection among female sex workers in Benin and Mali, West Africa. Int J Infect Dis 2021; 106:348-357. [PMID: 33848674 DOI: 10.1016/j.ijid.2021.04.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 03/31/2021] [Accepted: 04/04/2021] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVES This study in female sex workers (FSWs) aimed to: (1) estimate type-specific incidence and persistence of human papillomavirus (HPV) infection in Cotonou (Benin) and Bamako (Mali); and (2) identify the factors associated with type-specific incidence and persistence of high-risk HPV (HR-HPV) infection. METHODS A 1-year prospective cohort study on cervical cancer screening, and HPV and human immunodeficiency virus (HIV) infections was conducted among FSWs in Cotonou and Bamako from 2017 to 2019. Poisson regression models assessed factors associated with the incidence of HR-HPV infection, while log-binomial regression was performed to identify factors associated with the persistence of HR-HPV infection. Adjusted relative risks (ARR) and 95% confidence intervals (95% CI) were estimated. RESULTS The incidence of HR-HPV infection was 46.98 per 1000 women-months (predominant types HPV16, HPV35 and HPV59). Factors associated with the incidence of HR-HPV infection were age <20 years (ARR 15.10; 95% CI 3.29-69.19), age at sexual debut <18 years (ARR 6.92; 95% CI 1.97-24.27) and sex work duration ≤1 year (ARR 7.40; 95% CI 1.84-29.69). The persistence of HR-HPV infection at 12 months was 38.7% (most persistent types HPV59, HPV52 and HPV51). Persistence of HR-HPV infection was higher in women with chlamydia (P = 0.031), HIV infection (P < 0.001) and multiple-type HPV infections (P < 0.001). CONCLUSION FSWs in West Africa are at high risk of incident and persistent HR-HPV infection, suggesting an urgent need for cervical cancer screening in this population.
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Affiliation(s)
- Fatoumata Korika Tounkara
- Département de Médecine Sociale et Préventive, Université Laval, Québec, Canada; Axe Santé des Populations et Pratiques Optimales en Santé, Centre de recherche du CHU de Québec-Université Laval, Québec, Canada
| | - Ibrahima Téguété
- Département de Gynécologie-Obstétrique, CHU Gabriel Toure, BP 267, Bamako, Mali
| | - Fernand A Guédou
- Axe Santé des Populations et Pratiques Optimales en Santé, Centre de recherche du CHU de Québec-Université Laval, Québec, Canada; Dispensaire des Infections Sexuellement Transmissibles (DIST), Centre de santé de Cotonou-1, Cotonou, Benin
| | - Denis Talbot
- Département de Médecine Sociale et Préventive, Université Laval, Québec, Canada; Axe Santé des Populations et Pratiques Optimales en Santé, Centre de recherche du CHU de Québec-Université Laval, Québec, Canada
| | - Cheick B Traoré
- Département d'Anatomie-Pathologie, CHU Point G, Bamako, Mali
| | - Luc Béhanzin
- École Nationale de Formation des Techniciens Supérieurs en Santé Publique et en Surveillance Épidémiologique, Université de Parakou, Benin
| | - Sidy Traoré
- Département de Gynécologie-Obstétrique, CHU Gabriel Toure, BP 267, Bamako, Mali
| | - Ella Goma-Matsétsé
- Dispensaire des Infections Sexuellement Transmissibles (DIST), Centre de santé de Cotonou-1, Cotonou, Benin
| | - Marlène Aza-Gnandji
- Dispensaire des Infections Sexuellement Transmissibles (DIST), Centre de santé de Cotonou-1, Cotonou, Benin
| | - Bintou Keita
- Association de Recherche de Communication et d'Accompagnement à Domicile de personnes Vivant avec le VIH (ARCAD-SIDA), Bamako, Mali
| | - Julie Guenoun
- Département de Microbiologie et Infectiologie, Centre de recherche du CHU de Montréal, Montréal, Canada
| | - François Coutlée
- Département de Microbiologie et Infectiologie, Centre de recherche du CHU de Montréal, Montréal, Canada
| | - Michel Alary
- Département de Médecine Sociale et Préventive, Université Laval, Québec, Canada; Axe Santé des Populations et Pratiques Optimales en Santé, Centre de recherche du CHU de Québec-Université Laval, Québec, Canada; Institut national de santé publique du Québec, Québec, Canada.
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45
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Rezende MT, Bianchi AGC, Carneiro CM. Cervical cancer: Automation of Pap test screening. Diagn Cytopathol 2021; 49:559-574. [PMID: 33548162 DOI: 10.1002/dc.24708] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 01/20/2021] [Accepted: 01/24/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND Cervical cancer progresses slowly, increasing the chance of early detection of pre-neoplastic lesions via Pap exam test and subsequently preventing deaths. However, the exam presents both false-negatives and false-positives results. Therefore, automatic methods (AMs) of reading the Pap test have been used to improve the quality control of the exam. We performed a literature review to evaluate the feasibility of implementing AMs in laboratories. METHODS This work reviewed scientific publications regarding automated cytology from the last 15 years. The terms used were "Papanicolaou test" and "Automated cytology screening" in Portuguese, English, and Spanish, in the three scientific databases (SCIELO, PUBMED, MEDLINE). RESULTS Of the resulting 787 articles, 34 were selected for a complete review, including three AMs: ThinPrep Imaging System, FocalPoint GS Imaging System and CytoProcessor. In total, 1 317 148 cytopathological slides were evaluated automatically, with 1 308 028 (99.3%) liquid-based cytology slides and 9120 (0.7%) conventional cytology smears. The AM diagnostic performances were statistically equal to or better than those of the manual method. AM use increased the detection of cellular abnormalities and reduced false-negatives. The average sample rejection rate was ≤3.5%. CONCLUSION AMs are relevant in quality control during the analytical phase of cervical cancer screening. This technology eliminates slide-handling steps and reduces the sample space, allowing professionals to focus on diagnostic interpretation while maintaining high-level care, which can reduce false-negatives. Further studies with conventional cytology are needed. The use of AM is still not so widespread in cytopathology laboratories.
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Affiliation(s)
- Mariana T Rezende
- Postgraduate Program in Biotechnology, Biological Sciences Research Center (NUPEB), Federal University of Ouro Preto, Ouro Preto, MG, Brazil.,Cytology Laboratory, Clinical Analysis Department, Federal University of Ouro Preto, Ouro Preto, MG, Brazil
| | - Andrea G C Bianchi
- Computing Department, Federal University of Ouro Preto, Ouro Preto, MG, Brazil
| | - Cláudia M Carneiro
- Postgraduate Program in Biotechnology, Biological Sciences Research Center (NUPEB), Federal University of Ouro Preto, Ouro Preto, MG, Brazil.,Cytology Laboratory, Clinical Analysis Department, Federal University of Ouro Preto, Ouro Preto, MG, Brazil
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46
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Litwin TR, Irvin SR, Chornock RL, Sahasrabuddhe VV, Stanley M, Wentzensen N. Infiltrating T-cell markers in cervical carcinogenesis: a systematic review and meta-analysis. Br J Cancer 2021; 124:831-841. [PMID: 33257839 PMCID: PMC7884592 DOI: 10.1038/s41416-020-01184-x] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 10/22/2020] [Accepted: 11/05/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The host adaptive immune response helps determine which cervical HPV infections persist and progress to precancer and cancer, and systematic characterisation of T-cell infiltration would help inform key steps in cervical carcinogenesis. METHODS A systematic review and meta-analysis were conducted of infiltrating T-cells in normal cervix, low-grade lesions, high-grade lesions, and invasive cancers including epithelial, stromal, and total tissue and the following markers: CD3, CD4, CD8, FoxP3, CD25, and the CD4:CD8 ratio. An additional qualitative review summarised longitudinal data on associations between infiltrating T-cells and cervical disease persistence, regression, progression, or prognosis. RESULTS There were fewer CD3+, CD4+, and CD8+ cells in cervical lesions and more cells in cancers compared to normal epithelium. FoxP3 and CD25+ regulatory T-cell infiltration is high in persistent and precancerous lesions, and longitudinal data show improved outcomes with lower regulatory T-cell levels. CONCLUSIONS Successful immune evasion may reduce T-cell infiltration in HPV infected and precancerous epithelium, while invasive cancers are highly immunogenic, and regulatory T-cell infiltration increases with cervical disease progression. Understanding these factors may have prognostic value and could aid in novel treatment development and clinical guidelines, but published data are highly heterogeneous and leave important gaps to be filled by future studies.
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Affiliation(s)
- Tamara R Litwin
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA.
| | - Sarah R Irvin
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Rebecca L Chornock
- Department of Obstetrics and Gynecology, MedStar Washington Hospital Center, Washington, DC, USA
| | - Vikrant V Sahasrabuddhe
- Breast and Gynecologic Cancer Research Group, Division of Cancer Prevention, National Cancer Institute, Rockville, MD, USA
| | | | - Nicolas Wentzensen
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
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47
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Bonde J, Bottari F, Iacobone AD, Cocuzza CE, Sandri MT, Bogliatto F, Khan KS, Ejegod DM, Gary DS, Andrews JC. Human Papillomavirus Same Genotype Persistence and Risk: A Systematic Review. J Low Genit Tract Dis 2021; 25:27-37. [PMID: 33105450 PMCID: PMC7748037 DOI: 10.1097/lgt.0000000000000573] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The aim of the study was to examine whether high-grade cervical intraepithelial neoplasia (CIN) was more closely associated with human papillomavirus (HPV) same-genotype persistence (SGTP) versus clearance of prior infection with a subsequent infection by a new genotype (genotype switch [GS]), clearance of HPV infection, or acquisition of a new HPV infection after a negative infection status, during a follow-up testing subsequent to abnormal screening results. MATERIALS AND METHODS MEDLINE, Cochrane Library, Health Technology Assessment, and clinicaltrials.gov were searched from January 2000 to July 2019 for prospective controlled trials and observational studies of women and retrospective studies using HPV assays with extended- or full-genotype reporting. The primary outcome was high-grade CIN after at least 2 rounds of testing. Overall quality of evidence for the risk estimate outcomes was assessed. Of the 830 identified abstracts, 66 full-text articles were reviewed, and 7 studies were included in the synthesis. The study protocol was registered with the PROSPERO International Prospective Register of Systematic Reviews (CRD42018091093). RESULTS Continued HPV-positive women falls in 2 equally large groups: SGTP and GS. Sensitivity, positive predictive value, and positive likelihood ratio of SGTP were significantly higher than for GS. Human papillomavirus genotypes may be ranked into 3 tiers (immediate colposcopy, follow-up testing, return to routine screening), according to associated risk of persistence for high-grade CIN and to prevailing clinical action thresholds. CONCLUSIONS There is moderately high-quality evidence to support the clinical utility of SGTP to improve risk discrimination for high-grade CIN compared with qualitative HPV testing without genotype-specific information.
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Affiliation(s)
- Jesper Bonde
- Molecular Pathology Laboratory, Department of Pathology, Copenhagen University Hospital, Hvidovre, Denmark
| | - Fabio Bottari
- Division of Laboratory Medicine, European Institute of Oncology IRCCS, Milan, Italy
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Anna D. Iacobone
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
- Preventive Gynecology Unit, European Institute of Oncology IRCCS, Milan, Italy
| | | | - Maria-Teresa Sandri
- Division of Laboratory Medicine, Humanitas Clinical and Research Center IRCCS, Milan, Italy
| | | | - Khalid S. Khan
- Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain
| | - Ditte M. Ejegod
- Molecular Pathology Laboratory, Department of Pathology, Copenhagen University Hospital, Hvidovre, Denmark
| | - Devin S. Gary
- Becton, Dickinson and Company, BD Life Sciences – Diagnostic Systems, Sparks, MD
| | - Jeffrey C. Andrews
- Becton, Dickinson and Company, BD Life Sciences – Diagnostic Systems, Sparks, MD
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48
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Laake I, Feiring B, Jonassen CM, Pettersson JHO, Frengen TG, Kirkeleite IØ, Trogstad L. Concurrent infection with multiple human papillomavirus types among unvaccinated and vaccinated 17-year-old Norwegian girls. J Infect Dis 2020; 226:625-633. [PMID: 33205203 PMCID: PMC9441200 DOI: 10.1093/infdis/jiaa709] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 11/11/2020] [Indexed: 12/20/2022] Open
Abstract
Background Whether type-specific human papillomavirus (HPV) infection influences the risk of acquiring infections with other HPV types is unclear. We studied concurrent HPV infections in 17-year-old girls from 2 birth cohorts; the first vaccine-eligible cohort in Norway and a prevaccination cohort. Methods Urine samples were collected and tested for 37 HPV genotypes. This study was restricted to unvaccinated girls from the prevaccination cohort (n = 5245) and vaccinated girls from the vaccine-eligible cohort (n = 4904). Risk of HPV infection was modelled using mixed-effect logistic regression. Expected frequencies of concurrent infection with each pairwise combination of the vaccine types and high-risk types (6/11/16/18/31/33/35/39/45/51/52/56/58/59) were compared to observed frequencies. Results Infection with multiple HPV types was more common among unvaccinated girls than vaccinated girls (9.2% vs 3.7%). HPV33 and HPV51 was the only HPV pair that was detected together more often than expected among both unvaccinated (P = .002) and vaccinated girls (P < .001). No HPV pairs were observed significantly less often than expected. Conclusions HPV33 and HPV51 tended to be involved in coinfection among both unvaccinated and vaccinated girls. The introduction of HPV vaccination does not seem to have had an effect on the tendency of specific HPV types to cluster together.
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Affiliation(s)
- Ida Laake
- Division of Infection Control and Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Berit Feiring
- Division of Infection Control and Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Christine Monceyron Jonassen
- Division of Infection Control and Environmental Health, Norwegian Institute of Public Health, Oslo, Norway.,Center for Laboratory Medicine, Østfold Hospital Trust, Grålum, Norway
| | - John H-O Pettersson
- Zoonosis Science Center, Department of Medical Biochemistry and Microbiology, Uppsala University, Sweden.,Marie Bashir Institute for Infectious Diseases and Biosecurity, School of Life and Environmental Sciences and School of Medical Sciences, University of Sydney, Sydney, Australia
| | - Torstein Gjølgali Frengen
- Division of Infection Control and Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
| | | | - Lill Trogstad
- Division of Infection Control and Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
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49
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Asciutto KC, Borgfeldt C, Forslund O. 14-type HPV mRNA test in triage of HPV DNA-positive postmenopausal women with normal cytology. BMC Cancer 2020; 20:1025. [PMID: 33097006 PMCID: PMC7583187 DOI: 10.1186/s12885-020-07498-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 10/06/2020] [Indexed: 12/22/2022] Open
Abstract
Background During 2013 and 2016 the region of Skåne, Sweden started to analyse human papillomavirus (HPV) and cytology in postmenopausal women 60–65 years of age. Our aim was to evaluate high-risk (HR) HPV mRNA testing for the triage of HPV DNA-positive postmenopausal women with normal cytology. Methods A total of 271 women, 60–65 years of age, underwent liquid-based cytology (LBC) and HPV testing by using the HR-HPV DNA MGP-PCR-Luminex assay. HR-HPV DNA-positive women with normal cytology underwent complimentary HPV mRNA testing (Aptima, Hologic Inc.). Over a period of 49 months (SD 11.0) the women received regular follow-ups at intervals of 12–18 months. Women with abnormal cytology and/or a positive HR-HPV DNA and/or mRNA result at two subsequent visits were scheduled for colposcopy and clinical examination. Results Over the surveillance period, 3.6% (10/271) of the HR-HPV DNA-positive women developed histologically confirmed high-grade squamous intraepithelial lesions (HSILs) or worse. The cumulative incidence rates (CIR) were 29.7% (CI 24.8–30.1) for HSIL or worse among HPV mRNA-positive women at enrolment (39.5% 107/271) and 0% among HPV mRNA-negative women (60.5%, 164/271), (p = 0.002). Conclusions Postmenopausal women with normal cytology testing positive for HR-HPV mRNA are at increased risk for the development of high-grade cervical intraepithelial neoplasia (CIN), in contrast to women with a negative HR-HPV mRNA outcome. The HR-HPV mRNA APTIMA assay detecting 14 HR-HPV types may be a useful triage method among HPV DNA-positive postmenopausal women with normal cytology.
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Affiliation(s)
- Katrin Christine Asciutto
- Department of Obstetrics and Gynecology, Skåne University Hospital, Lund University, SE-22185, Lund, Sweden.
| | - Christer Borgfeldt
- Department of Obstetrics and Gynecology, Skåne University Hospital, Lund University, SE-22185, Lund, Sweden
| | - Ola Forslund
- Department of Laboratory Medicine Region Skåne, Lund University, Lund, Sweden
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50
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Qiu Y, Maione F, Capano S, Meda C, Picconi O, Brundu S, Pisacane A, Sapino A, Palladino C, Barillari G, Monini P, Bussolino F, Ensoli B, Sgadari C, Giraudo E. HIV Protease Inhibitors Block HPV16-Induced Murine Cervical Carcinoma and Promote Vessel Normalization in Association with MMP-9 Inhibition and TIMP-3 Induction. Mol Cancer Ther 2020; 19:2476-2489. [PMID: 33082275 DOI: 10.1158/1535-7163.mct-20-0055] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 07/09/2020] [Accepted: 10/01/2020] [Indexed: 11/16/2022]
Abstract
Antiretrovirals belonging to the human immunodeficiency virus (HIV) protease inhibitor (HIV-PI) class exert inhibitory effects across several cancer types by targeting tumor cells and its microenvironment. Cervical carcinoma represents a leading cause of morbidity and mortality, particularly in women doubly infected with high-risk human papillomaviruses (HR-HPV) and HIV; of note, combined antiretroviral therapy has reduced cervical carcinoma onset and progression in HIV-infected women. We evaluated the effectiveness and mechanism(s) of action of HIV-PI against cervical carcinoma using a transgenic model of HR-HPV-induced estrogen-promoted cervical carcinoma (HPV16/E2) and found that treatment of mice with ritonavir-boosted HIV-PI, including indinavir, saquinavir, and lopinavir, blocked the growth and promoted the regression of murine cervical carcinoma. This was associated with inhibition of tumor angiogenesis, coupled to downregulation of matrix metalloproteinase (MMP)-9, reduction of VEGF/VEGFR2 complex, and concomitant upregulation of tissue inhibitor of metalloproteinase-3 (TIMP-3). HIV-PI also promoted deposition of collagen IV at the epithelial and vascular basement membrane and normalization of both vessel architecture and functionality. In agreement with this, HIV-PI reduced tumor hypoxia and enhanced the delivery and antitumor activity of conventional chemotherapy. Remarkably, TIMP-3 expression gradually decreased during progression of human dysplastic lesions into cervical carcinoma. This study identified the MMP-9/VEGF proangiogenic axis and its modulation by TIMP-3 as novel HIV-PI targets for the blockade of cervical intraepithelial neoplasia/cervical carcinoma development and invasiveness and the normalization of tumor vessel functions. These findings may lead to new therapeutic indications of HIV-PI to treat cervical carcinoma and other tumors in either HIV-infected or uninfected patients.
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Affiliation(s)
- Yaqi Qiu
- Laboratory of Tumor Microenvironment, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Turin, Italy.,Department of Science and Drug Technology, University of Turin, Candiolo, Turin, Italy
| | - Federica Maione
- Laboratory of Tumor Microenvironment, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Turin, Italy.,Department of Science and Drug Technology, University of Turin, Candiolo, Turin, Italy
| | - Stefania Capano
- Laboratory of Tumor Microenvironment, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Turin, Italy.,Department of Science and Drug Technology, University of Turin, Candiolo, Turin, Italy
| | - Claudia Meda
- Laboratory of Tumor Microenvironment, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Turin, Italy.,Department of Science and Drug Technology, University of Turin, Candiolo, Turin, Italy
| | - Orietta Picconi
- National HIV/AIDS Research Center, Istituto Superiore di Sanità, Rome, Italy
| | - Serena Brundu
- Laboratory of Tumor Microenvironment, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Turin, Italy.,Department of Science and Drug Technology, University of Turin, Candiolo, Turin, Italy
| | - Alberto Pisacane
- Pathology Unit, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Turin, Italy
| | - Anna Sapino
- Pathology Unit, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Turin, Italy.,Department of Medical Science, University of Turin, Candiolo, Turin, Italy
| | - Clelia Palladino
- National HIV/AIDS Research Center, Istituto Superiore di Sanità, Rome, Italy
| | - Giovanni Barillari
- Department of Medical Science, University of Turin, Candiolo, Turin, Italy
| | - Paolo Monini
- National HIV/AIDS Research Center, Istituto Superiore di Sanità, Rome, Italy
| | - Federico Bussolino
- Laboratory of Vascular Oncology, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Turin, Italy.,Department of Oncology, University of Turin, Candiolo, Turin, Italy
| | - Barbara Ensoli
- National HIV/AIDS Research Center, Istituto Superiore di Sanità, Rome, Italy
| | - Cecilia Sgadari
- National HIV/AIDS Research Center, Istituto Superiore di Sanità, Rome, Italy.
| | - Enrico Giraudo
- Laboratory of Tumor Microenvironment, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Turin, Italy. .,Department of Science and Drug Technology, University of Turin, Candiolo, Turin, Italy
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