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Hsu LC, Tu TY, Chen HY, Chang R, Yip HT, Chou MC, Wei JCC, Tsui KH, Sheu JJC. Female Human Papillomavirus Infection Associated with Increased Risk of Ectopic Pregnancy: Early Evidence from Taiwan Population-Based Cohort Study. J Pers Med 2022; 12:jpm12020172. [PMID: 35207661 PMCID: PMC8876513 DOI: 10.3390/jpm12020172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 01/03/2022] [Accepted: 01/11/2022] [Indexed: 11/16/2022] Open
Abstract
Background: This is an investigation of the human papillomavirus (HPV) infection and its correlation with the risk of ectopic pregnancy (EP). Methods: The cohort study includes 11,239 patients with newly diagnosed HPV infections between 2000 and 2012, and by using computer-generated random numbers, patients who do not have HPV infections are selected randomly as the comparison cohort. The HPV infection cohort is matched to comparison individuals at a 1:10 ratio by age and index year. All individuals included in the study were followed up to the point they developed EP, pulled-out from the insurance program, lost to follow-up, or until the end of 2013. A Cox proportional-hazards regression analysis was used to analyze the risk of EP with the hazard ratios (HRs) and 95% confidence intervals (CIs) between the HPV and control cohort. Results: The adjusted hazard ratio (aHR) of EP for HPV patients relative to controls is 1.70 (95% CI = 1.04, 2.78), indicating a positive correlation between EP and HPV in the 13-year follow-up period, after adjusting for age and relevant comorbidities. The sensitivity analyses yield similar results. Conclusions: A history of HPV infection is a potential risk factor associated with the development of subsequent EP in Taiwanese individuals, especially those diagnosed with an HPV infection within 3 years.
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Affiliation(s)
- Li-Chuan Hsu
- Institute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung 804201, Taiwan;
- Department of Obstetrics and Gynecology, Kaohsiung Veterans General Hospital, Kaohsiung 813414, Taiwan
| | - Ting-Yu Tu
- Department of Orthopedics, Kaohsiung Veterans General Hospital, Kaohsiung 813414, Taiwan;
| | - Hui-Yuan Chen
- Institute of Medicine, Chung Shan Medical University, Taichung 402306, Taiwan;
| | - Renin Chang
- Department of Emergency Medicine, Kaohsiung Veterans General Hospital, Kaohsiung 813414, Taiwan;
| | - Hei-Tung Yip
- Management Office for Health Data, China Medical University Hospital, Taichung 404332, Taiwan;
- College of Medicine, China Medical University, Taichung 406040, Taiwan
- Institute of Public Health, National Yangming University, Taipei 112304, Taiwan
| | - Mei-Chia Chou
- Department of Recreation and Sports Management, Tajen University, Pingtung 907101, Taiwan
- Department of Physical Therapy, Shu-Zen Junior College of Medicine and Management, Kaohsiung 821004, Taiwan
- Department of Physical Medicine and Rehabilitation, Kaohsiung Veterans General Hospital, Pingtung 912012, Taiwan
- Graduate Institute of Bioresources, National Pingtung University of Science and Technology, Pingtung 912301, Taiwan
- Correspondence: (M.-C.C.); (J.C.-C.W.); (K.-H.T.); (J.J.-C.S.); Tel.: +886-87704115 (M.-C.C.)
| | - James Cheng-Chung Wei
- Institute of Medicine, Chung Shan Medical University, Taichung 402306, Taiwan;
- College of Medicine, China Medical University, Taichung 406040, Taiwan
- Division of Allergy, Immunology and Rheumatology, Chung Shan Medical University Hospital, Taichung 402306, Taiwan
- Graduate Institute of Integrated Medicine, China Medical University, Taichung 404333, Taiwan
- Correspondence: (M.-C.C.); (J.C.-C.W.); (K.-H.T.); (J.J.-C.S.); Tel.: +886-87704115 (M.-C.C.)
| | - Kuan-Hao Tsui
- Institute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung 804201, Taiwan;
- Department of Obstetrics and Gynecology, Kaohsiung Veterans General Hospital, Kaohsiung 813414, Taiwan
- Correspondence: (M.-C.C.); (J.C.-C.W.); (K.-H.T.); (J.J.-C.S.); Tel.: +886-87704115 (M.-C.C.)
| | - Jim Jinn-Chyuan Sheu
- Institute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung 804201, Taiwan;
- Correspondence: (M.-C.C.); (J.C.-C.W.); (K.-H.T.); (J.J.-C.S.); Tel.: +886-87704115 (M.-C.C.)
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Hill CJ, Fakhreldin M, Maclean A, Dobson L, Nancarrow L, Bradfield A, Choi F, Daley D, Tempest N, Hapangama DK. Endometriosis and the Fallopian Tubes: Theories of Origin and Clinical Implications. J Clin Med 2020; 9:E1905. [PMID: 32570847 PMCID: PMC7355596 DOI: 10.3390/jcm9061905] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 06/10/2020] [Accepted: 06/15/2020] [Indexed: 02/06/2023] Open
Abstract
Endometriosis is a common, oestrogen driven chronic condition, where endometrium-like epithelial and stromal cells exist in ectopic sites. At present, no curative treatments are available and the existing evidence for disease progression is conflicting. The pathogenesis is still unknown and evidently complex, as mechanisms of initiation may depend on the anatomical distribution of endometriotic lesions. However, amongst the numerous theories and plethora of mechanisms, contributions of the fallopian tubes (FT) to endometriosis are rarely discussed. The FT are implicated in all endometriosis associated symptomatology and clinical consequences; they may contribute to the origin of endometriotic tissue, determine the sites for ectopic lesion establishment and act as conduits for the spread of proinflammatory media. Here, we examine the available evidence for the contribution of the human FT to the origin, pathogenesis and symptoms/clinical consequences of endometriosis. We also examine the broader topic linking endometriosis and the FT epithelium to the genesis of ovarian epithelial cancers. Further studies elucidating the distinct functional and phenotypical characteristics of FT mucosa may allow the development of novel treatment strategies for endometriosis that are potentially curative.
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Affiliation(s)
- Christopher J. Hill
- Centre for Women’s Health Research, Department of Women’s and Children’s Health, Institute of Life Course and Medical Sciences, University of Liverpool, Member of Liverpool Health Partners, Liverpool L8 7SS, UK; (C.J.H.); (A.M.); (L.D.); (L.N.); (A.B.); (F.C.); (D.D.); (N.T.)
| | - Marwa Fakhreldin
- Liverpool Women’s NHS Foundation Trust, Member of Liverpool Health Partners, Liverpool L8 7SS, UK;
| | - Alison Maclean
- Centre for Women’s Health Research, Department of Women’s and Children’s Health, Institute of Life Course and Medical Sciences, University of Liverpool, Member of Liverpool Health Partners, Liverpool L8 7SS, UK; (C.J.H.); (A.M.); (L.D.); (L.N.); (A.B.); (F.C.); (D.D.); (N.T.)
- Liverpool Women’s NHS Foundation Trust, Member of Liverpool Health Partners, Liverpool L8 7SS, UK;
| | - Lucy Dobson
- Centre for Women’s Health Research, Department of Women’s and Children’s Health, Institute of Life Course and Medical Sciences, University of Liverpool, Member of Liverpool Health Partners, Liverpool L8 7SS, UK; (C.J.H.); (A.M.); (L.D.); (L.N.); (A.B.); (F.C.); (D.D.); (N.T.)
- Liverpool Women’s NHS Foundation Trust, Member of Liverpool Health Partners, Liverpool L8 7SS, UK;
| | - Lewis Nancarrow
- Centre for Women’s Health Research, Department of Women’s and Children’s Health, Institute of Life Course and Medical Sciences, University of Liverpool, Member of Liverpool Health Partners, Liverpool L8 7SS, UK; (C.J.H.); (A.M.); (L.D.); (L.N.); (A.B.); (F.C.); (D.D.); (N.T.)
- Liverpool Women’s NHS Foundation Trust, Member of Liverpool Health Partners, Liverpool L8 7SS, UK;
| | - Alice Bradfield
- Centre for Women’s Health Research, Department of Women’s and Children’s Health, Institute of Life Course and Medical Sciences, University of Liverpool, Member of Liverpool Health Partners, Liverpool L8 7SS, UK; (C.J.H.); (A.M.); (L.D.); (L.N.); (A.B.); (F.C.); (D.D.); (N.T.)
| | - Fiona Choi
- Centre for Women’s Health Research, Department of Women’s and Children’s Health, Institute of Life Course and Medical Sciences, University of Liverpool, Member of Liverpool Health Partners, Liverpool L8 7SS, UK; (C.J.H.); (A.M.); (L.D.); (L.N.); (A.B.); (F.C.); (D.D.); (N.T.)
| | - Diandra Daley
- Centre for Women’s Health Research, Department of Women’s and Children’s Health, Institute of Life Course and Medical Sciences, University of Liverpool, Member of Liverpool Health Partners, Liverpool L8 7SS, UK; (C.J.H.); (A.M.); (L.D.); (L.N.); (A.B.); (F.C.); (D.D.); (N.T.)
| | - Nicola Tempest
- Centre for Women’s Health Research, Department of Women’s and Children’s Health, Institute of Life Course and Medical Sciences, University of Liverpool, Member of Liverpool Health Partners, Liverpool L8 7SS, UK; (C.J.H.); (A.M.); (L.D.); (L.N.); (A.B.); (F.C.); (D.D.); (N.T.)
- Liverpool Women’s NHS Foundation Trust, Member of Liverpool Health Partners, Liverpool L8 7SS, UK;
| | - Dharani K. Hapangama
- Centre for Women’s Health Research, Department of Women’s and Children’s Health, Institute of Life Course and Medical Sciences, University of Liverpool, Member of Liverpool Health Partners, Liverpool L8 7SS, UK; (C.J.H.); (A.M.); (L.D.); (L.N.); (A.B.); (F.C.); (D.D.); (N.T.)
- Liverpool Women’s NHS Foundation Trust, Member of Liverpool Health Partners, Liverpool L8 7SS, UK;
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Yong PJ, Matwani S, Brace C, Quaiattini A, Bedaiwy MA, Albert A, Allaire C. Endometriosis and Ectopic Pregnancy: A Meta-analysis. J Minim Invasive Gynecol 2020; 27:352-361.e2. [DOI: 10.1016/j.jmig.2019.09.778] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 09/16/2019] [Accepted: 09/17/2019] [Indexed: 10/26/2022]
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Shaw JLV, Dey SK, Critchley HOD, Horne AW. Current knowledge of the aetiology of human tubal ectopic pregnancy. Hum Reprod Update 2010; 16:432-44. [PMID: 20071358 DOI: 10.1093/humupd/dmp057] [Citation(s) in RCA: 213] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND An ectopic pregnancy is a pregnancy which occurs outside of the uterine cavity, and over 98% implant in the Fallopian tube. Tubal ectopic pregnancy remains the most common cause of maternal mortality in the first trimester of pregnancy. The epidemiological risk factors for tubal ectopic pregnancy are well established and include: tubal damage as a result of surgery or infection (particularly Chlamydia trachomatis), smoking and in vitro fertilization. This review appraises the data to date researching the aetiology of tubal ectopic pregnancy. METHODS Scientific literature was searched for studies investigating the underlying aetiology of tubal ectopic pregnancy. RESULTS Existing data addressing the underlying cause of tubal ectopic pregnancy are mostly descriptive. There are currently few good animal models of tubal ectopic pregnancy. There are limited data explaining the link between risk factors and tubal implantation. CONCLUSIONS Current evidence supports the hypothesis that tubal ectopic pregnancy is caused by a combination of retention of the embryo within the Fallopian tube due to impaired embryo-tubal transport and alterations in the tubal environment allowing early implantation to occur. Future studies are needed that address the functional consequences of infection and smoking on Fallopian tube physiology. A greater understanding of the aetiology of tubal ectopic pregnancy is critical for the development of improved preventative measures, the advancement of diagnostic screening methods and the development of novel treatments.
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Affiliation(s)
- J L V Shaw
- Centre for Reproductive Biology, Queen's Medical Research Institute, 47 Little France Crescent, Edinburgh EH16 4TJ, UK
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King AE, Wheelhouse N, Cameron S, McDonald SE, Lee KF, Entrican G, Critchley HO, Horne AW. Expression of secretory leukocyte protease inhibitor and elafin in human fallopian tube and in an in-vitro model of Chlamydia trachomatis infection. Hum Reprod 2008; 24:679-86. [DOI: 10.1093/humrep/den452] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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