1
|
Tosado-Rodríguez E, Alvarado-Vélez I, Romaguera J, Godoy-Vitorino F. Vaginal Microbiota and HPV in Latin America: A Narrative Review. Microorganisms 2024; 12:619. [PMID: 38543670 PMCID: PMC10974203 DOI: 10.3390/microorganisms12030619] [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: 03/13/2024] [Accepted: 03/15/2024] [Indexed: 04/01/2024] Open
Abstract
With the expansion of human microbiome studies in the last 15 years, we have realized the immense implications of microbes in human health. The human holobiont is now accepted, given the commensal relationships with bacteria, fungi, parasites, viruses, and human cells. The cervicovaginal microbiota is a specific case within the human microbiome where diversity is lower to maintain a chemical barrier of protection against infections. This narrative review focuses on the vaginal microbiome. It summarizes key findings on how native bacteria protect women from disease or predispose them to damaging inflammatory processes with an emphasis on the role of HPV infections in Latin America, one of the world's regions with the highest cervical cancer prevalence.
Collapse
Affiliation(s)
- Eduardo Tosado-Rodríguez
- Department of Microbiology and Medical Zoology, Medical Sciences Campus, University of Puerto Rico School of Medicine, San Juan 00935, Puerto Rico
| | - Ian Alvarado-Vélez
- Department of Obstetrics and Gynecology, Medical Sciences Campus, University of Puerto Rico School of Medicine, San Juan 00935, Puerto Rico
| | - Josefina Romaguera
- Department of Obstetrics and Gynecology, Medical Sciences Campus, University of Puerto Rico School of Medicine, San Juan 00935, Puerto Rico
| | - Filipa Godoy-Vitorino
- Department of Microbiology and Medical Zoology, Medical Sciences Campus, University of Puerto Rico School of Medicine, San Juan 00935, Puerto Rico
| |
Collapse
|
2
|
Qin Y, Liu C, Li Q, Zhou X, Wang J. Mechanistic analysis of Th2-type inflammatory factors in asthma. J Thorac Dis 2023; 15:6898-6914. [PMID: 38249931 PMCID: PMC10797403 DOI: 10.21037/jtd-23-1628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 12/18/2023] [Indexed: 01/23/2024]
Abstract
Background The main pathological features of asthma are widespread chronic inflammation of the airways and restricted ventilation due to airway remodeling, which involves changes in a range of regulatory pathways. While the role of T helper type 2 (Th2)-related inflammatory factors in this process is known, the detailed understanding of how genes affect protein functions during airway remodeling is still lacking. This study aims to fill this knowledge gap by integrating gene expression data and protein function analysis, providing new scientific insights for a deeper understanding of the mechanisms of airway remodeling and for further development of asthma treatment strategies. Methods In this study, the mechanism of Th2-related inflammatory factors in tracheal remodeling was studied through differentially expressed gene (DEG) screening, enrichment analysis, protein-protein interaction (PPI) network construction, machine learning, and the construction of a line graph model. Results Our study revealed that S100A14, KRT6A, S100A2, ABCA13, UBE2C, RASSF10, PSCA, PLAT, and TIMP1 may be the key genes for airway remodeling; epithelial-mesenchymal transition (EMT)-related genes GEM, TPM4, SLC6A8, and SNTB1 may be involved in airway remodeling due to asthma; IL6 may affect the occurrence of airway remodeling by binding to UBE2C protein or by regulating GEM genes, respectively; IL6 and IL9 may affect the occurrence of airway remodeling by regulating the downstream Toll-like receptor (TLR) signaling pathway and thus IL6 and IL9 may influence the occurrence of tracheal remodeling by regulating downstream TLR signaling pathways. Conclusions This study further mined the asthma gene microarray database through bioinformatics analysis and identified key genes and important pathways affecting airway remodeling in asthma patients, providing new ideas to uncover the mechanism of airway remodeling due to asthma and then seek new therapeutic targets.
Collapse
Affiliation(s)
- Yingjiao Qin
- Department of Respiratory Diseases, The First Affiliated Hospital of Hainan Medical University, Hainan Province Clinical Medical Center of Respiratory Diseases, Haikou, China
| | - Chang Liu
- Department of Respiratory Diseases, The First Affiliated Hospital of Hainan Medical University, Hainan Province Clinical Medical Center of Respiratory Diseases, Haikou, China
| | - Qi Li
- Department of Respiratory Diseases, The First Affiliated Hospital of Hainan Medical University, Hainan Province Clinical Medical Center of Respiratory Diseases, Haikou, China
| | - Xiangdong Zhou
- Department of Respiratory Diseases, The First Affiliated Hospital of Hainan Medical University, Hainan Province Clinical Medical Center of Respiratory Diseases, Haikou, China
| | - Jie Wang
- Department of Respiratory Diseases, The First Affiliated Hospital of Hainan Medical University, Hainan Province Clinical Medical Center of Respiratory Diseases, Haikou, China
| |
Collapse
|
3
|
Blay Mensah LB, Ken-Amoah S, Essuman MA, Anane-Fenin B, Agbeno EK, Eliason S, Essien-Baidoo S. Cervical Microbiota Influences Cytokine Diversity in Cervical Intraepithelial Neoplasia among Rural Women in the Akyemansa District of Ghana. BIOMED RESEARCH INTERNATIONAL 2023; 2023:5129709. [PMID: 37635942 PMCID: PMC10450155 DOI: 10.1155/2023/5129709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 07/03/2023] [Accepted: 07/31/2023] [Indexed: 08/29/2023]
Abstract
Background In recent times, cervical dysbiosis which mostly causes and aggravates infections is highlighted for its role in immune modulation in cervical dysplasia, which promotes the shifting of Th1 phenotype immunity to Th2 phenotype immunity. This study therefore estimated and compared the levels of circulatory IL-4, IL-6, IL-10, TNF-α, and IFN-γ cytokines among adult women identified to have different grades of cervical intraepithelial neoplasia (CIN) and with cervicovaginal infection. Methods A total of 157 participants were recruited from the Akyemansa District of Ghana, and cervical swabs and blood samples were taken. The Pap smear test, microbiological culture, and ELISA were employed for cytology analysis, bacteria isolation, and identification and estimation of IL-4, IL-6, IL-10, TNF-α, and IFN-γ cytokines, respectively. Results Overall, 14/157 (8.9%) had CIN with 7.6% having CIN 1 and 1.3% having CIN 2. The main predictor for CIN was age above 46 years (OR 11.16, 95% CI: 2.4-51.8). Bacterial vaginosis (p = 0.003) and Candida infection (p = 0.012) were significantly higher in CIN. Again, Staphylococcus aureus (60% vs. 17.6%, p = 0.005), Citrobacter sp. (40.0% vs. 13.2%, p = 0.017), and Morganella morganii (40.0% vs. 4.4%, p = 0.002) isolates were significantly higher in CIN-positive participants. IL-10 and TNF-α concentrations were elevated in participants with CIN 1+ (TNF-α NIL vs. CIN 1+ only, p < 0.05) while IL-6 was decreased among participants with CIN 1+. In the presence of vaginal infection, TNF-α decreased among CIN 1+ participants while IL-10 remained elevated. Conclusion The findings of this study suggest that cervical dysbiosis causes immune suppression, which creates a suitable microenvironment for the development of CIN.
Collapse
Affiliation(s)
- Loretta Betty Blay Mensah
- Department of Microbiology and Immunology, School of Medical Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Sebastian Ken-Amoah
- Department of Obstetrics and Gynaecology, School of Medical Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Mainprice Akuoko Essuman
- Department of Medical Laboratory Science, School of Allied Health Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Betty Anane-Fenin
- Department of Obstetrics and Gynaecology, School of Medical Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Evans Kofi Agbeno
- Department of Obstetrics and Gynaecology, School of Medical Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Sebastian Eliason
- Department of Community Medicine, School of Medical Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Samuel Essien-Baidoo
- Department of Microbiology and Immunology, School of Medical Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
- Department of Medical Laboratory Science, School of Allied Health Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| |
Collapse
|
4
|
Hillyar CR, Kanabar SS, Pufal KR, Saw Hee JL, Lawson AW, Mohamed Y, Jasim D, Reed L, Rallis KS, Nibber A. A systematic review and meta-analysis of miRNAs for the detection of cervical cancer. Epigenomics 2023; 15:593-613. [PMID: 37535320 DOI: 10.2217/epi-2023-0183] [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] [Indexed: 08/04/2023] Open
Abstract
Aim: This study aimed to critically appraise the evidence of the diagnostic effectiveness of miRNAs for the detection of cervical cancer. Methods & materials: A systematic review and meta-analysis was performed, searching PubMed, EMBASE and Web of Science. An umbrella meta-analysis of meta-analyses of individual biomarkers was performed. A Grading of Recommendations, Assessment, Development and Evaluations (GRADE) assessment of evidence was also performed. Results: A total of 52 miRNAs were included. Umbrella meta-analysis revealed significant heterogeneity in terms of sensitivity, specificity, receiver operating characteristic (ROC), positive predictive value and/or negative predictive value. Umbrella effects were 0.76 (95% CI: 0.73-0.78), 0.78 (95% CI: 0.75-0.81), 0.77 (95% CI: 0.75-0.80), 0.75 (95% CI: 0.71-0.79) and 0.76 (95% CI: 0.74-0.79), respectively. Conclusion: Moderate quality evidence suggested miR199a-5p, miR21-5p and miR-141a had excellent diagnostic performance.
Collapse
Affiliation(s)
- Christopher Rt Hillyar
- Green Templeton College, University of Oxford, Oxford, OX2 6HG, UK
- Elderly Care, Royal Berkshire Hospital NHS Foundation Trust, Reading, RG1 5AN, UK
| | - Shivani S Kanabar
- General Surgery, Sandwell General Hospital, Sandwell & West Birmingham NHS Trust, West Bromwich, B71 4HJ, UK
| | - Kamil R Pufal
- General Surgery, Queens Hospital Burton, University Hospitals of Derby and Burton NHS Trust, Burton-on-Trent, DE13 0RB, UK
| | - Joshua Li Saw Hee
- Renal Unit, New Cross Hospital, The Royal Wolverhampton NHS Trust, Wolverhampton, WV10 0QP, UK
| | - Alexander W Lawson
- General Surgery, New Cross Hospital, The Royal Wolverhampton NHS Trust, Wolverhampton, WV10 0QP, UK
| | - Yethrib Mohamed
- General Surgery, Birmingham Heartlands Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, B9 5SS, UK
| | - Duha Jasim
- Intensive Care, Maidstone & Tunbridge Wells NHS Trust, Tunbridge Wells Hospital, Tunbridge Wells, TN2 4QJ, UK
| | - Lara Reed
- General Surgery, Weston General Hospital, University Hospitals Bristol and Weston NHS Foundation Trust, Weston-super-Mare, BS23 4TQ, UK
| | - Kathrine S Rallis
- Division of Hematology-Oncology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
- Center for Hematology-Oncology, Barts Cancer Institute, Queen Mary University of London, London, EC1M 6AU, UK
| | - Anjan Nibber
- Green Templeton College, University of Oxford, Oxford, OX2 6HG, UK
- Nuffield Department of Population Health, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, OX3 9DU, UK
| |
Collapse
|
5
|
Wagner J, Štibi S, Selak N, Alvir I, Mamić I, Marcelić L, Šušnjar L, Puljiz M, Heffer M, Danolić D. Interleukin 10 rs1800896 and interleukin 1B rs16944 polymorphisms and the risk of cervical cancer. Wien Med Wochenschr 2023; 173:57-61. [PMID: 35041104 DOI: 10.1007/s10354-021-00907-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 12/09/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND The purpose of this study was to evaluate the relationships between interleukin 10 (IL10) (rs1800896) and interleukin 1B (IL1B) (rs16944) genetic polymorphisms and the risk for cervical cancer in a cohort of women from Croatia. METHODS A case-control study of 81 patients with cervical cancer and 80 age-matched healthy controls was performed. We collected peripheral blood samples, extracted deoxiribonucleic acid (DNA), and analyzed two single-nucleotide polymorphisms (SNPs) rs1800896 and rs16944 using TaqMan assays (Fa. Thermo Fisher Scientific, Waltham, MA, USA) and real-time polymerase chain reaction (PCR). We investigated a possible association between two cytokine genetic polymorphisms and the occurrence of cervical cancer. RESULTS Our results showed no significant difference in the frequency of IL10 (rs1800896) and IL1B (rs16944) genotypes between the patients and the controls (χ2 test, P < 0.05). CONCLUSION In this study, no association was found between IL10 rs1800896 and IL1B rs16944 polymorphisms and cervical cancer development.
Collapse
Affiliation(s)
- Jasenka Wagner
- Department of Medical Biology and Genetics, Faculty of Medicine, University of Osijek, Osijek, Croatia
| | - Sanela Štibi
- Department of Medical Biology and Genetics, Faculty of Medicine, University of Osijek, Osijek, Croatia
| | - Nikica Selak
- Department of Medical Biology and Genetics, Faculty of Medicine, University of Osijek, Osijek, Croatia
| | - Ilija Alvir
- Department of Gynecologic Oncology, University Hospital for Tumors, Sestre milosrdnice University Hospital Center, Ilica 197, 10000, Zagreb, Croatia
| | - Ivica Mamić
- Department of Gynecologic Oncology, University Hospital for Tumors, Sestre milosrdnice University Hospital Center, Ilica 197, 10000, Zagreb, Croatia
| | - Luka Marcelić
- Department of Gynecologic Oncology, University Hospital for Tumors, Sestre milosrdnice University Hospital Center, Ilica 197, 10000, Zagreb, Croatia
| | - Lucija Šušnjar
- Department of Gynecologic Oncology, University Hospital for Tumors, Sestre milosrdnice University Hospital Center, Ilica 197, 10000, Zagreb, Croatia.
| | - Mario Puljiz
- Department of Gynecologic Oncology, University Hospital for Tumors, Sestre milosrdnice University Hospital Center, Ilica 197, 10000, Zagreb, Croatia
| | - Marija Heffer
- Department of Medical Biology and Genetics, Faculty of Medicine, University of Osijek, Osijek, Croatia
| | - Damir Danolić
- Department of Gynecologic Oncology, University Hospital for Tumors, Sestre milosrdnice University Hospital Center, Ilica 197, 10000, Zagreb, Croatia
| |
Collapse
|
6
|
Kumar N, Vyas A, Agnihotri SK, Chattopadhyay N, Sachdev M. Small secretory proteins of immune cells can modulate gynecological cancers. Semin Cancer Biol 2022; 86:513-531. [PMID: 35150864 DOI: 10.1016/j.semcancer.2022.02.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 02/04/2022] [Accepted: 02/05/2022] [Indexed: 01/27/2023]
Abstract
Small secretory proteins of immune cells are mostly Cytokines, which include chemokines, interleukins, interferons, lymphokines and tumor necrosis factors but not hormones or growth factors. These secretory proteins are the molecular messengers and primarily involved in autocrine, paracrine and endocrine signaling as immunomodulating agents. Hence, these proteins actually regulate the cells of immune system to communicate with one another to produce a synchronized, robust, still self-regulated response to a specific antigen. Chemokines are smaller secreted proteins that control overall immune cell movement and location; these chemokines are divided into 4 subgroups, namely, CXC, CC, CX3C and C according to the position of 4 conserved cysteine residues. Complete characterization of cytokines and chemokines can exploit their vast signaling networks to develop cancer treatments. These secretory proteins like IL-6, IL-10, IL-12, TNFα, CCL2, CXCL4 & CXCL8 are predominantly expressed in most of the gynecological cancers, which directly stimulate immune effector cells and stromal cells at the tumor site and augment tumor cell recognition by cytotoxic T-cells. Hence; these secretory proteins are the major regulators, which can actually modulate all kinds of gynecological cancers. Furthermore, advancements in adoptive T-cell treatment have relied on the use of multiple cytokines/chemokines to establish a highly regulated environment for anti-tumor T cell growth. A number of in vitro studies as well as animal models and clinical subjects have also shown that cytokines/chemokines have broad antitumor activity, which has been translated into a number of cancer therapy approaches. This review will focus on the foremost cytokines & chemokines involved in the majority of the gynecological malignancies and discuss their basic biology as well as clinical applications.
Collapse
Affiliation(s)
- Niranjan Kumar
- Division of Endocrinology, CSIR- Central Drug Research Institute, Lucknow, 226 031, India; Academy of Scientific and Innovative Research (AcSIR), Sector 19, Kamla Nehru Nagar, Ghaziabad, 201 002, India
| | - Akanksha Vyas
- Division of Endocrinology, CSIR- Central Drug Research Institute, Lucknow, 226 031, India; Academy of Scientific and Innovative Research (AcSIR), Sector 19, Kamla Nehru Nagar, Ghaziabad, 201 002, India
| | | | - Naibedya Chattopadhyay
- Division of Endocrinology, CSIR- Central Drug Research Institute, Lucknow, 226 031, India; Academy of Scientific and Innovative Research (AcSIR), Sector 19, Kamla Nehru Nagar, Ghaziabad, 201 002, India.
| | - Monika Sachdev
- Division of Endocrinology, CSIR- Central Drug Research Institute, Lucknow, 226 031, India; Academy of Scientific and Innovative Research (AcSIR), Sector 19, Kamla Nehru Nagar, Ghaziabad, 201 002, India.
| |
Collapse
|
7
|
Ntuli L, Mtshali A, Mzobe G, Liebenberg LJP, Ngcapu S. Role of Immunity and Vaginal Microbiome in Clearance and Persistence of Human Papillomavirus Infection. Front Cell Infect Microbiol 2022; 12:927131. [PMID: 35873158 PMCID: PMC9301195 DOI: 10.3389/fcimb.2022.927131] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 06/14/2022] [Indexed: 12/02/2022] Open
Abstract
Cervical cancer disproportionately affects women of reproductive age, with 80% of cases occurring in low- and middle-income countries. Persistent infection with high-risk human papillomavirus (HPV) genotypes has been described as the most common non-systemic biological risk factor for the development of cervical cancer. The mucosal immune system plays a significant role in controlling HPV infection by acting as the first line of host defense at the mucosal surface. However, the virus can evade host immunity using various mechanisms, including inhibition of the antiviral immune response necessary for HPV clearance. Pro-inflammatory cytokines and the vaginal microbiome coordinate cell-mediated immune responses and play a pivotal role in modulating immunity. Recently, diverse vaginal microbiome (associated with bacterial vaginosis) and genital inflammation have emerged as potential drivers of high-risk HPV positivity and disease severity in women. The potential role of these risk factors on HPV recurrence and persistence remains unclear. This article reviews the role of cellular or cytokine response and vaginal microbiome dysbiosis in the clearance, persistence, and recurrence of HPV infection.
Collapse
Affiliation(s)
- Lungelo Ntuli
- Department of Medical Microbiology, School of Laboratory Medicine and Medical Science, University of KwaZulu-Natal, Durban, South Africa
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban, South Africa
| | - Andile Mtshali
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban, South Africa
| | - Gugulethu Mzobe
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban, South Africa
| | - Lenine JP Liebenberg
- Department of Medical Microbiology, School of Laboratory Medicine and Medical Science, University of KwaZulu-Natal, Durban, South Africa
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban, South Africa
| | - Sinaye Ngcapu
- Department of Medical Microbiology, School of Laboratory Medicine and Medical Science, University of KwaZulu-Natal, Durban, South Africa
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Durban, South Africa
- *Correspondence: Sinaye Ngcapu,
| |
Collapse
|
8
|
Läsche M, Gallwas J, Gründker C. Like Brothers in Arms: How Hormonal Stimuli and Changes in the Metabolism Signaling Cooperate, Leading HPV Infection to Drive the Onset of Cervical Cancer. Int J Mol Sci 2022; 23:ijms23095050. [PMID: 35563441 PMCID: PMC9103757 DOI: 10.3390/ijms23095050] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 04/27/2022] [Accepted: 04/28/2022] [Indexed: 02/06/2023] Open
Abstract
Despite all precautionary actions and the possibility of using vaccinations to counteract infections caused by human papillomaviruses (HPVs), HPV-related cancers still account for approximately 5% of all carcinomas. Worldwide, many women are still excluded from adequate health care due to their social position and origin. Therefore, immense efforts in research and therapy are still required to counteract the challenges that this disease entails. The special thing about an HPV infection is that it is not only able to trick the immune system in a sophisticated way, but also, through genetic integration into the host genome, to use all the resources available to the host cells to complete the replication cycle of the virus without activating the alarm mechanisms of immune recognition and elimination. The mechanisms utilized by the virus are the metabolic, immune, and hormonal signaling pathways that it manipulates. Since the virus is dependent on replication enzymes of the host cells, it also intervenes in the cell cycle of the differentiating keratinocytes and shifts their terminal differentiation to the uppermost layers of the squamocolumnar transformation zone (TZ) of the cervix. The individual signaling pathways are closely related and equally important not only for the successful replication of the virus but also for the onset of cervical cancer. We will therefore analyze the effects of HPV infection on metabolic signaling, as well as changes in hormonal and immune signaling in the tumor and its microenvironment to understand how each level of signaling interacts to promote tumorigenesis of cervical cancer.
Collapse
|
9
|
Cervical Carcinoma: Oncobiology and Biomarkers. Int J Mol Sci 2021; 22:ijms222212571. [PMID: 34830452 PMCID: PMC8624663 DOI: 10.3390/ijms222212571] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Revised: 11/01/2021] [Accepted: 11/16/2021] [Indexed: 12/23/2022] Open
Abstract
Cervical cancer is one of the most common types of carcinomas causing morbidity and mortality in women in all countries of the world. At the moment, the oncology, oncobiology, and oncomorphology of cervical cancer are characterized by the accumulation of new information; various molecular biological, genetic, and immunohistochemical methods of investigation of the mechanisms of cervical carcinogenesis are tested and applied; targeted antitumour drugs and diagnostic, prognostic, and predictive biomarkers are being searched for. Many issues of the etiopathogenesis of cervical cancer have not been sufficiently studied, and the role of many biomarkers characterizing various stages of cervical carcinogenesis remains unclear. Therefore, the target of this review is to systematize and understand several problems in the pathogenesis of cervical cancer and to evaluate the significance and role of biomarkers in cervical carcinogenesis.
Collapse
|
10
|
R S J. The Immune Microenvironment in Human Papilloma Virus-Induced Cervical Lesions-Evidence for Estrogen as an Immunomodulator. Front Cell Infect Microbiol 2021; 11:649815. [PMID: 33996630 PMCID: PMC8120286 DOI: 10.3389/fcimb.2021.649815] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 03/29/2021] [Indexed: 12/24/2022] Open
Abstract
Globally, human papilloma virus (HPV) infection is a common sexually transmitted disease. However, most of the HPV infections eventually resolve aided by the body’s efficient cell-mediated immune responses. In the vast majority of the small group of patients who develop overt disease too, it is the immune response that culminates in regression of lesions. It is therefore a rarity that persistent infection by high-risk genotypes of HPV compounded by other risk factors progresses through precancer (various grades of cervical intraepithelial neoplasia—CIN) to cervical cancer (CxCa). Hence, although CxCa is a rare culmination of HPV infection, the latter is nevertheless causally linked to >90% of cancer. The three ‘Es’ of cancer immunoediting viz. elimination, equilibrium, and escape come into vogue during the gradual evolution of CIN 1 to CxCa. Both cell-intrinsic and extrinsic mechanisms operate to eliminate virally infected cells: cell-extrinsic players are anti-tumor/antiviral effectors like Th1 subset of CD4+ T cells, CD8+ cytotoxic T cells, Natural Killer cells, etc. and pro-tumorigenic/immunosuppressive cells like regulatory T cells (Tregs), Myeloid-Derived Suppressor Cells (MDSCs), type 2 macrophages, etc. And accordingly, when immunosuppressive cells overpower the effectors e.g., in high-grade lesions like CIN 2 or 3, the scale is tilted towards immune escape and the disease progresses to cancer. Estradiol has long been considered as a co-factor in cervical carcinogenesis. In addition to the gonads, the Peyer’s patches in the gut synthesize estradiol. Over and above local production of the hormone in the tissues, estradiol metabolism by the gut microbiome: estrobolome versus tryptophan non-metabolizing microbiome, regulates free estradiol levels in the intestine and extraintestinal mucosal sites. Elevated tissue levels of the hormone serve more than one purpose: besides a direct growth-promoting action on cervical epithelial cells, estradiol acting genomically via Estrogen Receptor-α also boosts the function of the stromal and infiltrating immunosuppressive cells viz. Tregs, MDSCs, and carcinoma-associated fibroblasts. Hence as a corollary, therapeutic repurposing of Selective Estrogen Receptor Disruptors or aromatase inhibitors could be useful for modulating immune function in cervical precancer/cancer. The immunomodulatory role of estradiol in HPV-mediated cervical lesions is reviewed.
Collapse
Affiliation(s)
- Jayshree R S
- Department of Microbiology, Kidwai Memorial Institute of Oncology, Bangalore, India
| |
Collapse
|
11
|
Cotrim ACDM, França EL, Martins JS, Silva KPG, Fujimori M, Ghalfi YC, Machado IT, Honorio-França AC, Tozetti IA. Correlation between melatonin concentration and cytokines in cervical mucus in positive samples for the presence of human papillomavirus. Cancer Immunol Immunother 2021; 70:2721-2726. [PMID: 33797568 DOI: 10.1007/s00262-021-02922-7] [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: 11/09/2020] [Accepted: 03/22/2021] [Indexed: 11/25/2022]
Abstract
The human papillomavirus (HPV) is the main causative agent of cervical cancer, characterized by neoplastic lesions in the cervix. Based on the morphology of the cells of the uterine cervix, the findings are classified as negative intraepithelial lesions for malignancies, low-grade squamous intraepithelial lesions, high-grade squamous intraepithelial lesions (HSILs), atypical squamous cells of undetermined significance and atypical squamous cells of undetermined significance without excluding HSILs (ASCs-H). The progression of neoplastic lesions is related to the cervix's microenvironmental inflammatory process and mediated by the expression and stimulation of cytokines. Cervical mucus is a viscous liquid secretion composed of proteins, inorganic components, pro-and anti-inflammatory agents, and an important protective barrier. This study aimed to quantify and correlate cytokines IL-6, IL-8, and IL-10 and Melatonin in cervical mucus. According to the results, a decrease in MLT was observed in LSIL, HSI, and ASC-H groups than in the NILM group. The cytokines IL-6 and IL-8 showed greater expression in the LSIL and HSIL groups than the NILM group. HSIL group showed a negative correlation between the MLT and IL-6 and IL-8 concentrations. In the ASC-US group, IL8 level was positively correlated to MLT levels. We suggest that IL-6, IL-8, and MLT levels in HSIL groups are decisive for the progression of neoplastic lesions in HPV infections. New cervical cancer treatment strategies may include cytokine and melatonin control targets for effective immunotherapy.
Collapse
Affiliation(s)
| | - Eduardo Luzia França
- Institute of Biological and Health Science, Federal University of Mato Grosso, Barra do Garças, MT, Brazil.
| | - Jordana Santos Martins
- Institute of Biological and Health Science, Federal University of Mato Grosso, Barra do Garças, MT, Brazil
| | | | - Mahmi Fujimori
- Institute of Biological and Health Science, Federal University of Mato Grosso, Barra do Garças, MT, Brazil
| | | | | | | | - Inês Aparecida Tozetti
- Institute of Biosciences, Federal University of South Mato Grosso, Campo Grande, MS, Brazil
| |
Collapse
|
12
|
Carrero YN, Callejas DE, Mosquera JA. In situ immunopathological events in human cervical intraepithelial neoplasia and cervical cancer: Review. Transl Oncol 2021; 14:101058. [PMID: 33677234 PMCID: PMC7937982 DOI: 10.1016/j.tranon.2021.101058] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Accepted: 02/22/2021] [Indexed: 12/15/2022] Open
Abstract
Neoplasia of the cervix represents one of the most common cancers in women. Clinical and molecular research has identified immunological impairment in squamous intraepithelial cervical lesions and cervical cancer patients. The in-situ expression of several cytokines by uterine epithelial cells and by infiltrating leukocytes occurs during the cervical intraepithelial neoplasia and cervical cancer. Some of these cytokines can prevent and others can induce the progression of the neoplasm. The infiltrating leukocytes also produce cytokines and growth factors relate to angiogenesis, chemotaxis, and apoptosis capable of modulating the dysplasia progression. In this review we analyzed several interleukins with an inductive effect or blocking effect on the neoplastic progression. We also analyze the genetic polymorphism of some cytokines and their relationship with the risk of developing cervical neoplasia. In addition, we describe the leukocyte cells that infiltrate the cervical uterine tissue during the neoplasia and their effects on neoplasia progression.
Collapse
Affiliation(s)
- Yenddy N Carrero
- Facultad de Ciencias de la Salud. Carrera de Medicina, Universidad Técnica de Ambato, Ambato, Ecuador.
| | - Diana E Callejas
- Departamento de Ciencias Biológicas, Facultad de Ciencias de la Salud, Universidad Técnica de Manabí, Portoviejo, Ecuador.
| | - Jesús A Mosquera
- Instituto de Investigaciones Clínicas Dr. Américo Negrette. Facultad de Medicina, Universidad del Zulia. Maracaibo, Venezuela.
| |
Collapse
|
13
|
Petrini CG, Bastos LB, Duarte G, Dos Santos Melli PP, Alves-Filho JC, Quintana SM. Downregulation of IL-2 and IL-23 in Cervical Biopsies of Cervical Intraepithelial Lesions: A Cross-Sectional Study. Acta Cytol 2020; 64:442-451. [PMID: 32599588 DOI: 10.1159/000508015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Accepted: 04/15/2020] [Indexed: 01/02/2023]
Abstract
INTRODUCTION Persistent infection with high-risk human papillomavirus (HPV) types is associated with high-grade intraepithelial lesions (HSILs) and invasive cervical cancer. The host immune response plays a key role in whether HPV clears or persists. Most studies on local immune response to HPV collect cervical mucus in order to quantify secreted cytokines; however, cells located inside the tissue can release different cytokines associated with HPV infection. OBJECTIVE This study compared the cytokine levels in cervical biopsy specimens of women with abnormal colposcopic findings according to the histopathological results: low-grade intraepithelial lesion (LSIL), HSIL, and no intraepithelial lesion (NSIL). METHODS A cross-sectional study enrolling 141 cervical biopsy specimens examined the cytokine profile for interleukin (IL-) 2, IL-4, IL-10, IL-12, IL-17, and IL-23 and interferon-γ, using the Luminex assay/ELISA. Differences in cytokine levels among the cervical lesion groups were assessed using the Kruskal-Wallis test. RESULTS The 141 specimens included 90 HSILs, 22 LSILs, and 29 NSILs. IL-2 levels were significantly higher in NSIL samples than in LSIL or in HSIL samples (p = 0.0001) and IL-23 levels were significantly higher in NSIL than in HSIL samples (p = 0.003). CONCLUSIONS Our study shows that in samples from the lesion site point, 2 important pro-inflammatory cytokines, IL-2 and IL-23, are downregulated in HPV lesions.
Collapse
Affiliation(s)
- Caetano Galvão Petrini
- Gynecology and Obstetrics Department, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Larissa Brito Bastos
- Gynecology and Obstetrics Department, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Geraldo Duarte
- Gynecology and Obstetrics Department, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | | | - José Carlos Alves-Filho
- Pharmacology Department, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Silvana Maria Quintana
- Gynecology and Obstetrics Department, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil,
| |
Collapse
|