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Tantengco OAG, Menon R. Breaking Down the Barrier: The Role of Cervical Infection and Inflammation in Preterm Birth. Front Glob Womens Health 2022; 2:777643. [PMID: 35118439 PMCID: PMC8803751 DOI: 10.3389/fgwh.2021.777643] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 12/27/2021] [Indexed: 01/06/2023] Open
Abstract
Approximately 40% of cases of spontaneous preterm birth (sPTB) are associated with ascending intrauterine infections. The cervix serves as a physical and immunological gatekeeper, preventing the ascent of microorganisms from the vagina to the amniotic cavity. The cervix undergoes remodeling during pregnancy. It remains firm and closed from the start until the late third trimester of pregnancy and then dilates and effaces to accommodate the passage of the fetus during delivery. Remodeling proceeds appropriately and timely to maintain the pregnancy until term delivery. However, risk factors, such as acute and chronic infection and local inflammation in the cervix, may compromise cervical integrity and result in premature remodeling, predisposing to sPTB. Previous clinical studies have established bacterial (i.e., chlamydia, gonorrhea, mycoplasma, etc.) and viral infections (i.e., herpesviruses and human papillomaviruses) as risk factors of PTB. However, the exact mechanism leading to PTB is still unknown. This review focuses on: (1) the epidemiology of cervical infections in pregnant patients; (2) cellular mechanisms that may explain the association of cervical infections to premature cervical ripening and PTB; (3) endogenous defense mechanisms of the cervix that protect the uterine cavity from infection and inflammation; and (4) potential inflammatory biomarkers associated with cervical infection that can serve as prognostic markers for premature cervical ripening and PTB. This review will provide mechanistic insights on cervical functions to assist in managing cervical infections during pregnancy.
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Affiliation(s)
- Ourlad Alzeus G. Tantengco
- Division of Basic and Translational Research, Department of Obstetrics and Gynecology, The University of Texas Medical Branch at Galveston, Galveston, TX, United States
- Department of Biochemistry and Molecular Biology, College of Medicine, University of the Philippines Manila, Manila, Philippines
| | - Ramkumar Menon
- Division of Basic and Translational Research, Department of Obstetrics and Gynecology, The University of Texas Medical Branch at Galveston, Galveston, TX, United States
- *Correspondence: Ramkumar Menon
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Kabre KM, Ouermi D, Zohoncon TM, Traore FPW, Gnoumou OPDP, Ouedraogo RA, Yonli AT, Bado P, Ouedraogo P, Ouedraogo TWC, Yelemkoure TE, Kuassi-Kpede PA, Obiri-Yeboah D, Ouedraogo CMRN, Simpore J. Molecular epidemiology of human papillomavirus in pregnant women in Burkina Faso. Biomol Concepts 2022; 13:334-340. [PMID: 36727673 DOI: 10.1515/bmc-2022-0026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Accepted: 12/08/2022] [Indexed: 02/03/2023] Open
Abstract
INTRODUCTION Genital human papillomavirus (HPV) infection is widespread among sexually active individuals. Several factors may contribute to increased risk of infection in pregnant women. The objective of this study was to determine the high-risk (HR-HPV) and low-risk (LR-HPV) oncogenic HPV genotypes among pregnant women in Ouagadougou. METHODOLOGY In this study, 100 endocervical samples were collected using a sterile swab on the sterile examination glove used during vaginal examination in pregnant women. DNA from each sample was amplified by PCR followed by hybridization using the HPV Direct Flow Chips kit detecting 36 HPV genotypes. RESULTS Twenty-three percent (23%) of pregnant women had HPV infection. Of the 36 genotypes tested, 29 genotypes had been identified with a predominance of HPV 52 (10.34%), HPV 35 (6.89%), and HPV 82 (6.89%) for high risk and HPV 43 (10.34%), HPV 44/55 (6.90%), and HPV 62/81 (6.89%) for low risk. CONCLUSION HPV is common among pregnant women in Burkina Faso. However, the available vaccines do not cover the frequent genotypes found in this study. HPV could therefore constitute a threat for pregnant women and a risk of infection for the newborn.
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Affiliation(s)
- Koudpoko Madeleine Kabre
- Laboratory of Molecular Biology and Genetics (LABIOGENE), Department of Biochemistry and Microbiology, University of Joseph KI-ZERBO, 03 BP 7021, Ouagadougou 03, Burkina Faso
- Pietro Annigoni Biomolecular Research Center (CERBA), 01 BP 364, Ouagadougou 01, Burkina Faso
| | - Djénéba Ouermi
- Laboratory of Molecular Biology and Genetics (LABIOGENE), Department of Biochemistry and Microbiology, University of Joseph KI-ZERBO, 03 BP 7021, Ouagadougou 03, Burkina Faso
- Pietro Annigoni Biomolecular Research Center (CERBA), 01 BP 364, Ouagadougou 01, Burkina Faso
| | - Théodora Mahoukèdè Zohoncon
- Laboratory of Molecular Biology and Genetics (LABIOGENE), Department of Biochemistry and Microbiology, University of Joseph KI-ZERBO, 03 BP 7021, Ouagadougou 03, Burkina Faso
- Pietro Annigoni Biomolecular Research Center (CERBA), 01 BP 364, Ouagadougou 01, Burkina Faso
- Faculty of Medicine, University of Saint Thomas Aquinas, 06 BP 10212, Ouagadougou 01, Burkina Faso
- Saint Camille Hospital of Ouagadougou (HOSCO), Ouagadougou BP 444, Burkina Faso
| | | | | | - Rogomenoma Alice Ouedraogo
- Laboratory of Molecular Biology and Genetics (LABIOGENE), Department of Biochemistry and Microbiology, University of Joseph KI-ZERBO, 03 BP 7021, Ouagadougou 03, Burkina Faso
- Pietro Annigoni Biomolecular Research Center (CERBA), 01 BP 364, Ouagadougou 01, Burkina Faso
| | - Albert Théophane Yonli
- Laboratory of Molecular Biology and Genetics (LABIOGENE), Department of Biochemistry and Microbiology, University of Joseph KI-ZERBO, 03 BP 7021, Ouagadougou 03, Burkina Faso
- Pietro Annigoni Biomolecular Research Center (CERBA), 01 BP 364, Ouagadougou 01, Burkina Faso
| | - Prosper Bado
- Laboratory of Molecular Biology and Genetics (LABIOGENE), Department of Biochemistry and Microbiology, University of Joseph KI-ZERBO, 03 BP 7021, Ouagadougou 03, Burkina Faso
- Pietro Annigoni Biomolecular Research Center (CERBA), 01 BP 364, Ouagadougou 01, Burkina Faso
| | - Paul Ouedraogo
- Saint Camille Hospital of Ouagadougou (HOSCO), Ouagadougou BP 444, Burkina Faso
| | - Teega-Wendé Clarisse Ouedraogo
- Laboratory of Molecular Biology and Genetics (LABIOGENE), Department of Biochemistry and Microbiology, University of Joseph KI-ZERBO, 03 BP 7021, Ouagadougou 03, Burkina Faso
- Pietro Annigoni Biomolecular Research Center (CERBA), 01 BP 364, Ouagadougou 01, Burkina Faso
| | - Tampoula Edwige Yelemkoure
- Laboratory of Molecular Biology and Genetics (LABIOGENE), Department of Biochemistry and Microbiology, University of Joseph KI-ZERBO, 03 BP 7021, Ouagadougou 03, Burkina Faso
- Pietro Annigoni Biomolecular Research Center (CERBA), 01 BP 364, Ouagadougou 01, Burkina Faso
| | - Punya Akouélé Kuassi-Kpede
- Laboratory of Molecular Biology and Genetics (LABIOGENE), Department of Biochemistry and Microbiology, University of Joseph KI-ZERBO, 03 BP 7021, Ouagadougou 03, Burkina Faso
- Pietro Annigoni Biomolecular Research Center (CERBA), 01 BP 364, Ouagadougou 01, Burkina Faso
| | - Dorcas Obiri-Yeboah
- Department of Microbiology and Immunology, School of Medical Sciences, University of Cape Coast, Cape Coast, Ghana
| | | | - Jacques Simpore
- Laboratory of Molecular Biology and Genetics (LABIOGENE), Department of Biochemistry and Microbiology, University of Joseph KI-ZERBO, 03 BP 7021, Ouagadougou 03, Burkina Faso
- Pietro Annigoni Biomolecular Research Center (CERBA), 01 BP 364, Ouagadougou 01, Burkina Faso
- Faculty of Medicine, University of Saint Thomas Aquinas, 06 BP 10212, Ouagadougou 01, Burkina Faso
- Saint Camille Hospital of Ouagadougou (HOSCO), Ouagadougou BP 444, Burkina Faso
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