Empowering Women's Health: Insights Into HPV Vaccination and the Prevention of Invasive Cervical Cancer

Unraveling the triad of immunotherapy, tumor microenvironment, and skeletal muscle biomechanics in oncology

The intricate interaction between skeletal muscle biomechanics, the tumor microenvironment, and immunotherapy constitutes a pivotal research focus oncology. This work provides a comprehensive review of methodologies for evaluating skeletal muscle biomechanics, including handheld dynamometry, advanced imaging techniques, electrical impedance myography, elastography, and single-fiber experiments to assess muscle quality and performance. Furthermore, it elucidates the mechanisms, applications, and limitations of various immunotherapy modalities, including immune checkpoint inhibitors, adoptive cell therapy, cancer vaccines, and combined chemoimmunotherapy, while examining their effects on skeletal muscle function and systemic immune responses. Key findings indicate that although immunotherapy is effective in augmenting antitumor immunity, it frequently induces muscle-related adverse effects such as weakness, fatigue, or damage, primarily mediated by cytokine release and immune activation. This work underscores the significance of immune niches within the tumor microenvironment in influencing treatment outcomes and proposes strategies to optimize therapy through personalized regimens and combinatorial approaches. This review highlights the need for further research on the formation of immune niches and interactions muscle-tumor. Our work is crucial for advancing the efficacy of immunotherapy, reducing adverse effects, and ultimately improving survival rates and quality of life of patients with cancer.

Cervical cancer burden and attributable risk factors across different age and regions from 1990 to 2021 and future burden prediction: results from the global burden of disease study 2021

Background

Cervical cancer (CC) is a global public health problem. We aimed to evaluate the global and regional CC burden between 1990 and 2021, identify the attributable risk factors, and project its burden up to 2035.

Methods

Data were extracted from the Global Burden of Disease Study 2021, and the CC incidence, mortality, age-standardized incidence rate (ASIR), age-standardized death rate (ASDR), age-standardized disability-adjusted life years (DALYs), and attributable risk factors from 1990 to 2021 were analyzed. The impacts of geographical variations, different age groups, and the socio-demographic index (SDI) on CC morbidity and mortality measurements were assessed. The attributable risk factors to CC death and DALY were evaluated, and the incidence, mortality, and DALYs to 2035 were projected.

Results

Globally, the number of CC cases has increased from 409,548.49 cases in 1990 to 667,426.40 cases in 2021. However, the ASIR decreased from 18.11 to 15.32 per 100,000, with the greatest ASIR decrease in high SDI regions (estimated annual percentage change: -1.41). Between 1990 and 2021, the global ASDR decreased from 9.68 to 6.62 per 100,000, and the rate of age-standardized DALYs decreased from 330.11 to 226.28 per 100,000. However, these improvements were not consistent across different SDI regions. The CC incidence was the highest in the 55-59 age group, globally. The risk factors, which included unsafe sex and smoke, significantly varied by region. The global ASIR exhibited a downward trend from 2021 to 2035.

Conclusion

From 1990 to 2021, although the overall trend in incidence, mortality, and DALYs of CC exhibited a global and regional downward trend, there were significant disparities among areas with different socioeconomic development. More efficient targeted prevention and management strategies, easy access to health care in less developed regions, and risk factor modifications should be promoted, in order to reduce the global burden of CC.

Regulation of Granzymes A and B by High-Risk HPV: Impact on Immune Evasion and Carcinogenesis

The number of new cancer cases is soaring, and currently, there are 440.5 per 100,000 new cases reported every year. A quarter of these are related to human papillomavirus (HPV) infections, particularly types 16 and 18. These include oropharyngeal, anal, vaginal, and penile cancers. A critical aspect of their oncogenic potential lies in their ability to manipulate host immune responses, facilitating immune evasion and carcinogenesis. High-risk HPVs target key immune components like granzymes A and B and MHC-I, which are crucial for the elimination of virus-infected and transformed cells, thereby weakening immune surveillance. Evidence suggests that high-risk HPVs downregulate the expression of tumor suppressors, such as p53 and pRB, and the activity of these immune components, weakening CTL and NK cell responses, thus enabling persistent infection and carcinogenesis. We discuss the implications of granzyme and MHC-I dysregulation for immune evasion, tumor progression, and potential therapeutic strategies. This review further explores the regulation of granzyme A, B, and MHC-I by high-risk HPVs, focusing on how viral oncoproteins, E6 and E7, interfere with granzyme-mediated cytotoxicity and antigen presentation. The complex interplay between high-risk HPVs, granzyme A, granzyme B, and MHC-I may provide insights into novel approaches for targeting HPV-associated cancers.

Immunotherapeutic effects of TCL-E5 and TCL-E5-pulsed DCs: two novel HPV therapeutic vaccine candidates

AIM

This study investigated the potential of HPV16 E5 oncoprotein-modified tumor cell lysate (TCL-E5) and dendritic cells (DCs) pulsed with TCL-E5 (TCL-E5-pulsed DCs) to enhance antitumor immunity in a murine model.

MATERIALS AND METHODS

For generation of TCL-E5, TC1 tumor cells were transduced with lentiviral particles harboring E5 protein. Moreover, the cell supernatants were prepared from DCs pulsed with TCL-E5. Their immunological responses and antitumor effects were investigated in a mouse model.

RESULTS

The TCL-E5-pulsed DCs regimen could direct immunity toward Th1 and CTL responses, leading to tumor volume reduction and high percentage of tumor-free mice.

CONCLUSION

The TCL-pulsed DCs regimen could not induce significant antitumor effects compared to TCL-E5-pulsed-DCs regimen indicating main role of E5 in vaccine development.

Empowering India's fight against cervical cancer: Harnessing routine HPV immunisation

Cervical cancer, driven by human papillomavirus (HPV) infection, presents a significant health challenge in India, marked by high morbidity and mortality rates among women. This systemic review synthesises the latest research on HPV epidemiology in India, evaluates the effectiveness of existing vaccination programmes and compares India's strategies with those of countries that have successfully mitigated cervical cancer burden. Despite available vaccines targeting high-risk HPV types, vaccine coverage remains suboptimal due to challenges, such as accessibility, vaccine hesitancy and socioeconomic barriers. Comparative analysis suggests that school-based and community engagement strategies could enhance vaccination efforts. Addressing India's cervical cancer burden requires a multifaceted approach that includes expanding HPV vaccination coverage, implementing public awareness campaigns and adopting best practices from global successes. Economic analyses affirm the cost-effectiveness of such strategies, highlighting the potential for significant public health and financial benefits.

Attitudes and awareness related to cervical cancer vaccine

INTRODUCTION

Cervical cancer causes major morbidity and mortality around the world. This makes prophylactic vaccines a significant tool for preventing the disease. As these vaccines become more widely available, they have the potential to drastically lower the cancer's prevalence and burden in the future.

Factors influencing human papillomavirus vaccine uptake among parents and teachers of schoolgirls in Saudi Arabia: a cross-sectional study

Introduction

Cervical cancer is a highly prevalent disease among women worldwide. However, the advent of a vaccine against HPV, the main cause of the disease, has prevented its spread. The acceptability of the HPV vaccine to different sectors of the Saudi community has yet to be clarified. Since parents and teachers are major influencers in the decision-making process of vaccination for HPV, this study aimed to assess the knowledge and attitudes of teachers and parents toward cervical cancer, HPV, and the HPV vaccine, and unraveled the factors that would influence recommending the vaccine.

Methods

A cross sectional study was done among 927 individuals (373 teachers and 356 parents). A newly developed validated questionnaire was used to collect data on knowledge, attitude, and factors influencing cervical cancer, HPV, HPV vaccine. The relationship between different factors with knowledge and attitude were assessed using univariate and multivariate analysis.

Results

Of the study participants, 94% were females, with a median (Interquartile range) age of 38(31-44) years, 12.2% were teachers, 38.7% were parents and 49.1% were parents and teachers. The majority (78.5%) were married, and 75.6% had at least one child. Among those with children, 88.6% had at least one girl, and among those with girls, 72.2% had at least one girl aged between 10 and 18 years. The total median (IQR) knowledge score was 9 [(-5)-(-26)] and the total median (IQR) attitude score was 49 (43-56). The knowledge score significantly increased by receiving postgraduate education, working in the health or education sectors, if a person knew someone diagnosed with cervical cancer, having girls in the age group of 10-18 years, reading about medical issues or having previously heard about the HPV vaccine. The attitude score significantly increased by high knowledge score and decreased if the person has previously diagnosed with cervical cancer.

Conclusion

Physician's recommendation and the amount of information on the HPV vaccine, opinions about vaccines in general, and government decrees are the main factors influencing decision on HPV vaccine Uptake. This study emphasizes the role of healthcare providers, awareness of cervical cancer, HPV and its vaccine, and social status, in favoring vaccine uptake in Saudi Arabia.

Optimizing Human Papillomavirus (HPV) Screening: Urine Sample Analysis and Associated Factors in Uzbekistan

Objective This study assessed the accuracy of detecting Human Papillomavirus (HPV) DNA in urine samples compared to cervical samples and identified factors associated with HPV DNA positivity in Uzbekistan. Methods A total of 218 paired urine and cervical samples were collected from women in Uzbekistan. HPV DNA was detected using polymerase chain reaction (PCR) with genotyping. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and Cohen's Kappa coefficient were calculated. Univariate and multivariate analyses were conducted to identify factors associated with HPV DNA positivity. Results The study included 32.6% (71/218) positive HPV DNA by cervical samples, which demonstrated 19.7% (43/218) HPV DNA presence by urine samples. Urine HPV testing had a sensitivity of 57.7%, specificity of 98.6%, PPV of 95.3%, NPV of 82.9%, and Kappa coefficient of 60.1. To reveal factors associated with HPV DNA positivity, we set the positive 71 cases as the main group, and 147 negative samples as the control group. The results of the multivariate analysis found the association between HPV DNA positivity and included age 31-40 years (AOR=8.2), working as medical staff (AOR=7.51), condom use (AOR=0.12), having foamy (AOR=7.26) or purulent (AOR=6.84) vaginal discharge. Conclusion Urine HPV testing showed good agreement with cervical samples, although sensitivity was lower than some previous reports. Several sociodemographic and clinical factors were associated with HPV DNA positivity. Further optimization of urine collection, storage, and testing methods may improve sensitivity. Targeted screening of high-risk groups could enhance HPV prevention strategies in Uzbekistan.

A combination of cuproptosis and lncRNAs predicts the prognosis and tumor immune microenvironment in cervical cancer

BACKGROUND

Cuproptosis induces proteotoxic stress and eventually leads to cell death. However, the relationship between cuproptosis and lncRNAs in cervical cancer has not been fully elucidated. Therefore, we aim to explore the association among lncRNAs, cuproptosis and clinical features in cervical cancer.

METHODS

RNA sequencing, genetic mutations, and clinical data of CESC patients were obtained from TCGA. Cuproptosis-associated genes were gathered. WGCNA was used to cluster important modules, and KEGG, GO, GSEA and GSVA were used to explore functional and pathway enrichment. The association between immune microenvironment and cuproptosis-related lncRNAs was performed by using cibersort algorithm and other platforms, including XCELL, TIMER, QUANTISEQ, MCPCOUNTER and EPIC. Fluorescence quantitative PCR was employed to detect the expression of LINC01833 and LINC02321, and CCK-8 and cell scratch assays were used to assess cell proliferation and migration capabilities after LINCRNA interference.

RESULTS

202 upregulated and 45 downregulated lncRNAs were selected. The survival analysis showed that there was a statistically significant difference in survival rates between the high-risk and low-risk groups. The prognosis of tumour mutation burden and the degree of immune infiltration were differed noticeably between the high-risk and low-risk groups. BHG712, TL-2-105, FR-180204, Masitinib, TAK-715, ODI-027, JW-7-24-2, and OSI-930 had substantially higher IC50 values in the high-risk group. Notably, we found AL360178.1 was associated with RNF44 E3 ubiquitin ligase expression. In cervical cancer cell lines, LINC01833 and LINC02321 displayed significant upregulation. Efficient siRNA transfection led to a decreased expression of LINC01833 and LINC02321. This knockdown significantly hindered both cell proliferation and migration capabilities in cervical cancer cells compared to the negative control.

CONCLUSION

In conclusion, we constructed five cuprotosis-related lncRNA prognostic models, which may be new tumor therapeutic targets for the prevention and treatment of cervical cancer.