Pathways of IFN-alpha Activation in Patients with Cervical Intraepithelial Neoplasia (CIN)

OBJECTIVE

 The aim of the present study was to compare the local and systemic expression of the factors linked to the interferon alpha (IFN-α) activation pathway in different degrees of cervical intraepithelial neoplasia (CIN) and cervical cancer.

METHODS

 A total of 128 patients with CIN I, CIN II, CIN III and cervical cancer was evaluated. The real-time polymerase chain reaction (RT-PCR) technique was used to evaluate the gene expression of IFNR1, IFNR2, IFN-α, oligoadenylate synthase (2'5'OAS), cytokine signal suppressor 1 (SOCS) 1, SOCS3, signal transducer and transcription activator 1 (STAT1), and IRF9 from 128 biopsies. A total of 46 out of 128 samples were evaluated by flow cytometry for IFNAR1, IFNAR2, STAT1, IRF7 and IFN-α in peripheral blood cells.

RESULTS

 Patients with CIN II and III (63 samples) had a low local expression of IFNR1, but not IFNR2. Patients with some degree of injury showed high expression of SOCS1 and SOCS3. Systemically, patients with CIN II and III (20 samples) had a significant increase in IFNR1, IFNR2, STAT1, IRF7, and IFN-α in helper, cytotoxic T lymphocytes, and in monocytes.

CONCLUSION

 Patients with high-grade lesions have increased systemic expression of IFN-α and its activation pathways in helper and cytotoxic T lymphocytes, as well as in monocytes due to an exacerbation of the immune response in these patients. This phenomenon is not accompanied by resolution of the lesion due to a defect in the IFN-α activation pathway that revealed by low local IFNAR1 expression and high local expression of SOCS1 and SOCS3.

The clinical use of type 1 interferon in gynecology

Interferons were initially described in terms of their role in blocking viral replication. They are important cytokines that act on various aspects of cell physiology. Importantly, they can affect cell proliferation or induce the differentiation of neoplastic cells. The exact way in which the interferon complex (IFN) acts on tumours is still unknown, although their use in clinical practice has been widely recommended, especially with tumours that are resistant to conventional treatments, or in situations where surgical removal might lead to a loss of organ function. IFN can be employed as a treatment for various chronic diseases, including tumours. Indeed interferon cytokines are the therapy of choice in certain situations. However, one of the difficulties yet to be overcome is the need for frequent administrations of the drug. We believe that the development of new formulations is needed to match the demand for its use in oncology treatment.

Frequency of infectious agents for vaginitis in patients with a cytological diagnosis of atypical squamous cells of undetermined significance

AIM

To evaluate the presence of infectious agents for vaginitis in patients with ASCUS.

METHODS

33,388 patients who underwent cervical-vaginal cytology from 08/1993 to 05/2002 were included in the study, and 1,104 (3.4%) presented positive ASCUS. The appraised infectious agents were Coccobacilli, Candida sp, Trichomonas vaginalis, and clue cells (Gardnerella vaginalis).

RESULTS

In the group with ASCUS a larger frequency of Coccobacilli (22.37%) and Trichomonas vaginalis (5.25%) was found when compared with the group with negative ASCUS (17.79% and 3.98%, respectively; p < 0.05). Cytolysis occurred more frequently in patients with ASCUS (3.8 vs 6.3%, first phase and 4.5 vs 10%, second phase).

CONCLUSIONS

We believe that some diagnoses of ASCUS can be induced by the presence of infectious agents for vaginitis, mainly cocci and coccoides. ASCUS occurs more frequently in the first phase of the menstrual cycle, therefore in less acid vaginal pH.