Gynaecological Infections as Risk Determinants of Subsequent Cervical Neoplasia

Viikki, Merja; Pukkala, Eero; Nieminen, Pekka; Hakama, Matti

doi:10.1080/028418600431003

Cited by 178 publications

(113 citation statements)

References 20 publications

Supporting

Mentioning

104

Contrasting

Unclassified

Order By: Relevance

“…Indeed v. trichomonas may act as co-factor of HPV exposure in carcinogenesis. 10,12,40 For example, in a meta-analysis of v. trichomoniasis and CIN I-III plus CC, the OR was 1.93 (1.22-2.65) in 2 cohort studies, whereas the OR in 22 case-control studies was much less consistent. 42 In our study, we did not collect data on treatment for infection.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for HPV infection and cervical cancer among unscreened women in a high-risk rural area of China

et al. 2006

View full text Add to dashboard Cite

We report a prevalence rate of 23.6% human papillomavirus (HPV) infection with oncogenic subtypes and 2.4% cervical intraepithelial neoplasia (CIN) III and cervical cancer (CC) in rural middle-aged women in 2 counties with the highest CC mortality in Shanxi Province, China. We examined the association of risk factors to HPV infection and to CIN III and CC in 8,798 unscreened women aged 35-50 years. Multivariate odds ratios (OR) and 95% confidence intervals (CI) for each endpoint were obtained for risk factors after adjustment for covariates. The OR of oncogenic HPV were: 1.41 (95% CI 5 1.25-1.60) and 1.42 (95% CI 5 1.24-1.61) for the participant and her husband having multiple sexual partners, respectively; 1.67 (95% CI 5 1.37-2.04), 1.15 (95% CI 5 1.04-1.26), and 0.82 (95% CI 5 0.72-0.94) for ever (vs. never) diagnosed with tuberculosis, cervical inflammation and vaginal trichomoniasis, respectively; while bathing in a public (v. private) facility had an OR of 1.23 (95% CI 51.11-1.35). Seasonal fluctuations in HPV infection, but not CC, appeared in Xiangyuan County, with OR of 1.23 (95% CI 5 1.14-1.33) and 1.51 (95% CI 5 1.35-1.67) in Spring and Winter compared to Summer, respectively. The OR of CIN III and CC in the HPV positives were: 2.03 (95% CI 5 1.63-2.53) for ages 45 years (vs. <40); and 4.01 (95% CI 5 1.46-11.0) for 3 (vs. no) home births. Public health interventions and control strategies for improving the reproductive health of women in these rural populations need to be developed to reduce risk of HPV and subsequent CC. ' 2005 Wiley-Liss, Inc.Key words: cervical cancer; human papillomavirus; tuberculosis; trichomoniasis Wide disparities in cervical cancer (CC) incidence and mortality throughout the world are mainly attributable to differences in access to programs that detect and treat pre-invasive disease of the cervix.1 Although the CC mortality rate in China has declined markedly from 14.6 to 4.3/100,000 in the past 20 years, 2 some medically underserved rural areas without access to CC screening continue to experience high mortality. A prime example is Yangcheng County with a mortality rate of 52/100,000 in Shanxi Province, which has the highest CC mortality rate in China.2 Cervical cancer represents a major health burden in poor rural areas like Shanxi Province located in the middle of China.Although infection with oncogenic subtypes of human papillomavirus (HPV) has been clearly established as a necessary cause of CC, 3,4 the low incidence of CC in contrast with the extremely high lifetime cumulative incidence of cervical infection with HPV suggests additional etiologic co-factors are involved in CC pathogenesis. 5,6 Research on risk factors for CC or HPV infection has been carried out in many countries, 7-10 but only 2 earlier studies have examined risk factors for CC in China.11,12 State-of-the-art techniques for detecting HPV DNA and biopsy-based diagnoses have changed since earlier reports in China, with the potential for changes in previous prevalence estimates of HPV infection and the ide...

show abstract

Section: Discussionmentioning

confidence: 99%

Risk factors for HPV infection and cervical cancer among unscreened women in a high-risk rural area of China

et al. 2006

View full text Add to dashboard Cite

show abstract

“…Previous studies have already demonstrated that the production of IL-8 by neutrophils [12] and monocytes [13] is stimulated in response to T. vaginalis. In addition, nitric oxide (NO) is an effector of macrophage-mediated cytotoxicity against the parasite [14], and leukotriene B 4 (LTB 4 ) is a neutrophil-activating factor released by T. vaginalis [15]. These molecules are found in the vaginal discharges of symptomatic patients [16] and provide the induction of a rapid accumulation of neutrophils at the affected site in order to eliminate the invading mucosal pathogen [17].…”

Section: Introductionmentioning

confidence: 99%

“…There are 160-180 million cases occurring each year worldwide [1]. Trichomonosis has been associated with serious health consequences for women, including adverse pregnancy outcomes [2], infertility [3], predisposition to cervical cancer [4], and pelvic inflammatory disease [5]. The infection among men is a recognized cause of urethritis, and complications such as prostatitis, epididymitis, and infertility have been described [6].…”

Section: Introductionmentioning

confidence: 99%

Involvement of purinergic signaling on nitric oxide production by neutrophils stimulated with Trichomonas vaginalis

Frasson

Carli

Bonan

et al. 2011

Purinergic Signalling

View full text Add to dashboard Cite

Trichomonas vaginalis is a parasite from the human urogenital tract that causes trichomonosis, the most prevalent non-viral sexually transmitted disease. The neutrophil infiltration has been considered to be primarily responsible for cytological changes observed at infection site, and the chemoattractants can play an important role in this leukocytic recruitment. Nitric oxide (NO) is one of the most widespread mediator compounds, and it is implicated in modulation of immunological mechanisms. Extracellular nucleotides and nucleosides are signaling molecules involved in several processes, including immune responses and control of leukocyte trafficking. Ectonucleoside triphosphate diphosphohydrolase members, ecto-5′-nucleotidase, and adenosine deaminase (ectoADA) have been characterized in T. vaginalis. Herein, we investigated the effects of purinergic system on NO production by neutrophils stimulated with T. vaginalis. The trophozoites were able to induce a high NO synthesis by neutrophils through iNOS pathway. The extracellular nucleotides ATP, ADP, and ATPγS (a nonhydrolyzable ATP analog) showed no significant change in NO secretion. In contrast, adenosine and its degradation product, inosine, promoted a low production of the compound. The immunosuppressive effect of adenosine upon NO release by neutrophils occurred due to adenosine A 2A receptor activation. The ecto-5′-nucleotidase activity displayed by T. vaginalis was shown to be important in adenosine generation, indicating the efficiency of purinergic cascade. Our data suggest the influence of purinergic signaling, specifically adenosinergic system, on NO production by neutrophils in T. vaginalis infection, contributing to the immunological aspects of disease.

show abstract

“…Each year, 160-180 million people are infected with T. vaginalis worldwide (McClelland 2008). T. vaginalis infection is associated with serious adverse health consequences in women, including infertility (El-Shazly et al 2001), atypical pelvic inflammatory disease (Moodley et al 2002), pre-term delivery and delivery of low birth weight infants (Cotch et al 1997) and predisposition to cervical neoplasia (Viikki et al 2000). The effects of Tritrichomonas foetus infection in cows vary from mild vaginitis or cervicitis to endometritis, abortion and infertility (Parsonson et al 1976, Anderson et al 1996.…”

mentioning

confidence: 99%

Trichomonas vaginalis and Tritrichomonas foetus: interaction with fibroblasts and muscle cells - new insights into parasite-mediated host cell cytotoxicity

Vilela

Benchimol

2012

Mem. Inst. Oswaldo Cruz

View full text Add to dashboard Cite

Trichomonas vaginalis and Tritrichomonas foetus are parasitic, flagellated protists that inhabit the urogenital tract of humans and bovines, respectively. T. vaginalis causes the most prevalent non-viral sexually transmitted disease worldwide and has been associated with an increased risk for human immunodeficiency virus-1 infection in humans. Infections by T. foetus cause significant losses to the beef industry worldwide due to infertility and spontaneous abortion in cows. Several studies have shown a close association between trichomonads and the epithelium of the urogenital tract. However, little is known concerning the interaction of trichomonads with cells from deeper tissues, such as fibroblasts and muscle cells. Published parasite-host cell interaction studies have reported contradictory results regarding the ability of T. foetus and T. vaginalis to interact with and damage cells of different tissues. In this study, parasite-host cell interactions were examined by culturing primary human fibroblasts obtained from abdominal biopsies performed during plastic surgeries with trichomonads. In addition, mouse 3T3 fibroblasts, primary chick embryo myogenic cells and L6 muscle cells were also used as models of target cells. The parasite-host cell cultures were processed for scanning and transmission electron microscopy and were tested for cell viability and cell death. JC-1 staining, which measures mitochondrial membrane potential, was used to determine whether the parasites induced target cell damage. Terminal deoxynucleotidyltransferase-mediated dUTP nick end labelling staining was used as an indicator of chromatin damage. The colorimetric crystal violet assay was performed to ana-lyse the cytotoxicity induced by the parasite. The results showed that T. foetus and T. vaginalis adhered to and were cytotoxic to both fibroblasts and muscle cells, indicating that trichomonas infection of the connective and muscle tissues is likely to occur; such infections could cause serious risks to the infected host

show abstract

Gynaecological Infections as Risk Determinants of Subsequent Cervical Neoplasia

Cited by 178 publications

References 20 publications

Risk factors for HPV infection and cervical cancer among unscreened women in a high-risk rural area of China

Risk factors for HPV infection and cervical cancer among unscreened women in a high-risk rural area of China

Involvement of purinergic signaling on nitric oxide production by neutrophils stimulated with Trichomonas vaginalis

Trichomonas vaginalis and Tritrichomonas foetus: interaction with fibroblasts and muscle cells - new insights into parasite-mediated host cell cytotoxicity

Contact Info

Product

Resources

About