The role of genital pathogens in morbidity following diathermy loop excision of the transformation zone of the uterine cervix

Arko, Darja; Dovnik, Andraž; Fokter, Nina; Takač, Iztok

doi:10.1016/j.ijgo.2011.11.015

Cited by 4 publications

(5 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…An explanation of the relatively common ASC found in the genital epithelium of pups could be shifts in the local microbiome during neonatal development, as has been reported for humans [61] and mice [62], or alternatively, infections by other pathogens, such as Candida, Chlamydia, Trichomonas and Mycoplasma [41][42][43], some of which are common inhabitants of the genital tracts of otariid pinnipeds [13,63]. These possibilities need to be explored in the future.…”

Section: Discussionmentioning

confidence: 95%

“…LSIL includes mild dysplasia and cervical intraepithelial neoplasia grade I [40]. ASC refers to the presence of atypical cells that do not tend to transform to a malignant state and could be caused by infection by various pathogens, such as Trichomonas vaginalis, Mycoplasma genitalium, Chlamydia trachomatis, Candida and Streptococcus agalactiae [41][42][43].…”

Section: Cytologymentioning

confidence: 99%

See 1 more Smart Citation

Transformation of the genital epithelial tract occurs early in California sea lion development

et al. 2016

View full text Add to dashboard Cite

An unusually high prevalence of metastatic urogenital carcinoma has been observed in free-ranging California sea lions stranded off the coast of California in the past two decades. No cases have been reported for sea lions in the relatively unpolluted Gulf of California. We investigated occurrence of genital epithelial transformation in 60 sea lions (n=57 pups and 3 adult females) from the Gulf of California and examined whether infection by a viral pathogen previously found to be associated with urogenital carcinoma accounted for such alterations. We also explored the contribution of MHC class II gene expression on transformation. Cellular alterations, such as squamous cell atypia (ASC), atypical squamous cells of undetermined significance (ASCUS) and low-grade squamous intraepithelial lesions were observed in 42% of the pups and in 67% of the adult females. Normal genital epithelium was more common in male than female pups. ASC was five times more likely to occur in older pups. Epithelial alterations were unrelated to infection by the potentially oncogenic otarine type I gammaherpesvirus (OtHV-1), but ASCUS was more common in pups with marked and severe inflammation. Expression of MHC class II DRB loci (Zaca DRB-D) by peripheral antigen-presenting leucocytes showed a slightly ‘protective’ effect for ASC. We propose that transformation of the California sea lion genital epithelium is relatively common in young animals, increases with age and is probably the result of infection by an unidentified pathogen. Expression of a specific MHC class II gene, suggestive of presentation of specific antigenic peptides to immune effectors, appears to lower the risk of transformation. Our study provides the first evidence that epithelial transformation of the California sea lion genital tract is relatively common, even from an early age, and raises questions regarding differences in sea lion cancer-detection and -repair success between geographical regions.

show abstract

Section: Discussionmentioning

confidence: 95%

Section: Cytologymentioning

confidence: 99%

Transformation of the genital epithelial tract occurs early in California sea lion development

et al. 2016

View full text Add to dashboard Cite

show abstract

“…In addition to serving as a physical barrier, CMPs contain a variety of antimicrobial compounds including cytokines, lactoferrin, lysozyme, and AMPs (Hein et al, 2002;Lee et al, 2011;Arko et al, 2012). Thus, the CMP may be intrinsically antimicrobial and serve as a checkpoint in preventing vaginal pathogens from ascending through the cervix to invade the uterus (Hein et al, 2001;Becher et al, 2009).…”

Section: The Cervical Mucus Plug: a Barrier To Ascensionmentioning

confidence: 99%

Bacterial and Host Determinants of Group B Streptococcal Vaginal Colonization and Ascending Infection in Pregnancy

Brokaw

Furuta

Dacanay

et al. 2021

Front. Cell. Infect. Microbiol.

View full text Add to dashboard Cite

Group B streptococcus (GBS) is a gram-positive bacteria that asymptomatically colonizes the vaginal tract. However, during pregnancy maternal GBS colonization greatly predisposes the mother and baby to a wide range of adverse outcomes, including preterm birth (PTB), stillbirth, and neonatal infection. Although many mechanisms involved in GBS pathogenesis are partially elucidated, there is currently no approved GBS vaccine. The development of a safe and effective vaccine that can be administered during or prior to pregnancy remains a principal objective in the field, because current antibiotic-based therapeutic strategies do not eliminate all cases of invasive GBS infections. Herein, we review our understanding of GBS disease pathogenesis at the maternal-fetal interface with a focus on the bacterial virulence factors and host defenses that modulate the outcome of infection. We follow GBS along its path from an asymptomatic colonizer of the vagina to an invasive pathogen at the maternal-fetal interface, noting factors critical for vaginal colonization, ascending infection, and vertical transmission to the fetus. Finally, at each stage of infection we emphasize important host-pathogen interactions, which, if targeted therapeutically, may help to reduce the global burden of GBS.

show abstract

“…During pregnancy, a dense and viscous mucoid structure known as the cervical mucus plug (CMP) forms in the cervical canal. In addition to acting as a physical barrier, CMPs can harbor pro-inflammatory cytokines as well as a variety of antimicrobial compounds, including lysozyme, lactoferrin, calprotectin, and secretory leukoprotease inhibitor 1, which vary by individual [171][172][173]. Although our understanding of the CM P's role in defending against pathogenic bacteria is poor, a recent study examining 60 human CMPs showed that CMP-associated proteins activated leukocytes in whole blood, resulting in increased GBS killing [174].…”

Section: Cmp Compositionmentioning

confidence: 99%

“…Maternal CPS-specific antibody production Associated with asymptomatic vaginal colonization [149,150] Associated with enhanced vaginal clearance [150] Associated with reduced risk of early onset disease in newborns [151] CPS-based conjugate vaccines [152][153][154][155][156][157][158] Mucosal immunity Neutrophils [97,98,161], macrophages [97], mast cells [99] promote clearance of GBS from the vagina Soluble inflammatory mediators promote clearance of GBS from the vagina [97,98,161] IL-17 and IL-17+ cells promoted clearance of persistent strain [161] Humoral immunity in vaginal mucosa promotes clearance of GBS from the vagina [162] Deficiencies may increase risk for invasive disease Mucosal vaccination tested using in vivo mouse models [162] Vaginal epithelial exfoliation Disrupts barrier function of vaginal epithelia, promotes ascending GBS infection [170] None known Cervical mucus plug Physical barrier between lower genital tract and uterus Can secrete pro-inflammatory cytokines, chemokines (not tested in vivo) [171][172][173] Can retain antibiotic drugs that kill GBS [174] Antimicrobial compounds within CMPs insufficient to kill GBS [174] None known Mast cell chymase Inhibits GBS's ability to bind fibronectin [87] None known…”

Section: Factor Effect On Gbs Colonization/virulence Interventionmentioning

confidence: 99%

The Double Life of Group B Streptococcus: Asymptomatic Colonizer and Potent Pathogen

Armistead

Oler

Waldorf

et al. 2019

Journal of Molecular Biology

View full text Add to dashboard Cite

Group B Streptococcus (GBS) is a β-hemolytic Gram-positive bacterium that colonizes the lower genital tract of approximately 18% of women globally as an asymptomatic member of the gastrointestinal and/or vaginal flora. If established in other host niches, however, GBS is highly pathogenic. During pregnancy, ascending GBS infection from the vagina to the intrauterine space is associated with preterm birth, stillbirth, and fetal injury. In addition, vertical transmission of GBS during or after birth results in life-threatening neonatal infections, including pneumonia, sepsis, and meningitis. Although the mechanisms by which GBS traffics from the lower genital tract to vulnerable host niches are not well understood, recent advances have revealed that many of the same bacterial factors that promote asymptomatic vaginal carriage also facilitate dissemination and virulence. Further, highly pathogenic GBS strains have acquired unique factors that enhance survival in invasive niches. Several host factors also exist that either subdue GBS upon vaginal colonization or alternatively permit invasive infection. This review summarizes the GBS and host factors involved in GBS's state as both an asymptomatic colonizer and invasive pathogen. Gaining a better understanding of these mechanisms is key to overcoming the challenges associated with vaccine development and identification of novel strategies to mitigate GBS virulence.

show abstract

The role of genital pathogens in morbidity following diathermy loop excision of the transformation zone of the uterine cervix

Abstract: Genital pathogens are very common among patients with CIN and do not affect the occurrence or severity of pain, discharge, or postoperative bleeding after diathermy LETZ.

Cited by 4 publications

References 20 publications

Transformation of the genital epithelial tract occurs early in California sea lion development

Transformation of the genital epithelial tract occurs early in California sea lion development

Bacterial and Host Determinants of Group B Streptococcal Vaginal Colonization and Ascending Infection in Pregnancy

The Double Life of Group B Streptococcus: Asymptomatic Colonizer and Potent Pathogen

Contact Info

Product

Resources

About