Baseline characteristics and prevalence of HPV 6, 11, 16, 18 in young German women participating in phase III clinical trials of a quadrivalent HPV (6/11/16/18) vaccine.

INTRODUCTION: As limited data among German women exist about HPV, Chlamydia trachomatis (CT) and Neisseria gonorrhoeae, we report the prevalence of these genital infections and general baseline demographics of the young German women enrolled in the phase III trials of the quadrivalent HPV vaccine. MATERIALS AND METHODS: German females (n = 437; 9-23 years) were recruited among 3 international phase 3 studies of an HPV-6/11/16/18 vaccine. We present baseline characteristics, prevalence of HPV-6/11/16/18 and, for women aged 16-23, abnormal cervical cytology and sexually transmitted diseases. RESULTS: Chlamydia trachomatis and Neisseria gonorrhoeae prevalence was 5 and 0.3%, respectively. Approximately 17% of participants had HPV-6, 11, 16, or 18 DNA or antibodies. All subjects <17 years were naïve to the four vaccine types. DISCUSSION: The results of the vaccine trials have demonstrated that it is worth administering prophylactic HPV vaccines before sexual debut; however, none of these sexually active German women were positive to all four types and most were positive to only one type. Thus, all women had the potential to benefit from vaccination with a quadrivalent HPV vaccine.

Immunohistochemical visualisation of cathepsin-D expression in breast cancer.

BACKGROUND: Cathepsin D (Cath-D), a lysosomal protease, is considered to be involved in the breakdown of the extracellular matrix during the process of tumour metastasis. Its expression in breast cancer in association with known factors of prognosis was investigated in this study. MATERIAL AND METHODS: 120 breast cancer tumours were analysed immunohistochemically and evaluated with the immunoreactive score (IRS). Statistical evaluation was performed using the Mann-Whitney test (p < 0.05). RESULTS: For nodal-positive tumors we found a statistically significant increase of Cath-D immunohistochemical reaction. Ductal carcinomas showed a significantly higher immunohistochemical reaction compared to lobular carcinomas. We found a non-significant increase from G1 to G2 and G1 to G3, and a non-significant increase of Cath-D expression of all receptor-positive over all receptor-negative tumours. CONCLUSION: Cath-D expression was found to be associated with known prognostic factors. The clinical relevance of the observed difference depending on the histological type needs further investigation. Cath-D might be a useful marker to discriminate between ductal and lobular subtypes of breast cancer.

Glycodelin expression in correlation to grading, nodal involvement and steroid receptor expression in human breast cancer patients.

BACKGROUND: Glycodelin (Gd) is an endometrially secreted glycoprotein, found in high quantities during early pregnancy. It shapes local immune responses in order to allow implantation and invasion of the semiallogeneic blastocyst into the maternal endometrium. It exists in various glycosylation isoforms, that influence their staining behaviour. MATERIALS AND METHODS: A polyclonal anti-Gd IgG-antibody specific for the core amino acid sequence of Gd was used to stain 121 paraffin-embedded breast cancer tissue blocks. We correlated Gd expression to known prognostic markers such as grading, nodal involvement and steroid-receptor positivity. RESULTS: Gd was expressed in invasive lobular and ductal breast cancer and its expression was significantly reduced upon dedifferentiation. A non significant increase in Gd staining intensity was noted upon axillary lymph node involvement steroid receptor positivity. CONCLUSION: These results indicate that Gd may be useful as an additional marker for the differentiation of breast cancer tissue, yet indicating an increased tendency towards lymph node metastasis.

Immunohistochemical expression of glycodelin in breast cancer correlates with estrogen-receptor alpha and progesterone-receptor A positivity.

Glycodelin (Gd), previously known as placental protein 14 (PP 14), acts as an immuno-suppressive glycoprotein by suppressing the cytolytic capacity of human natural killer (NK) cells and T-cells in vitro. Glycodelin is expressed in normal glandular epithelium of the endometrium as well as in normal and malignant glandular cells in and outside of the reproductive tract. Recently, Gd expression was demonstrated in normal and cancerous human breast tissue. Paraffin-embedded breast cancer tissue blocks (n=121) were examined for Gd expression. No part of the specimens contained carcinoma in situ. Gd expression was present in lobular and ductal breast carcinoma. We observed expression of Gd in breast cancer independent of grading. With regard to nodal status, no significant differences in the expression of Gd between cancer tissue from patients with or without axillary lymph node metastases were present. However, Gd expression was found to be significantly higher in breast cancer tissue when the staining reaction for steroid receptors was also positive. These results implicate that Gd might be an additional marker for the differentiation of breast cancer tissue. To which extent Gd could serve as an additional indicator for breast cancer survival is part of our ongoing research.

Epidemiology of Streptococcus agalactiae colonization in Germany.

Streptococcus agalactiae can cause severe pneumonia, sepsis and meningitis in neonates and remains one of the most prevalent causes of invasive neonatal infections. Maternal transmission of S. agalactiae during delivery can be prevented by prenatal screening and peripartal antibiotic prophylaxis. Implementation of CDC guidelines for group B streptococci (GBS) disease prevention resulted in a significant decline of invasive neonatal S. agalactiae infections in the USA. Similar national guidelines were issued in 2000 for Germany. However, the epidemiology of S. agalactiae colonization in Germany has not been investigated for more than 15 years and the impact these guidelines will have is therefore unknown. To assess colonization rates in Germany, we cultured vaginal and rectal swabs for S. agalactiae from pregnant and non-pregnant adult patients in the region of Aachen and Munich. Swabs were cultivated in selective broth medium for 24h and subsequently plated on blood agar plates according to the CDC recommendations. Colonies negative for catalase and pyrrolidonyl aminopeptidase were further differentiated by the CAMP test and a DNA probe specific for S. agalactiae. Rectal or vaginal colonization of S. agalactiae was found in 34 (16%) of 210 pregnant patients and in 41 (16%) of 250 non-pregnant women. S. agalactiae was found only in rectal swabs in 4% of pregnant and non-pregnant patients. For further characterization of the strains capsular serotypes and major surface protein antigens were determined by Ouchterlony immunodiffusion and PCR. Among the 75 different patient isolates serotype III was the most prevalent with 21 (28%) isolates, followed by 16 (21%) isolates of serotype II, 13 (17%) isolates of serotype Ia, 12 (16%) of serotype V, 11 (15%) of serotype Ib and only 2 (3%) isolates of serotype IV. The vast majority of all strains harbored genes for the major surface protein antigens, the alpha-C-protein or alpha-C-protein like antigens like Alp2-4, epsilon and Rib. These data show that S. agalactiae colonization is common in Germany and strict adherence to the guidelines for the preventions of GBS disease will result in peripartal antibiotic prophylaxis in up to 20% of all deliveries.