Perianal fistulizing Crohn's disease is associated with a higher prevalence of HPV in the anorectal fistula tract. A comparative study.

BACKGROUND & AIMS: Perianal fistulizing Crohn's disease is the main risk factor for anal cancer in patients with inflammatory bowel disease. Whether this occurs due to a higher frequency of human papillomavirus remains unclear. The authors aimed to evaluate the prevalence of HPV and high-risk HPV in patients with perianal Crohn's disease, compared with a control group. METHODS: The authors conducted a two-center cross-sectional study in which perianal fistulizing Crohn's disease patients were matched for age and sex with patients with anorectal fistula without Crohn's disease. Biopsy specimens were obtained from fistulous tracts during examination under anesthesia for both groups. The samples were sent for HPV detection and genotyping using the INNO-LiPA test. RESULTS: A total of 108 subjects (54 in each group) were recruited. The perianal fistulizing Crohn's disease group showed a statistically higher frequency of HPV in the fistulous tract than the control group (33.3% vs. 16.7%; p = 0.046). Separate analyses on high-risk types demonstrated that there was a numerically higher frequency of HPV in the perianal fistulizing Crohn's disease group. In multiple logistic regression, patients with perianal fistulizing Crohn's disease were found to have a chance of HPV 3.29 times higher than patients without Crohn's disease (OR = 3.29; 95% CI 1.20‒9.01), regardless of other variables. The types most frequently identified in the perianal fistulizing Crohn's disease group were HPV 11 (12.96%) and HPV 16 (9.26%). CONCLUSION: Perianal fistulizing Crohn's disease is associated with a higher prevalence of HPV than in patients with anorectal fistula without Crohn's disease.

Perianal fistulizing Crohn's disease is associated with a higher prevalence of HPV in the anorectal fistula tract. A comparative study

Abstract Background & Aims Perianal fistulizing Crohn's disease is the main risk factor for anal cancer in patients with inflammatory bowel disease. Whether this occurs due to a higher frequency of human papillomavirus remains unclear. The authors aimed to evaluate the prevalence of HPV and high-risk HPV in patients with perianal Crohn's disease, compared with a control group. Methods The authors conducted a two-center cross-sectional study in which perianal fistulizing Crohn's disease patients were matched for age and sex with patients with anorectal fistula without Crohn's disease. Biopsy specimens were obtained from fistulous tracts during examination under anesthesia for both groups. The samples were sent for HPV detection and genotyping using the INNO-LiPA test. Results A total of 108 subjects (54 in each group) were recruited. The perianal fistulizing Crohn's disease group showed a statistically higher frequency of HPV in the fistulous tract than the control group (33.3% vs. 16.7%; p = 0.046). Separate analyses on high-risk types demonstrated that there was a numerically higher frequency of HPV in the perianal fistulizing Crohn's disease group. In multiple logistic regression, patients with perianal fistulizing Crohn's disease were found to have a chance of HPV 3.29 times higher than patients without Crohn's disease (OR = 3.29; 95% CI 1.20‒9.01), regardless of other variables. The types most frequently identified in the perianal fistulizing Crohn's disease group were HPV 11 (12.96%) and HPV 16 (9.26%). Conclusion Perianal fistulizing Crohn's disease is associated with a higher prevalence of HPV than in patients with anorectal fistula without Crohn's disease.

Local and systemic immunomodulatory mechanisms triggered by Human Papillomavirus transformed cells: a potential role for G-CSF and neutrophils.

Cervical cancer is the last stage of a series of molecular and cellular alterations initiated with Human Papillomavirus (HPV) infection. The process involves immune responses and evasion mechanisms, which culminates with tolerance toward tumor antigens. Our objective was to understand local and systemic changes in the interactions between HPV associated cervical lesions and the immune system as lesions progress to cancer. Locally, we observed higher cervical leukocyte infiltrate, reflected by the increase in the frequency of T lymphocytes, neutrophils and M2 macrophages, in cancer patients. We observed a strong negative correlation between the frequency of neutrophils and T cells in precursor and cancer samples, but not cervicitis. In 3D tumor cell cultures, neutrophils inhibited T cell activity, displayed longer viability and longer CD16 expression half-life than neat neutrophil cultures. Systemically, we observed higher plasma G-CSF concentration, higher frequency of immature low density neutrophils, and tolerogenic monocyte derived dendritic cells, MoDCs, also in cancer patients. Interestingly, there was a negative correlation between T cell activation by MoDCs and G-CSF concentration in the plasma. Our results indicate that neutrophils and G-CSF may be part of the immune escape mechanisms triggered by cervical cancer cells, locally and systemically, respectively.

Avaliaçäo da infecçäo e caracterizaçäo de tipos de papilomavírus humano(HPV) em gestantes infectadas pelo vírus da imunodeficiência humana(HIV-1) / Detection and characterization of human papillomavirus types in pregnant women infected by the human immunodeficiency virus(HIV-1)

Os papilomavírus humanos (HPV) estão associados a diversas lesões tumorais do trato anogenital, tanto malignas quanto benignas. Estudos demonstram que a infecção pelo HPV vem sendo cada vez mais diagnosticada em mulheres portadoras do vírus da imunodeficiência humana (HIV), entretanto, pouco é conhecido sobre a infecção pelo HPV em gestantes portadoras do HIV. O objetivo do presente estudo foi avaliar através de técnicas de biologia molecular, a prevalência da infecção pelo HPV durante o período gestacional, e a persistência da infecção após o parto em gestantes HIV positivo e gestantes HIV negativo, caracterizando os tipos de HPV encontrados. Um total de 188 gestantes HIV positivo e 99 gestantes HIV negativo, provenientes da cidade de São Paulo - SP foi submetido à coleta endocervical para pesquisa de HPV pelos métodos complementares (citopatologia e biópsia cervical dirigida por colposcopia), métodos moleculares (Captura Híbrida - II e PCR) seguido de tipagem viral do HPV por RFLP ou sequenciamento e à contagem de células CD4+ e da carga viral do HIV no plasma. A DNA-HPV foi detectado em 53,2 por cento das gestantes HIV positivo e 19,2 por cento das gestantes HIV negativo (p < 0,001). A infecção persistente por HPV, definida como a detecção do mesmo tipo de HPV na gestação e no puerpério foi detectada em 65,6por cento das mulheres HIV positivo e 20 por cento nas mulheres HIV negativo (p < 0,001). 38,1 por cento por cento das mulheres HIV positivo tiveram infecção persistente com HPV 16 ou HPV 18, que são os tipos mais fortemente associados com câncer cervical. Nível de células CD4+ £ 200 células/mm3 foi associado com alto risco para infecção pelo HPV na gestação. Altas taxas de infecção pelo HPV foram evidenciadas em mulheres grávidas infectadas pelo HIV. Estes resultados demonstram a necessidade de avaliação ginecológicas periódicas no pré-natal por métodos sensíveis, visando o diagnóstico precoce da infecção pelo HPV que está associada a lesões malignas da região cervical