Polymorphism of clinical manifestation of HPV infection in the genital mucosa - 3-year retrospective study.

BACKGROUND: Human papillomaviruses (HPVs) are associated with a wide variety of cutaneous and mucosal infections and with malignancies in humans. More than 100 HPV types have been identified, some of which have affinity for skin and others for mucosal sites. AIM: The purpose of this study came from our desire to support the "Stop Cervical Cancer" campaign, adopted as "Cervical Cancer Removed as a Public Health Problem", following the World Health Organization (WHO) initiative in 2019-2020. At European level, cervical cancer mortality has fallen by more than 30% over the past 30 years, through coherent, consistent and comprehensive prevention programs based on accurate and consistent public information. Romania is in an unfavorable situation with regard to incidence (32.8 new cases∕100 000 women) and cervical cancer mortality (10.9 deaths∕100 000 women). Free Babes-Papanicolau (Pap) testing for early detection of cervical cancer was valid this year until March. PATIENTS, MATERIALS AND METHODS: The study runs over a period of three years, between 2016-2018, in the "Elena Doamna" Hospital of Obstetrics and Gynecology, Iasi, Romania. Of the 8500 patients hospitalized for various diseases (ovarian cysts, uterine fibroids, endometriosis, abnormal vaginal bleeding, dysmenorrhea, ectopic pregnancies, placenta praevia, spontaneous abortions and on demand, benign, malignant tumors), only 382 were present in the ambulatory for Pap test. For the other conditions, Pap test denied because the patients did not want this but to solve the condition for which they presented themselves. RESULTS: We retrospectively review 382 Pap tests of patients who presented themselves in the Ambulatory Service of the Hospital both at the advice of the gynecologist and due to the program initiated by the WHO and supported by the Department of Public Health, Iasi: "Cervical cancer can be eliminated as a problem of public health". Lesions equal to or worse than high-grade squamous intraepithelial lesion (HSIL) equivalate with high-grade lesions including HSIL (cervical intraepithelial neoplasia - CIN1, CIN2). Endometrial lesions were excluded from the study. As seen of this campaign, the number of patients has increased in 2018 (242 cases), compared to 46 cases in 2017 and 94 cases in 2016. CONCLUSIONS: Our study demonstrated that 35% (7/20) of HSIL-confirmed biopsies previously had negative HPV assays. Despite the previous negative HPV tests, a wide variety of HPV genotypes has been detected in most biopsies. In our case, we frequently identified the HPV 59 and 45 strains, 51 cases with HSIL lesions presented a first positive HPV test, 13 cases with low-grade squamous intraepithelial lesion (LSIL) showed three negative HPV tests. Prevention plays an important role in reducing the incidence of cervical cancer cases. The Pap test is now considered the primary prevention method, but consecutive vaccination significantly increases protection against high-risk HPV strains. Education plays an important role in the prophylaxis of HPV infection and cancer. It should be instituted in schools, from puberty age through partnerships or government programs with public health directorates and university hospitals or using European funds.

[Clinical and immunological efficiency of sodium nucleospermate in treating chronic endometritis and infertility complicated by HPV infection].

Clinical efficacy of sodium nucleospermate (SNS) has shown in the treatment of 26 female patients with chronic endometritis, unsuccessful attempts at in vitro fertilization, and persistent viral infection. Cells from endometrium were processed by liquid cytology and studied by immunocytochemistry techniques. It has been clearly established that, after SNS treatment, the frequency of CD20- and CD56-positive cells was significantly decreased (p < 0.05) and the frequency of TLR4 and TLR9 expressing cells in endometrium has been significantly improved (p < 0.05). In addition, the human papilloma virus (HPV) load was reduced as manifested by the real-time PCR test. The obtained results show good prospects for successful use SNS as a means of pathogenetic therapy in patients with this diagnosis.

Probiotics enhance the clearance of human papillomavirus-related cervical lesions: a prospective controlled pilot study.

Probiotics have been proposed for a number of urogenital infectious conditions. In this study, we examine a possible effect on human papillomavirus (HPV)-related precancerous lesions in cervical cytology. We conducted a prospective controlled pilot study, in which 54 women with an HPV+low-grade squamous intraepithelial lesion diagnosis in their PAP smear were followed for 6 months. The intervention group consumed a daily probiotic drink during the study period; the control group received no treatment, according to common care policy. Outcome measures were the control PAP smear and HPV status after 6 months. Probiotic users had a twice as high chance of clearance of cytological abnormalities (60 vs. 31%, P=0.05). HPV was cleared in 19% of control patients versus 29% of probiotic users (P=0.41). This exploratory pilot study suggests that the probiotic studied promotes the clearance of HPV-related cytological abnormalities. If confirmed, this would represent an entirely new option to manage cervical cancer precursors.

Does food intolerance play a role in recurrent respiratory papillomatosis?

BACKGROUND: The purpose of this study is to evaluate the potential role of food intolerances in the management of recurrent respiratory papillomatosis (RRP). METHODS: This is a retrospective case review of 4 pediatric patients with RRP. All of the patients, cared for by the primary author between 2005 and 2010, were managed using microdebrider resection, intralesional injection of cidofovir, and required multiple surgeries. Skin prick test (SPT) and/or radioallergosorbent test (RAST) were obtained for 2 patients. Oral food challenge was utilized in all 4 patients. RESULTS: Standard SPT and RAST did not identify any immunoglobulin E (IgE)-based allergens. A detailed medical history followed by an oral food challenge was successful at identifying food intolerances in all 4 patients. When specific food elimination was implemented in these patients' treatments in addition to microdebrider resection and cidofovir injection, statistically significant long-term remissions were achieved. CONCLUSION: Food intolerance and its impact on RRP and immune dysfunction deserve further investigation and may benefit some patients with RRP.

A dietary pattern associated with LINE-1 methylation alters the risk of developing cervical intraepithelial neoplasia.

There is a paucity of research examining the relationships between dietary patterns and risk of developing precancerous lesions as well as biomarkers associated with such dietary patterns. The purpose of the current study was to identify dietary patterns that are associated with higher grades of cervical intraepithelial neoplasia (CIN 2+) and to determine whether these dietary patterns are associated with the degree of DNA methylation in the long interspersed nucleotide elements (L1s) of peripheral blood mononuclear cells (PBMCs), a biomarker associated with risk of developing CIN 2+. Study population consisted of 319 child-bearing age women. Dietary patterns were derived by factor analysis. The degree of PBMC L1 methylation was assessed by pyrosequencing. Logistic regression models were used to evaluate the associations between dietary patterns and CIN 2+. Similar models were used to evaluate the associations between dietary patterns and degree of PBMC L1 methylation in women free of CIN 2+. Women with the unhealthiest dietary pattern were 3.5 times more likely to be diagnosed with CIN 2+ than women with the healthiest dietary pattern [OR = 3.5; 95% confidence interval (CI), 1.2-10.1; P = 0.02]. Women at risk for developing CIN 2+ with the healthiest dietary pattern were 3.3 times more likely to have higher PBMC L1 methylation than women with the unhealthiest dietary pattern (OR = 3.3; 95% CI, 1.0-10.6; P = 0.04). Our findings suggest that human papilloma virus associated risk of developing CIN 2+ may be reduced by improving dietary patterns. The degree of PBMC L1 methylation may serve as a biomarker for monitoring the effectiveness of dietary modifications needed for reducing the risk of CIN 2+.

[Coriolus versicolor--innovation in prevention of oncogynecological diseases, especially HPV].

Coriolus-MRL is a nutrient adjuvant, which contains biomass of the fungus Coriolus versicolor and is studied to reverse early stages of cervical cancer and to reduce risk factors of reoccurring HPV virus.