Peculiarities of the vagina microbiome and functional activity of epithelial cells in cervical intraepithelial neoplasia of the cervix in women of perimenapausal age

Beniuk, V.O.; Goncharenko, V.M.; Laskava, T.G.; Shcherba, O.A.; Lastovetska, L.D.; Nykoniuk, T.R.; Maidannyk, I.V.; Veretelnyk, Ya.I.

doi:10.30841/2708-8731.4.2023.285767

Cited by 3 publications

(4 citation statements)

References 23 publications

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“…жіночого населення, летальність -7,9 на 100 тис. населення [4]. Тому одним із ключових завдань гінеколога на сучасному етапі є своєчасна профілактика передракових процесів ШМ, їхня діагностика і ефективне лікування.…”

Section: Cervical Dysplasia Cervicitis and Inflammatory Bowel Disease...unclassified

Cervical dysplasia, cervicitis and inflammatory bowel disease – is there a relationship? (Literature review)

Khashcha,

Sozanska,

Mitsoda

et al. 2024

RHW

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The state of health of the female population of Ukraine is of particular concern due to the year-by-year increase in the frequency of precancerous and oncological diseases of the reproductive organs. Benign and precancerous pathologies of the cervix occupy an important place among gynecological diseases.The objective of this article is to review foreign literature and domestic data sources for assessment the risk of dysplasia and cervical cancer in patients with inflammatory bowel disease (IBD) and cervicitis.Early onset of sexual life and a large number of sexual partners are factors that increase the risk of contracting the human papillomavirus (HPV) and other sexually transmitted infections (STIs). Trauma to the cervical epithelium – mechanical one or caused by an STI – can cause HPV to enter the basal layer of the cervical epithelium. Cervical cancer (CC) is preceded by HPV lesions of the cervical epithelium, including low-grade and high-grade squamous intraepithelial lesions, which are usually diagnosed in women of reproductive age.Cervical intraepithelial neoplasia (CIN) is characterized by impaired maturation and differentiation of cells of the multilayered squamous epithelium and is the most frequent form of morphological precancer of the cervix. Up to 90% of CIN are localized at the border of single-layered cylindrical and multilayered flat epithelium (transformation zone). CIN of various degrees is a precancerous disease in which the index of malignancy (oncological transformation) can reach 50%.The clinical course of dysplastic changes in CIN is asymptomatic, and the patients have no specific complaints. During the infectious process in the vagina, CIN can be accompanied by an increase in the amount of vaginal discharges in the form of mucus or milky secretions. Therefore, in modern conditions timely diagnosis, effective treatment and prevention of precancerous processes, which include CIN of the cervix, is one of the important tasks of a gynecologist. Women of perimenopausal age, who are traditionally classified as a risk group, deserve special attention.Today, there is information in the literature that diseases of a multifactorial nature make up 90–95% of all diseases, which also includes CIN. Despite extensive research efforts and advances in screening and prevention strategies, CC remains an unsolved public health challenge, particularly in low- and middle-income countries. Every year in the world, more than half a million women are diagnosed with CC.The world scientific community pays great attention to the study of epidemiology, pathogenesis, treatment and development of methods of prevention of neoplastic processes in general and CC in particular. So far, this has not been thoroughly studied, and there are no large studies that take into account a variety of potential factors. Understanding the risk factors for the development of CC in patients with IBD and cervicitis may help develop screening and prevention strategies and ultimately improve treatment outcomes.

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Section: Cervical Dysplasia Cervicitis and Inflammatory Bowel Disease...unclassified

Cervical dysplasia, cervicitis and inflammatory bowel disease – is there a relationship? (Literature review)

Khashcha,

Sozanska,

Mitsoda

et al. 2024

RHW

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“…Жінки перименопаузального віку традиційно належать до групи ризику розвитку CIN і РШМ [1,19]. Це пов'язано насамперед з низькою спонтанною елімінацією вірусу, тенденцією до персистенції ВПЛ на тлі хронічних рецидивних запальних процесів генітальної сфери, розвитком рецидиву дисплазії епітелію шийки матки (CIN II, CIN III) при одночасному виявленні декількох генотипів ВПЛ і високому вірусному навантаженні.…”

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“…Інтерферон (ІФН)-α та ІФН-β чинять противірусну дію, а ІФН-γ -основний активатор лімфоцитів -посилює бактерицидну активність фагоцитів, має протипухлинний, імуномодулювальний вплив. Водночас ПВІ, яка є пусковим механізмом у виникненні дисплазії, та неадекватна реакція імунної системи можуть бути причиною рецидивів цієї патології [1].…”

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“…Незважаючи на сучасні методи діагностики і лікування, включаючи цитоморфологічні дослідження, тестування на ВПЛ та хірургічну конізацію, рецидиви диспластичних станів шийки матки діагностують у 6-30% пацієнток [1,14,15]. Згідно з рекомендаціями Українського національного консенсусу з обстеження та лікування жінок після проходження первинного цервікального скринінгу [24], у разі рецидиву епітеліальної дисплазії (CIN II) після конізації шийки матки і ВПЛ (+) рекомендоване проведення реконізації.…”

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Pharmacological correction of immunological disorders in perimenopausal women with recurrent epithelial cervical dysplasia associated with human papillomavirus infection

Beniuk,

Ginzburg,

Goncharenko

et al. 2024

RHW

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Despite the successes achieved in implementing screening programs and treating diseases caused by human papillomavirus (HPV) infection, the frequency of cervical intraepithelial neoplasia (CIN) of moderate and high grades associated with high-risk human papillomavirus (HR-HPV) remains between 9% to 21%. Vaginal dysbiosis and the development of immunodeficient states due to persistent HR-HPV infection require effective immunomodulatory and antiviral therapy before cervical surgery in perimenopausal women with recurrent CIN II.The objective: to evaluate the effectiveness of antiviral and immunomodulatory therapy by determining the state of vaginal biocenosis, immunological status and papillomavirus load of the cervical mucosa before surgical treatment in perimenopausal women with recurrent CIN II.Materials and methods. A prospective study was conducted on 98 women aged 40 to 55 years old, including 60 patients with morphologically verified recurrent CIN II associated with high-risk HPV, forming the main group. The control group comprised 38 women with negative HPV test results and without significant gynecological or somatic pathology. In the main group, a complex consisting of a blend of plant extracts of sod pike grass (Deschampsia caespitosa), ground cinquefoil grass (Calamagrostis epigeios), and echinacea purpurea grass (Echinaceae purpureae) was administered orally.Vaginal microbiota was assessed using Hey-Іson criteria, and immunological status was examined in patients using solid-phase enzyme-linked immunosorbent assay to determine IgG, IgM, IgA antibodies in serum and cervical mucus, levels of interleukin-1β (IL-1β), interferons alpha (IFN-α), gamma (IFN-γ), tumor necrosis factor alpha (TNF-α). Additionally, the DNA of high-risk HPV in cervical mucosa was quantitatively assessed using real-time PCR. The investigations were conducted before and after the applied therapy.Results. The investigation of vaginal content revealed the presence of bacterial vaginosis in 65.0% of patients in the main group, the frequency of which decreased by 2 times after treatment, with the number of women with an intermediate type of vaginal content increasing by 2.8 times (51.7%) and those with normal microbiota increasing by 2.5 times. Disruptions in cellular and humoral immunity systems were identified. After treatment, there was an increase in viral load in the significant «threshold» category (3–5 lg) by 1.25 times and in the «above threshold for progression» category (>5 lg) by 2.3 times, reflecting natural HPV clearance. No direct correlation was found between viral load activity and the degree of CIN or positive morphological changes regarding regression of cervical intraepithelial lesions.Conclusions. The use of a complex containing a blend of plant extracts of sod pike grass (Deschampsia caespitosa), ground cinquefoil grass (Calamagrostis epigeios), and echinacea purpurea grass (Echinacea purpureae) improves the state of vaginal biocenosis, indicators of cellular and humoral immunity, and promotes HPV elimination, it has adequate safety and tolerability, which determines the feasibility of its use in the complex treatment of cervical intraepithelial neoplasia at the preparatory stage before surgery and in the postoperative period to prevent complications and relapses.

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The relevance of the human papillomavirus problem at the present stage

Ilchenko,

Kiziun,

Syzova

et al. 2024

RHW

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Humam papillomavirus (HPV) is one of the most common sexually transmitted pathogens. The virus may not manifest itself for years, so a person does not even know that he is infected. The pathogen spreads, affects the partner and is transmitted further along the chain.The problem is that HPV can cause background precancerous and cancerous diseases in both women and men. The population is interested in methods of prevention of HPV infection in order to preserve their own life and health. But, as it turned out, there is insufficient sanitary and educational activity in Ukraine.HPV is one of the most dangerous enemies of human health. Ease of infection, low level of awareness, lack of vaccination – all this leads to oncological diseases of the reproductive system and, as a result, the reduction of the population of the nation. Cancer of the cervix, vagina, vulva, penis, anal canal is far from a complete list of oncological pathologies that threaten human life and health.And, despite the aggressiveness, these diseases can be easily prevented. It is enough only to carry out specific prevention, namely, to be vaccinated against HPV. This is not discussed, sanitary and educational activities are carried out at an inadequate level. Ukrainians want to know more, they are ready to get vaccinated. It is only important to give them such an opportunity.The article presents a detailed study of the problem of public awareness of HPV, analyzes the level of education of doctors and patients regarding HPV, the diseases it causes, methods of specific prevention to improve the health of the nation, describes the types of development and implementation of new methods and approaches to sanitary and educational activities and promotion of vaccination.Also provided is an analysis of data from worldwide and Ukrainian statistics on the prevalence of HPV, oncological diseases it causes, the level of vaccination, characteristics of vaccines, as well as an analysis of the results of randomized trials, data from preventive vaccination calendars in European countries.

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Peculiarities of the vagina microbiome and functional activity of epithelial cells in cervical intraepithelial neoplasia of the cervix in women of perimenapausal age

Cited by 3 publications

References 23 publications

Cervical dysplasia, cervicitis and inflammatory bowel disease – is there a relationship? (Literature review)

Cervical dysplasia, cervicitis and inflammatory bowel disease – is there a relationship? (Literature review)

Pharmacological correction of immunological disorders in perimenopausal women with recurrent epithelial cervical dysplasia associated with human papillomavirus infection

The relevance of the human papillomavirus problem at the present stage

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