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Database - Alliance francophone pour l'accouchement respecté (AFAR)

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Currently 3059 records
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https://afar.info/id=3170

Created on : 25 May 2021
Modified on : 25 May 2021

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Bibliographical entry (without author) :

The interplay between the vaginal microbiome and innate immunity in the focus of predictive, preventive, and personalized medical approach to combat HPV-induced cervical cancer. EPMA Journal.

Author(s) :

Erik Kudela, Alena Liskova, Marek Samec, Lenka Koklesova, Veronika Holubekova, Tomas Rokos, Erik Kozubik, Terezia Pribulova, Kevin Zhai, Dietrich Busselberg, Peter Kubatka & Kamil Biringer

Year of publication :

2021

URL(s) :

https://link.springer.com/article/10.1007/s13167-0…
https://doi.org/10.1007/s13167-021-00244-3

Résumé (français)  :

Les HPV représentant la maladie sexuellement transmissible la plus courante sont un groupe de virus cancérigènes ayant un potentiel oncogène variable. Le système immunitaire et le microbiome vaginal représentent les facteurs de risque modifiables et importants de la carcinogenèse induite par le HPV. L’infection par le HPV augmente considérablement la diversité du microbiome vaginal, conduisant à une augmentation progressive de l’abondance des bactéries anaérobies et par conséquent de la gravité de la dysplasie cervicale. La délimitation de la composition exacte du microbiome vaginal et de l’environnement immunitaire avant l’acquisition du HPV, pendant les infections persistantes progressives et après la clairance, permet de mieux comprendre les mécanismes complexes de la carcinogenèse cervicale. Il donne des indices concernant la prédiction du potentiel malin. La prévalence relativement élevée du HPV dans la population générale est un défi pour les diagnostics et les directives thérapeutiques modernes et personnalisés. L’identification des biomarqueurs microbiens dominants de la dysplasie de haut et de bas grade pourrait nous aider à trier les patients présentant des chances marquées de régression ou de progression des lésions. Tout traitement chirurgical inutile de la dysplasie cervicale pourrait affecter négativement les résultats obstétricaux et la vie sexuelle. Par conséquent, comprendre l’effet et le rôle des thérapies à base de microbiome est un point de rupture dans la gestion conservatrice des précancéroses associées au HPV. L’évaluation détaillée des capacités du HPV à échapper aux mécanismes immunitaires de divers biofluides (prélèvements vaginaux, lavage cervico-vaginal, sécrétions ou sang) pourrait favoriser l’identification de nouvelles cibles immunologiques pour de nouveaux diagnostics et thérapies individualisés. L’évaluation qualitative et quantitative de l’environnement immunitaire et microbien local et des facteurs de risque associés constitue le cadre essentiel de la médecine préventive, prédictive et personnalisée qui est essentielle pour améliorer les soins médicaux de pointe chez les patientes atteintes de précancéroses cervicales et de cancer du col de l’utérus. L’article de synthèse se concentre sur l’influence et les applications diagnostiques et thérapeutiques potentielles du système immunitaire inné local et des marqueurs microbiens dans les cancers liés au HPV dans le contexte de la médecine 3P.

Abstract (English)  :

HPVs representing the most common sexually transmitted disease are a group of carcinogenic viruses with different oncogenic potential. The immune system and the vaginal microbiome represent the modifiable and important risk factors in HPV-induced carcinogenesis. HPV infection significantly increases vaginal microbiome diversity, leading to gradual increases in the abundance of anaerobic bacteria and consequently the severity of cervical dysplasia. Delineation of the exact composition of the vaginal microbiome and immune environment before HPV acquisition, during persistent/progressive infections and after clearance, provides insights into the complex mechanisms of cervical carcinogenesis. It gives hints regarding the prediction of malignant potential. Relative high HPV prevalence in the general population is a challenge for modern and personalized diagnostics and therapeutic guidelines. Identifying the dominant microbial biomarkers of high-grade and low-grade dysplasia could help us to triage the patients with marked chances of lesion regression or progression. Any unnecessary surgical treatment of cervical dysplasia could negatively affect obstetrical outcomes and sexual life. Therefore, understanding the effect and role of microbiome-based therapies is a breaking point in the conservative management of HPV-associated precanceroses. The detailed evaluation of HPV capabilities to evade immune mechanisms from various biofluids (vaginal swabs, cervicovaginal lavage/secretions, or blood) could promote the identification of new immunological targets for novel individualized diagnostics and therapy. Qualitative and quantitative assessment of local immune and microbial environment and associated risk factors constitutes the critical background for preventive, predictive, and personalized medicine that is essential for improving state-of-the-art medical care in patients with cervical precanceroses and cervical cancer. The review article focuses on the influence and potential diagnostic and therapeutic applications of the local innate immune system and the microbial markers in HPV-related cancers in the context of 3P medicine.

Sumário (português)  :

Os HPVs que representam as doenças sexualmente transmissíveis mais comuns são um grupo de vírus carcinogênicos com diferentes potenciais oncogênicos. O sistema imunológico e o microbioma vaginal representam os fatores de risco modificáveis ​​e importantes na carcinogênese induzida pelo HPV. A infecção por HPV aumenta significativamente a diversidade do microbioma vaginal, levando a aumentos graduais na abundância de bactérias anaeróbias e, consequentemente, na gravidade da displasia cervical. O delineamento da composição exata do microbioma vaginal e do ambiente imunológico antes da aquisição do HPV, durante as infecções progressivas/persistentes e após a eliminação, fornece informações sobre os mecanismos complexos da carcinogênese cervical. Ele dá dicas sobre a previsão do potencial maligno. A prevalência de HPV relativamente alta na população em geral é um desafio para diagnósticos e diretrizes terapêuticas modernos e personalizados. Identificar os biomarcadores microbianos dominantes de displasia de alto e baixo grau pode nos ajudar a triagem dos pacientes com chances marcantes de regressão ou progressão da lesão. Qualquer tratamento cirúrgico desnecessário da displasia cervical pode afetar negativamente os resultados obstétricos e a vida sexual. Portanto, compreender o efeito e o papel das terapias baseadas em microbioma é um ponto de ruptura no manejo conservador de pré-cânceres associados ao HPV. A avaliação detalhada das capacidades do HPV para evadir os mecanismos imunológicos de vários biofluidos (esfregaços vaginais, secreções de lavagem cervicovaginal ou sangue) pode promover a identificação de novos alvos imunológicos para novos diagnósticos e terapias individualizadas. A avaliação qualitativa e quantitativa do ambiente imunológico e microbiano local e os fatores de risco associados constituem a base crítica para a medicina preventiva, preditiva e personalizada, essencial para melhorar o atendimento médico de última geração em pacientes com pré-câncer cervical e câncer cervical. O artigo de revisão enfoca a influência e as aplicações diagnósticas e terapêuticas potenciais do sistema imunológico inato local e os marcadores microbianos em cânceres relacionados ao HPV no contexto da medicina 3P.

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Argument (français) :

L’infection par le VPH augmente considérablement la diversité du microbiome vaginal, conduisant à une augmentation progressive de l’abondance des bactéries anaérobies et la gravité de la dysplasie cervicale. Tout traitement chirurgical inutile de la dysplasie cervicale pourrait affecter négativement les résultats obstétricaux et la vie sexuelle. L’évaluation de l’environnement immunitaire et microbien local pourrait améliorer les soins médicaux chez les patientes atteintes de CIN et de cancer du col de l’utérus.

Argument (English):

HPV infection dramatically increases the diversity of the vaginal microbiome, leading to a gradual increase in the abundance of anaerobic bacteria and the severity of cervical dysplasia. Any unnecessary surgical treatment for cervical dysplasia could negatively affect obstetric outcomes and sex life. Assessment of the local immune and microbial environment could improve medical care in patients with CIN and cervical cancer.

Argumento (português):

A infecção por HPV aumenta drasticamente a diversidade do microbioma vaginal, levando a um aumento gradual na abundância de bactérias anaeróbias e na gravidade da displasia cervical. Qualquer tratamento cirúrgico desnecessário para displasia cervical pode afetar negativamente os resultados obstétricos e a vida sexual. A avaliação do ambiente imunológico e microbiano local pode melhorar o atendimento médico em pacientes com NIC e câncer cervical.

Keywords :

➡ evidence-based medicine/midwifery ; guidelines ; public health ; prevention ; HPV human papillomavirus ; vaginal microbiota

Author of this record :

Marion Corbe — 25 May 2021

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