Department of Oral Pathology, Institute of Dentistry, University of Turku, Turku, Finland.
Virchows Arch. 2009 Dec;455(6):505-15. doi: 10.1007/s00428-009-0850-7. Epub 2009 Nov 12.
Bypassing the local immunological defense reactions in the cervix is one of the prerequisites for human papillomaviruses (HPV) infections to progress to intraepithelial neoplasia (CIN). The role of potent immunosuppressive cytokines, e.g., interleukin-10 (IL-10), depressing these local virus-specific immunological responses is incompletely studied. To assess, whether IL-10 expression in cervical HPV lesions has any implications in the outcome of HPV infections or disease progression to CIN. Baseline cervical biopsies from 225 women of the LAMS study sub-cohort were analyzed for IL-10 expression using immunohistochemistry, to assess its associations with CIN grade, and high-risk HPV (HR-HPV) at baseline, as well as in predicting outcomes of HR-HPV infections, and development of incident CIN1+ and CIN2+ in this longitudinal setting. Expression of IL-10 in cervical lesions was up-regulated most often in high-grade CIN, and IL-10 over-expression retained its value as independent predictor of CIN2+ (odds ratio (OR) = 4.92) and CIN3+ (OR = 7.51) also in multivariate model, including HR-HPV and several known covariates of IL-10 expression. Up-regulation was not related to HR-HPV detection, and showed no relationship to HR-HPV viral loads. Using longitudinal predictive indicators (SE, SP, PPV, NPV), IL-10 expression was of no value in predicting (1) the outcomes of HR-HPV infections, or (2) the surrogate endpoints (incident CIN1+, CIN2+) of progressive disease. IL-10 over-expression (along with HR-HPV) was one of the independent covariates of CIN2/3. This immunosuppressive cytokine might play an important role in creating a microenvironment that favors progressive cervical disease and immune evasion by HR-HPV.
绕过宫颈局部免疫防御反应是人类乳头瘤病毒(HPV)感染进展为上皮内瘤变(CIN)的前提之一。具有强大免疫抑制作用的细胞因子,如白细胞介素 10(IL-10),会抑制这些局部病毒特异性免疫反应,但目前对其作用的研究并不完全。本研究旨在评估宫颈 HPV 病变中 IL-10 的表达是否对 HPV 感染的结果或疾病进展为 CIN 有影响。对 LAMS 研究子队列的 225 名女性的基线宫颈活检进行免疫组织化学分析,以评估其与 CIN 分级、基线时高危型 HPV(HR-HPV)以及 HR-HPV 感染结果、CIN1+和 CIN2+的发生的相关性。在这种纵向研究中,宫颈病变中 IL-10 的表达在高级别 CIN 中上调最常见,并且在多变量模型中,IL-10 过表达仍然是 CIN2+(比值比(OR)=4.92)和 CIN3+(OR=7.51)的独立预测因子,该模型包括 HR-HPV 和 IL-10 表达的几个已知协变量。上调与 HR-HPV 检测无关,与 HR-HPV 病毒载量也没有关系。使用纵向预测指标(SE、SP、PPV、NPV),IL-10 表达在预测(1)HR-HPV 感染结果或(2)疾病进展的替代终点(CIN1+、CIN2+)方面没有价值。IL-10 过表达(与 HR-HPV 一起)是 CIN2/3 的独立协变量之一。这种免疫抑制细胞因子可能在创造有利于 HR-HPV 进行性宫颈疾病和免疫逃逸的微环境中发挥重要作用。