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阴道微生物群的改变以及作为人乳头瘤病毒诱发宫颈癌发生的关键共同致病因素。

Alterations of Vaginal Microbiota and as Crucial Co-Causative Factors in Cervical Cancer Genesis Procured by HPV.

作者信息

Gargiulo Isacco Ciro, Balzanelli Mario G, Garzone Stefania, Lorusso Mara, Inchingolo Francesco, Nguyen Kieu C D, Santacroce Luigi, Mosca Adriana, Del Prete Raffaele

机构信息

Department of Interdisciplinary Medicine, School of Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy.

SET-118, Pre-Hospital and Emergency Department, SG Giuseppe Moscati Hospital, 74120 Taranto, Italy.

出版信息

Microorganisms. 2023 Mar 6;11(3):662. doi: 10.3390/microorganisms11030662.

Abstract

and human papillomavirus (HPV) are the most common pathogens found in sexually transmitted infections (STIs), and both are known to increase the risk of cervical cancer (CC) and infertility. HPV is extremely common worldwide, and scientists use it to distinguish between low-risk and high-risk genotypes. In addition, HPV transmission can occur via simple contact in the genital area. From 50 to 80% of sexually active individuals become infected with both and HPV viruses during their lifetime, and up to 50% become infected with an HPV oncogenic genotype. The natural history of this coinfection is strongly conditioned by the balance between the host microbiome and immune condition and the infecting agent. Though the infection often regresses, it tends to persist throughout adult life asymptomatically and silently. The partnership between HPV and is basically due to their similarities: common transmission routes, reciprocal advantages, and the same risk factors. is a Gram-negative bacteria, similar to HPV, and an intracellular bacterium, which shows a unique biphasic development that helps the latter continue its steady progression into the host throughout the entire life. Indeed, depending on the individual's immune condition, the infection tends to migrate toward the upper genital tract and spread to the uterus, and the fallopian tubes open up a pathway to HPV invasion. In addition, most HPV and infections related to the female genital tract are facilitated by the decay of the first line of defense in the vaginal environment, which is constituted by a healthy vaginal microbiome that is characterized by a net equilibrium of all its components. Thus, the aim of this paper was to highlight the complexity and fragility of the vaginal microenvironment and accentuate the fundamental role of all elements and systems involved, including the strains () and the immune-endocrine system, in preserving it from oncogenic mutation. Therefore, age, diet, and genetic predisposition together with an unspecific, persistent low-grade inflammatory state were found to be implicated in a high frequency and severity grade of disease, potentially resulting in pre-cancerous and cancerous cervical lesions.

摘要

人乳头瘤病毒(HPV)是性传播感染(STIs)中最常见的病原体,二者均会增加宫颈癌(CC)和不孕症的风险。HPV在全球极为常见,科学家据此区分低风险和高风险基因型。此外,HPV可通过生殖器部位的简单接触传播。50%至80%性活跃个体在一生中会感染沙眼衣原体和HPV病毒,高达50%的个体感染致癌基因型HPV。这种合并感染的自然病程在很大程度上取决于宿主微生物群与免疫状况以及感染病原体之间的平衡。尽管感染通常会自行消退,但往往会在成年期无症状且悄然持续存在。HPV和沙眼衣原体之间的关联主要源于它们的相似性:共同的传播途径、相互的优势以及相同的风险因素。沙眼衣原体是一种革兰氏阴性菌,与HPV类似,是一种细胞内细菌,具有独特的双相发育过程,有助于后者在整个生命周期中持续稳定地侵入宿主。实际上,根据个体的免疫状况,沙眼衣原体感染往往会向上生殖道迁移并扩散至子宫,输卵管为HPV入侵开辟了途径。此外,大多数与女性生殖道相关的HPV和沙眼衣原体感染是由于阴道环境中第一道防线的衰退所致,而健康的阴道微生物群构成了这道防线,其特征是所有成分达到净平衡。因此,本文旨在强调阴道微环境的复杂性和脆弱性,并强调包括沙眼衣原体菌株(Ct)和免疫内分泌系统在内的所有相关元素和系统在保护其免受致癌突变方面的重要作用。因此,年龄、饮食、遗传易感性以及非特异性、持续性的低度炎症状态被发现与疾病的高频率和严重程度相关,可能导致宫颈癌前病变和癌性病变。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/91f1/10053692/4616ea2c72c6/microorganisms-11-00662-g001.jpg

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