Department of Gynecology, Affiliated Hospital of North Sichuan Medical College, Sichuan, China.
Int J Gynaecol Obstet. 2023 Sep;162(3):983-988. doi: 10.1002/ijgo.14768. Epub 2023 Apr 3.
To evaluate the changes of cervical soluble immune markers after focused ultrasound (FU) treatment to explore the underlying local immune effects of FU in the treatment of high-risk human papillomavirus (HR-HPV) infection-related low-grade squamous intraepithelial lesion (LSIL).
A total of 35 patients diagnosed with HR-HPV infection-related histological LSIL who met the inclusion criteria were enrolled in this prospective study and treated with FU. The authors used cytometric bead array to measure T-helper type 1 (Th1) cytokine (interleukin [IL] 2, tumor necrosis factor, and interferon γ) and Th2 cytokine (IL-4, IL-5, IL-6, and IL-10) levels in the cervicovaginal lavage of patients before and 3 months after FU treatment.
After FU treatment, the concentrations of Th2 cytokines IL-5 and IL-6 were significantly lower than those before FU treatment (P = 0.044 and P = 0.028, respectively). HR-HPV infection was cleared in 27 patients, with a clearance rate of 77.1% (27 of 35). The concentration of IL-4 in patients with HR-HPV clearance after FU treatment was significantly lower than that in patients without HR-HPV clearance (P = 0.045).
FU can inhibit the production of certain Th2 cytokines and may improve the local immune status of the cervix, thereby eliminating HR-HPV infection.
评估高强度聚焦超声(FU)治疗后宫颈可溶性免疫标志物的变化,以探讨 FU 在治疗高危型人乳头瘤病毒(HR-HPV)感染相关低度鳞状上皮内病变(LSIL)中的潜在局部免疫效应。
本前瞻性研究共纳入 35 例符合纳入标准的 HR-HPV 感染相关组织学 LSIL 患者,均接受 FU 治疗。作者采用流式细胞术微珠阵列检测 FU 治疗前后患者宫颈阴道灌洗液中辅助性 T 细胞 1(Th1)细胞因子(白细胞介素 [IL]2、肿瘤坏死因子和干扰素 γ)和 Th2 细胞因子(IL-4、IL-5、IL-6 和 IL-10)水平。
FU 治疗后,Th2 细胞因子 IL-5 和 IL-6 的浓度明显低于 FU 治疗前(P=0.044 和 P=0.028)。27 例患者 HR-HPV 感染清除,清除率为 77.1%(27/35)。FU 治疗后 HR-HPV 清除患者的 IL-4 浓度明显低于 HR-HPV 未清除患者(P=0.045)。
FU 可抑制某些 Th2 细胞因子的产生,并可能改善宫颈局部免疫状态,从而消除 HR-HPV 感染。