Changes in the indicators of cytokine status and autoimmunity in female patients with latent forms of human papillomavirus infection

Tkachenko L.V., Sviridova N.I., Shishimorova S.G., Deleske I.A.

Volgograd State Medical University, Ministry of Health of Russia, Volgograd, Russia
Objective. To study the impact of immunostimulating therapy on changes in the indicators of local cytokine status and autoimmunity in female patients with latent forms of human papillomavirus infection (PVI).
Materials and methods. Clinical and laboratory examinations were made in 96 patients aged 18 to 45 years with the latent forms of PVI. A study group consisted of 48 patients who underwent follow-up and a differentiated approach to using the immunostimulating and antiviral drug Inosine pronabex 1000 mg thrice daily for 28 days. A comparison group included 48 women who underwent co-testing at 12 months after the start of the follow-up.
Results. Analyzing the outcomes of latent forms of PVI following 12 months showed that in the study group, there was a complete elimination of human papillomavirus (HPV) and a clinically insignificant viral load in 95.8% of cases, which was 1.5 times more often than in the comparison group. Moreover, in the latter group, every three (35.5%) patients had a "significant" high-risk HPV concentration.
Conclusion. Immunostimulating and antiviral therapy with Groprinosin-Richter in patients with latent forms of PVI leads to elimination of the initial imbalance of cytokines and to normalization of autoantibody levels, which suggests that the local inflammatory changes in the cervical epithelium are eliminated, and, as a result, the reproductive potential is preserved.

Keywords

latent forms of papillomavirus infection
human papillomavirus
inosine pranobex

References

  1. Абакарова П.Р., Прилепская В.Н. ВПЧ-ассоциированные заболевания шейки матки. Возможности комплексной терапии. Гинекология. 2017; 19(5): 4-9. [Abakarova P.R, Prilepskaya V.N. HPV-associated diseases of cervix. Complex therapy options. Gynecology. 2017; 5: 4-9. (in Russian)].
  2. Тихомиров А.Л., Сарсания С.И, Филатова Г.А. Вирус папилломы человека: от понимания иммуногенеза к рациональной тактике ведения. Гинекология. 2018; 20(3): 5-11. [Tikhomirov A.L., Sarsaniya S.I., Filatova G.A. Human papilloma virus: from understanding of immunopathogenesis to rational tactics of management. Gynecology. 2018; 3: 5-11. (in Russian)].
  3. Киселев В.И., Муйжнек Е.Л., Ашрафян А.Л., Сухих Г.Т. Новая парадигма прогрессирования цервикальных неоплазий: от фундаментальных знаний – к практической гинекологии. Акушерство и гинекология. 2019; 1: 5-12. [Kiselev V.I., Muyzhnek E.L., Ashraphyan L.A., Sukhikh G.T. A new paradigm in cervical neoplasia progression: from fundamental knowledge to practical gynecology. Obstetrics and gynecology. 2019; 1: 5-12. (in Russian)].
  4. Савельева Г.М., Сухих Г.Т., Манухин И.Б., Радзинский В.Е., ред. Гинекология. Национальное руководство. М.: ГЭОТАР-Медиа. 2017; 1048с. [Saveleva G.M., Sukhikh G.T., Manukhin I.B., Radzinskii V.E., red. Gynecology. National leadership. M.: GEOTAR-Media. 2017; 1048 p.(in Russian)].
  5. Mittal S., Banks L. Molecular mechanisms underlying human papillomavirus E6 and E7 oncoprotein-includid cell transformation. Mutat. Res. Rev. 2017; 772: 23-35.
  6. Steenberg R.D., Snijders P.J., Heideman D.A., Meijer C.J. Clinical implicatios of epigenetic changes in HPV-induced cervical precancerous lesions. Nat. Rev. Cancer. 2014; 14(6): 395-405.
  7. Sano D., Oridate N. The molecular mechanism of human papillomavirus-induced carcinogenesis in head and neck squamouse cell carcinoma. Int. J. Clin. Oncol. 2016; 21 (5): 819-26.
  8. Винокурова С.В. Генетические и эпигенетические механизмы регуляции вирусов папиллом человека. Успехи молекулярной онкологии. 2016; 2(3): 18-25. [Vinokurova S.V. Genetic and epigenetic mechanisms of regulation of human papillomavirus. Advances in Molecular Oncology. 2016; 3 (2): 18-25. (in Russian)].
  9. Tang Y., Zheng L., Yang S. et al. Epidemiology and genotype distribution of human papillomavirus (HPV) in Southwest China: a cross-sectional five years study in non-vaccinated women. Virol. J. 2017; 14: 84.
  10. Роговская С.И., Липова Е.В. Шейка матки, влагалище, вульва. Физиология, патология, эстетическая коррекция. Руководство для практикующих врачей. М.: Издательство журнала Status Praesens; 2016. 832 с. [Rogovskoya SI, Lipova EV. Cervix, vagina, vulva. Physiology, pathology, aesthetic correctyion: a guide for practitioners. M.: Izdatelstvo zhurnala Status Praesens, 2016; 832. (In Russian)]
  11. Байрамова Г.Р., Баранов И.И., Ежова Л.С., Трофимов Д.Ю., Припутневич Т.В., Амирханян А.С., Старинская А.М. Плоскоклеточные интраэпителиальные поражения шейки матки: возможности ранней диагностики и тактики ведения пациенток. Доктор.Ру. 2019; 11: 61-7. [Bairamova G.R., Baranov I.I., Ezhova L.S., Trofimov D.Yu., Priputnevich T.V., Amirkhanyan A.S., Starinskaya A.M. Squamous Intraepithelial Cervix Lesions: Possible Early Diagnostics and Management. Doctor.Ru. 2019; 11 (166): 61-7. (in Russian)].
  12. Hong S., Laimins L.A. Manipulation of innate immune response by human papillomavirusses. Virus Res. 2017; 231: 34-40.
  13. Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines, 2015. MMWR Morbid. Mortal. Wkly Rep. 2015; 64 (RR3); 1-137.
  14. Andersen A.S., Koldiaer Solling A.S., Ovesen T. et al. The interplay between HPV and host immunity in head and neck squamous cell carcinoma. Int. J. Cancer. 2014; 134(12): 2755-63.
  15. Межевитинова Е.А., Донников А.Е., Прилепская В.Н. Дисплазия шейки матки. Роль цитокинотерапии в повышении эффективности лечения. Акушерство и гинекология: новости, мнения, обучение. 2019; 7(4): 66-71. [Mezhevitinova E.A., Donnikov A.E., Prilepskaya V.N. Cervical intraepithelial neoplasia. Role of cytokine therapy in treatment efficiency improvement. Obstetrics and gynecology: News, Opinions, Training. 2019; 7(4): 66-71. (in Russian)].
  16. Боровиков И.О., Куценко И.И., Горринг Х.И. Опыт применения иммуномодулирующего препарата в терапии папилломавирусной инфекции гениталий у женщин. Акушерство и гинекология. 2018; 3: 122-8. [Borovikov I.O., Kutsenko I.I., Gorring C.I. Experience of usin the immunomodulator in the therapy of papillomavirus infection of genitalia in women. Obstetrics and gynecology. 2018; 3: 122-8. (in Russian)].
  17. Абакарова П.Р., Прилепская В.Н., Межевитинова Е.А., Донников А.Е. Локальная цитокинотерапия в комплексном лечении ВПЧ-ассоциированных заболеваний шейки матки. Гинекология. 2019; 21(1): 28-32. [Abakarova P.R., Prilepskaya V.N., Mezhevitinova E.A., Donnikov A.E. Local cytokine therapy in a comprehensive treatment of HPV-associated cervical diseases. Gynecology. 2019; 21 (1): 28-32. (in Russian)].
  18. Дубровина С.О., Ардинцева О.А., Красильникова Л.В., Варичева М.В., Африкьян О.А. К вопросу о диагностике, профилактике и терапии патологии шейки матки. Гинекология. 2018; 20(5): 33-6. [Dubrovina S.O., Ardintseva O.A., Krasilnikova L.V. et al. To the question about diagnostics, prevention and therapy of pathology of the cervix. Gynecology. 2018; 20 (5): 33-6. (in Russian)].
  19. Зароченцева Н.В., Джиджихия Л.К. Цервикальные интраэпителиальные неоплазии: современный взгляд на проблему и пути решения. Акушерство и гинекология: новости, мнения, обучение. 2016; 4: 92-101. [Zharochentseva N.V., Dzhidzhkhiea L.K. Cervical intraepithelial neoplasia: a modern view on the problem and solutions. Obstetrics and gynecology: News, Opinions, Training. 2016; 4: 92-101. (in Russian)].
  20. Vidal 2019. Справочник Видаль. Лекарственные препараты в России. М.: Астрафармcервис; 2019. 857с. [Vidal 2019. Reference book Vidal. Drugs in Russia. M.: Astrapharmservis; 2019. 857 p. (in Russian)].
  21. Lasek W., Janyst M., Wolny R. et al. Immunomodulatory effects of inosine pronabex on cytokine production by human lymphocytes. Acta Pharm. 2015; 65(2): 171-80.
  22. Majeuwska A., Lasek W., Janyst M. et al. Vitro inhibition of HHV-1 Replication by inosine pronabex and interferon-α. Acta Pol. Pharm .2016; 73(3): 637-44.
  23. Косенко И.А., Костевич Г.В., Артемьева Т.П., Жук Е.Г., Василевский А.П., Серова Т.Н., Литвинова Т.М. К вопросу о патогенезе, диагностике и лечении вирус-ассоциированной патологии шейки матки. Медицинские новости. 2016; 2: 17-21. [Kostenko I.A., Kostevich G.V., Artemeva T.P. et al. To the question of the pathogenesis diagnosis and treatment of virus-associated cervical pathology. Med. news. 2016; 2: 17-21. (in Russian)].
  24. Давыдов А.И., Лебедев В.А., Шахламова М.Н. Гигантская кондилома Бушке-Левенштейна: выбор послеоперационной терапии. Вопросы гинекологии, акушерства и перинатологии. 2017; 16(4): 76-80. [Davydov A.L., Lebedev V.A., Shakhlamova M.N. Giant condyloma of Buschke and Levenstein: a choice of post-operative therapy. Gynecology, Obstetrics and Perinatology. 2017; 16 (4): 76-80. (in Russian)].
  25. Давыдов А.И., Шахламова М.Н. Лебедев В.А. Цервикальная интраэпителиальная неоплазия, ассоциированная с папилломавирусной инфекцией: патогенетическое обоснование лечения пациенток в репродуктивном периоде. Вопросы гинекологии, акушерства и перинатологии. 2018; 17(3): 66-72. [Davydov A.L., Shakhlamova M.N., Lebedev V.A. Cervical intraepithelial neoplasia associated with papillomavirus infection: pathogenetic rationale of treating patients during the reproductive period. Gynecology, Obstetrics and Perinatology. 2018; 17 (3): 66-72. (in Russian)].
  26. Клинические рекомендации (протоколы диагностики и ведения больных) «Доброкачественные и предраковые заболевания шейки матки с позиции профилактики рака». М.; 2017. 54с. [Clinical recommendations (protocols for the diagnosis and management of patients) «Benign and precancerous diseases of the cervix uteri from the perspective of cancer prevention». Moscow. 2017; 54p. (in Russian)].
  27. Полетаев А.Б. Физиологическая иммунология (естественные аутантитела и проблемы наномедицины). М.: Миклош. 2015. 219с. [Poletaev A.B. Physiological immunology (autoantibodies and problems of nanomedicine). М.: Мiklosh. 2015; 219p. (in Russian)].

Received 22.05.2020

Accepted 08.09.2020

About the Authors

Lyudmila V. Tkachenko, Doctor of Medical Sciences, Professor, Head Department of Obstetrics and Gynecology, Faculty of Advanced Medical Studies,
Volgograd State Medical University, Ministry of Health of Russia. Теl.: +7(8442)34-11-05. E-mail: tkachenko.fuv@mail.ru.
400131, Russia, Volgograd, pl. Fallen fighters, 1.
Natalia I. Sviridova, Doctor of Medical Sciences, Associate Professor, Professor of the Department of Obstetrics and Gynecology,
Faculty of Advanced Training of Doctors, Volgograd State Medical University, Ministry of Health of Russia. Теl.: +7(8442)34-11-05. E-mail: n.i.sviridova@yandex.ru.
400131, Russia, Volgograd, pl. Fallen fighters, 1.
Svetlana G. Shishimorova, a graduate student in the Department of Obstetrics and Gynecology at the Faculty of Advanced Training of Doctors
of Volgograd State Medical University, Ministry of Health of Russia. Теl.: +7(8442)34-11-05. E-mail: trigerz@mail.ru.
400131, Russia, Volgograd, pl. Fallen fighters, 1.
Inna A. Deleske, a graduate student in the Department of Obstetrics and Gynecology, Institute of Continuing Medical and Pharmaceutical Education,
Volgograd State Medical University, Ministry of Health of Russia. Теl.: +7(8442)34-11-05. E-mail: deleske25@mail.ru.
400131, Russia, Volgograd, pl. Fallen fighters, 1.

For citation: Tkachenko L.V., Sviridova N.I., Shishimorova S.G., Deleske I.A. Changes in the indicators of cytokine status and autoimmunity in female patients with latent forms of human papillomavirus infection.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2020; 9: 225-232 (in Russian)
https://dx.doi.org/10.18565/aig.2020.9.225-232

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