Year: 2012
Type: book-chapter
Study design: Systematic Review
Abstract: Recent Advances in Immunology to Target Cancer, Inflammation and Infections 4 been used to characterize cell-mediated immune responses to HPV.Such approaches include measurement of cytokines and other immune markers that commonly lead to infiltration of immune cells.Cytokines are pleiotropic glycoproteins that regulate cell survival, proliferation, differentiation and activation at both local and systemic levels.During inflammation, their excessive release may lead to both chronicity and pathogenicity.The purpose of this review is to describe the current state of knowledge regarding these important regulators or other important immune markers of cell-mediated immune response in HPV infection.To this end, we have evaluated studies in plasma or serum from peripheral blood, in cervical secretions, in unstimulated and stimulated PBMCs (and cellular subsets thereof), and in cervical tissues themselves.Importantly, this chapter will highlight not only the large amount of knowledge gained from these studies, but also the many scientific gaps in knowledge that remain. MethodsRelevant studies were identified by searching MEDLINE (via PubMed) using broad search term categories for cervix and immunity (Appendix 1).The search included studies identified through 3 November 2011.Studies that evaluated cell-mediated immune response immune response by HPV status (positivity, persistence, or clearance) were included if there were at least 10 women in each comparison group (usually HPV-positive versus HPVnegative; sometime HPV persistence versus clearance or difference by HPV type).To focus on more functional aspects of immune response, only studies of immune-related proteins and mRNA (evidence of expression) and studies with HPV DNA detection were included.Studies were excluded if the HPV status and disease status of the referent group was unclear or if they focused on DNA polymorphisms alone.Given the focus on HPV infection, studies were also excluded if they include cervical cancer patients, but no other groups [i.e.normal women, women with low-grade squamous intraepithelial lesions (LSIL) or cervical intraepithelial neoplasia (CIN)].Studies that included some cervical cancer patients along with CIN or normal patients were retained.Post-treatment studies or studies involving mice, cell lines, or HPV at extra-cervical anatomical sites were excluded as well.Data were abstracted on the study characteristics, HPV measurement, immune marker measurement, and results pertinent to this review.Study characteristics included the country in which the study was conducted, the method of cervical secretion collection, and descriptions of comparison groups relevant for this review (e.g., women with incident HPV versus no HPV).The assay used to detect HPV was also noted.Immune marker-related data included the assay used to measure the immune marker and the specific markers measured, along with the results.Approximately 50% of studies were double abstracted. Literature reviewIn total, 35 studies met our inclusion criteria.These studies fell into four broad categories (Tables 1 to 4): circulating immune markers in plasma or serum (N = 7), those secreted locally in the cervix (N = 7), immune responses in patient-derived PBMCs (N = 10), and tissue-based immune markers (N = 12).One study contributed to both the circulating and PBMC-based immune marker categories.Circulating Immune Markers in Plasma/Serum.Cytokines and soluble immune markers are increasingly being measured in readily accessible plasma and serum in the hope that they will provide useful diagnostic and prognostic information, as well as insight into the pathogenesis www.intechopen.com
Source: InTech eBooks
DOI: 10.5772/32540
Authors: Jill Koshiol, Melinda Butsch
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
OpenAlex ID: W1536882033