Features of biochemical parameters and non-specific resistance factors of vaginal contents in women with urogenital trichomoniasis and cervical intraepithelial neoplasia against the background of papillomavirus infection

Authors

DOI:

https://doi.org/10.18370/2309-4117.2022.63.73-84

Keywords:

urogenital trichomoniasis, intraepithelial neoplasia, cervix, papillomavirus infection, vaginal contents, biochemical parameters, factors of non-specific resistance

Abstract

Research objective: to improve the effectiveness of diagnosis and prognosis of complications in women of reproductive age with atypical squamous cells of undetermined significance/cervical intraepithelial neoplasia (ASCUS/CIN) of the cervix in Trichomonas and papillomavirus infection by studying the main biochemical and immunological parameters of vaginal contents.
Materials and methods. 200 women of reproductive age with ASCUS/CIN of the cervix were examined against the background of papillomavirus infection associated with trichomoniasis, who were divided into three main groups according to the results of the PAP-test. Group I consisted of 50 patients with ASCUS, II – 118 women with LSiL, III – 32 patients with HSiL. The control group included 50 healthy non-pregnant women. The analysis of biochemical parameters of vaginal contents was carried out, which included determining the concentration of total protein, urea, studying mineral and lipid metabolism, glucose, enzyme activity, as well as factors of non-specific resistance – secretory immunoglobulin A and hydrogen peroxide.
Results. There was a 2.6-fold increase in the amount of discharge from the genital tract and their pathological nature in patients with urogenital trichomoniasis and ASCUS/CIN against the background of papillomavirus infection, an increase in acidity by 1.2 times, the indicator of the amine test by 13 times, protein concentration by 2.3 times, compared with similar indicators in healthy women. Analysis of mineral metabolism in this contingent of patients revealed a decrease in the concentration of copper ions by 1.7 times, iron by 1.9 times, and calcium by 1.6 times. Evaluation of the enzyme activity revealed an increase in the level of alkaline phosphatase by 3.7 times, creatine phosphokinase by 10.6 times, AST by 6.5 times, ALT by 9.1 times, lactate dehydrogenase by 5.4 times, and α-amylase by 3.3 times compared to women in the control group. A decrease in the average value of sІgA content in patients with ASCUS/CIN on the background of HPV and Trichomonas invasion was found than in healthy women by 1.7, 1.9 and 2 times, respectively, in the I, II and III main groups, which can serve as a predictor of the development of post-trichomonas vaginal dysbiosis.
Conclusions. Analysis of the results of studies of vaginal contents in women with ASCUS/CIN against the background of human papillomavirus and Trichomonas invasion revealed significant changes in biochemical parameters and factors of non-specific resistance, determining the corresponding pathological changes in the functional activity of the vaginal epithelium and the composition of the vaginal biotope.

Author Biographies

O.A. Dyndar, O.O. Bogomolets National Medical University, Kyiv

MD, professor, Obstetrics and Gynaecology Department No. 3

V.O. Beniuk, O.O. Bogomolets National Medical University, Kyiv

MD, professor, head of the Obstetrics and Gynaecology Department No. 3

T.V. Kovaliuk, O.O. Bogomolets National Medical University, Kyiv

PhD, associate professor, Obstetrics and Gynaecology Department No. 3

T.R. Nykoniuk, O.O. Bogomolets National Medical University, Kyiv

PhD, associate professor, Obstetrics and Gynaecology Department No. 3

O.S. Neymark, O.O. Bogomolets National Medical University, Kyiv

Post-graduate student, Obstetrics and Gynaecology Department No. 3

References

  1. Dyndar, O.A., Nykoniuk, T.R., Neimark, O.S. “Modern approaches of cervical intraepithelial neoplasia treatment with the background of genital papillomavirus infection associated with trichomoniasis.” Medicine and health care in modern society: topical issues and current aspects. Lublin, Repablic of Poland, Feb 26–27 (2021): 48–51. DOI: 10.30525/978-9934-26-038-4-12
  2. Bayramova, G.R., Baranov, I.I., Ezhova, L.S., et al. “Squamous intraepithelial lesions of the cervix: possibilities of early diagnosis and tactics of patient management.” Gynecology 11.166 (2019): 61–7. DOI: 10.31550/1727-2378-2019-166-11-61-67
  3. Venediktova, M.G., Sarantsev, A.N., Morozova, K.V., et al. “Modern view on the complex therapy of cervical dysplasia in conditions of infection with the human papillomavirus.” Russian Journal of Woman and Child Health 3 (2019): 46–51. DOI: 10.32364/2618-8430-2019-2-3-237-242
  4. Schefer, V.V., Krutovа, V.A., Сhuprinenko, L.M., et al. “Features of the course and treatment of patients with dysplastic conditions of the cervix amid the disorders of vaginal microbiocenosis.” Kuban Scientific Medical Bulletin 2 (2018): 105–9. DOI: 10.25207/1608-6228-2018-25-2-149-155
  5. Pyrohova, V.I., Feita, J.R., Shurpiac, S.O. “Clinical efficacy of vaginal microbiota correction in women with a history of reproductive health dysfunction and postpartum complications.” Health of Woman 5.131 (2018): 40–3. DOI: 10.15574/HW.2018.131.40
  6. Beniuk, V.O., Nykoniuk, T.R., Kovaliuk, T.V. “Experience in restoring vaginal normocenosis in the treatment of bacterial vaginosis in women of reproductive age.” Health of Woman 1.137 (2019): 96–100. DOI: 10.15574/HW.2019.137.96
  7. Malanchuk, L.M., Picik, I.B., Malanchuk, A.S. “The role of the microbiota of reproductive tract in the development of pathology of the cervix – look of the preventive medicine.” Health of Woman 9.10 (2020): 71–5. DOI: 10.15574/HW.2020.155-156.71
  8. Chilova, R.A., Proklova, G.F., Goncharenko, N.V. “Problems of differential diagnosis and treatment of bacterial vaginosis.” Russian Journal of Woman and Child Health 3.1 (2020): 39–43. DOI: 10.32364/2618-8430-2020-3-1-39-43
  9. Nykoniuk, T.R., Dyndar, O.A, Neimark, O.S. “Modern trends in the bacterial vaginosis treatment.” Trends in the development of modern scientific thought. Abstracts of X International Scientific and Practical Conference. Vancouver, Canada, November 23–26 (2021): 314–7. Available from: [https://isg-konf.com/wp-content/uploads/X-Conference-23-26-VancouverCanada-Book.pdf].
  10. Norenhag, J., Du, J., Olovsson, M., et al. “The vaginal microbiota, human papillomavirus and cervical dysplasia: a systematic review and network metaanalysis.” BJOG 127 (2020): 171–80. DOI: 10.1111/1471-0528.15854
  11. Brusselaers, N., Shrestha, S., van de Wijgert, J., et al. “Vaginal dysbiosis and the risk of human papillomavirus and cervical cancer: systematic review and metaanalysis.” Am J Obstet Gynecol 221.1 (2019): 9–18. DOI: 10.1016/j.ajog.2018.12.011
  12. Marshall, V.J. Clinical Biochemistry. 6th ed., reprint and additional. – Moscow.-St. Petersburg: “BINOM Publishing House”-“Dialect” (2011): 408 p.
  13. Dyndar, O.A. “Experience in the use of the drug Magnefar B6 in obstetric practice.” Health of Woman 8.134 (2018): 58–64. DOI: 10.15574/HW.2018.134.58
  14. Ingerleib, M.B. Complete handbook of analyses and research in medicine / M.B. Ingerleib. – Moscow: Omega-L (2014): 500 p.
  15. Rees, J.B., Urry, L.A., Kane, M.L., et al. Campbell Biology, Volume 1. Chemistry of Life. Cell. Genetics. Moscow “Dialectics” (2021): 672 p.
  16. Bulavenko, O.V. “The modern view of the obstetrician-gynecologist on multivitamin complexes for pregnant women.” Reproductive endocrinology 3.47 (2019): 64–6. DOI: 10.18370/2309-4117.2019.47.64-67
  17. Zimenkovsky, B.S. Biological and bioorganic chemistry. Book 1. Bioorganic chemistry. Ed. B.S. Zimenkovsky, I.V. Nizhenkovskaya. Second edition. Kyiv “Medicine” (2018): 296 p.
  18. Kuznetsova L.V., Babajana V.D., Kharchenko N.V. Imunologiya. Vinnitsia, TOV “Mercury-Podilla” (2013): 565 p.
  19. Gomes de Oliveira, G., Eleutério, R.M.N., Silveira Gonçalves, A.K., et al. “Atypical Squamous Cells in Liquid-Based Cervical Cytology: Microbiology, Inflammatory Infiltrate, and Human Papillomavirus-DNA Testing.” Acta Cytol 62.1 (2018): 28–33. DOI: 10.1159/000481654
  20. Sommer, V., Castello, C.E., Hayes, G.R., et al. “Identification of Trichomonas vaginalis cysteine proteases that induce apoptosis in human vaginal epithelial cells II.” J Biol Chem 3 (2005): 414–8. DOI: 10.1074/jbc.M501752200
  21. Yadav, M., Dubey, M.L., Gupta, L., et al. “Cysteine proteinase 30 (CP30) and antibody response to CP30 in seram and vaginal washes of symptomatic and asymptomatic Trichomonas vaginalis-infected woman.” Parasite Immunol 29.7 (2007): 359–65. DOI: 10.1111/j.1365-3024.2007.00952.x
  22. Radonjic, I.V., Dramic, S.M., Popadic, D.M. “Diagnosis of Trichomonas vaginalis infection: the sensities and specificities of microscopy, culture and PCR assay.” Eur J Obstet Gynecol Reprod Biol 126.1 (2006): 116–20. DOI: 10.1016/j.ejogrb.2005.07.033
  23. Boris, E.N., Gervazyuk, O.I. “Analysis of the results of the all-Ukrainian study of the use of the drug Laferomax in the complex therapy of urogenital infections and pathology of the cervix in women of different ages.” Health of Woman 9.115 (2016): 33–9.
  24. Dyndar, O.A., Nykoniuk, T.R., Neymark, O.S. “The use of ultrasonic cavitation for the treatment of cervical intraepithelial neoplasia on the background of ingenious papillomavirus infection associated with trichomoniasis.” Scientific digest of Association of obstetricians and gynaecologists of Ukraine 2.46 (2020): 41–8. DOI: 10.35278/2664-0767.2(46).2020.219471
  25. Zhang, X., Shen, D. “p16INK4a and Ki-67 measurement predict progression of cervical low-grade squamous intraepithelial lesion.” Int J Clin Exp Pathol 11.8 (2018): 4109–16. Available from: [https://e-century.us/files/ijcep/11/8/ijcep0078929.pdf].
  26. Wentzensen, N., Clarke, M.A., Bremer, R., et al. “Clinical Evaluation of Human Papillomavirus Screening with p16/Ki-67 Dual Stain Triage in a Large Organized Cervical Cancer Screening Program.” JAMA Intern Med 179.7 (2019): 881–8. DOI: 10.1001/jamainternmed.2019.0306
  27. Wouters, T., Hendriks, N., Koeneman, M., et al. “Systemic adverse events in imiquimod use for cervical intraepithelial neoplasia – A case series.” Case Rep Womens Health 21 (2019): e00105. DOI: 10.1016/j.crwh.2019.e00105
  28. Kashtalyan, N.M. “Ablative treatment of endometriosis and benign pathology of the cervix on the background of mild dysplasia.” Оdessa Medical Journal 2 (2018): 63–7. Available from: [http://repo.odmu.edu. ua:80/xmlui/handle/123456789/3275].
  29. Clarke, M.A., Cheung, L.C., Castle, P.E., et al. “Five-Year Risk of Cervical Precancer Following p16/Ki-67 Dual-Stain Triage of HPV-Positive Women.” JAMA Oncol 5 (2019): 181–6. DOI: 10.1001/jamaoncol.2018.4270
  30. Koeneman, M.M., Kruse, A.J., Kooreman, L.F., et al. “Preliminary stop of the TOPical Imiquimod treatment of high-grade Cervical intraepithelial neoplasia (TOPIC) trial.” BMC Cancer 17 (2017): 110. DOI: 10.1186/s12885-017-3108-9
  31. Grema, B.A., Aliyu, I., Michael, G.C., et al. “Diagnosing Premalignant Lesions of Uterine Cervix in A Resource Constraint Setting: A Narrative Review.” West Afr J Med 36.1 (2019): 48–53. Available from: [https://cutt.ly/2Siug9T].
  32. Labzina, M.V., Labzina, L.Y., Nechaykin, A.S., et al. “Analysis of the results of colposcopy in the diagnosis of cervical neoplasia.” Bulletin of Science and Practice 2 (2020): 103–5. DOI: 10.33619/2414-2948/51/09
  33. Blesmanovich, A.E., Petrov, Y.A., Alyokhina, A.G. “Risk factors and preventive diagnosis of cervical cancer.” Health and education in the XXI century 1 (2019): 23–9.
  34. Rachkovskaya, V.V., Gorbunov, A.P., Pashov, L.V., Volkova, L.V. “The use of mass spectrometry in the diagnosis of cervical pathology (literature review).” Siberian Medical Review 3.123 (2020): 30–7. DOI: 10.20333/2500136-2020-3-30-37

Published

2022-05-27

How to Cite

Dyndar, O., Beniuk, V., Kovaliuk, T., Nykoniuk, T., & Neymark, O. (2022). Features of biochemical parameters and non-specific resistance factors of vaginal contents in women with urogenital trichomoniasis and cervical intraepithelial neoplasia against the background of papillomavirus infection. REPRODUCTIVE ENDOCRINOLOGY, (63-64), 73–84. https://doi.org/10.18370/2309-4117.2022.63.73-84

Issue

Section

Gynecology