The Dynamic Process of VMB and Mucosal Immunity After FUS Treatment of CIN Patients With Fertility Requirement
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- STATUS
- Recruiting
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- End date
- Jun 30, 2023
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- participants needed
- 90
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- sponsor
- Shufang Chang
Summary
With the popularization of cervical cancer screening more and more patients of cervical intraepithelial lesions have been found. The liberalization of the three child fertility policy also makes the treatment of patients with cervical intraepithelial lesions to retain cervical anatomic and physiological function become a trend. Compared with traditional ablation methods, focused ultrasound has good tissue penetration and controllable focused characteristics.Preliminary studies have shown that focused ultrasound is no less effective than traditional cryotherapy in the treatment of cervical intraepithelial lesions. However, as a new treatment method, the impact of focused ultrasound on cervical anatomic and physiological function is not clear. At the same time, it is unclear whether focused ultrasound ablation treatment for cervical intraepithelial lesions will stimulate immune response to HPV. Although the role of cytokines and vaginal microecology in cervical disease has been studied, the interaction between vaginal microecology, HPV and mucosal immunity is not completely clear.Therefore, this study is aimed at investigating the vaginal microecology and local cervical micro-environment for focused ultrasound ablation in the management of cervical intraepithelial neoplasia.This will provide a new and noninvasive method for the ablation of cervical intraepithelial lesions.
Description
Studies have shown that the mucus secreted by cervical mucosa is the main physical barrier against HPV. HPV can invade through locally damaged cervical mucosa that stimulate the body's non-specific immunity and specific immune response to resist the invasion of the virus.The specific cellular immune response plays a major role in resisting virus proliferation and inhibiting tumor progression. When pathogens invade, DCs are greatly activated. After activated by the antigen peptide presented by DCs, CD4 helper T-cells differentiate into Th1 and Th2 effector subsets.A Th1 type cytokine IFN- is mainly involved in cellular immune response.Th2 type cytokines(IL-1IL-8IL-10) are mainly inducing humoral immune response and inhibiting cellular immune response. The increased expression of IFN-contributes to the clearance of high-risk HPV. It may be a prognostic marker for the clearance of high-risk HPV in local cervical lesions. The down-regulation of IFN- and the up-regulation of IL-10 are considered to be one of the mechanisms of HPV escaping from the host immune system, which can produce a local immunosuppressive environment and inhibit the anti-tumor function. According to The Human Protein Atlas, IL-1 and IL-8 are unfavorable prognostic marker in cervical cancer, and the expression of them increased in the local cervical lesion with the progression of cervical intraepithelial neoplasia lesions. The occurrence of humoral immune response is later than cellular immune response.Th2 cells can promote the proliferation of B Cells and induce local reproductive tract mucosa to secrete IgA.In addition, studies have reported that HPV related IgA are mainly produced in HPV persistent infection.
Persistent HPV infection is the main factor in the progression of cervical lesions and the occurrence of cervical cancer, but only a few HPV infected women developing cervical cancer, which indicates that other factors may affect the occurrence of cervical cancer. The diversity of vaginal microecology is related to HPV infection, cervical lesions and cervical cancer. According to a new study, the surgical excision of cervical lesions can not alter vaginal microbiota composition.It appears more plausible that women with CIN have inherent genetic, epigenetic and environmental factors that shape vaginal microecology composition before and after treatment. However, it is certain that Lactobacillus can promote HPV clearance and the reversal of cervical lesions. Relevant studies indicate Lactobacillus inhibit the proliferation of HeLa cells.
This prospective observational study of women planned for local cervical treatment aims to explore the impact of the ablation of disease on the vaginal microecology and innate immune, and further explore how these pre- and post-treatments compare to healthy untreated controls.
Details
| Condition | cervical intraepithelial neoplasms, Cervical Intraepithelial Neoplasia |
|---|---|
| Treatment | Focused Ultrasound |
| Clinical Study Identifier | NCT05142397 |
| Sponsor | Shufang Chang |
| Last Modified on | 4 October 2022 |
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