伊米奎莫德
医学
宫颈上皮内瘤变
免疫系统
病变
免疫组织化学
宫颈癌
肿瘤科
内科学
鳞状上皮内病变
免疫检查点
HPV感染
人乳头瘤病毒疫苗
癌症
免疫学
免疫疗法
病理
作者
Andrej Cokan,Neila Caroline Henrique da Silva,Rajko Kavalar,Igor But,Maja Pakiž,Sheilla Andrade de Oliveira,Fabiana Oliveira dos Santos Gomes,Rodrigo Soares da Silva,Christina Alves Peixoto,Norma Lucena‐Silva
出处
期刊:Cancers
[MDPI AG]
日期:2024-03-25
卷期号:16 (7): 1272-1272
标识
DOI:10.3390/cancers16071272
摘要
(1) Background: Cervical intraepithelial neoplasia (CIN) is a precancerous condition linked to human papillomavirus (HPV) infection, often necessitating surgical interventions carrying the risk of subsequent preterm births. This study explores the potential of imiquimod (IMQ), as a non-invasive alternative treatment. The focus is on understanding IMQ impact on immune checkpoint molecules, particularly PD-1, PD-L1, and sHLA-G, which play pivotal roles in shaping immune responses and cancer progression. (2) Methods: Forty-three patients diagnosed with a high-risk squamous intraepithelial lesion (HSIL, p16-positive) self-applied 5% IMQ encapsulated in sachets containing 250 g of cream into the vaginal cavity three times a week for 16 weeks. The impact of IMQ therapy on cervical lesion regression was assessed through immunohistochemistry (IHC), examining changes in sHLA-G, PD-L1, and PD-1 levels. The antiviral activity of IMQ was evaluated through HPV-E7 immunofluorescence. Ethical considerations were adhered to, and the research methods were based on a previously approved clinical trial (clinicaltrials.gov Identifier: NCT04859361). (3) Results: IMQ treatment demonstrated efficacy, leading to lesion regression. sHLA-G levels in CIN before starting IMQ application were associated with unsuccessful treatment (p = 0.0036). IMQ did not significantly alter the expression of PD-1. We observed a decrease in PD-L1 levels in those who were successfully treated (p = 0.0509) and a reduction in HPV burden. (4) Conclusions: IMQ exhibits promise as a non-invasive treatment for CIN, emphasising its potential to modulate the immune microenvironment. Baseline sHLA-G levels emerge as potential predictors of treatment response. Understanding the nuanced dynamics of immune checkpoints sheds light on IMQ mechanism of action. Further exploration is warranted to decipher the intricate mechanisms underlying IMQ treatment in the context of cervical lesions.
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