Comparative efficacy of vaginal and rectal cytokine therapy in pregnant women with cervical dysplasia

Abstract

E.I. Borovkova1, S.A. Zalesskaya1, I.V. Stepanyants2 1Pirogov Russian National Research Medical University, Moscow, Russian Federation 2City Clinical Hospital No. 40, Moscow, Russian Federation Aim: to assess the efficacy of vaginal and rectal cytokine therapy with Superlymph in pregnant women with cervical dysplasia. Patients and Methods: 50 pregnant women with moderate cervical dysplasia were enrolled in this prospective study. 30 women received vaginal cytokine therapy and 20 women received rectal cytokine therapy. Human papillomavirus (HPV) viral load and innate immunity gene (TNF-α, TLR-9, TLR-2, HBD-1) expression levels in endocervical and vaginal epithelium were measured before and 20 days after the treatment. Results: HPV was identified in 100% of cases. HPV A9 group was identified in 83.3% in the study group and 55% in the control group. HPV-51 and HPV-56 was identified in 10% and 35%, respectively and HPV A7 group (HPV-18) in 5.6% and 10%, respectively. Vaginal cytokine therapy with Superlymph reduced HPV A9 group viral load by 1.3 times and HPV A7 group viral load by 1.8 times. No significant changes were demonstrated for HPV-51 and HPV-56. Rectal cytokine therapy reduced HPV A7 group viral load by 1.4 times. Superlymph modulated innate immunity factor expression independently of its administration route. TLR-2 and TLR-9 expression increased in vaginal epithelium while TNF-α and HBD-1 levels increased both in endocervical and vaginal epithelium. Conclusion: vaginal cytokine therapy with Superlymph provides more significant therapeutic effect manifested by elevated expression of innate immunity factors in genital tract epithelium and greater viral load reduction. Keywords: cervical dysplasia, pregnancy, human papillomavirus, innate immunity, tumor necrosis factor, TLR-9, TLR-2, HDB-1, cytokine therapy, Superlymph. For citation: Borovkova E.I., Zalesskaya S.A., Stepanyants I.V. Comparative efficacy of vaginal and rectal cytokine therapy in pregnant women with cervical dysplasia. Russian Journal of Woman and Child Health. 2019;2(3):173–176.