Anna Kwaśniewska

Prevalence of human papillomavirus in spontaneously aborted products of conception

Objective. To compare the prevalence of human papillomavirus (HPV) in placentas from women with spontaneous abortions and from control women after term delivery. Design. Cross‐sectional study. Setting. Department of Obstetrics and Pathology of Pregnancy, Medical University of Lublin (Poland). Population. Patients whose spontaneous abortions occurred between the 6th and the 16th week of pregnancy (n=51), and women after term delivery (n=78). Method. Polymerase chain reaction (PCR). Main outcome measures. HPV DNA prevalence rate and the fraction of HPV 16/18 infections in aborted products of conception and placentas. Results. Patients with spontaneous abortion did not differ from the controls in terms of mean age and the fraction of primiparas. The DNA of HPV was detected in 17.7% of aborted products of conception and in 24.4% of placentas from term deliveries. The aborted products of conception and full‐term placentas were positive for HPV 16/18 in 11.8 and 12.8% cases, respectively. Patients whose material was positive for HPV DNA or those with confirmed HPV 16/18 did not differ significantly from HPV‐negative women in terms of mean age and the fraction of primiparas. Conclusions. The HPV 16/18 infection rate does not seem be higher in cases of spontaneous abortions. Nevertheless, further study of the consequences of HPV infection in pregnancy is still needed.

Peripheral Dendritic Cells and CD4+CD25+Foxp3+ Regulatory T Cells in the First Trimester of Normal Pregnancy and in Women with Recurrent Miscarriage.

The development of pregnancy is possible due to initiation of immune response in the body of the mother resulting in immune tolerance. Miscarriage may be caused by the impaired maternal immune response to paternal alloantigens located on the surface of trophoblast and fetal cells. The aim of the study was to compare the population of circulating dendritic cells (DCs) and CD4+CD25+Foxp3+ regulatory T cells (TREGs) in the first trimester of a normal pregnancy and in women with recurrent miscarriage and an attempt to determine the relationship between these cells and the role they may play in human reproductive failures. The study was conducted in a group of 33 first trimester pregnant women with recurrent miscarriage and in a group of 20 healthy pregnant women in the first trimester of normal pregnancy. Among mononuclear cells isolated from peripheral blood, the populations of DCs and TREGs were assessed by flow cytometry. The percentage of myeloid DCs and lymphoid DCs showed no significant difference between study and control group. Older maternal age and obesity significantly reduced the pool of circulating myeloid and lymphoid DCs (R=-0.39, p=0.02). In miscarriages the percentage of circulating TREGs was significantly lower compared to normal pregnancies (p=0.003). Among the analysed factors the percentage of TREGs was the most sensitive and the most specific parameter which correlated with the pregnancy loss. The reduction in the population of circulating TREGs suggests immunoregulatory mechanisms disorder in a pregnancy complicated by miscarriage.

Content of α-tocopherol in blood serum of human Papillomavirus-infected women with cervical dysplasias

The studies were carried out in a group of 228 female patients with normal cytological smear and 324 patients with cervical intraepithelial neoplasia. The applied method of identification, i.e., the human Papillomavirus (HPV) digene hybrid capture system, made it possible to select a control group consisting of 168 HPV-negative patients with normal Pap smear, as well as a group of 228 HPV-positive patients with cervical intraepithelial neoplasia. The high-performance liquid chromatography method was employed to evaluate the level of alpha-tocopherol in the blood serum of the patients who were examined. A statistically significantly lower level of alpha-tocopherol was observed in the blood serum of HPV-positive patients with cervical intraepithelial neoplasia. The risk of dysplasia was four times higher for an alpha-tocopherol level < 7.95 mumol/l.

Risk factors of the vertical transmission of human papilloma virus in newborns from singleton pregnancy – preliminary report

Abstract Objective: The aim of this study was to analyze the relationship between the frequency of Human Papilloma Virus (HPV) isolation in pregnant women and their offspring, and to assess the risk of maternal-neonatal transmission. Study design: The study included vaginal/buccal smears of 135 pregnant women, as well as the buccal smears and the respiratory discharge samples from their neonates. The material was tested for the presence of HPV DNA by means of PCR. Results: Twenty-two HPV 11-positive cases (16.3%) were detected amongst pregnant women, along with 16 neonatal HPV 11-positive cases (11.85%). The concordance rate of maternal and neonatal HPV 11 DNA was 54.5%. Three maternal variables: the presence of HPV 11, less than 10 years of education, and common law proved significant risk factors for vertical transmission. Conclusion: Asymptomatic HPV infection of a pregnant woman rather than the mode of delivery or other obstetrical characteristics constitutes significant risk factor of vertical transmission.

Analysis of the coding sequence and expression of the coiled-coil α-helical rod protein 1 gene in normal and neoplastic epithelial cervical cells

The role of the CCHCR1 (coiled-coil α-helical rod protein 1) protein in the cell is poorly understood. It is thought to be engaged in processes such as proliferation and differentiation of epithelial cells, tissue-specific gene transcription and steroidogenesis. It is supposed to participate in keratinocyte transformation. It has also been found that this protein interacts with the E2 protein of human papilloma virus type 16 (HPV16). The oncogenic HPV forms, such as HPV16, are known to be necessary but not sufficient agents in the development of cervical carcinoma. In the present study, the CCHCR1 gene coding sequence and its expression was analyzed in normal, precancerous and cervical cancer cells. Changes in the non-coding region were found in 20.3% of the examined probes from women with cervical cancer or precancerous lesions and in 16.67% of the control probes. Most of the detected changes were single nucleotide polymorphisms (SNPs). Changes in the coding region were found in 22.8% of the probes with cervical cancer and in 16.67% of the control probes and all of them were SNPs. The level of CCHCR1 transcripts was determined using the real-time PCR method and the highest gene expression was detected in the H-SIL group and slightly decreased in the cervical carcinoma cells, compared with the control probes. It suggests that CCHCR1 could have a role in the process of cervical epithelial cell transformation, but this suggestion must be confirmed experimentally.

The Prevalence of Human Papillomavirus between the Neonates and Their Mothers

The impact of human papillomavirus (HPV) infection on pregnancy is a major problem of medicine. The transmission of the virus from mother to fetus is a process yet unresolved. The immune response and changed hormonal status of pregnant women might facilitate infection. A research on the prevalence of HPV infection was conducted at the Clinic of Obstetrics, Medical University of Lublin (Poland). The studied group included 152 randomly selected women. The material was tested for the presence of HPV DNA by means of polymerase chain reaction (PCR). The aim of the research was to assess the relation between HPV infections detected in the buccal smears of the neonates and the incidence of such infections in the cervical/buccal smears of their mothers. In the group of 152 infants HPV was found in 16 (10.53%). Among the cervical/buccal smears, HPV was isolated, respectively, in 24 (15.79%) and in 19 (12.5%) pregnant women. Statistically significant differences in the prevalence of HPV swabs from the newborns and the cervical/buccal smears of their mothers were found (p < 0.001). The identification of mothers in whose buccal smears HPV was detected can help develop a group of children who run a relatively significant risk of being infected.

Association between rs7901695 and rs7903146 polymorphisms of the TCF7L2 gene and gestational diabetes in the population of Southern Poland

OBJECTIVES The etiology of gestational diabetes mellitus (GDM) remains to be fully elucidated. Elevated risk for type 2 diabetes in patients with history of GDM and for GDM in women with familial history of diabetes may suggest that GDM and type 2 diabetes share a common genetic and environmental background. The TCF7L2 (Transcription Factor 7 Like 2) gene is one of the most important genetic factors of the established correlation with type 2 diabetes, and it may also play a role in the pathophysiology of GDM. The aim of the study was to assess the influence of two polymorphisms of the TCF7L2 gene (rs7901695 and rs7903146), which are associated with the development of type 2 diabetes, in women with GDM. MATERIAL AND METHODS The study included 50 women with glucose tolerance disorders diagnosed for the first time during the current pregnancy. Single nucleotide polymorphisms (SNPs) were genotyped using allelic discrimination. The results were confirmed using the sequencing method. Selected clinical parameters were also analyzed. RESULTS No correlation between the studied polymorphisms of the TCF7L2 gene and GDM was observed. Glycemic control with diet or diet and insulin was associated with better control of the weight gain during pregnancy. CONCLUSIONS No correlation between rs7903146 and rs7901695 polymorphisms of the TCF7L2 gene and GDM was found. Glycemic control with diet or diet and insulin is associated with better control of the weight gain during pregnancy.

Expression of TSG101 protein and LSF transcription factor in HPV‑positive cervical cancer cells

Our previous study demonstrated a decreased expression of tumor susceptibility gene 101 (TSG101) in cervical cancer cells. To identify the mechanism responsible for TSG101 downregulation during cervical cancer development, we analyzed the TSG101 promoter using cis-element cluster finder software. One of the transcription factors whose binding site was detected in the TSG101 promoter was late SV40 factor (LSF). The aim of this study was to analyze the TSG101 protein and LSF expression levels during cervical cancer development. Immunohistochemical analysis confirmed a previously observed decreased expression of TSG101, whereas quantitative polymerase chain reaction (qPCR) and immunohistochemistry analysis revealed high expression of LSF in cervical, precancer and cancer cells compared with human papillomavirus (HPV)-negative non-cancer samples. High expression of LSF in cervical cancer HPV-positive cells suggests that this protein may be important in the regulation of TSG101 expression, as well as in cervical carcinogenesis. The role of LSF as a mediator in cervical cancer development must be confirmed in future studies.

Prenatal diagnosis of persistent right umbilical vein – Incidence and clinical impact. A prospective study

Persistent right umbilical vein (PRUV) is usually an isolated finding but it may be accompanied by other fetal malformations.

Complementary role of magnetic resonance imaging after ultrasound examination in assessing fetal renal agenesis: a case report.

IntroductionUltrasonography is used routinely during pregnancy to screen and detect fetal abnormalities. However, there are some conditions like anhydramnios (a prevalent state in renal agenesis) or maternal obesity that may limit the diagnostic accuracy of ultrasonography. Magnetic resonance imaging has proven to be useful when ultrasound alone is insufficient to make a correct diagnosis.Case presentationWe present the case of a 22-year-old Caucasian woman who was admitted to our unit at the 26th week of gestation for a detailed anatomy scan. Anhydramnios and failure to visualize the kidneys, bladder and renal vessels were confirmed with the use of sonography in our department. Since the lack of amniotic fluid limited the acoustic window for fetal ultrasonography, a magnetic resonance imaging scan was requested to confirm suspected renal agenesis. A fetal magnetic resonance imaging scan was performed and confirmed the suspected diagnosis. A baby boy was born by breech vaginal delivery after spontaneous onset of labor at the 34th week of gestation. The boy weighed 1690g, with Apgar scores of 6 and 4 at two and five minutes respectively, and died one hour after delivery. The diagnosis of bilateral renal agenesis was confirmed on autopsy.ConclusionsThe aim of this study was to evaluate the potential contribution of magnetic resonance imaging in diagnostic procedure after inconclusive ultrasound examination during the assessment of fetal urinary tract abnormalities in the third trimester.