Cristina Iulia Mitran

New Insights in the Pathogenesis of HPV Infection and the Associated Carcinogenic Processes: The Role of Chronic Inflammation and Oxidative Stress

Human papillomavirus (HPV) is a small double-stranded DNA virus with tropism for epithelial cells. To this date, over 150 genotypes are known and are classified into two major groups, low-risk and high-risk strains, depending on the ability of the virus to induce malignant transformation. The hosts immunity plays a central role in the course of the infection; therefore, it may not be clinically manifest or may produce various benign or malignant lesions. The pathogenic mechanisms are complex and incompletely elucidated. Recent research suggests the role of chronic inflammation and oxidative stress (OS) in the pathogenesis of HPV infection and the associated carcinogenic processes. Chronic inflammation induces OS, which in turn promotes the perpetuation of the inflammatory process resulting in the release of numerous molecules which cause cell damage. Reactive oxygen species exert a harmful effect on proteins, lipids, and nucleic acids. Viral oncogenes E5, E6, and E7 are involved in the development of chronic inflammation through various mechanisms. In addition, HPV may interfere with redox homeostasis of host cells, inducing OS which may be involved in the persistence of the infection and play a certain role in viral integration and promotion of carcinogenesis. Knowledge regarding the interplay between chronic inflammation and OS in the pathogenesis of HPV infection and HPV-induced carcinogenesis has important consequences on the development of new therapeutic strategies.

Ascorbic acid deficiency in patients with lichen planus

ABSTRACT Objectives. Recent studies have highlighted the role of oxidative stress in the pathogenesis of lichen planus (LP). In the present study, the interest of the authors is focused on the investigation of ascorbic acid status in patients with LP and identification of parameters that might influence the level of this vitamin. Material and method. We analyzed the level of urinary ascorbic acid (reflectometric method) in 77 patients with LP (cutaneous LP (CLP)—49 cases; oral LP (OLP)—28 cases) and 50 control subjects. The evaluation of all participants included clinical examination and laboratory and imaging tests. Results. Compared to the control group (19.82 mg/dl) the level of ascorbic acid was significantly lower both in patients with CLP (8.47 mg/dl, p = 0.001) and in those with OLP (8.04 mg/dl, p = 0.001). In patients with LP it was found that the deficiency of ascorbic acid increases with age (r = -0.318, p = 0.032). The urinary concentrations of ascorbic acid were significantly lower in patients with LP associated with infections compared to patients with LP without infections. Conclusions. The urinary ascorbic acid level may be a useful parameter in identifying patients with LP who are at risk of developing viral or bacterial infections.

Psoriasis during pregnancy. A literature review

Psoriasis is a chronic, recurrent inflammatory disorder characterized by the occurrence of well demarcated, erythematous papules and plaques covered by thick, silvery-white scales, generally affecting the elbows, knees, sacral area and scalp. It is a common disorder affecting women during their reproductive years. There is evidence that psoriasis might affect the course of pregnancy and that pregnancy can influence the course of psoriasis. The aim of this paper is to look over the most recent data regarding the impact of psoriasis on pregnancy and vice versa reviewing the current evidence for the safety of topical and systemic treatments for psoriasis during pregnancy.

Mammary Paget’s disease - case presentation and a brief review of the literature

Mammary Paget’s disease is a rare form of cancer, which involves the nipple-areola complex. In most cases it is associated with an underlying tumor of the breast. Diagnosis is based on clinical appearance and is confirmed by histopathological examination. Imaging tests play an important role in detecting the associated ductal carcinoma. We present the case of a 90-year-old woman, who presented to our clinic for an erythemato-squamous lesion that covers her entire left nipple. The lesion was previously treated as eczema. Histopathological examination revealed features characteristic of Paget’s disease.

Flibanserin – a challenging drug in the treatment of hypoactive sexual desire disorder

Hypoactive sexual desire disorder (HSDD) is a condition characterized primarily by the decrease of sexual desire, affecting the quality of life. HSDD seems to be the most common sexual dysfunction in women. Therefore it should not be ignored, but treated. Recently the first drug for the treatment of HSDD, flibanserin, has been approved by FDA. Flibanserin is an agonist at 5-hydroxytryptamine (5HT1A) receptors and antagonist at 5HT2A receptors, acting also on dopamine receptors. It has been approved for premenopausal women but with certain restrictions. It was originally developed as an antidepressant drug, but studies have not supported its safety and efficacy. Its effect in HSDD was observed serendipitously. Studies conducted in North America and Europe have highlighted that flibanserin increases the number of satisfying sexual events and sexual desire, reducing the distress among premenopausal women.