The role of peptide immunotherapy in the treatment of cervical dysplasia: clinical cases

Abstract

Since one of the main factors determining the pathogenic effect of HPV infection is local immunodeficiency, a number of authors suggest using various cytokines and immunomodulators. Recently, peptide-based agents have been increasingly used in routine clinical practice. Objective. To study the effect of peptide immunocorrection on molecular and cellular factors affecting the course of grade II cervical dysplasia (CIN2) as a precancerous process and to evaluate the effectiveness of the proposed regimen. Materials and methods. The study included 2 groups of patients aged 28 to 44 years who were colposcopically and cytologically diagnosed with grade 2 cervical dysplasia. Clinical monitoring, determination of HPV by PCR, immunohistochemical studies of biomarkers of inflammation and proliferation, as well as counting of T-lymphocytes in cervical mucus preparations were performed before treatment, after treatment, after 6 weeks and after 3 months. Results. During the study of the expression level of pro-oncogenic interleukin IL-8 and anti-oncogenic IL-12, it was established that in both observation groups after the immunotherapy, a tendency to decrease the pro-oncogenic potential of cervical mucus was noted. Analysis of the level of expression of the cell proliferation marker Ki-67 in the clinical monitoring groups showed that the proposed therapy schemes reduced the proliferative potential of the cervical epithelium. The number of active cytotoxic lymphocytes in the cervical mucus in both observation groups predictably increased after the use of local immunotherapy. The study showed that immunotherapy of cervical dysplasia with the use of peptides demonstrated significantly better clinical results compared to the reference group. Conclusion. Taking into account the obtained research results and the given clinical cases, peptide immunocorrection can be reasonably recommended as an immunological component in the treatment of cervical dysplasia (ASCUS and LSIL).