Анализ результатов ряда исследований показал взаимосвязь между инфицированностью вирусом папилломы человека (ВПЧ) и бактериальным вагинозом, более частой персистенцией ВПЧ и его рецидивированием вплоть до возникновения ВПЧ-ассоциированных заболеваний. Предрасположенность к тропности ВПЧ и локальный иммунитет для элиминации инфекции могут быть изменены под воздействием ряда неблагоприятных факторов. Одним из них является бактериальный вагиноз, который нарушает сбалансированную экосистему влагалища и ее защитные механизмы против других инфекций и болезней.
Ключевые слова: вирус папилломы человека, бактериальный вагиноз.
________________________________________________
Analysis of the results of several studies has shown a correlation between human papillomavirus (HPV) infection and bacterial vaginosis (BV), and a more frequent persistence of HPV and its recurrence until the occurrence of HPV-associated diseases. Susceptibility to HPV tropism and local immunity's ability to eliminate the infection can be changed under the influence of a number of adverse factors. One of these factors is bacterial vaginosis (BV), which gives a balanced ecosystem of the vagina and its defense mechanisms against other infections and diseases.
Key words: human papilloma virus, bacterial vaginosis.
1. Dunne EF, Unger ER, Sternberg M et al. Prevalence of HPV infection among females in the United States. J Am Med Assoc 2007; 297 (8): 813–9.
2. Gillet E, Meys JF, Verstraelen H et al. Bacterial vaginosis is associated with uterine cervical human papillomavirus infection: a meta-analysis. BMC Infectious Diseases 2011; 11, article 10.
3. Moscicki AB, Hills N, Shiboski S et al. Risks for incident human papillomavirus infection and low-grade squamous intraepithelial lesion development in young females. J Am Med Assoc 2001; 285 (23): 2995–3002.
4. Rahkola P, Mikkola TS, Ylikorkala O, Vaisanen-Tommiska M. Association between high risk papillomavirus DNA and nitric oxide release in the human uterine cervix. Gynecol Oncol 2009; 114 (2): 323–6.
5. Verteramo R, Pierangeli A, Mancini E et al. Human Papillomaviruses and genital co-infections in gynaecological outpatients. BMC Infect Dis 2009; 9, article 16.
6. Kahn JA, Lan D, Kahn RS. Sociodemographic factors associated with high-risk human papillomavirus infection. Obstet Gynecol 2007; 110 (1): 87–95.
7. King CC, Jemieson DJ, Wiener J et al. Bacterial vaginosis and the natural history of human papillomavirus. Infect Dis Obstet Gynecol 2011; 319460 (10): 1155.
8. Quayle AJ. The innate and early immune response to pathogen challenge in the female genital tract and the pivotal role of epithelial cells. J Reprod Immunol 2002; 57: 61–79.
9. Cole AM. Innate host defense of human vaginal and cervical mucosae. Curr Top Microbiol Immunol 2006; 306: 199–230.
10. Iijima N, Thompson JM, Iwasaki A. Dendritic cells and macrophages in the genitourinary tract. Mucosal Immunol 2008; 1: 451–9.
11. Ochiel DO, Fahey JV, Ghosh M et al. Innate Immunity in the Female Reproductive Tract: Role of Sex Hormones in Regulating Uterine Epithelial Cell Protection Against Pathogens. Curr Womens Health Rev 2008; 4: 102–17.
12. Eschenbach DA, Thwin SS, Patton DL et al. Influence of the normal menstrual cycle on vaginal tissue, discharge, and microflora. Clin Infect Dis 2000; 30: 901–7.
13. Valore EV, Park CH, Igreti SL, Ganz T. Antimicrobial components of vaginal fluid. Am J Obstet Gynecol 2002; 187: 561–8.
14. Rohan LC, Sassi AB. Vaginal drug delivery systems for HIV prevention. AAPS J 2009; 11: 78–87.
15. Wira CR, Grant-Tschudy KS, Crane-Godreau MA. Epithelial cells in the female reproductive tract: a central role as sentinels of immune protection. Am J Reprod Immunol 2005; 53: 65–76.
16. Klein LL, Jonscher KR, Heerwagen MJ et al. Shotgun proteomic analysis of vaginal fluid from women in late pregnancy. Reprod Sci 2008; 15: 263–73.
17. St John E, Mares D, Spear GT. Bacterial vaginosis and host immunity. Curr HIV/AIDS Rep 2007; 4: 22–8.
18. Balu RB, Savitz DA, Ananth CV et al. Bacterial vaginosis, vaginal fluid neutrophil defensins, and preterm birth. Obstet Gynecol 2003; 101: 862–8.
19. Novak RM, Donoval BA, Graham PJ et al. Cervicovaginal levels of lactoferrin, secretory leukocyte protease inhibitor, and RANTES and the effects of coexisting vaginoses in human immunodeficiency virus (HIV)-seronegative women with a high risk of heterosexual acquisition of HIV infection. Clin Vaccine Immunol 2007; 14: 1102–7.
20. Valore EV, Wiley DJ, Ganz T. Reversible deficiency of antimicrobial polypeptides in bacterial vaginosis. Infect Immun 2006; 74: 5693–702.
21. Wiesenfeld HC, Heine RP, Krohn MA et al. Association between elevated neutrophil defensin levels and endometritis. J Infect Dis 2002; 186: 792–7.
22. Xu J, Holzman CB, Arvidson CG et al. Midpregnancy vaginal fluid defensins, bacterial vaginosis, and risk of preterm delivery. Obstet Gynecol 2008; 112: 524–31.
23. Сухих Г.Т., Трофимов Д.Ю., Бурменская О.В. и др. Профиль экспрессии мРНК генов цитокинов в вагинальных мазках женщин репродуктивного возраста при неспецифическом вагините и бактериальном вагинозе. Акуш. и гинекол. 2011; 7/2: 33–8.
24. Прилепская В.Н. Вагинальные инфекции и локальные препараты комплексного действия. В чем причина успеха? Гинекология. 2011; 13 (6).
25. Лаврова Л.В., Левочкина Л.Н., Копейкина Е.А., Шеманаева Т.В. Бактериальный вагиноз: сравнительная оценка эффективности локальной антибактериальной терапии. Гинекология. 2011; 13 (3): 41–3.
26. Уварова Е.В., Анкирская А.С., Григоренко Ю.П., Кумыкова З.Х. Эффективность терапии бактериального вагиноза у женщин вне беременности (результаты многоцентрового исследования). Акуш. и гинекол. 2010; 1: 1–10.
________________________________________________
1. Dunne EF, Unger ER, Sternberg M et al. Prevalence of HPV infection among females in the United States. J Am Med Assoc 2007; 297 (8): 813–9.
2. Gillet E, Meys JF, Verstraelen H et al. Bacterial vaginosis is associated with uterine cervical human papillomavirus infection: a meta-analysis. BMC Infectious Diseases 2011; 11, article 10.
3. Moscicki AB, Hills N, Shiboski S et al. Risks for incident human papillomavirus infection and low-grade squamous intraepithelial lesion development in young females. J Am Med Assoc 2001; 285 (23): 2995–3002.
4. Rahkola P, Mikkola TS, Ylikorkala O, Vaisanen-Tommiska M. Association between high risk papillomavirus DNA and nitric oxide release in the human uterine cervix. Gynecol Oncol 2009; 114 (2): 323–6.
5. Verteramo R, Pierangeli A, Mancini E et al. Human Papillomaviruses and genital co-infections in gynaecological outpatients. BMC Infect Dis 2009; 9, article 16.
6. Kahn JA, Lan D, Kahn RS. Sociodemographic factors associated with high-risk human papillomavirus infection. Obstet Gynecol 2007; 110 (1): 87–95.
7. King CC, Jemieson DJ, Wiener J et al. Bacterial vaginosis and the natural history of human papillomavirus. Infect Dis Obstet Gynecol 2011; 319460 (10): 1155.
8. Quayle AJ. The innate and early immune response to pathogen challenge in the female genital tract and the pivotal role of epithelial cells. J Reprod Immunol 2002; 57: 61–79.
9. Cole AM. Innate host defense of human vaginal and cervical mucosae. Curr Top Microbiol Immunol 2006; 306: 199–230.
10. Iijima N, Thompson JM, Iwasaki A. Dendritic cells and macrophages in the genitourinary tract. Mucosal Immunol 2008; 1: 451–9.
11. Ochiel DO, Fahey JV, Ghosh M et al. Innate Immunity in the Female Reproductive Tract: Role of Sex Hormones in Regulating Uterine Epithelial Cell Protection Against Pathogens. Curr Womens Health Rev 2008; 4: 102–17.
12. Eschenbach DA, Thwin SS, Patton DL et al. Influence of the normal menstrual cycle on vaginal tissue, discharge, and microflora. Clin Infect Dis 2000; 30: 901–7.
13. Valore EV, Park CH, Igreti SL, Ganz T. Antimicrobial components of vaginal fluid. Am J Obstet Gynecol 2002; 187: 561–8.
14. Rohan LC, Sassi AB. Vaginal drug delivery systems for HIV prevention. AAPS J 2009; 11: 78–87.
15. Wira CR, Grant-Tschudy KS, Crane-Godreau MA. Epithelial cells in the female reproductive tract: a central role as sentinels of immune protection. Am J Reprod Immunol 2005; 53: 65–76.
16. Klein LL, Jonscher KR, Heerwagen MJ et al. Shotgun proteomic analysis of vaginal fluid from women in late pregnancy. Reprod Sci 2008; 15: 263–73.
17. St John E, Mares D, Spear GT. Bacterial vaginosis and host immunity. Curr HIV/AIDS Rep 2007; 4: 22–8.
18. Balu RB, Savitz DA, Ananth CV et al. Bacterial vaginosis, vaginal fluid neutrophil defensins, and preterm birth. Obstet Gynecol 2003; 101: 862–8.
19. Novak RM, Donoval BA, Graham PJ et al. Cervicovaginal levels of lactoferrin, secretory leukocyte protease inhibitor, and RANTES and the effects of coexisting vaginoses in human immunodeficiency virus (HIV)-seronegative women with a high risk of heterosexual acquisition of HIV infection. Clin Vaccine Immunol 2007; 14: 1102–7.
20. Valore EV, Wiley DJ, Ganz T. Reversible deficiency of antimicrobial polypeptides in bacterial vaginosis. Infect Immun 2006; 74: 5693–702.
21. Wiesenfeld HC, Heine RP, Krohn MA et al. Association between elevated neutrophil defensin levels and endometritis. J Infect Dis 2002; 186: 792–7.
22. Xu J, Holzman CB, Arvidson CG et al. Midpregnancy vaginal fluid defensins, bacterial vaginosis, and risk of preterm delivery. Obstet Gynecol 2008; 112: 524–31.
23. Сухих Г.Т., Трофимов Д.Ю., Бурменская О.В. и др. Профиль экспрессии мРНК генов цитокинов в вагинальных мазках женщин репродуктивного возраста при неспецифическом вагините и бактериальном вагинозе. Акуш. и гинекол. 2011; 7/2: 33–8.
24. Прилепская В.Н. Вагинальные инфекции и локальные препараты комплексного действия. В чем причина успеха? Гинекология. 2011; 13 (6).
25. Лаврова Л.В., Левочкина Л.Н., Копейкина Е.А., Шеманаева Т.В. Бактериальный вагиноз: сравнительная оценка эффективности локальной антибактериальной терапии. Гинекология. 2011; 13 (3): 41–3.
26. Уварова Е.В., Анкирская А.С., Григоренко Ю.П., Кумыкова З.Х. Эффективность терапии бактериального вагиноза у женщин вне беременности (результаты многоцентрового исследования). Акуш. и гинекол. 2010; 1: 1–10.
Авторы
В.Н.Прилепская, Н.М.Назарова
ФГБУ Научный центр акушерства, гинекологии и перинатологии им. акад. В.И.Кулакова Минздрава России, Москва