Oxidation of the vaginal space may reduce the risk of cervical cancer, according to a recent study published in Open Medicine.
Takeaways
- Oxidation in the vaginal space may lower the risk of cervical cancer, as suggested by a recent study published in Open Medicine.
- Cervical cancer is a growing global health concern, with a significant increase in new cases and deaths reported in 2020 compared to 2018.
- Traditional methods for managing cervical cancer include PAP smear, HPV typing, colposcopy, biopsy, surgery, chemotherapy, and radiotherapy, but recent data suggests Lactobacillus species in the vaginal space may play a role in preventing HPV invasion.
- The relationship between oxidative stress, reactive oxygen species (ROS), and the development of cervical intraepithelial neoplasia (CIN) and cervical cancer is a subject of investigation. Increased ROS risk is associated with reduced oxygen presence.
- Reactive oxygen species, particularly NF-kB activation, may have a significant impact on cervical cancer initiation, progression, and treatment resistance. Increasing oxygen concentration in the vaginal space could potentially be a future option for preventing and managing CIN and cervical cancer.
In 2020, 604,127 new cases and 341,831 deaths from cervical cancer were reported, 35,000 and 30,000 greater than in 2018, respectively. This indicates cervical cancer as a global health problem, highlighting the need for solutions.
Available management methods include PAP smear, human papillomavirus (HPV) typing, colposcopy, biopsy, radical surgery, chemotherapy, and radiotherapy. However, recent data has also reported vaginal Lactobacillus species as a potential method of preventing HPV from invading cervical epithelial cells.
Data on etiological and carcinogenesis functions remain lacking, indicating a need for further investigation. Investigators conducted a study to summarize current information and hypothesize whether reduction of oxygen to reactive oxygen species (ROS) within the vaginal space may promote cervical intraepithelial neoplasia (CIN) or cervical cancer development.
Knowledge about uterine cervical cancer pathogenesis has improved over the past 5 decades. HPV and woman’s age have both been associated with CIN, with CIN events most common in women aged 20 to 30 years.
Without therapy, higher grade lesions are more likely to persist. Regression rates have also been reported to be higher in younger patients with CIN, regardless of CIN grade or HPV high-risk infection.
Data has indicated nuclear factor kappaB (NF-kB) is constitutively reactivated during progression to high-grade intraepithelial neoplasia and cervical cancer. NF-kB activation significantly impacts adaptive immune response and is implicated in human cancer initiation, progression, and treatment resistance.
Lactobacillus species uses the physiological path inside the vaginal space to convert glycogen to lactic acid. This can be used to manage the pH levels in the vaginal space.It also has a mutualistic relationship with a woman’s body, protecting it from invasions by pathogens. A low lactate concentration reduces oxygen presence, increasing ROS risk.
ROS formation increases the risk of oxidative stress, severely threatening aerobic organisms. Decreased activity of antioxidants may also cause oxidative stress, with adverse outcomes including chronic inflammation, cell damage, and cancer development.
There are multiple methods of diagnosing and treating CIN, with increasing oxygen concentration in the vaginal space being a promising future option. Investigators recommended confirmation of their hypothesis to determine how neoplasia can still develop in women receiving HPV prevention and cervical cancer screening.
Reference
Despot A, Fureš R, Despot AM, et al. Reactive oxygen species within the vaginal space: An additional promoter of cervical intraepithelial neoplasia and uterine cervical cancer development? Open Med (Wars). 2023;18(1):20230826. doi:10.1515/med-2023-0826
