Trichomonas vaginalis e sua associação com o câncer cervical: uma revisão sistemática / Trichomonas vaginalis associated with cervical cancer: a systematic review

A correlação entre Trichomonas vaginalis (T. vaginalis) e o desenvolvimento do câncer cervical foi estabelecida. Uma revisão sistemática baseada em artigos originais (padrão ouro) foi conduzida a partir de duas importantes bases eletrônicas: PubMed e MEDLINE. A partir das bases de dados Medical Subject Headings (MeSH) e Descritores em Ciências da Saúde (DeCS) os seguintes termos "T. vaginalis & uterine cervical neoplasms" e "T. vaginalis & signal transduction" foram buscados. Critérios de inclusão e exclusão foram estabelecidos considerando as características específicas de cada artigo visando garantir a qualidade dos artigos selecionados (testes de relevância 1 e 2). Com relação aos efeitos patogênicos de T. vaginalis, o teste de relevância 1 selecionou 13 artigos de ambas as bases, PubMed e MEDLINE, enquanto o teste de relevância 2 finalizou com 8 artigos. Os estudos selecionados demonstraram correlação entre T. vaginalis e neoplasia cervical, apontando os efeitos citopatogênicos do parasito e enfatizando a importância das vias de sinalização, tais como as proteínas mitógenoativadas (MAPK).(AU)

A correlation between Trichomonas vaginalis (T. vaginalis) and the development of cervical cancerwas investigated. A systematic review based on original articles (the gold standard) was conducted by performing a search of two major electronic databases, PubMed and MEDLINE. The search was performed by using the exploded MeSH and DeCS terms "T. vaginalis & uterine cervical neoplasms" and "T. vaginalis & signal transduction". Inclusion and exclusion criteria were assessed using specific characteristics to determine whether the quality of each article was high enough to warrant selection (the first and second tests of relevance). With reference to the cytopathogenic effects of T. vaginalis, the first test of relevance selected13 articles from both databases, PubMed and MEDLINE, whereas the second test of relevance selected8 articles. The studies selected showed a correlation between T. vaginalis and cervical neoplasia, demonstrating the cytopathogenic effects of the parasite and highlighting the importance of cell signaling pathways such as the mitogen-activated protein kinase (MAPK) pathway.(AU)

Citopatogenicidade de Trichomonas vaginalis: uma via de sinalização carboidrato-dependente / Trichomonas vaginalis' pathogenic effect and cell signaling in a carbohydrate-dependent manner

Trichomonas vaginalis é um agente infectante da microbiota vaginal que vem sendo correlacionado ao câncer cervical. Um receptor denominado alectina-1 (Gal 1) pode ser expresso em células epiteliais cervicais humanas se ligando à glicofosfolipídica (LPG) de T. vaginalis. A interação de T. vaginalis com as células epiteliais é mediada por cadeias galactose e N-acetilglucosamina (LacNac). Gal 1 se liga aos sítios poly-LacNAC e está relacionada com a aderência de T. vaginalis à célula humana. A sinalização ocorre por intermédio de sítios da proteína Src (SH2) que se associam, ocorrendo sob os domínios de PI3K que fosforilam a membrana de lípides fosfatidilinositol (PIP e PIP2). Aderindo-se às membranas citoplasmáticas e secretando enzimas, T. vaginalis pode ocasionar a ruptura do envoltório celular podendo fagocitar células epiteliais em meio vaginal. O núcleo N-acetilactosamina de Gal 1 pode mediar a regulação do crescimento celular com a ajuda da proteína GRB2; entretanto, Gal 1 pode contribuir para a supressão da inflamação por meio da indução de apoptose pelas células T ativadas. (AU)

Trichomonas vaginalis is an infectious agent of the vaginal flora which has been associated with cervical cancer. Galectin-1 (Gal 1) is a cell receptor expressed in cervical epithelial cells binding T. vaginalis? lipophosphoglican (LPG). Interaction between T. vaginalis and the epithelial cell is mediated by poly-LacNac domains (galactoside and acetil-lactosamin) and is related to cell adherence as well. Cell signaling occurs by the time Src (SH2) domains are correlated with this interaction and PI3K phosphorilation brings up phosphatidil inositol lipid membranes (PIP and PIP2). T. vaginalis adheres to cytoplasm membrane and secrets specific enzymes that probably lead to membrane rupture. Moreover this parasite may phagocyte epithelial cells in vaginal discharge. Gal 1 nucleus called N-acetil-lactosamin can mediate growth development through GRB2 protein and may contribute to inflammation suppression owing to apoptosis induction of activated T cells.(AU)

Mecanismos específicos de patogenicidadede protozoários de mucosa: Entamoeba histolytica, Giardia lamblia e Trichomonas vaginali / Specific pathogenic mechanisms of mucosal protozoans: Entamoeba histolytica, Giardia lamblia and Trichomonas vaginalis

Entamoeba histolytica e Giardia lamblia são protozoários que podem parasitar a mucosa intestinal, causando principalmente diarreia. Trichomonas vaginalis coloniza a mucosa vaginal causando tricomonose, a doença sexualmente transmissível não viral mais comum no mundo. Embora coletivamente estes parasitos infectem mais de um bilhão de pessoas a cada ano, seus mecanismos de patogenicidade ainda não estão totalmente esclarecidos. Assim, esta revisão reúne os principais mecanismos envolvidos na patogenicidade destes protozoários, bem como os fatores do microambiente que podem interferir no sucesso da colonização. A patogênese da E. histolytica envolve adesão, lise, fagocitose de células epiteliais e bactérias, invasão tecidual por ação de enzimas e evasão da resposta imune do hospedeiro. A lectina Gal/GalNAc, os amebaporos e as cisteína proteases são as principais moléculas envolvidas nesses processos. O estabelecimento da giardiose depende de diversos mecanismos patogênicos e de virulência desenvolvidos pela G. lamblia, tais como as moléculas envolvidas na adesão, encistamento e variação antigênica. Para o sucesso da colonização da mucosa vaginal, o T. vaginalis expressa moléculas como as adesinas de superfície, lipofosfoglicanos e galectina, envolvidas na adesão às células epiteliais vaginais e alteração da expressão gênica, tanto do parasito como do hospedeiro.

Entamoeba histolytica and Giardia lamblia are protozoans that may parasitize the intestinal mucosa, mainly causing diarrhea. Trichomonas vaginalis colonizes the vaginal mucosa causing trichomonosis, the most common non-viral sexually transmitted disease in the world. Although collectively these parasites infect over a billion people each year, their pathogenic mechanisms have not been completely understood so far. Hence, this review of the literature demonstrates the main mechanisms involved in the pathogenicity of these protozoans, as well as the microenvironmental factors that can interfere with successful colonization. The pathogenesis of E. histolytica involves adhesion, lysis, phagocytosis of epithelial cells and bacteria, tissue invasion by enzymatic action, and evasion of host immune response. Lectin Gal/GalNac, amoebapores, and cysteine proteases are the main molecules involved in these processes. The establishment of giardiosis depends on several pathogenic mechanisms and virulence developed by G. lamblia, such as molecules involved in adhesion, encystation and antigenic variation. For successful colonization of vaginal mucosa, T. vaginalis express molecules like adhesins on the surface and galectin and lipophosphoglycan, involved in the adherence to vaginal epithelial cells and altered gene expression of both the parasite and the host.

Infección humana por Trichomonas vaginalis y su relación con otros agentes patógenos / Human infection from Trichomonas vaginalis and its relation to other pathogen agent

Trichomonas vaginalis es un protozooo flagelado causante de la trichomonosis urogenital en humanos. La asociación y coexistencia de T. vaginalis con otros agentes patógenos causantes de infecciones de transmisión sexual es bastante común. Se realizó una revisión de la literatura, incluyendo las últimas publicaciones sobre las principales manifestaciones clínicas de T. vaginalis y su relación con otros agentes de transmisión sexual

Trichomonas vaginalis is a flagellate protozoon causing urogenital trichomoniasis in humans. Association and co-existence of T. vaginalis with other pathogen agents causing of sexually transmitted infections is fairly common. A bibliographic review was carried out including the last publications on the main clinical manifestations from T. vaginalis, and its relation to other sexual transmission agents

Estabilidad de diagnosticador para infecciones vaginales / Diagnosis method stability used for vaginal infections

FemPure es un diagnosticador de infecciones vaginales compuesto por componentes biológicos multidosis. Se estudió su estabilidad en condiciones reales de conservación durante el uso hasta agotar el contenido del frasco y a largo plazo por 24 meses. Durante la estabilidad en uso los indicadores de la calidad mantuvieron los valores en los límites de aceptación establecidos. A largo plazo los lßtex-anti T.vaginalis y anti C. albicans conservaron las propiedades físicas, la detectabilidad y valores de sensibilidad y especificidad mayores del 90 por ciento. El látex-anti G. vaginalis a los 18 meses no detectó G. vaginalis a la concentración establecida como límite de detección, lo que coincidió con la disminución de la sensibilidad hasta 71 por ciento. Se conservó por primera vez una mezcla estable de suspensiones celulares compuesta por bacteria, levadura y parásito como control positivo. El control positivo a los 24 meses disminuyó su funcionamiento por da±o celular del parásito T. vaginalis. Se estableció 12 meses como tiempo de validez del producto.

RemPure is a diagnosis tool for vaginal infections composed of multidose biological compounds. Its stability level under real conditions of preservation during from its use to selling-out of content and long-term at 24 hours was studied. During use of stability, quality indicators remain values within established acceptation limits. T.vaginalis and anti-C.albincans maintained physical properties, detection parameters, and sensitivity and specificity values over 90 percent. The use of latex-anti G vaginalis at 18 months fails in the detection of this parasite at established concentration to detection limit, coinciding with decrease in sensitivity up to 71 percent. We preserved an stable mix of cellular suspensions composed of bacterium, yeast, and parasite as a positive control. This control at 24 months decreases its functioning by cellular damage caused by T.vaginalis parasite.

Prevalence and risk factors of trichomoniasis among women in Tabriz

We investigated frequency of trichomoniasis among non-pregnant women in health centers of Tabriz, Iran. 1000 non-pregnant women aged 15-49 in health centers of Tabriz, Iran were examined by wet smears and Diamond culture methods for Trichomonas vaginalis, during the period of March to September 2005. Among 1000 specimens 92 cases were revealed to be positive for Trichomonas vaginalis by culture method and 31 cases by wet smear method. There was no significant difference in the isolation rate of trichomoniasis in women according to age, occupation, husband education level, abortion, parity, menstrual status and contraception use. The difference in the isolation rate of trichomoniasis in women with marriage age of more than 18 years [10.9%] and in women with marriage age of less than 18 years [8%] was statistically significant, Infection rates in different education levels did not show statistically significant difference. Trichomonas vaginalis is one of the important diseases with a high prevalence in women in Tabriz. Eradication of this disease is possible with extensive public health education and administration of specific therapeutic agents to the infected patients

Factors influencing the prevalence and pathogenicity of Trichomoflas vaginalis

Trichomonas vaginalis is a common parasite of both male and female genital tracts. Transmission of the infection is mainly by sexual intercourse; however contaminated towels, douche equipments examination instruments and other objects may be responsible for some infections. Is to study the influence of some factors that affect the spread of this parasite such as socioeconomic status, marital status, pregnancy and parity etc. The study was conducted in the period from November 1992 to August 1993 on 480 female patients presented with vaginal discharge with or without itching, compared to 50 females complaining of gynecological problems other than infections. Investigations carried out during this study include: Wet mount examination. Culture on artificial media. Examination of fixed stained smear with: a.Gram's stain.Leischmans stain. Giemsa's stain.Papanicolaous stained smear. 4. Measuring the PH of the vaginal discharge or the PH of the vaginal side wall. The effect of some factors on the prevalence and pathology of Trichomonas vaginalis was evaluated in this study. Among different socioeconomic groups, the higher infection rate [65.22%] was seen in the low socioeconomic group. The infection rate of trichomoniasis was found to be higher among married females [19.81%], than divorced [16.66%], widowed [12.5%] or singles [11.11%]. Regarding the menstrual cycle, infection with Trichomonas vaginal/s was found to be increasing during the postmenstrual phase of the cycle [24.21%] compared to the infection rate obtained from patients in the premenstrual phase of the cycle [16.09%]. A higher infection rate was reported among non pregnant females [20%] than pregnant [9.09%].Females using different contraceptive measures showed an infection rate of [28.88%], which was higher than that reported among those not using any contraceptive measures [18.95%]. The PH values of the vaginal discharge were measured in 90 patients and the highest infection were seen at PH values 6.0 [28.88%] and 5.5 [20%] respectively. Conclusion: The spread of Trichomonas vagina/is infection may be affected by many factors such as socioeconomic status, marital status, pregnancy status and parity, phase of the menstrual cycle, the use of different contraceptive measures and the PH values of the vaginal discharge

Evaluación de 4 medios de cultivo para aislamiento primario de trichomonas vaginalis / Evaluation of four media the primary isolation of trichomonas vaginalis

The incidence sexually transmitted diseases (STD) is a global public health problem, highly complicated by infections produced by the human immunodeficiency virus. Parasitic etiological agents of STD in Chile are limited to trichomonas vaginalis, sarcoptes scabiei and phthirus pubis. Only T. vaginalis has a trophozoite stage which can be diagnosed with a high degree of success in the laboratory. The present study reports on four culture methods which facilitate the primary isolation of this protozoan from clinical samples. The best results for primary isolation of T. vaginalis were obtained using modified diamond media. It was demonstrated that Kupferberg-Agar medium was the best for growth of T. vaginalis without re-inoculation. The optimal pH for the growth of T. vaginalis in the cultures was 6.5, and 10 percent horse serum gave the best yields in development and viability of T. vaginalis over time.

La incidencia de las enfermedades de transmisión sexual (ETS) se mantiene como problema de salud pública a nivel mundial, agravado por las infecciones por los virus de la inmunodeficiencia humana. Los agentes etiológicos parasitarios de ETS que existen en Chile se limitan a Trichomonas vaginalis, Sarcoptes scabiei y Phthirus pubis. T. vaginalis sólo posee estadio de trofozoito por lo que el diagnóstico de laboratorio es de alta exigencia. En este trabajo se evaluaron 4 medios de cultivo para facilitar el aislamiento primario de este protozoo a partir de muestras clínicas. Con el medio Diamond Modificado se obtuvo los mejores resultados para el aislamiento primario de T. vaginalis. Se comprobó que el medio Kupferberg-Agar fue el más adecuado para el crecimiento sin repique de T. vaginalis. Se determinó que el pH del medio de cultivo para el crecimiento óptimo de T. vaginalis, fue dr 6,5, y suero quino al 10 por ciento fue la concentración de mejor rendimiento para desarrollo y viabilidad en el tiempo de T. vaginalis.

Double-stranded RNA viral infection in Cuban Trichomonas vaginalis isolates

Trichomonas vaginalis can be infected with double-stranded RNA (dsRNA) viruses designated T. vaginalis virus (TVV), which may have important implications for trichomonal virulence and disease pathogenesis. We tested for TVV in 40 fresh T. vaginalis isolates from Cuban patients by total extraction of nucleic acids (DNA and RNA). TVV was detected in 22 (55 percent) of the 40 T. vaginalis isolates. This gives an estimate of the infection rate of Cuban T. vaginalis isolates by the dsRNA virus. Future research should focus on the association between trichomonosis symptoms and the presence of TVV.

Trichomoniasis / Trichomoniasis

Las trichomonas vaginales fueron descritas por primera vez por Donné en 1836, pero no es hasta 1950 que es relacionada con las enfermedades de transmisión sexual. Trichomonas vaginalis es el más sencillo de todos los parásitos protozoos. Sólo existe en forma de trofozoito. Es unicelular y cosmopolita y se localiza en el tracto genitourinario de la mujer y el hombre. Según la Organización Mundial de la Salud (OMS) se tiene un estimado anual de 180 000000 de personas afectadas en el planeta. Se asocia con cervicitis, colpitis, enfermedad inflamatoria pélvica y uretritis. Además de haberse encontrado relación con resultados perinatales desfavorables como: bajo peso al nacer, parto pretermino y sepsis perinatal. Otro aspecto de interes es su asociación con otras enfermedades de transmisión sexual, como las moniliasis, las vaginosis bacterianas, infecciones por HPV, VIH SIDA y papiloma virus. Muchos han sido los medios de diagnóstico utilizados para este protozoos desde las escuelas que la diagnóstican y tratan por la clínica hasta otro que han ido mas allá de los medios convencionales de diagnóstico y han creado clip de diagnósticos rápidos. Igualmente se han probado varios tipos de tratamientos, pero los que mejor resultados han dado son los que se logran con tratamientos con los 5 imidazoles; no obstante, hay ya evidencias que reportan pobres resultados perinatológicos en los casos que se trata la entidad, sobre todo si es en las formas asintomáticas

Comportamiento in vivo de aislamientos de Trichomonas vaginalis, utilizando ratones NMRI como modelo experimental / Behavior in vitro of isolations of Trichomonas vaginalis, using mice NMRI as experimental model

Se estudió la correlación entre intensidad clínica de la tricomoniasis vaginal en adolescentes y la virulencia de Trichomonas vaginalis en un modelo experimental. Para ello fueron inoculados por vía intraperitoneal en ratones NMRI, 40 aislamientos de T. vaginalis obtenidas a partir de exudados vaginales provenientes de adolescentes, clínicamente clasificadas como asintomáticas, y sintomáticas leves, moderadas o severas, atendidas en las consultas Infanto-Juvenil, de Interrupción de Embarazo y de Infecciones de Transmisión Sexual (ITS), de hospitales Gineco-obstétricos de Ciudad de La Habana. La concentración parasitaria ideal a inocular fue del orden de 8 x 106. El hígado fue el órgano más afectado y se diferenció significativamente (p < 0,01) del resto de los órganos. Se pudo observar mediante la prueba de Kruskal -Wallis que existieron diferencias significativas (p < 0,0001) entre la puntuación obtenida por cada grupo de ratones según el tipo de aislamiento de acuerdo a la clasificación clínica de procedencia, lo que demostró una posible correlación entre el grado de virulencia de cada aislamiento y las intensidad clínica de tricomoniasis vaginal en adolescentes.

preliminary study on the relationship between trichomonas vaginalis and cervical cancer in Egyptian women

The relationship between Trichomonas vaginalis and cancer cervix was investigated by detection of T. vaginalis antibodies in the sera of 48 invasive cervical cancer patients and 100 random age matched female controls using western immunoblot technique. It was found that antibodies to T. vaginalis were detected in sera of 18.75% of cervical cancer patients compared with 5% of the controls. The increase was evident in the age group 40-49 years and of those with squamous cell carcinoma [6/9] and mainly with grades II and III. All the reactive sera of invasive cancer patients reacted strongly with T. Vaginalis surface antigen of about 109.9, 86.1, 56.2, 48.2 and 30 Kda. So, there may be an association between T. vaginalis and the risk of cervical cancer, as there was more than 3-fold increase in the prevalence of T. Vaginalis antibodies in patients with invasive cervical cancer compared with the age matched female controls. This study highlighted the importance of clinically detection of T. vaginalis infection, which is among the factors involved in the genesis and progression of cervical cancer. In addition, its treatment would aid in restricting the rising incidence of this disease

study on trichomoniasis vaginalis and female infertility

In this study, a total of 280 patients [240 infertile and 40 pregnant] was subjected to thorough history taking, general and local examination for the exclusion of organic lesion, laboratory investigations to exclude parasitic, bacterial and fungal infections. Sterile vaginal swab was taken from the posterior fornix and examined by wet smear preparation, Giemsa staining and cultivation on CPLM medium for Trichomoniasis infection. Out of 240 infertile women; 18.75% complained of discharge, 17.5% itching, 15.42% dysuria, 14.58% dyspareunia and 10% had cervical lesion. Of the 40 controls; 5% complained of discharge, 2.5% complained of itching, dysuria and dyspareunia and none had cervical lesion. Of the total cases, 36 had T. vaginalis. The clinical data observed were significantly higher among the infertile group than the control group. Cultures were positive in 14.58% of the infertile group and 2.5% in the control group

Strategies by which some pathogenic trichomonads integrate diverse signals in the decision-marking process

The interaction between each one of Trichomonas vaginalis and Tritrichomonas foetus with their hosts is a complex process in which components associated to the cell surfaces of both parasites and host epithelial cells, and also to soluble components found in vaginal/urethral secretions, are involved. Either cytoadhesion or the cytotoxicity exerted by parasites to host cells can be dictated by virulence factors such as adhesins, cysteine proteinases, laminin-binding proteins, integrins, integrin-like molecules, a cell detachment factor, a pore-forming protein, and glycosidases among others. How trichomonads manipulate informations from the extracellular medium, transduce such informations, and respond to them by stimulating the activities of some surface molecules and/or releasing enzymes are the aspects concerning trichomonal virulence which are here briefly reviewed and discussed.

Infección y parto prematuro: enlace epidemiológico y bioquímico / Infection and preterm birth: epidemiological and biochemical linkage

Esta revisión define parto prematuro e infección intrauterina (origen, vías y estadios). Resumimos las asociaciones epidemiológicas entre parto prematuro y los diferentes microorganismos. Se discute la interacción entre productos bacterianos y el sistema monocitomacrófago del huésped, los atributos de las citoquinas proinflamatorias y el papel desempeñado en el mecanismo del parto y el síndrome de respuesta inmune fetal

Trichomonosis en adolescentes embarazadas de Antofagasta, Chile / Trichomonosis in pregnant adolescent from Antofagasta, Chile

Los problemas de salud de la adolescencia se caracterizan por una carga psicosocial elevada y un nivel de daño relativamente bajo término de morbilidad y mortalidad, sin embargo, la disminución de la edad promedio de la menarquia y el inicio precoz de actividad sexual coital son factores de riesgo para el embarazo y las enfermedades de transmisión sexual (ETS) entre los adolescentes. En este trabajo se investigó la infección por Trichomonas vaginalis y los factores epidemiológicos y obstétricos relacionados entre 300 adolescentes embarazadas de la ciudad de Antofagasta, cuyas edades variaron entre 12 y 18 años, de las cuales el 87,7 por ciento se concentró en el rango 15 y 17 años, en tanto que el 76,0 por ciento tuvo su menarquia entre los 12-14 años y el 27,3 por ciento inició su actividad sexual antes de los 15 años. Se determinó una tasa de infección por T. vaginalis de un 5,7 por ciento

Parasitological and histopathological study of chronic trichomonas prostatitis aided by transcrectal ultrasound biopsies

The aim of this work was to detect the role of transrectal prostatic biopsy and the use of different stains in the diagnosis of chronic trichomonas prostatitis. Trichomoniasis vaginalis was diagnosed in 28% of 100 male patients with urethritis. The diagnosis was based on the detection of Trichomonas vaginalis trophozoites in urethral discharge by wet mount and Giemsa positive stain which was seen in 28 cases, while trophozoites were detected in the sediments of centrifuged urine of only 21 cases. Among 28 trichomonas positive urethritis patients, 14 cases were diagnosed clinically as chronic prostatitis. The histopathology in ten cases confirmed the diagnosis of trichomonas chronic prostatitis by demonstrating Trichomonas vaginalis trophozoites in the prostatic biopsies stained with both modified periodic acid Schiff and Giemsa stains. All patients were cured both clinically and parasitologically after treating them and their parents with metronidazol. In conclusion, better results were obtained by the use of easy available and cheap stains for the detection and identification of T. vaginalis in prostatic biopsies

Hemolitic aspects of strains and clones of trichomonas vaginalis

Se investigó la actividad hemolítica de 11 cepas y 6 clones vivos de trichomonas vaginalis. Las cepas y los clones fueron subsecuentemente estudiados frente a los eritrocitos de 7 especies animales adultas. Cada una da 11 cepas y 6 clones lisó los eritrocitos de todos los grupos sanguineos humanos, lo mismo que los de conejo, rata, pollo, caballo, bovino y ovino. No se detectó la liberación de hemolisina por el parásito (cepas y clones). Los resultados sugieren que la acividad hemolítica no es debida a la liberación de hemolisina por la T. vaginalis o por un producto de su metabolismo

Study of trichomoniasis among egyptian male patients

In the present study, Trichomonas vaginalis was diagnosed in 28.8% male patients with urethral discharge and in 8.2% suffering from impotence and infertility. Diagnosis was based on examination of urethral discharge, urine, semen and prostatic massage fluid by wet mount, stained films and culture inoculation. Diamond's culture proved to be the method of choice