ABSTRACT
Cervical cancer is associated with infection by certain types of human papillomaviruses (HPVs), and this affects women worldwide. Despite the improvements in prevention and cure of HPV-induced cervical cancer, it remains the second most common type of cancer in women in the least developed regions of the world. Epigenetic modifications are stable long-term changes that occur in the DNA, and are part of a natural evolutionary process of necessary adaptations to the environment. They do not result in changes in the DNA sequence, but do affect gene expression and genomic stability. Epigenetic changes are important in several biological processes. The effects of the environment on gene expression can contribute to the development of numerous diseases. Epigenetic modifications may serve a critical role in cancer cells, by silencing tumor suppressor genes, activating oncogenes, and exacerbating defects in DNA repair mechanisms. Although cervical cancer is directly related to a persistent high-risk HPV infection, several epigenetic changes have been identified in both the viral DNA and the genome of the infected cells: DNA methylation, histone modification and gene silencing by non-coding RNAs, which initiate and sustain epigenetic changes. In the present review, recent advances in the role of epigenetic changes in cervical cancer are summarized.
ABSTRACT
O Sistema Único de Saúde (SUS) brasileiro garante o acesso universal e integral aos serviços de saúde. Entretanto, na prática, o SUS não tem permitido que os cidadãos desfrutem de uma assistência com equidade, reforçando a dificuldade de se atingir a justiça social em uma sociedade tão desigual e injusta como a brasileira. A ética propõe a equidade como base para resolver as distorções na distribuição da saúde, possibilitando o acesso universal. Este artigo tem como objetivo precípuo discutir como a bioética pode auxiliar para que haja maior equidade na assistência médica em nosso país.
Brazilian ́s Unified Health System (SUS) ensures universal access to comprehensive health services. However, in practice SUS has not allowed citizens to enjoy a health care with equity, increasing the difficulty of achieving social justice in a society as unequal and unfair as the Brazilian. Ethics proposes equity as a basis for resolving the distortions in the distribution of health, enabling universal access. This article aims to discuss how bioethics can help for greater equity in health care in our count.
