Caracterização do perfil de citocinas do eixo Th1/Th2/ e Th17 e do polimorfismo gênico de IL17A/IL17RA em pacientes com câncer cervical

Abstract

Cervical cancer (CC) is a public health problem that affects many women around the world and its etiology and pathogenesis are intrinsically linked to Human Papillomavirus (HPV), representing the fourth cause of death among women. Estimates report that about 80% of sexually active women will acquire an infection in their lifetime. It is known that the host's immune system, in most cases, is able to eliminate the HPV virus, but in some cases the patient will develop a persistent infection, which will culminate in the emergence of cervical cancer. Considering the importance of the immune system in this process, it is necessary to understand the cells and mechanisms involved. Therefore, evaluating the T helper cell pattern 1, 2 and 17 (Th1, Th2 and Th17) via cytokine quantification and associating the gene polymorphism of the IL-17-RA17 axis is the objective of the present study. This is a case-control observational study, with acquisition of data and biological samples from a biorepository. The construction of the biorepository was carried out from 2015 to 2019, and the study population consisted of 428 samples from a group of patients from the Lower Genital Pathology outpatient clinic of the Januário Cicco Maternity School (MEJC) and the Hospital Luiz Antônio da Liga Contra the Cancer. Samples were stratified into 104 (24%) with cervical cancer (CC), 125 (29%) with high-grade lesion, 86 (20%) with low-grade lesion, 104 (24%) were NILM, and 9 (3%) of indeterminate lesions, with patients identified as NILM classified as control in this study. The execution of this work involves the realization of the gene polymorphism of the IL17A/IL17RA axis in the following steps: DNA extraction and quantification; Polymerase Chain Reaction (PCR); and electrophoresis, while cytokine quantification was performed using the BD™ Cytometric Bead Array (CBA) Human Th1/Th2/Th17 cytokine kit (Becton, Dickinson and Company- BD, New Jersey, EUA). In our series, we did not find an association between the gene polymorphism of the IL-17/RA17 axis and the diagnosis of CC, in addition, there was no production of cytokines in the samples with cervical cancer. Conclusion: We believe that the data found for soluble mediators can be justified by the fact that HPV is a little cytopathic virus, imperceptible to the immune system. Furthermore, another limiting factor is the number of samples in the study, which may have contributed to the lack of association with gene polymorphism.