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Cervical Cancer Induction Enhancement Potential of Chlamydia Trachomatis: A Systematic Review

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Abstract

Human papillomavirus (HPV) persistent infection is the necessary but not sufficient cause of cervical cancer. Other co-factors are required to induce cell transformation that will evolve to malignant cervical cancer. These co-factors include physical elements, other sexually transmitted infections, and immune response. Chlamydia trachomatis the most common bacterial sexually transmitted infection is often asymptomatic but causes various syndromes such as cervicitis, endometritis, pelvic inflammatory disease, and infertility. It is established that this bacterium is involved in cell proliferation process and inhibit apoptosis. Furthermore, C. trachomatis may induce chronic inflammation, interfere with immune response by decreasing the number of antigen presenting cells, and reduce the cell-mediated immunity allowing the persistence of HPV. However, it is unclear whether this bacterium plays a particular role in cervical cancer induction. We therefore aimed at enlightening the actual knowledge about the relationship between C. trachomatis and cervical cancer or precursor lesions through a systematic literature review. We summarized and analyzed the epidemiological data on C. trachomatis and its co-infection with HPV and their association to cervical cancer.

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References

  1. IARC (2012) Iarc Monographs on the Evaluation of Carcinogenic Risks To Humans. 100:417–441

  2. Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M, Parkin DM, Forman D, Bray F (2015) Cancer incidence and mortality worldwide: Sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer 136:E359–E386. https://doi.org/10.1002/ijc.29210

    Article  CAS  Google Scholar 

  3. Walboomers JMM, Jacobs MV, Manos MM, Bosch FX, Kummer JA, Shah KV, Snijders PJ, Peto J, Meijer CJ, Muñoz N (1999) Human papillomavirus is a necessary cause of invasive cervical cancer worldwide. J Pathol 189:12–19. https://doi.org/10.1002/(SICI)1096-9896(199909)189

    Article  CAS  PubMed  Google Scholar 

  4. Bosch FX, de Sanjosé S (2007) The epidemiology of human papillomavirus infection and cervical cancer. Dis Markers 23:213–227

    Article  Google Scholar 

  5. Castellsagué X, Bosch FX, Muñoz N (2002) Environmental co-factors in HPV carcinogenesis. Virus Res 89:191–199. https://doi.org/10.1016/S0168-1702(02)00188-0

    Article  PubMed  Google Scholar 

  6. Cavalcanti SMB, Zardo LG, Passos MRL, Oliveira LHS (2000) Epidemiological aspects of human papillomavirus infection and cervical cancer in Brazil. J Infect 40:80–87. https://doi.org/10.1053/jinf.1999.0596

    Article  CAS  PubMed  Google Scholar 

  7. Vermund SH, Kelley KF, Klein RS, Feingold AR, Schreiber K, Munk G, Burk RD (1991) High risk of human papillomavirus infection and cervical squamous intraepithelial lesions among women with symptomatic human immunodeficiency virus infection. Am J Obstet Gynecol 165:392–400

    Article  CAS  Google Scholar 

  8. Brunham RC, Rey-Ladino J (2005) Immunology of Chlamydia infection: implications for a Chlamydia trachomatis vaccine. Nat Rev Immunol 5:149–161. https://doi.org/10.1038/nri1551

    Article  CAS  PubMed  Google Scholar 

  9. Paavonen J (2012) Chlamydia trachomatis infections of the female genital tract: state of the art. Ann Med 44:18–28. https://doi.org/10.3109/07853890.2010.546365

    Article  CAS  PubMed  Google Scholar 

  10. Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group (2009) Preferred reporting Items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 6:e1000097. https://doi.org/10.1371/journal.pmed.1000097

    Article  PubMed  PubMed Central  Google Scholar 

  11. Deluca GD, Basiletti J, Schelover E, Vásquez ND, Alonso JM, Marín HM, Lucero RH, Picconi MA (2011) Chlamydia trachomatis as a probable cofactor in human papillomavirus infection in aboriginal women from northeastern Argentina. Braz J Infect Dis 15:567–572. https://doi.org/10.1016/S1413-8670(11)70252-5

    Article  PubMed  Google Scholar 

  12. Finan RR, Musharrafieh U, Almawi WY (2006) Detection of Chlamydia trachomatis and herpes simplex virus type 1 or 2 in cervical samples in human papilloma virus (HPV)-positive and HPV-negative women. Clin Microbiol Infect 12:927–930. https://doi.org/10.1111/j.1469-0691.2006.01479.x

    Article  CAS  PubMed  Google Scholar 

  13. Finan RR, Tamim H, Almawi WY (2002) Identification of Chlamydia trachomatis DNA in human papillomavirus (HPV) positive women with normal and abnormal cytology. Arch Gynecol Obs 266:168–171

    Article  CAS  Google Scholar 

  14. Golijow CD, Abba MC, Mourón SA, Laguens RM, Dulout FN, Smith JS (2005) Chlamydia trachomatis and human papillomavirus infections in cervical disease in Argentine women. Gynecol Oncol 96:181–186. https://doi.org/10.1016/j.ygyno.2004.09.037

    Article  PubMed  Google Scholar 

  15. de Paula FDF, Fernandes AP, Carmo BB do, Vieira DCD, Dutra MS, Santos CGM, dos,, Andrade TCA, Vago AR, Fernandes PA, Souza MDCM (2007) Molecular detection of Chlamydia trachomatis and HPV infections in cervical samples with normal and abnormal cytopathological findings. Diagn Cytopathol 35:198–202. https://doi.org/10.1002/dc.20629

    Article  PubMed  Google Scholar 

  16. Tamim H, Finan RR, Sharida HE, Rashid M, Almawi WY (2002) Cervicovaginal coinfections with human papillomavirus and chlamydia trachomatis. Diagn Microbiol Infect Dis 43:277–281. https://doi.org/10.1016/S0732-8893(02)00403-0

    Article  PubMed  Google Scholar 

  17. Verteramo R, Pierangeli A, Mancini E, Calzolari E, Bucci M, Osborn J, Nicosia R, Chiarini F, Antonelli G, Degener AM (2009) Human Papillomaviruses and genital co-infections in gynaecological outpatients. BMC Infect Dis 9:16. https://doi.org/10.1186/1471-2334-9-16

    Article  PubMed  PubMed Central  Google Scholar 

  18. Muñoz N, Kato I, Bosch FX, Eluf-Neto J, De Sanjosé S, Ascunce N, Gili M, Izarzugaza I, Viladiu P, Tormo MJ, Moreo P, Gonzalez LC, Tafur L, Walboomers JM, Shah KV (1996) Risk factors for HPV DNA detection in middle-aged women. Sex Transm Dis 23:504–510

    Article  Google Scholar 

  19. Seraceni S, De Seta F, Colli C, Del Savio R, Pesel G, Zanin V, D’Agaro P, Contini C, Comar M (2014) High prevalence of hpv multiple genotypes in women with persistent chlamydia trachomatis infection. Infect Agent Cancer 9:30. https://doi.org/10.1186/1750-9378-9-30

    Article  PubMed  PubMed Central  Google Scholar 

  20. Silva J, Cerqueira F, Ribeiro J, Sousa H, Osório T, Medeiros R (2013) Is Chlamydia trachomatis related to human papillomavirus infection in young women of southern European population? A self-sampling study. Arch Gynecol Obstet 288:627–633. https://doi.org/10.1007/s00404-013-2771-6

    Article  PubMed  Google Scholar 

  21. Samoff E, Koumans EH, Markowitz LE, Sternberg M, Sawyer MK, Swan D, Papp JR, Black CM, Unger ER (2005) Association of Chlamydia trachomatis with persistence of high-risk types of human papillomavirus in a cohort of female adolescents. Am J Epidemiol 162:668–675. https://doi.org/10.1093/aje/kwi262

    Article  PubMed  Google Scholar 

  22. Silins I, Ryd W, Strand A, Wadell G, Törnberg S, Hansson BG, Wang X, Arnheim L, Dahl V, Bremell D, Persson K, Dillner J, Rylander E (2005) Chlamydia trachomatis infection and persistence of human papillomavirus. Int J Cancer 116:110–115. https://doi.org/10.1002/ijc.20970

    Article  CAS  PubMed  Google Scholar 

  23. Vriend HJ, Bogaards JA, van Bergen JEAM., Brink AATP., van den Broek IVF, Hoebe CJPA., King AJ, van der Sande MAB, Wolffs PFG, de Melker HE, Medical Microbiological Laboratories and the CSI group (2015) Incidence and persistence of carcinogenic genital human papillomavirus infections in young women with or without Chlamydia trachomatis co-infection. Cancer Med 4:1589–1598. https://doi.org/10.1002/cam4.496

    Article  PubMed  PubMed Central  Google Scholar 

  24. Magalhães PAF, Miranda CAN, Lima ÉG, Moizéis RNC, de Lima DBS, Cobucci RNO, de Medeiros Fernandes TAA, de Azevedo JCV, de Azevedo PRM, de Araújo JMG, Fernandes JV (2015) Genital tract infection with Chlamydia trachomatis in women attended at a cervical cancer screening program in Northeastern from Brazil. Arch Gynecol Obstet 291:1095–1102. https://doi.org/10.1007/s00404-014-3514-z

    Article  PubMed  Google Scholar 

  25. de Abreu ALP, Nogara PRB, Souza RP, da Silva MC, Uchimura NS, Zanko RL, Ferreira EC, Tognim MCB, Teixeira JJV, Gimenes F, Consolaro MEL (2012) Molecular detection of HPV and Chlamydia trachomatis infections in Brazilian women with abnormal cervical cytology. Am J Trop Med Hyg 87:1149–1151. https://doi.org/10.4269/ajtmh.2012.12-0287

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. da Silva Barros NK, Costa MC, Alves RRF, Villa LL, Derchain SFM, Zeferino LC, dos Santos Carneiro MA, Rabelo-Santos SH (2012) Association of HPV infection and Chlamydia trachomatis seropositivity in cases of cervical neoplasia in Midwest Brazil. J Med Virol 84:1143–1150. https://doi.org/10.1002/jmv.23312

    Article  PubMed  Google Scholar 

  27. Castellsagué X, Pawlita M, Roura E, Margall N, Waterboer T, Bosch FX, De Sanjosé S, Gonzalez CA, Dillner J, Gram IT, Tjønneland A, Munk C, Pala V, Palli D, Khaw KT, Barnabas RV, Overvad K, Clavel-Chapelon F, Boutron-Ruault MC, Fagherazzi G, Kaaks R, Lukanova A, Steffen A, Trichopoulou A, Trichopoulos D, Klinaki E, Tumino R, Sacerdote C, Mattiello A, Bueno-De-Mesquita HB, Peeters PH, Lund E, Weiderpass E, Quirós JR, Sánchez MJ, Navarro C, Barricarte A, Larrañaga N, Ekström J, Hortlund M, Lindquist D, Wareham N, Travis RC, Rinaldi S, Tommasino M, Franceschi S, Riboli E (2014) Prospective seroepidemiologic study on the role of Human Papillomavirus and other infections in cervical carcinogenesis: evidence from the EPIC cohort. Int J Cancer 135:440–452. https://doi.org/10.1002/ijc.28665

    Article  CAS  PubMed  Google Scholar 

  28. de Abreu AL, Malaguti N, Souza RP, Uchimura NS, Ferreira ÉC, Pereira MW, Carvalho MD, Pelloso SM, Bonini MG, Gimenes F, Consolaro ME (2016) Association of human papillomavirus, Neisseria gonorrhoeae and Chlamydia trachomatis co-infections on the risk of high-grade squamous intraepithelial cervical lesion. Am J Cancer Res 6:1371–1383

    PubMed  PubMed Central  Google Scholar 

  29. Robial R, Longatto-Filho A, Roteli-Martins CM, Silveira MF, Stauffert D, Ribeiro GG, Linhares IM, Tacla M, Zonta MA, Baracat EC (2017) Frequency of Chlamydia trachomatis infection in cervical intraepithelial lesions and the status of cytological p16/Ki-67 dual-staining. Infect Agent Cancer 12:3. https://doi.org/10.1186/s13027-016-0111-8

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. Costa-Lira E, Jacinto AHVL., Silva LM, Napoleão PFR, Barbosa-Filho RAA, Cruz GJS, Astolfi-Filho S, Borborema-Santos CM (2017) Prevalence of human papillomavirus, Chlamydia trachomatis, and Trichomonas vaginalis infections in Amazonian women with normal and abnormal cytology. Genet Mol Res Genet Mol Res. https://doi.org/10.4238/gmr16029626

    Article  PubMed  Google Scholar 

  31. Castle PE, Escoffery C, Schachter J, Rattray C, Schiffman M, Moncada J, Sugai K, Brown C, Cranston B, Hanchard B, Palefsky JM, Burk RD, Hutchinson ML, Strickler HD (2003) Chlamydia trachomatis, herpes simplex virus 2, and human T-cell lymphotrophic virus type 1 are not associated with grade of cervical neoplasia in Jamaican colposcopy patients. Sex Transm Dis 30:575–580

    Article  Google Scholar 

  32. Ferrera A, Baay MF, Herbrink P, Figueroa M, Velema JP, Melchers WJ (1997) A sero-epidemiological study of the relationship between sexually transmitted agents and cervical cancer in Honduras. Int J Cancer 73:781–785

    Article  CAS  Google Scholar 

  33. Safaeian M, Quint K, Schiffman M, Rodriguez AC, Wacholder S, Herrero R, Hildesheim A, Viscidi RP, Quint W, Burk RD (2010) Chlamydia trachomatis and risk of prevalent and incident cervical premalignancy in a population-based cohort. J Natl Cancer Inst 102:1794–1804. https://doi.org/10.1093/jnci/djq436

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  34. Valadan M, Yarandi F, Eftekhar Z, Danvish S, Fathollahi MS, Mirsalehian a (2010) Chlamydia trachomatis and cervical intraepithelial neoplasia in married women in a Middle Eastern community. East Mediterr Health J 16:304–307

    Article  CAS  Google Scholar 

  35. Takac I, Gorisek B (1999) Chlamydia trachomatis infection in women with and without cervical intraepithelial neoplasia. Int J STD AIDS 10:331–333. https://doi.org/10.1258/0956462991914050

    Article  CAS  PubMed  Google Scholar 

  36. Koskela P, Anttila T, Bjørge T, Brunsvig A, Dillner J, Hakama M, Hakulinen T, Jellum E, Lehtinen M, Lenner P, Luostarinen T, Pukkala E, Saikku P, Thoresen S, Youngman L, Paavonen J (2000) Chlamydia trachomatis infection as a risk factor for invasive cervical cancer. Int J Cancer 85:35–39. https://doi.org/10.1002/(SICI)1097-0215(20000101)85

    Article  CAS  PubMed  Google Scholar 

  37. Smith JS, Bosetti C, Muñoz N, Herrero R, Bosch FX, Eluf-Neto J, Meijer CJLM., Van Den Brule AJC, Franceschi S, Peeling RW (2004) Chlamydia trachomatis and invasive cervical cancer: a pooled analysis of the IARC multicentric case-control study. Int J Cancer 111:431–439. https://doi.org/10.1002/ijc.20257

    Article  CAS  PubMed  Google Scholar 

  38. Madeleine MM, Anttila T, Schwartz SM, Saikku P, Leinonen M, Carter JJ, Wurscher M, Johnson LG, Galloway DA, Daling JR (2007) Risk of cervical cancer associated with Chlamydia trachomatis antibodies by histology, HPV type and HPV cofactors. Int J Cancer 120:650–655. https://doi.org/10.1002/ijc.22325

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  39. Smelov V, Gheit T, Sundström K, Ploner A, McKay-Chopin S, Eklund C, Tommasino M, Dillner J (2016) Lack of significant effects of Chlamydia trachomatis infection on cervical adenocarcinoma risk: nested CASE-control study. PLoS ONE 11:e0156215. https://doi.org/10.1371/journal.pone.0156215

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  40. Edelman M, Fox A, Alderman E, Neal W, Shapiro A, Silver EJ, Spigland I, Suhrland MJ (2000) Cervical Papanicolaou smear abnormalities and Chlamydia trachomatis in sexually active adolescent females. J Pediatr Adolesc Gynecol 13:65–69. https://doi.org/10.1016/S1083-3188(00)00003-6

    Article  CAS  PubMed  Google Scholar 

  41. Naucler P, Chen H-C, Persson K, You S-L, Hsieh C-Y, Sun C-A, Dillner J, Chen C-J (2007) Seroprevalence of human papillomaviruses and Chlamydia trachomatis and cervical cancer risk: nested case-control study. J Gen Virol 88:814–822. https://doi.org/10.1099/vir.0.82503-0

    Article  CAS  PubMed  Google Scholar 

  42. Castellsagué X, Muñoz N (2003) Chapter 3: cofactors in human papillomavirus carcinogenesis—role of parity, oral contraceptives, and tobacco smoking. J Natl Cancer Inst Monogr 20–28

    Article  Google Scholar 

  43. Gillet E, Meys JFA, Verstraelen H, Verhelst R, De Sutter P, Temmerman M, Broeck D, Vanden (2012) Association between bacterial vaginosis and cervical intraepithelial neoplasia: systematic review and meta-analysis. PLoS ONE 7:e45201. https://doi.org/10.1371/journal.pone.0045201

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  44. Koutsky LA, Holmes KK, Critchlow CW, Stevens CE, Paavonen J, Beckmann AM, DeRouen TA, Galloway DA, Vernon D, Kiviat NB (1992) A cohort study of the risk of cervical intraepithelial neoplasia grade 2 or 3 in relation to papillomavirus infection. N Engl J Med 327:1272–1278. https://doi.org/10.1056/NEJM199210293271804

    Article  CAS  PubMed  Google Scholar 

  45. Smith JS, Herrero R, Bosetti C, Muñoz N, Bosch FX, Eluf-Neto J, Castellsagué X, Meijer CJLM., Van den Brule AJC, Franceschi S, Ashley R, International Agency for Research on Cancer (IARC) Multicentric Cervical Cancer Study Group (2002) Herpes simplex virus-2 as a human papillomavirus cofactor in the etiology of invasive cervical cancer. J Natl Cancer Inst 94:1604–1613

    Article  CAS  Google Scholar 

  46. Fernández-Benítez C, Mejuto-López P, Otero-Guerra L, Margolles-Martins MJ, Suárez-Leiva P, Vazquez F, Chlamydial Primary Care Group (2013) Prevalence of genital Chlamydia trachomatis infection among young men and women in Spain. BMC Infect Dis 13:388. https://doi.org/10.1186/1471-2334-13-388

    Article  PubMed  PubMed Central  Google Scholar 

  47. Lewis D, Newton DC, Guy RJ, Ali H, Chen MY, Fairley CK, Hocking JS (2012) The prevalence of Chlamydia trachomatis infection in Australia: a systematic review and meta-analysis. BMC Infect Dis 12:113. https://doi.org/10.1186/1471-2334-12-113

    Article  PubMed  PubMed Central  Google Scholar 

  48. Wilson JS, Honey E, Templeton A, Paavonen J, Mårdh PA, Stray-Pedersen B, EU Biomed Concerted Action Group (2002) A systematic review of the prevalence of Chlamydia trachomatis among European women. Hum Reprod Update 8:385–394

    Article  CAS  Google Scholar 

  49. Zhu H, Shen Z, Luo H, Zhang W, Zhu X (2016) Chlamydia Trachomatis infection-associated risk of cervical cancer: A meta-analysis. Medicine (Baltimore) 95:e3077. https://doi.org/10.1097/MD.0000000000003077

    Article  Google Scholar 

  50. Bhatla N, Puri K, Joseph E, Kriplani A, Iyer VK, Sreenivas V (2013) Association of Chlamydia trachomatis infection with human papillomavirus (HPV) & cervical intraepithelial neoplasia - a pilot study. Indian J Med Res 137:533–539

    PubMed  PubMed Central  Google Scholar 

  51. Anttila T, Saikku P, Koskela P, Bloigu A, Dillner J, Ikäheimo I, Jellum E, Lehtinen M, Lenner P, Hakulinen T, Närvänen A, Pukkala E, Thoresen S, Youngman L, Paavonen J (2001) Serotypes of Chlamydia trachomatis and risk for development of cervical squamous cell carcinoma. JAMA 285:47–51

    Article  CAS  Google Scholar 

  52. Gurumurthy RK, Maurer AP, Machuy N, Hess S, Pleissner KP, Schuchhardt J, Rudel T, Meyer TF (2010) A loss-of-function screen reveals Ras- and Raf-independent MEK-ERK signaling during Chlamydia trachomatis infection. Sci Signal 3:ra21-ra21. https://doi.org/10.1126/scisignal.2000651

    Article  CAS  Google Scholar 

  53. Byrne GI, Ojcius DM (2004) Chlamydia and apoptosis: life and death decisions of an intracellular pathogen. Nat Rev Microbiol 2:802–808. https://doi.org/10.1038/nrmicro1007

    Article  CAS  PubMed  Google Scholar 

  54. Chumduri C, Gurumurthy RK, Zadora PK, Mi Y, Meyer TF (2013) Chlamydia Infection promotes host DNA damage and proliferation but impairs the DNA damage response. Cell Host Microbe 13:746–758. https://doi.org/10.1016/j.chom.2013.05.010

    Article  CAS  PubMed  Google Scholar 

  55. Kun D, Xiang-lin C, Ming Z, Qi L (2013) Chlamydia inhibit host cell apoptosis by inducing Bag-1 via the MAPK/ERK survival pathway. Apoptosis 18:1083–1092. https://doi.org/10.1007/s10495-013-0865-z

    Article  CAS  PubMed  Google Scholar 

  56. Cerny KL, Fleet M, Van, Slepenkin A, Peterson EM, Bridges PJ, Pj B (2015) Differential expression of mRNA encoding cytokines and chemokines in the reproductive tract after infection of Mice with Chlamydia trachomatis HHS public access. https://doi.org/10.4172/2161-038X.1000152

  57. Fischer N (2002) Chlamydia trachomatis infection in cervical intraepithelial neoplasia and invasive carcinoma. Eur J Gynaecol Oncol 23:247–250

    CAS  PubMed  Google Scholar 

  58. Silva J, Cerqueira F, Medeiros R (2014) Chlamydia trachomatis infection: implications for HPV status and cervical cancer. Arch Gynecol Obstet 289:715–723. https://doi.org/10.1007/s00404-013-3122-3

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Laboratory of Microbiology and Molecular Biology, Faculty of Medicine and Pharmacy of Fez (FMPF), Sidi Mohammed Ben Abdellah University (USMBA), Fez, Morocco

    Safae Karim & Bahia Bennani

  2. Laboratory of Biotechnologies, Faculty of Sciences Dhar El Mahraz, USMBA, Fez, Morocco

    Safae Karim & Mohamed Benlemlih

  3. Faculty of Science and Technology, University of Kara, Kara, Togo

    Tiatou Souho

  4. Team of Microorganisms, Genomic and Oncogene Factors, Laboratory of Human Pathology, Biomedicine and Environmental, FMP, USMBA, Fez, Morocco

    Bahia Bennani

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Karim, S., Souho, T., Benlemlih, M. et al. Cervical Cancer Induction Enhancement Potential of Chlamydia Trachomatis: A Systematic Review. Curr Microbiol 75, 1667–1674 (2018). https://doi.org/10.1007/s00284-018-1439-7

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