Perfil de citocinas na secreção endocervical e no soro periférico de pacientes com lesões precursoras e câncer cervical

Abstract

Uterine’s câncer evolution, in most cases, occurs slowly, passing through pre-clinical, detectable and curable phases. As mediators of immune and inflammatory responses, cytokines can act antagonistically (inhibiting others effect) and synergistically (two or more cytokines potentializing each other effects). They also have a role in lymphocyte growth and differentiation (activation phase); activation of effector cells (innate and acquired immunity) and development of hematopoietic cells. The aim of this study was to compare cytokines profile (TGF-β, IL-4, IL-10, IL-2, IL-12, IFN-γ and TNF-α) in serum and endocervical secretion of low, high grade and invasive cervical cancer. These cytokines levels were evaluated by immunoenzymatic assay (ELISA) in endocervical secretion and in peripheral serum of 100 women with alterations in uterine cervix were 15 of them with invasive cervical cancer, 45 with low grade intraepithelial lesion (LSIL) and 40 with intraepithelial lesion high-grade (HSIL). As statistical analysis, Mann Whitney test was performed considering p ≤ 0.05 as significant sampling. RESULT. As a result, the Treg profile (TGF-β study) shows similar cytokine concentrations in the vaginal secretion between the three groups studied as a higher peripheral serum dosage in the LSIL group. As results, about Treg profile (TGF-β study), it was realized similar cytokine concentrations in vaginal secretion between the three groups, on the other hand, it was observed higher peripheral serum dosage in LSIL group. Relating Th2 profile cytokines (IL-4 and IL-10), it was verified that these cytokines increased in endocervical secretion according to disease progression. On peripheral serum dosage of these same cytokines, higher IL-4 concentration were detected in HSIL group followed by higher IL-10 concentration in cervical cancer. Studying Th1 profile cytokines (IL-2, IL-12, IFN-γ and TNF-α), there was an increase in endocervical secretion of IL-2 and IL-12 in cervical cancer group and TNF-α had its increased levels within disease progression. Dosing these Th1 profile cytokines in peripheral serum, higher IL-2 concentration was detected in cancer group, whereas IL-12, IFN-γ and TNF-α are higher in LSIL group, polarizing to a Th1 profile with anti-tumoral features. Analyzing endocervical secretion, it was noted an increase in IL-4, IL-10 and TNF-α levels according to lesion progression, not having a specific cytokine pattern for each diagnosis type, that is, both Th1 and Th2 citokynes, and this dichotomy may induce infection persistence, thus promoting cervical lesions progression.