Virally mediated cervical cancer in the iatrogenically immunocompromised: applications for psychoneuroimmunology.
Oncogenic or high-risk (HR) human papillomavirus (HPV) infection is implicated in the pathogenesis of a number of cancers, including cervical cancer. HPV infected individuals who are immunocompromised secondary to acquired (e.g., human immunodeficiency virus [HIV]) or iatrogenic (e.g., systemic lupus erythematosus [SLE] patients and organ and hematopoeitic stem cell transplant recipients undergoing immunosuppressive therapy) immune deficiency are particularly at risk for HPV-initiated cervical neoplasia and cancer. Psychoneuroimmunologic (PNI) research has demonstrated that psychosocial factors such as stress, pessimism, and sleep quality may play a role in the promotion of HPV-mediated cervical neoplasia in HIV-positive women. However, no research to our knowledge has examined PNI mechanisms of HPV-mediated cervical neoplasia and cancer in women who are undergoing iatrogenic immunosuppressive therapy for the treatment of autoimmune disease or the prevention of graft-rejection. This article reviews the PNI mechanisms that may underlie the promotion of HPV-mediated cervical neoplasia and applies this model to HPV-infected women who are iatrogenically immunosuppressed, an understudied population at-risk for cervical cancer. Female transplant recipients, one such group, may provide a unique paradigm in which to explore further PNI mechanisms of HPV-mediated cervical neoplasia.
Jensen
Sally E
SE
Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA.
Lehman
Brandy
B
Antoni
Michael H
MH
Pereira
Deidre B
DB
D052685:Alphapapillomavirus / Q000145:classification / Q000276:immunology* / Q000472:pathogenicity; D005260:Female; D006679:HIV Seropositivity / Q000276:immunology / Q000523:psychology; D006801:Humans; D016867:Immunocompromised Host / Q000276:immunology*; D007166:Immunosuppressive Agents / Q000276:immunology*; D011584:Psychology; D011598:Psychoneuroimmunology; D002583:Uterine Cervical Neoplasms / Q000276:immunology / Q000821:virology*
D007166:Immunosuppressive Agents