MMP-9/RECK Imbalance: A Mechanism Associated with High-Grade Cervical Lesions and Genital Infection by Human Papillomavirus and Chlamydia trachomatis

• Published in: Cancer epidemiology, biomarkers & prevention Vol. 24; no. 10; pp. 1539 - 1547
• Main Authors: Discacciati, Michelle G, Gimenes, Fabrícia, Pennacchi, Paula C, Faião-Flores, Fernanda, Zeferino, Luiz C, Derchain, Sophie M, Teixeira, Júlio C, Costa, Maria C, Zonta, Marco, Termini, Lara, Boccardo, Enrique, Longatto-Filho, Adhemar, Consolaro, Marcia E L, Villa, Luisa L, Maria-Engler, Silvya S
• Format: Journal Article
• Language: English
• Published: United States 01.10.2015
• Subjects: Adult; Carcinoma, Squamous Cell - genetics; Carcinoma, Squamous Cell - metabolism; Carcinoma, Squamous Cell - virology; Cervix Uteri - metabolism; Cervix Uteri - pathology; Chlamydia Infections - genetics; Chlamydia Infections - metabolism; Chlamydia Infections - pathology; Chlamydia trachomatis - genetics; Cross-Sectional Studies; DNA, Bacterial - genetics; DNA, Neoplasm - genetics; DNA, Viral - genetics; Female; Gene Expression Regulation, Bacterial; Gene Expression Regulation, Neoplastic; Genotype; GPI-Linked Proteins - biosynthesis; GPI-Linked Proteins - genetics; Human papillomavirus 16 - genetics; Humans; Immunohistochemistry; Matrix Metalloproteinase 9 - biosynthesis; Matrix Metalloproteinase 9 - genetics; Papanicolaou Test; Papillomavirus Infections - genetics; Papillomavirus Infections - metabolism; Papillomavirus Infections - virology; Real-Time Polymerase Chain Reaction; Retrospective Studies; Uterine Cervical Neoplasms - genetics; Uterine Cervical Neoplasms - metabolism; Uterine Cervical Neoplasms - virology; Uterine Cervicitis - genetics; Uterine Cervicitis - metabolism; Uterine Cervicitis - microbiology; Vaginal Smears
• ISSN: 1055-9965; 1538-7755
• DOI: 10.1158/1055-9965.EPI-15-0420

Matrix metalloproteinases (MMP) are important enzymes in the tumor microenvironment associated with progression of cervical intraepithelial neoplasia (CIN) toward squamous cell carcinoma (SCC) of the cervix. However, the role of MMPs in the inflammatory process associated with Chlamydia trachomatis infection concomitant with the carcinogenic process driven by HPV has not yet been addressed. In the present study, we analyzed the state of the MMP-9-RECK axis in cervical carcinogenesis. The levels of MMP-9 and RECK expression were analyzed by immunocytochemistry in liquid-based cytology samples from 136 women with high-grade cervical lesions (CIN2/CIN3) and cervical SCC diagnosed by LLETZ, and in 196 women without cervical neoplasia or CIN1. Real-time qPCR was performed to analyze expression of MMP-9 and RECK in 15 cervical samples. The presence of HPV-DNA and other genital pathogens was evaluated by PCR. We found a higher expression of MMP-9 [OR, 4.2; 95% confidence interval (CI), 2.2-7.8] and lower expression of RECK (OR, 0.4; 95% CI, 0.2-0.7) in women with CIN2/CIN3/SCC when compared with women from the control group (no neoplasia/CIN1). A statistically significant association was also found between MMP-9/RECK imbalance and infection by alpha-9 HPV and C. trachomatis. The prevalence of C. trachomatis infection was significantly higher in women with high-grade cervical disease (OR, 3.7; 95% CI, 1.3-11.3). MMP-9/RECK imbalance in cervical smears is significantly associated with high-grade cervical diseases and infection by alpha-9 HPV and C. trachomatis. MMP-9/RECK imbalance during cervical inflammation induced by C. trachomatis might play a role in HPV-mediated cervical carcinogenesis.