Article

Effectiveness of the treatment with beta-glucan in the HPV-CIN1 lesions

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Abstract

The aim of the study was to evaluate the effectiveness of the beta-glucan in women with abnormal cytology, including the women with a positive screening for ASCUS-LSIL furtherly divided in women with positive cytology (ASCUS or LSIL) and negative colposcopy and women with abnormal cytology, positive colposcopy and human papilloma virus (HPV)-CIN1 hystology who opted for follow-up. From September 2007 to December 2008, 60 women with ASCUS-LSIL diagnosis were recruited at the ambulatory of Lasersurgery and Cervico-Vaginal Patology, Department of Gynecology and Obstetrics of Policlinico Umberto I of Rome. The women was subdivided in two groups: 1) women with cytological diagnosis of ASCUS or LSIL and negative colposcopy; 2) women with abnormal cytology, positive colposcopy and HPV-CIN1 histology, who opted for follow-up. All the women were treated with two cycles of a daily topical application of beta-glucan for 20 consecutive days with a suspension of 10 days. The effects of beta-glucan were analyzed with colposcopy and cytology at 3.6 and 12 months from the beginning of the therapy. After 3 months of treatment, of the 30 women with positive cytology and negative colposcopy, 80% with ASCUS diagnosis resulted negative, 35% with LSIL diagnosis resulted negative; after 6 months 100% with ASCUS diagnosis resulted negative, 70% with LSIL diagnosis resulted negative; after 12 months 85% with LSIL diagnosis resulted negative. Of the 30 women with positive cytology, positive colposcopy and HPV-CIN1 histology after 3 months 20% resulted negative, after 6 months 60% resulted negative and after 12 months 80% resulted negative. The persistence of the HPV-CIN1 histology was verified in the 13% of the women. For these women the definitive treatment was the TFD. Our study demonstrate the effectiveness of the treatment with beta-glucan in the women with ASCUS-LSIL lesions and HPV-CIN1 lesions, increasing of the regressions rate after 12 months of the treatment of the 15-20%.

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... The beta-glucans anti-tumoral activity lies in their role in the modulation of adaptive and innate immunity. Two research were conducted on analyzing the impact of beta-glucans low grade intraepithelial cervical lesions and the common conclusion was that these natural substances can eradicate cervical lesions resulted from HPV infection and also have a significant effect on the infection's amplitude (13,14). ...
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A successfully implemented screening program for cervical cancer is essential for detecting cervical intraepithelial lesions which offer the possibility of appropriate management and monitoring, implicitly the limitation of the progression to an invasive form of cancer. For different grades of squamous intraepithelial lesions, the use of vaginal tablets or applicators based on various natural substances as hyaluronic acid, beta-glucan and Coriolus Versicolor is possible with the purpose of expectative management or prior and post excisional intervention. We present the incidence trend of abnormal Pap smear results for the last five years in the University Emergency Hospital of Bucharest, with a summary of the literature regarding the biochemical mechanism of the main natural components from vaginal tablets used in the management of precancerous cervical lesions HPV induced and we share our personal experience with three clinical cases that benefited from this therapy. As there is a therapeutic window between the Pap-smear result, colposcopy and preparing for intervention, local treatment with natural components is a suitable choice as it is easy to use, inexpensive and efficient. The conclusion we reached is that the vaginal treatment with natural substances can be useful in terms of improving the local inflammatory process on the one hand and lubricating and regenerating tissues with the improvement of subsequent procedural performance on the other.
... Recently, a non-hormonal vaginal gel has been approved in Europe as a medical device (Papilocare Ò ; Procare Health Iberia, distributed by Shionogi, Rome, Italy). The gel combines ingredients of known properties, such as moisturizing, tissue regenerating, healing, and balancing of vaginal microbiota (hyaluronic acid, Asian centella, Aloe vera, and alpha-glucan oligosaccharide), with other ingredients having demonstrated positive effects on both HPV-dependent cervical lesions and HPV clearance (Coriolus versicolor, Azadirachta indica, and carboxymethyl-b-glucan) [15][16][17]. The gel acts as a moisturizer and lubricant because of strong hydrating properties, also enhancing and accelerating repair of atrophic or injured cervicovaginal mucosa. ...
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Background: Vaginal microbiotas can be clustered into five different possible categories (CST I to V), according to their bacterial dominance. In CST I, the dominance of Lactobacillus crispatus seems to correlate with better vaginal health and with a lower incidence of sine causa infertility, preterm delivery, bacterial vaginosis, and viral (including human papillomavirus; HPV) infection. According to the same method of classifying the vaginal microbiome, CST IV (non-Lactobacillusdominated) demonstrates a higher incidence of disorders. Methods: In an open, non-controlled study, we enrolled 35 HPV-positive women who mostly (N=24) demonstrated CST IV status, with the other individuals categorized as having either CST III (N=10) or CST II (N=1) microbiotas. Results: After 90 days of oral treatment with a probiotic (L. crispatus M247) we observed a reduction of approximately 70% in HPV positivity and a significant change in CST status with 94% of women now classified as CST I. Conclusions: Despite the limitations of our study, it is the first demonstration that it is possible to intervene orally with an L. crispatus probiotic to bring about a change in CST status and, in parallel, increased HPV clearance.
... Recently, a non-hormonal vaginal gel has been approved in Europe as a medical device (Papilocare Ò ; Procare Health Iberia, distributed by Shionogi, Rome, Italy). The gel combines ingredients of known properties, such as moisturizing, tissue regenerating, healing, and balancing of vaginal microbiota (hyaluronic acid, Asian centella, Aloe vera, and alpha-glucan oligosaccharide), with other ingredients having demonstrated positive effects on both HPV-dependent cervical lesions and HPV clearance (Coriolus versicolor, Azadirachta indica, and carboxymethyl-b-glucan) [15][16][17]. The gel acts as a moisturizer and lubricant because of strong hydrating properties, also enhancing and accelerating repair of atrophic or injured cervicovaginal mucosa. ...
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IntroductionA Coriolus versicolor-based vaginal gel is available for treating women with cervical uterine high-risk human papillomavirus (HPV) infection through re-epithelizing and re-balancing microbiota actions.MethodsA longitudinal retrospective observational study was performed to evaluate efficacy and safety of the gel. Women treated with Coriolus versicolor-based vaginal gel were compared with women not treated with the gel. Both groups were monitored for HPV infection by an HPV DNA test, Pap smear (cytology) and colposcopy at baseline and after 6 months.ResultsOverall, 183 high-risk HPV positive women were enrolled (97 treated and 86 controls). After 6 months, the HPV DNA test became negative in 67.0% versus 37.2% of treated and controls, respectively (p < 0.0001). Furthermore, 76.1% versus 40.8% registered a colposcopy improvement (p = 0.0005) and 60.4% versus 40.8% showed a remission (p = 0.05), for treated versus controls, respectively. Regarding to cytology, 78.5% of treated versus 37.7% of controls registered an improvement, while 70.8% of treated versus 34.8% of controls had a remission (p < 0.0001 for both variables). At multivariate analyses adjusted for age, smoking habit, and use of estroprogestinic pill, compared to controls, women treated with the gel showed a significantly higher likelihood to experience the clearence of HPV DNA (OR 4.81; 95% 2.43–9.53), and remission at colposcopy (OR 2.30; 95% 1.00–5.31), and cytology (OR 5.13; 95% 2.40–10.96) at 6 months. No adverse event was reported during the follow-up.Conclusions The use of a Coriolus versicolor-based vaginal gel in high-risk HPV patients is safe and effective based on all examined tests.
... The literature reported a rate of spontaneous CIN 1 lesion remission of about 60% over a 12-24-month period [11]. Our data agree with the data of Scardamaglia et al. 5 BioMed Research International [12] and Stentella et al. [13] who demonstrated a significant regression of CIN 1 lesion in patients treated with carboxymethyl beta-glucan. ...
Article
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Objective: Evaluate the effects of carboxy-methyl-beta-glucan on cervical epithelialization and on the vaginal microbiota in patients with HPV infection or low-grade cervical preneoplastic lesion (CIN 1). Materials and methods: Seven-hundred eighty-four women with positive HPV tests or diagnosed with CIN 1 were enrolled in a retrospective case-control study. All the recruited women performed, at baseline and after 6 months, Pap test, HPV test, evaluation of vaginal health according to the Amsel criteria, colposcopy, and punch biopsy. The study population was then divided into 2 groups in relation to the therapy performed during the follow-up period. Group A performed treatment with vaginal gel based on carboxy-methyl-beta-glucan (1 application/day for 20 days per month for 3 months). Group B was the control group. Results: The patients of group A had a significant improvement in the ectopia pattern and a greater number of cases with metaplasia in the maturation phase with a significant increase in Lugol uptake. In the experimental group, a significant improvement in the pH indices, a negative Swift test and a resolution of the leucorrhoea were observed. A negative result of the 37.1% Pap test and the 39.9% HPV test (vs. 15.2% and 16.5%, respectively) were demonstrated in the treatment group with respect to the control group. A negativization of the colposcopic pictures was observed with a reduction in the amount of CIN 1 found higher in the treatment group. Conclusions: Vaginal therapy based on carboxy-methyl-beta-glucan has been able to improve overall vaginal health; this effect seemed to positively impact the risk of persistence and progression of CIN.
... In 2010, two studies were conducted on the subject of "the beta-glucans' influence on the HPV-correlated lesions in the genital area". The first study found that beta-glucans are able to treat the lesions related to HPV infection [143] and the second study revealed the efficacy of beta-glucan treatment for HPV-CIN1 lesions [144]. These studies suggested that besides the anti-cancer effects of beta-glucans, they also have some effects on HPV infection, the main cause of cervical cancer. ...
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