Magister Scientiae - MSc (Biotechnology) / The vaginal mucosa is dominated by Gram positive, rod shaped lactobacilli which serve as a natural barrier against infection. In both healthy and BV infected women Lactobacillus crispatus and Lactobacillus jensennii has been found to be the predominant Lactobacillus species. Many studies have been conducted to assess factors influencing lactobacilli dominance in the vaginal microbiome. However, no study has evaluated the impact of plasmids on the vaginal lactobacilli. In the present study two plasmids, pLc17 and pLc4, isolated from vaginal Lactobacillus species of both healthy and BV infected women were characterized. pLc4 was present in both Lactobacillus crispatus and Lactobacillus jensennii while pLc17 was only present in Lactobacillus crispatus. pLc17 (16663 bp in size) encoded a ribonucleotide diphosphate reductase (RNR), a filamentation induced by cAMP-like (FIC-like) protein and numerous mobile elements.

Magister Scientiae (Medical Bioscience) - MSc(MBS) / Athymic nude mouse models have been extensively used to study biological behaviour of normal and diseased human tissues. In such models, immune-deficient mice act as hosts for cysts constructed from human material. A unique biocyst model that entails transplantation of human vaginal cysts into athymic nude mice has been implemented to study diseases of oral mucosa. To date, only one immunohistochemical study of this biocyst model has been reported. Nevertheless, conclusions made in that study were only based on the observed expression patterns of human and murine markers. Statistical assessment of immunohistochemical data had been omitted by the investigator. Therefore, the objective of this study was to further delineate the immunohistochemical profile of normal human vaginal tissue and human vaginal tissue that had been xenografted into nude mice.Experimental cysts constructed from human vaginal mucosa were xenografted into athymic nude mice and harvested 9-weeks post transplantation. Immunohistochemical analysis of normal human vaginal tissue and human vaginal tissue that had been xenografted into nude mice was performed using a panel of human and murine markers. Expression patterns of human and murine markers were assessed. Human markers included cytokeratin 1,cytokeratin 5, cytokeratin 13, cytokeratin 14, collagen type IV, laminin, elastin, fibronectin,Langerhans cells and VEGFR-3. Murine markers included collagen type IV, laminin,fibronectin, Langerhans cells and VEGFR-2. Staining intensities were quantified and statistically analysed using one-way ANOVA with subsequent Friedman’s test for multiple comparisons. Since the sample size was small, the power of the test statistic was enhanced by including Dunn’s post-test for further multiple comparisons. A strong positive expression of all cytokeratins was detected in both normal and xenografted vaginal tissues. Human markers that exhibited weak to moderate positive expression were collagen IV, laminin, fibronectin and VEGFR-3. Human elastin and human Langerhans cells exhibited strong and varying expression patterns respectively. Weak expression patterns for all murine markers were reported, with an exception of VEGFR-2 which was negatively expressed in all xenografted vaginal tissues. Significant differences (P<0.05) in the mean staining intensities between normal and xenografted vaginal tissues were reported for cytokeratin 1, fibronectin and Langerhans cells. There were no statistical differences (P>0.05) in the mean staining intensities for other markers.In conclusion, immunohistochemical studies proved that human vaginal tissue could not only survive in nude mice, but could also become active and develop structures necessary for survival, in this case, a newly formed stromal layer. The epithelium and stromal layer exhibited a human ecosystem.

Para a metabolização de hormônios esteroides sexuais é essencial a participação de enzimas esteroidogênicas. A enzima citocromo P450c17 é responsável pela produção de andrógenos e a enzima citocromo P450 aromatase é responsável pela produção de estrógenos, sendo que, ambas as enzimas necessitam formar um complexo com uma enzima parceira, denominada NADPH citocromo P450 redutase, para realizar a metabolização destes hormônios essenciais para a diferenciação sexual. Objetivou-se imunolocalisar as três enzimas acima citadas no tecido vaginal de fêmeas de roedores Galea spixii. Para tanto, o experimento foi desenvolvido utilizando técnicas de citologia esfoliativa vaginal para definição das fases do ciclo estral, técnicas de microscopia de Luz, Eletrônica de Varredura e testes de imunohistoquímica para detecção das enzimas: citocromo P450c17, citocromo P450 aromatase, e NADPH citocromo P450 redutase. Constatou-se no presente estudo que o ciclo estral das fêmeas de preás silvestres do semiárido apresenta ciclo estral com duração de 15,85 ± 1,4 dias, com a formação e ruptura da membrana de oclusão vaginal durante cada ciclo estral. A vagina apresenta um clitóris hipertrofiado com o óstio uretral que se abre no topo do mesmo, e ausência de um vestíbulo vaginal. O epitélio da mucosa vaginal sofre modificações proliferativas, se espessando e se adelgando de acordo com a respectiva fase do ciclo estral. As enzimas citocromo P450 aromatase e NADPH redutase estão imunolocalizadas durante todo o ciclo estral no epitélio e tecido conjuntivo da vagina de Galea spixii. Por outro lado, a enzima P450c17 está imunolocalizada no epitélio vaginal durante todas as fases do ciclo estral, porém não está presente no estro. Com estes dados pode-se sugerir que ocorre uma metabolização local de hormônios estrógenos e andrógenos no tecido vaginal o que podem estar relacionado com a proliferação celular, variação na vascularização e inervação e ruptura da membrana de oclusão vaginal. / To the metabolism of sex steroid hormones is essential the participation of esteroidogenic enzymes. The enzyme cytochrome P450c17 is responsible for androgen production; and the enzyme aromatase cytochrome P450 is responsible for estrogen production, however, both enzymes require forming a complex with an enzyme partner called NADPH cytochrome P450 reductase to perform the metabolism of these hormones, which are essential for sexual differentiation. This study aimed to immunolocalization of the three enzymes above mentioned in the vaginal tissue from female rodents Galea spixii. Therefore, the experiment was carried out using vaginal cytology techniques for definition of the estrous cycle phases, techniques for light microscopy, scanning electron and immunohistochemical tests for the detection of enzymes: cytochrome P450c17, cytochrome P450 aromatase, and NADPH cytochrome P450 reductase. It was found that the estrus cycle of Galea spixii female lasts 15.85 ± 1.4 days, with the formation and rupture of vaginal closure membrane during each oestrous cycle. The vagina has a hypertrophied clitoris with the urethral orifice that opens on top of it, and it is observed the absence of a vaginal vestibule. The vaginal mucosal epithelium undergoes proliferative changes, with thickening and thinning according to the respective estrous cycle phase. The enzymes cytochrome P450 aromatase and NADPH reductase are immunolocated throughout the oestrous cycle in the epithelium and connective tissue of the vagina from Galea spixii. On the other hand, the enzyme cytochrome P450c17 is immune located in the vaginal epithelium during all stages of the estrous cycle, except at estrous. With these data may be suggested that there is a local estrogens and androgens metabolism in vaginal tissue which may be associated with cell proliferation, vascularization and innervation variation besides the formation and rupture of the vaginal closure membrane.

Para a metabolização de hormônios esteroides sexuais é essencial a participação de enzimas esteroidogênicas. A enzima citocromo P450c17 é responsável pela produção de andrógenos e a enzima citocromo P450 aromatase é responsável pela produção de estrógenos, sendo que, ambas as enzimas necessitam formar um complexo com uma enzima parceira, denominada NADPH citocromo P450 redutase, para realizar a metabolização destes hormônios essenciais para a diferenciação sexual. Objetivou-se imunolocalisar as três enzimas acima citadas no tecido vaginal de fêmeas de roedores Galea spixii. Para tanto, o experimento foi desenvolvido utilizando técnicas de citologia esfoliativa vaginal para definição das fases do ciclo estral, técnicas de microscopia de Luz, Eletrônica de Varredura e testes de imunohistoquímica para detecção das enzimas: citocromo P450c17, citocromo P450 aromatase, e NADPH citocromo P450 redutase. Constatou-se no presente estudo que o ciclo estral das fêmeas de preás silvestres do semiárido apresenta ciclo estral com duração de 15,85 ± 1,4 dias, com a formação e ruptura da membrana de oclusão vaginal durante cada ciclo estral. A vagina apresenta um clitóris hipertrofiado com o óstio uretral que se abre no topo do mesmo, e ausência de um vestíbulo vaginal. O epitélio da mucosa vaginal sofre modificações proliferativas, se espessando e se adelgando de acordo com a respectiva fase do ciclo estral. As enzimas citocromo P450 aromatase e NADPH redutase estão imunolocalizadas durante todo o ciclo estral no epitélio e tecido conjuntivo da vagina de Galea spixii. Por outro lado, a enzima P450c17 está imunolocalizada no epitélio vaginal durante todas as fases do ciclo estral, porém não está presente no estro. Com estes dados pode-se sugerir que ocorre uma metabolização local de hormônios estrógenos e andrógenos no tecido vaginal o que podem estar relacionado com a proliferação celular, variação na vascularização e inervação e ruptura da membrana de oclusão vaginal. / To the metabolism of sex steroid hormones is essential the participation of esteroidogenic enzymes. The enzyme cytochrome P450c17 is responsible for androgen production; and the enzyme aromatase cytochrome P450 is responsible for estrogen production, however, both enzymes require forming a complex with an enzyme partner called NADPH cytochrome P450 reductase to perform the metabolism of these hormones, which are essential for sexual differentiation. This study aimed to immunolocalization of the three enzymes above mentioned in the vaginal tissue from female rodents Galea spixii. Therefore, the experiment was carried out using vaginal cytology techniques for definition of the estrous cycle phases, techniques for light microscopy, scanning electron and immunohistochemical tests for the detection of enzymes: cytochrome P450c17, cytochrome P450 aromatase, and NADPH cytochrome P450 reductase. It was found that the estrus cycle of Galea spixii female lasts 15.85 ± 1.4 days, with the formation and rupture of vaginal closure membrane during each oestrous cycle. The vagina has a hypertrophied clitoris with the urethral orifice that opens on top of it, and it is observed the absence of a vaginal vestibule. The vaginal mucosal epithelium undergoes proliferative changes, with thickening and thinning according to the respective estrous cycle phase. The enzymes cytochrome P450 aromatase and NADPH reductase are immunolocated throughout the oestrous cycle in the epithelium and connective tissue of the vagina from Galea spixii. On the other hand, the enzyme cytochrome P450c17 is immune located in the vaginal epithelium during all stages of the estrous cycle, except at estrous. With these data may be suggested that there is a local estrogens and androgens metabolism in vaginal tissue which may be associated with cell proliferation, vascularization and innervation variation besides the formation and rupture of the vaginal closure membrane.

Thesis (MMedSc )--University of Stellenbosch, 2011. / ENGLISH ABSTRACT: The present study investigated in particularly the specific nature of the supporting stromal layer located between the implanted human cyst and host murine tissue, which has yet to be reported. During an initial phase of this study, the particular light microscopic properties of the existing hematoxylin and eosin (H&E) stained experimental cyst was investigated, with regards to the presence or absence of specific morphological features, namely spongiosis, exocytosis, epithelial keratinization, epithelial thickness and hyperplasia, and the vascularity and fibrosis present in the stroma of these experimental sections. Subsequent analysis reported significant spongiosis, in addition to increased exocytosis of immune cells and epithelial keratinization in a number of cysts. Additionally, increased epithelial thickness and hyperplasia was reported in only 2 / 10 experimental tissues, whereas increased vascularity was observed in the stroma following analysis of H&E and Special staining, such as Verhoeff-von Gieson and Masson trichrome results. During the second phase of the study, immunohistochemical analysis with a particularly wide array of antibodies raised against specific human and mouse antigens had been applied. This involved automated immunohistochemical staining with mouse anti-human primary antibodies, in addition to manual staining with rabbit anti-mouse primary antibodies. Subsequent visualization was achieved by means of linking to biotinylated secondary antibodies, and Streptavidin-HRP incubation for standard visualization, followed by counterstaining with Hematoxylin. Maintained positive expression of cytokeratins 5, 13, and 14 was demonstrated in both control human vaginal mucosa and experimental cysts, whereas similar findings were not reported for cytokeratin 1, given the vast keratinization which was observed. Human collagen type IV and laminin of the basement membrane reported positive expression in 9 / 10 and 6 / 10 control human vaginal mucosa tissues respectively. In comparison, negative mouse collagen type IV and laminin was reported in most experimental cysts compared to positive staining in positive control mouse tissues. Immunohistochemical staining for human elastin, fibronectin, von Willebrand factor, and fibroblasts revealed maintained positive staining in all control human vaginal mucosa and experimental cysts. However, maintained expression of CD34 (endothelial marker), CD1a (langerhans cells), and human VEGFR-3 in experimental cysts was not demonstrated, compared to positive expression in control human vaginal mucosa. Subsequent analysis of murine antigens illustrated uniformly negative staining for mouse fibronectin, langerhans cells (CD207), and fibroblasts, in addition to negative staining in positive control mouse tissue sections. Furthermore, negative staining for mouse VEGFR-2 was reported in all experimental cysts; however strong positive staining of this marker in mouse kidney tissue had been reported. The findings of this study suggested that the exact nature of the stromal layer is of both human and murine origin. Furthermore, the tissue region located beneath the human vaginal epithelium is suggested to be of human nature, whereas the second distinct region located at the periphery of experimental cyst tissues, is suggested to be murine origin; however the findings of immunohistochemical analysis could not illustrate definitively the exact nature of the intermediate stromal layer, but could in fact demonstrate a mixture of human and murine tissue. / AFRIKAANSE OPSOMMING: Die huidige studie het die spesifieke molekulêre en histologiese eienskappe van die stromale laag geleë tussen menslike sist- en muis velweefsel bestudeer, wat tans nog nie bekend is nie. Gedurende die eerste fase van hierdie studie is die besondere lig-mikroskopiese eienskappe van die bestaande hematoksilien en eosien (H&E) eksperimentele siste bestudeer, met betrekking tot die aan- of afwesigheid van spesifieke morfologiese eienskappe, naamlik spongiose, eksositose van immuunselle, epiteel keratinisasie, epiteel dikte en hiperplasie, en laastens die stromale vaskulariteit en fibrose. Gevolglike analise het daarop gedui dat beduidende spongiose, eksositose en epiteel keratinisasie gevind word in die eksperimentele siste in vergelyking met kontrole vaginal weefsel. Hierteenoor is die verdikking van die epiteel en hiperplasie in slegs 2 / 10 eksperimentele siste gevind, terwyl vermeerderde vaskulariteit aangedui is na gevolglike H&E en spesiale (soos byvoorbeeld Verhoeff-von Gieson en Masson trichrome) kleuringsresultate. Die tweede fase van die studie het die immunokleuring met verskeie mens- en muis spesifieke antiliggame behels, waarby die uitdrukking van verskeie mens antigene vergelyk is met dié van muis. As sulks is ge-automatiseerde immunohistochemie toegepas met muis primêre antiliggame, tesame met fisiese kleuring met konyn primêre antiliggame toegepas. Gevolglike visualisasie is aangedui deur middel van binding met sekondêre antiliggaam en Streptavidin- HRP, gevolg deur teenkleuring met Hematoksilien. Algehele behoud van positiewe uitdrukking van sitokeratien 5, 13, en 14 is bevind, terwyl sitokeratien 1 uitdrukking nie daarwerklik vergelykbaar is met dié van kontrole mens vaginale weefsel nie. Die uitdrukking van mens kollageen IV en laminien van die basaal membraan is verder bestudeer, en het egter positiewe kleuring in 9 / 10 en 6 / 10 van kontrole mens vaginale mukosa aangedui. In vergelykking hiermee kon die huidige bevindings egter net positiewe kleuring in 4 / 10 en 3 / 10 eksperimentele siste vir kollageen IV en laminien onderskeidelik, illustreer. Immunohistochemiese analise van menslike elastien, fibronektien, von Willebrand (vW) faktor en fibroblaste het op deurgaans positiewe uitdrukking van hierdie merkers aangedui in beide eksperimentele en kontrole menslike weefsel. In teenstelling hiermee is volgehoue uitdrukking van CD34 (endoteel merker), CD1a (Langerhans sel merker) en mens VEGFR-3 in ekperimentele siste egter nie illustreerbaar nie, in vergelykking met deurgaans positiewe uitdrukking van hierdie antigene in kontrole mens vaginale mukosa. In opvolging is deurgaans negatiewe uitdrukking van muis fibronektien, langerhans sel (CD207) en fibroblaste bevestig, terwyl negatiewe kleuring ook deurgaans in positiwe kontrole muis weefsel, bekom deur die disseksie van ‘n naakte muis, gevind is. Verder is ook negatiewe kleuring vir VEGFR-2 in alle eksperimentele siste gevind, terwyl egter sterk positiewe kleuring in muis nierweefsel as positiewe weefsel gevind is. Die resultate van die huidige studie het daarop gedui dat die stromale laag onderliggend tot mens vaginale epiteel van menslike oorsprong is, terwyl die periferale stroma onderliggend tot muis velweefsel, ongetwyfeld van muis oorsprong is. Laastens kon die spesifieke oorsprong van die tussenliggende stroma nie aangedui word nie, maar dat dit moontlik uit beide menslike- en muisweefsel bestaan.

L’avènement des multi-thérapies antirétrovirales a permis une réduction importante de la mortalité associée au VIH en induisant notamment la chute de la charge virale à moins de 50 copies/mL et une récupération progressive du nombre de lymphocytes T CD4+ (LT-CD4). Cependant, certains patients définis comme mauvais répondeurs immunologiques (MRI) ne parviennent pas à récupérer un taux de CD4 généralement considéré comme « protecteur » (>500cellules/µL). L’interleukine-7 (IL-7), cytokine essentielle à la thymopoïèse et à l’homéostasie lymphocytaire T, a été utilisée en étude clinique afin de restaurer et maintenir le taux de LT-CD4 chez les patients MRI. La première partie de mon travail de thèse visait à évaluer l’impact d’une telle thérapie sur le réservoir viral circulant. Dans l’essai clinique sur lequel nous avons travaillé (INSPIRE 3, Cytheris), des cycles d’administration d’IL-7 ont induit une augmentation significative du nombre de LT-CD4 et CD8 circulants, avec une expansion majoritaire des populations naïves et centrales mémoires. Nous avons montré qu’un cycle d’injections d’IL-7 induisait une augmentation significative de la quantité de cellules infectées circulantes 28 jours et 3 mois post-injection. Cependant, malgré l’accroissement de la fréquence de LT-CD4 infectés 28 jours post-injection, nous avons observé une diminution significative de la charge virale ADN par million de LT-CD4 chez la majorité des patients 3 mois après l’initiation de la thérapie, suggérant une élimination partielle de cellules infectées. Suite au second cycle d’injections, nous n’avons pas observé d’évolution de la quantité de cellules infectées circulantes ni de la fréquence de LT-CD4 infectés, suggérant un impact différent des 2 cycles d’injections sur la dynamique du réservoir viral périphérique. Enfin, certains patients ayant développé des anticorps neutralisants anti-IL-7 (Nab) suite au second cycle d’injections d’IL-7, nous avons cherché à identifier des facteurs prédictifs de l’apparition de ces anticorps ainsi que leurs conséquences physiologiques in vivo. Le seul paramètre caractérisant ces patients est l’amplitude de la reconstitution T-CD4 au cours du premier cycle d’injections d’IL-7. Il semble donc qu’une meilleure réponse à l’IL-7 ait pour conséquence de faciliter le développement de la réponse immune contre cette cytokine. Cependant, ces anticorps ne sont détectables que de façon transitoire chez les patients. De plus, nous avons observé une diminution significative, mais transitoire, de la prolifération des thymocytes chez les patients présentant des Nab, démontrant un impact fonctionnel de ces anticorps sur l’activité biologique de l’IL-7 endogène. L’injection systémique d’IL-7 induit la migration des cellules circulantes vers différents compartiments tissulaires lymphoïdes et non lymphoïdes. Dans une seconde partie de mon travail de thèse, j’ai étudié le pouvoir adjuvant de cette cytokine administrée localement par pulvérisation à la surface de la muqueuse vaginale. Dans le modèle macaque rhésus, nous avons mis en évidence une augmentation de la production d’un large spectre de chimiokines dans le chorion et l’épithélium vaginal des animaux 48 heures après l’administration vaginale d’IL-7. Cette surexpression de chimiokines s’accompagne d’une migration massive de LT-CD4, CD8, macrophages, cellules dendritiques et cellules NK dans cette muqueuse, suggérant l’augmentation de la vigilance immunologique. L’effet adjuvant de cette cytokine a été confirmé par l’analyse de la réponse humorale muqueuse de macaques vaccinés par pulvérisation vaginale d’antigènes 48h après l’administration du spray d’IL-7. Dans les lavages cervicovaginaux (CVL) des animaux traités à l’IL-7, nous avons mis en évidence des réponses spécifiques de type IgA et IgG plus rapides, plus fortes et plus durables que chez les animaux contrôles, démontrant la capacité de l’IL-7 à préparer la muqueuse vaginale à répondre à une stimulation antigénique locale. / Highly Active Antiretroviral Therapy (HAART) has led to significant reduction of HIV-associated mortality by maintaining an undetectable viral load and inducing progressive CD4-T cell restoration. However, some patients, defined as poor immunological responders (PIR), fail to restore their CD4 counts to 500cells/µL during treatment, a threshold considered as the protective against AIDS related or non AIDS related malignancies, opportunistic infections and cardiovascular events. Interleukin-7 (IL-7), an essential cytokine for thymopoïesis and T cell homeostasis has been used in clinical trials aimed at restoring and maintaining CD4 counts in PIR patients. The first part of my thesis project aimed at assessing the impact of IL-7 therapy on circulating HIV reservoir. In the clinical study we worked on (INSPIRE 3, Cytheris), cycles of IL-7 injections led to a significant increase of the number of circulating CD4 and CD8 T-cells, with a predominance of naïve and central memory T cell expansion. We have shown that one cycle of IL-7 injections induced a significant increase in the number of circulating infected cells 28 days and 3 months post-injections. However, despite a significant increase in the frequency of infected CD4 T-cells 28 days post-injections, we observed a significant decrease of HIV-DNA load in CD4 T-cells in the majority of patients 3 months after the therapy initiation. These data suggest a partial elimination of HIV infected cells. After the second cycle of IL-7 injections, we did not observed any change in the number or frequency of circulating infected cells, suggesting a differential impact of the two IL-7 injection cycles on the dynamics of circulating HIV-reservoir. Finally, considering that some patients developed anti-IL-7 neutralizing antibodies (Nab) after the second cycle of IL-7 injections, we looked for predictive factors of this immunogenicity and analyzed its physiological consequences in vivo. The only parameter that distinguished Nab and non-Nab patients was the extent of CD4 T-cell reconstitution during the first cycle of therapy. This suggests that a better response to IL-7 also facilitates the development of auto-antibodies to the cytokine. However, these antibodies were only transiently detectable after the second cycle of therapy. Moreover, the appearance of Nab was associated with a significant but transient decrease of thymocyte proliferation, suggesting a functional impact of these antibodies on the endogenous IL-7 function. Systemic injection of IL-7 induces circulating T cells homing from the blood into lymphoid and non-lymphoid tissues. In the second part of my thesis project, I evaluated whether this cytokine could be used as an adjuvant when sprayed on the vaginal mucosa. Ten micrograms of IL-7 directly sprayed in the vaginal tract of rhesus monkeys induced, 48h after administration, the production of a large pattern of chemokines in the vaginal chorion and epithelium. This chemokine expression was accompanied by massive homing of CD4 and CD8-T cells, macrophages, dendritic cells and NK cells in the vaginal mucosa, suggesting an increased immunological vigilance. Finally, the adjuvant potential of this cytokine was confirmed by analyzing local humoral immune response after vaginal administration of antigens 48h following IL-7 spray. In cervicovaginal washes (CVL) of treated animals, we observed a faster, stronger and longer-lasting specific IgA and IgG response than in control animals, highlighting the capacity of IL-7 to prepare the vaginal mucosa response to local antigen stimulation.

Este estudo caracterizou e relacionou as leveduras do gênero Candida isoladas das mucosas oral e vaginal de mulheres com lesões causadas por HPV de alto risco para câncer do colo do útero. Foram examinadas 42 mulheres tratadas no ambulatório de Patologia do Trato Genital Inferior do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo sendo, 30 com lesões uterinas de alto grau (G1) com média de idade de 36,5 anos ± 11,1 e 12 com lesões uterinas de baixo grau (G2) com média de idade de 34,75 anos ± 15,5. Condições clínicas e dados laboratoriais sobre HPV foram coletados do prontuário médico das pacientes; os dados sócio-demográficos obtidos a partir de um questionário apropriado. Para o estudo de associação entre as variáveis foi utilizada a análise de razão de chance (Odds Ratio) a partir do programa STATA 13.1. Foram identificadas associação entre lesões uterinas de baixo grau com cultura positiva em mucosa oral (OR= 0,215) e com presença de doenças crônicas (OR = 0,167), sendo que pacientes com lesões uterinas de alto grau possuem maior prevalência para diabetes e os resultados indicaram 23% de prevalência de Candida spp. em mucosa oral e 27% em mucosa vaginal, em pacientes do G1,no G2 foi de 42% em mucosa oral e de 33% em mucosa vaginal. Entre as espécies encontradas em mucosa oral e vaginal das pacientes, Candida albicans foi a mais isolada com 88%, seguida de C. tropicalis (8%)e C. glabrata (4%). As cepas de C. albicans isoladas de ambas as mucosas apresentaram sensibilidade a todos os antifúngicos testados, ao contrário da cepa de C. tropicalis isolada no Grupo 2, em mucosa vaginal, que apresentou um perfil de resistência ao fluconazol. Assim, torna-se importante o acompanhamento e supervisão por meio de exames clínicos e laboratoriais das pacientes com HPV, reforçando a necessidade sobre cuidados, tratamento e prevenção de infecções relacionadas ao HPV e a Candida spp. / This study characterized and related yeasts of the genus Candida isolated from the oral and vaginal mucous membranes of women with lesions caused by high-risk HPV for cervical cancer. Forty-two women treated at the Lower Genital Tract Pathology Clinic of the University of São Paulo Medical School\'s Hospital of Clinics were examined, with 30 high-grade (G1) uterine lesions with a mean age of 36.5 years ± 11, 1 and 12 with low grade (G2) uterine lesions with a mean age of 34.75 years ± 15.5. Clinical conditions and laboratory data on HPV were collected from patients\' medical records; the socio-demographic data obtained from an appropriate questionnaire. For the study of association between the variables, Odds Ratio analysis was used from the STATA 13.1 program. An association between low grade uterine lesions with positive culture in oral mucosa (OR = 0.215) and presence of chronic diseases (OR = 0.167) was identified. Patients with high grade uterine lesions had a higher prevalence for diabetes and the results indicated 23% prevalence of Candida spp. In oral mucosa and 27% in vaginal mucosa, in G1 patients, in G2 it was 42% in oral mucosa and 33% in vaginal mucosa. Among the species found in oral and vaginal mucosa of patients, Candida albicans was the most isolated with 88%, followed by C. tropicalis (8%) and C. glabrata (4%). The strains of C. albicans isolated from both mucosa presented sensitivity to all tested antifungal agents, unlike the C. tropicalis strain isolated in Group 2, in vaginal mucosa, which presented a resistance profile to fluconazole. Thus, monitoring and supervision through clinical and laboratory testing of HPV patients is important, reinforcing the need for care, treatment and prevention of HPV-related infections and Candida spp.

Este estudo caracterizou e relacionou as leveduras do gênero Candida isoladas das mucosas oral e vaginal de mulheres com lesões causadas por HPV de alto risco para câncer do colo do útero. Foram examinadas 42 mulheres tratadas no ambulatório de Patologia do Trato Genital Inferior do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo sendo, 30 com lesões uterinas de alto grau (G1) com média de idade de 36,5 anos ± 11,1 e 12 com lesões uterinas de baixo grau (G2) com média de idade de 34,75 anos ± 15,5. Condições clínicas e dados laboratoriais sobre HPV foram coletados do prontuário médico das pacientes; os dados sócio-demográficos obtidos a partir de um questionário apropriado. Para o estudo de associação entre as variáveis foi utilizada a análise de razão de chance (Odds Ratio) a partir do programa STATA 13.1. Foram identificadas associação entre lesões uterinas de baixo grau com cultura positiva em mucosa oral (OR= 0,215) e com presença de doenças crônicas (OR = 0,167), sendo que pacientes com lesões uterinas de alto grau possuem maior prevalência para diabetes e os resultados indicaram 23% de prevalência de Candida spp. em mucosa oral e 27% em mucosa vaginal, em pacientes do G1,no G2 foi de 42% em mucosa oral e de 33% em mucosa vaginal. Entre as espécies encontradas em mucosa oral e vaginal das pacientes, Candida albicans foi a mais isolada com 88%, seguida de C. tropicalis (8%)e C. glabrata (4%). As cepas de C. albicans isoladas de ambas as mucosas apresentaram sensibilidade a todos os antifúngicos testados, ao contrário da cepa de C. tropicalis isolada no Grupo 2, em mucosa vaginal, que apresentou um perfil de resistência ao fluconazol. Assim, torna-se importante o acompanhamento e supervisão por meio de exames clínicos e laboratoriais das pacientes com HPV, reforçando a necessidade sobre cuidados, tratamento e prevenção de infecções relacionadas ao HPV e a Candida spp. / This study characterized and related yeasts of the genus Candida isolated from the oral and vaginal mucous membranes of women with lesions caused by high-risk HPV for cervical cancer. Forty-two women treated at the Lower Genital Tract Pathology Clinic of the University of São Paulo Medical School\'s Hospital of Clinics were examined, with 30 high-grade (G1) uterine lesions with a mean age of 36.5 years ± 11, 1 and 12 with low grade (G2) uterine lesions with a mean age of 34.75 years ± 15.5. Clinical conditions and laboratory data on HPV were collected from patients\' medical records; the socio-demographic data obtained from an appropriate questionnaire. For the study of association between the variables, Odds Ratio analysis was used from the STATA 13.1 program. An association between low grade uterine lesions with positive culture in oral mucosa (OR = 0.215) and presence of chronic diseases (OR = 0.167) was identified. Patients with high grade uterine lesions had a higher prevalence for diabetes and the results indicated 23% prevalence of Candida spp. In oral mucosa and 27% in vaginal mucosa, in G1 patients, in G2 it was 42% in oral mucosa and 33% in vaginal mucosa. Among the species found in oral and vaginal mucosa of patients, Candida albicans was the most isolated with 88%, followed by C. tropicalis (8%) and C. glabrata (4%). The strains of C. albicans isolated from both mucosa presented sensitivity to all tested antifungal agents, unlike the C. tropicalis strain isolated in Group 2, in vaginal mucosa, which presented a resistance profile to fluconazole. Thus, monitoring and supervision through clinical and laboratory testing of HPV patients is important, reinforcing the need for care, treatment and prevention of HPV-related infections and Candida spp.