Impact of Autoimmune Diseases on Cervical Intraepithelial Neoplasia Risk

The article presents an analysis of scientific studies investigating the effect of autoimmune diseases (AIDs) on the risk of developing cervical intraepithelial lesions, including cervical cancer. 458 scientific publications in foreign and domestic search engines PubMed, Cochrane, and Elibrary were analyzed by keywords and their combinations: "cervical cancer", "autoimmune diseases", "immunosuppressive therapy", "cervical intraepithelial neoplasia", "risk of developing cervical cancer". The final review included 28 articles. The qualitative analysis allowed us to form an idea of the effect of AIDs on the development of intraepithelial neoplastic changes in cervical cancer (CC), in the pathogenesis of which an important place is occupied by the chronic inflammatory process – there is activation of signaling pathways, including NF-kB, JAK-STAT, MAPK and TLR. These agents induce the production of various proinflammatory, tissue-damaging factors, such as cytokines, chemokines, and metalloproteinases. In addition, both in AID and in CC, activated inflammasomes and the signaling pathway of the GMP-AMP interferon synthase stimulating gene (cGAS-STING) are involved in the development of chronic inflammation. It is noted that the C5aR system is associated with carcinogenesis activity and the recruitment of myeloid suppressor cells MDSC, which suppress the antitumor immune response. The presence of immunosuppressive therapy (mainly the use of azathioprine) plays an important role in the progression of intraepithelial changes in the cervix. Several studies present data on the positive effect of vaccination against human papillomavirus (HPV) in patients with systemic lupus erythematosus, while it is recommended to vaccinate against HPV regardless of the presence or absence of this virus in anamnesis. Along with the literature review, the article presents a clinical case of intraepithelial cervical lesion in a patient with systemic lupus erythematosus. Therefore, immunological changes in AIDs in combination with immunosuppressive therapy can contribute to the progression of carcinogenesis. At the same time, it should be noted that when studying this topic, controversial issues remain, which require further development of this problem.