Project 1: Infection and Inflammation
Group Leader: Jorma Paavonen, MD
Chlamydia Research Group (ChlRG)is focusing on the immunopathogenesis of C.trachomatis (CT) infection, specifically the cell mediated immune (CMI) response to chlamydial antigens linked to subfertility and tubal factor infertility (TFI). Individual genetic variation in the host immune response explains to a large extent the enormous morbidity caused by CT. For instance, we have shown that TFI prediction model can be much improved by combining 4 distinct markers of humoral and CMI response to key chlamydial antigens.
Human Papillomavirus Research Group (HPVRG)is focusing on eradication of high risk HPV infections and associated cervical neoplasia by vaccination.HPV VLP vaccines have shown striking effectiveness against persistent HPV infection and high grade cervical, vulvar, and vaginal intraepithelial neoplasia (CIN2/3, VIN 2/3, VaIN 2/3) and adenocarcinoma in situ (AIS). HPVRG plays a major role in the ongoing international Phase III vaccination trials because of the nationwide trial infrastructure and strikingly successful population based recruitement strategy and exceptionally high compliance rate. We have enrolled a total of 7,000 16-17 year old adolescents representing >20% of the overall worldwide recruitment. The projects have produced a large number of publications in high impact journals (NEJM, Lancet, Lancet oncoloy, BMJ, JNCI, JID and others).
Preterm Birth Research Group (PTBRG)is focusing on the development of new biomarkers for better prediction of idiopathic preterm birth. We have defined bacterial vaginosis (BV) and periodontal disease as risk factors or risk markers for preterm birth. Insulin-like growth factor binding protein-1 (IGFBP-I, a decidual protein) in the cervix has been proven as a sensitive and specific marker of decidual damage. Matrix metalloproteinase-8 (MMP-8) is another biomarker of interest by our group.
Abnormal Placentation Research Group is performing population-based registry linkage studies to estimate the total disease burden associated with this increasingly common ombstetric catastrophe..
HIV infection has shifted to women and more attention is directed to HIV in women. HIV in women Research Group showed already that multidisciplinary approach is highly effective in the management of pregnancy and delivery among HIV-positive women allowing conservative obstetrical management in most cases . We showed that young age, low CD4-cell count, and high HI-viral load are risk factors for the development of CIN. Recently, we demonstrated that progestin releasing intrauterine system (LNG-IUS) is safe for contraception among HIV-positive women and provides additional health benefits. Research addressing women-specific topics such as effect of sexual hormones on HIV transmission and disease progression, and women-spesific prevention interventions is ongoing.
Prevention of Cervical Cancer Research Group (Chief Investigator Pekka Nieminen, MD) is focusing on randomised evaluation of new screening techniques, long term effects of treatment of precancerous lesions, and development of new prognostic biomarkers. The research group is systematically evaluating and implementing new cervical cancer screening methods, and performing registry based evaluation of long-term adverse reproductive health effects associated with the surgical management of premalignant cervical disease. The latter is largely ignored, but an important research field since the target population consists of young women. The group is performing a large randomised controlled trial (>1 million women) on automation assisted cytological screening and primary HPV DNA screening. This study is the first using cervical cancer incidence trend as the primary endpoint. The group has also demonstrated that the risk of cancer remains increased up to for 20 years after treatment of CIN. These results have been instrumental in the development of national and European Guidelines for Cervical Cancer Screening.
Recent publications related to the project: Jorma Paavonen
Page updated 20 October, 2011