medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2024-398medsovet-8659Research ArticleИНФЕКЦИИINFECTIONSДоказательная медицина: индол-3-карбинол и ресвератрол при состояниях, ассоциированных с вирусом папилломы человекаEvidence-based medicine: Indole-3-carbinol and resveratrol in human papillomavirus-associated conditionshttps://orcid.org/0000-0001-8885-1587ЕньковаЕ. В.EnkovaE. V.

Енькова Елена Владимировна, д.м.н., профессор кафедры акушерства и гинекологии №2

394036, Воронеж, ул. Студенческая, д. 10

Elena V. Enkova, Dr. Sci. (Med.), Professor of the Department of Obstetrics and Gynecology No. 2

10, Studencheskaya St., Voronezh, 394036

enkova@bk.ruhttps://orcid.org/0000-0003-4199-8156ХоперскаяО. В.KhoperskayaO. V.

Хоперская Ольга Викторовна, к.м.н., доцент кафедры акушерства и гинекологии №2

394036, Воронеж, ул. Студенческая, д. 10

Olga V. Khoperskaya, Cand. Sci. (Med.), Associate Professor of the Department of Obstetrics and Gynecology No. 2

10, Studencheskaya St., Voronezh, 394036

khoperskaya88@bk.ruhttps://orcid.org/0000-0002-9259-180XШамаринС. В.ShamarinS. V.

Шамарин Станислав Вячеславович, к.м.н., доцент кафедры акушерства и гинекологии №2

394036, Воронеж, ул. Студенческая, д. 10

Stanislav V. Shamarin, Cand. Sci. (Med.), Associate Professor of the Department of Obstetrics and Gynecology No. 2

10, Studencheskaya St., Voronezh, 394036

shamarin-med@yandex.ruhttps://orcid.org/0000-0002-3383-5755ЕньковаВ. В.EnkovaV. V.

Енькова Валерия Вадимовна, к.м.н., доцент кафедры акушерства и гинекологии №2

394036, Воронеж, ул. Студенческая, д. 10

Valeria V. Enkova, Cand. Sci. (Med.), Associate Professor of the Department of Obstetrics and Gynecology No. 2

10, Studencheskaya St., Voronezh, 394036

enkova_lera@mail.ruhttps://orcid.org/0009-0008-4033-516XАсеевА. В.AseevA. V.

Асеев Александр Вадимович, студент лечебного факультета

394036, Воронеж, ул. Студенческая, д. 10

Alexandr V. Aseev, Student of the Faculty of Medicine

10, Studencheskaya St., Voronezh, 394036

al-aseev@mail.ruВоронежский государственный медицинский университет им. Н.Н. БурденкоРоссияVoronezh State Medical University named after N.N. BurdenkoRussian Federation2024071120240177481Copyright © Енькова Е.В., Хоперская О.В., Шамарин С.В., Енькова В.В., Асеев А.В., 20242024Енькова Е.В., Хоперская О.В., Шамарин С.В., Енькова В.В., Асеев А.В.Enkova E.V., Khoperskaya O.V., Shamarin S.V., Enkova V.V., Aseev A.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/8659

Из всех видов рака женской репродуктивной системы рак шейки матки имеет наибольшее социальное значение ввиду того, что поражает молодых пациенток, часто даже еще не выполнивших репродуктивную функцию, и является третьей по значимости причиной смерти от рака. Учитывая отсутствие этиотропной терапии вируса папилломы человека и ассоциированных с вирусом заболеваний, высокоэффективных методов медикаментозной терапевтической поддержки и золотого стандарта лечения, кроме деструктивных и эксцизионных методов, представляется целесообразным рассмотреть применение нутриентов, обладающих антиканцерогенным действием при лечении цервикальных интраэпителиальных неоплазий легкой степени как в дополнение к выжидательной тактике, так и при применении аблативных методов лечения, а также их адъювантное назначение при облигатном предраке. На основании отечественных и зарубежных литературных источников из электронных баз PubMed, CyberLeninka, Elibrary в обзоре представлены данные о применении транс-ресвератрола и индол-3-карбинола при ассоциированных с вирусом папилломы человека заболеваниях. Комбинация из двух взаимно дополняющих антиканцерогенных антиоксидантов – индол-3-карбинола, обладающего преимущественно антипролиферативным действием, и транс-ресвератрола, восстанавливающего клеточные механизмы апоптоза, – комплексно воздействует на патогенетические механизмы вирус-индуцированного патологического процесса: доказанно снижает экспрессию онкогенов Е6 и Е7, повышает экспрессию белков – супрессоров опухолей p53, pRb, PTEN и снижает – маркеров пролиферации PCNA и Ki-67. Комбинация 200 мг индол-3-карбинола и 60 мг транс-ресвератрола для профилактики персистенции папилломавирусной инфекции и лечения цервикальных интраэпителиальных неоплазий обладает впечатляющим потенциалом, однако необходимы дальнейшие исследования для подбора наиболее эффективных схем применения.

Of all types of cancer in the female reproductive system, cervical cancer has the greatest social significance due to its impact on young patients, often even those who have not yet completed their reproductive function, and it is the third leading cause of cancer-related death. Considering the lack of etiological therapy for human papillomavirus and associated diseases, the high demand for effective methods of medical therapeutic support, and the absence of a gold standard treatment apart from destructive and excisional methods, it seems reasonable to consider the use of nutrients with anticancer effects in the treatment of low-grade cervical intraepithelial neoplasia both as an addition to the watchful waiting strategy and in the use of ablative treatment methods, as well as their adjuvant appointment in the case of obligatory precancer. Based on domestic and foreign literature sources from electronic databases such as PubMed, CyberLeninka, and Elibrary, this review presents data on the use of trans-resveratrol and indole-3-carbinol in HPV-associated diseases. The combination of two mutually complementary anticancer antioxidants – indole-3-carbinol, which primarily has antiproliferative effects, and trans-resveratrol, which restores cellular apoptosis mechanisms, comprehensively affects the pathogenetic mechanisms of the virus-induced pathological process: it has been proven to reduce the expression of oncogenes E6 and E7, increase the expression of tumor suppressor proteins – p53, pRb, PTEN, and decrease markers of proliferation PCNA and Ki-67. The combination of 200 mg of indole-3-carbinol and 60 mg of trans-resveratrol for the prevention of persistent papillomavirus infection and the treatment of cervical intraepithelial neoplasia has impressive potential; however, further research is needed to determine the most effective application schemes.

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The authors declare that there are no conflicts of interest present.