Cervical cancer remains a significant public health challenge, disproportionately affecting women in low- and middle-income countries (LMICs). Persistent infection with high-risk types of human papillomavirus (HPV), particularly HPV16 and HPV18, is the central cause of cervical carcinogenesis, driven by the viral oncoproteins E6 and E7, which disrupt the host tumor suppressors p53 and retinoblastoma protein (pRb). Advances in molecular understanding have catalyzed effective primary and secondary prevention strategies. Prophylactic HPV vaccination, especially the nonavalent formulation, has demonstrated high efficacy in reducing HPV infections and cervical precancer. Concurrently, HPV deoxyribonucleic acid (DNA) testing, self-sampling, and screen-and-treat protocols are transforming screening paradigms, particularly in resource-limited settings. However, global disparities in vaccine access, screening coverage, and health infrastructure persist, impeding progress toward the World Health Organization’s (WHO) 90–70–90 elimination targets. By synthesizing recent advances in virology, prevention strategies, and implementation innovations, such as therapeutic vaccines, artificial-intelligence (AI)-driven diagnostics, and mobile health solutions, this review sheds light on their potential to narrow these equity gaps.
Oxidative stress, defined as the imbalance between reactive oxygen species (ROS) and antioxidant defenses, plays a pivotal role in the pathogenesis of several pregnancy complications, notably preeclampsia (PE), gestational diabetes mellitus (GDM), fetal growth restriction (FGR), and recurrent pregnancy loss (RPL). During normal pregnancy, low to moderate ROS levels support essential placental functions such as angiogenesis and trophoblast differentiation. However, excessive ROS production overwhelms antioxidant systems, leading to lipid peroxidation, protein and DNA damage, and impaired placental function. This review synthesizes current evidence linking oxidative stress to adverse pregnancy outcomes, highlighting key biomarkers such as malondialdehyde (MDA), 8-hydroxy-2′-deoxyguanosine (8-OHdG), and 8-iso-prostaglandin F2α (8-iso-PGF2α). While antioxidant therapies—particularly vitamins C and E, selenium, and folic acid—have shown promise in reducing oxidative markers, their impact on clinical outcomes remains inconsistent. The variability in results underscores the need for standardized biomarker protocols and personalized treatment strategies based on genetic predispositions and baseline oxidative status. Future research may better harness antioxidant interventions to improve maternal–fetal health by addressing these gaps.
Background/Objectives: Type 2 diabetes mellitus (T2DM), is a rapidly growing global health concern, often accompanied by chronic kidney disease (CKD) and metabolic disturbances. Obesity-related indices, such as the visceral adiposity index (VAI) and body adiposity index (BAI), have been linked to cardiovascular and renal complications in diabetic patients. However, studies integrating both the atherogenic coefficient (AC) and prognostic nutritional index (PNI) for evaluating diabetic nephropathy (DN) remain limited. This study aimed to assess the associations of obesity-related indices with immunological and nutritional factors in patients with T2DM and prediabetes (PreDM). Methods: A retrospective, cross-sectional study was conducted over six months at a university clinical hospital in Dolj County, Romania. The study enrolled 268 newly diagnosed T2DM patients and 150 PreDM patients. Anthropometric parameters, laboratory tests, and demographic data were collected. AC and PNI were calculated using standard formulas, and statistical analyses were performed to determine their associations with metabolic and inflammatory markers. Results: Our study found that T2DM patients had significantly lower PNI values, indicating mild malnutrition, while PreDM patients maintained a normal nutritional status. AC was significantly higher in T2DM patients, correlating with lipid profile alterations and systemic inflammation. Obesity indices, particularly VAI, were significantly elevated in T2DM patients with higher AC values. Statistically significant differences in total cholesterol, low-density lipoprotein cholesterol (LDL-c), and triglycerides were observed between AC subgroups, reinforcing its role in cardiovascular risk assessment. Conclusions: The findings highlight the potential of AC and PNI as biomarkers for assessing nutritional, inflammatory, and lipemic status in diabetic patients. The significant associations between obesity-related indices, lipid profiles, and inflammation markers suggest that early assessment of these parameters may potentially aid in predicting diabetic complications. Further studies are needed to explore the clinical utility of AC and PNI in managing T2DM and CKD progression. Future research should investigate how the lipidic spectrum alters the progression of DN across various patient groups with diabetes and prediabetes
Gestational diabetes mellitus (GDM) is one of the most common metabolic complications during pregnancy, affecting up to 14% of pregnancies globally. GDM is characterized by glucose intolerance that arises or is first identified during pregnancy and is linked to significant short- and long-term adverse outcomes for both mothers and their offspring. The pathophysiology of GDM involves more than maternal insulin resistance and β-cell dysfunction. It is influenced by complex interactions among placental hormones, adipokines, inflammatory mediators, and oxidative stress pathways. Additionally, placental-derived exosomes and metabolomic signatures have emerged as promising biomarkers for early prediction and monitoring of the disease. Despite advancements in clinical diagnosis and management, including lifestyle interventions and pharmacological treatments, current strategies are still inadequate to prevent complications for both mothers and newborns entirely. Recent molecular insights into GDM development have been explored, along with emerging biomarkers and potential therapies. This synthesis also considers prospects for precision medicine strategies that could significantly improve GDM management. The urgent need for improved prevention and treatment of GDM is evident. A deeper understanding of the molecular foundations of GDM is essential and urgent, as it may enhance clinical outcomes and provide opportunities for early prevention of intergenerational metabolic disease risk.
Preeclampsia involves an angiogenic imbalance, but circulating vascular endothelial growth factor A (VEGF A) remains inconsistently described, particularly in relation to maternal adiposity. We studied 90 second-trimester pregnancies, 30 uncomplicated and 60 with preeclampsia, recording maternal body mass index (BMI) and gestational age at sampling. Serum soluble fms-like tyrosine kinase 1 (sFlt1), placental growth factor (PlGF), and VEGF A were measured by enzyme-linked immunosorbent assay (ELISA), and the sFlt1-to-PlGF ratio was calculated. Preeclampsia was associated with higher pre-pregnancy and pregnancy BMI, lower PlGF, and an approximately threefold higher sFlt1-to-PlGF ratio, while sFlt1 alone was only borderline higher. VEGF A was elevated in preeclampsia and rose across higher sFlt1-to-PlGF ratio categories, supporting the interpretation of VEGF A within the integrated sFlt1,PlGF axis rather than as an isolated signal.