Smoking is accompanied by a suppressed cervical nitric oxide release in women with high‐risk human papillomavirus infection

Abstract

Both smoking and the release of nitric oxide (NO) in the uterine cervix are determinants for high-risk human papillomavirus (hrHPV) infection. We compared the cervical NO release between smoking and non-smoking women with and without hrHPV infection. Open clinical cohort study. University Hospital in Finland. One hundred and twenty-five smoking and 301 non-smoking women, with (n = 244) and without (n = 182) hrHPV infection. In total, 264 women showed cytological and/or histological cervical epithelial changes. The presence of hrHPV was tested by an HPV DNA test and the release of NO was assessed from NO metabolites in the cervical fluid by the Griess reaction. The difference in cervical NO release between smoking and non-smoking women with and without hrHPV. Infection with hrHPV in smokers (70%) was more frequent (p = 0.001) than in non-smokers (52%). As a whole, smoking was accompanied by a 35% decrease (p = 0.04) in NO release in hrHPV-infected women (35.9 μmol/L, 95% confidence interval 27.0-44.2) compared with non-smoking hrHPV- infected women (48.3 μmol/L, 95% confidence interval 38.0-56.2). No difference in NO release between smokers and non-smokers was seen in women with healthy cervical epithelium, but smoking was accompanied by a suppressed (26%) NO release (p = 0.03) in women with either cytological or histological changes. Smoking may suppress NO release in the uterine cervix in women with hrHPV infection.