Anna Barbara Moscicki, MD
Professor of Pediatrics
Director for Clinical Services
Contact Info
My primary area of research focuses on the natural history of human papillomavirus (HPV), the causative agent in cervical cancer. Our study reflects one of the longest running cohort studies of HPV with over 17 years of follow-up on many of the women. Our research focuses on defining patterns of HPV expression (i.e., latency, persistence and clearance) and what influences them, specifically local and systemic immune responses. The mucosal immune responses are likely the most important and yet most complex within the cervix because of the complex microbiologic milieu. However, we believe that mucosal responses are critical to study since HPV is a localized infection. We have developed two assays; one looking at the cervical mucous compartment; likely predominantly secretory and one examining cytokine expression from cervical cells including CD4 and CD8 cells. We have also focused our attention on assays for T regulatory cell (using Foxp3 expression) and Toll Like receptors using cervical samples.
Another area of interest includes examining the Natural history of precancer lesions, CIN 2 in adolescents. The overall low sensitivity and specificity of cytology to identify women with what is considered a true precancerous lesions [high grade squamous intra-epithelial lesions-(HSIL)] has resulted in many clinical and scientific groups questioning today’s current screening practices. The primary purpose of this study is to define the natural history of CIN-2 among adolescents and to define factors associated with regression of CIN-2 which may have important counseling, triage and therapeutic implications.
My interests also lie in studies of HIV infected children and youth. Currently, I am co-PI for Pediatric AIDS Clinical trial groups HPV vaccine study of HIV infected children. I also am site PI for the San Francisco site of the Adolescent clinical trials Network, a Network set up to perform clinical trials in adolescents with HIV infection.
Another area includes studies of vaginal microbicides and mucosal health. Recent studies have shown that microbicides can cause harm rather than protection in acquiring HIV or HSV despite showing no evidence of standard inflammation (i.e., visible by colposcopy). Our phase I study was specifically designed to include immune parameters that may give us insight into a drug’s safety or harm.
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Moscicki AB, Hills N, Shiboski S, Powell K, Jay N, Hanson E, Miller S, Clayton L, Farhat S, Broering J, Darragh T, Palefsky J: Risks for Incident Human Papillomavirus Infection and Low Grade Squamous Intra-Epithelial Lesion Development in a Longitudinal Cohort of Adolescent and Young Women. JAMA 2001; 285(23):2995-3002.
Moscicki AB, Shiboski S, Hills NK, Powell KJ, Jay N, Hanson EN, Miller S, Canjura-Clayton KL, Farhat S, Broering JM, Darragh TM. Regression of low-grade squamous intra-epithelial lesions in young women. Lancet 2004;6;364(9446):1678-83.
Scott ME, Ma Y, Farhat S, Shiboski S, Moscicki AB. Covariates of cervical cytokine mRNA expression by real-time PCR in adolescents and young women: effects of chlamydia trqachomatis infection, hormonal contraception, and smoking. Journal of Clinical Immunology 2006;26(3):222-32.
Saslow D, Castle PE, Cox JT, Davey DD, Einstein MH, Ferris DG, Goldie SJ, Harper DM, Kinney W, Moscicki AB, Noller KL, Wheeler CM, Ades T, Andrews KS, Doroshenk MK, Kahn KG, Schmidt C, Shafey O, Smith RA, Partridge EE and Garcia F. American Cancer Society Guideline for human papillomavirus (HPV) vaccine use to prevent cervical cancer and its precursors. CA: A Cancer Journal for Clinicians2007;57(1):7-28.
Lieberman JA, Moscicki AB, Sumerel JL, Ma Y, Scott ME. Determination of cytokine protein levels in cervical mucus samples from young women by a multiplex immunoassay method and assessment of correlates. Clin Vaccine Immunol 2008. 15: 49-54.
Moscicki AB. Vaginal microbicides: where are we and where are we going? J Infect Chemother 2008 Oct;14(5):337-341.
Moscicki AB, Smith JS. Issues in human papillomavirus vaccination in adolescents. J Adolesc Health 2008 Oct;43(4 Suppl):S1-4.
Sawaya GF, Chirenje MZ, Magure MT, et al. Effect of diaphragm and lubricant gel provision on human papillomavirus infection among women provided with condoms: a randomized controlled trial. Obstet Gynecol 2008 Nov;112(5):990-997.
Moscicki AB, Ma Y, Wibbelsman C, Powers A, Darragh TM, Farhat S, Shaber R, Shiboski S. Risks for Cervical Intraepithelial Neoplasia 3 Among Adolescents and Young Women With Abnormal Cytology. Obstet Gynecol 2008 Dec;112(6):1335-1342.
Scott ME, Ma Y, Kuzmich L, Moscicki AB. Diminished IFN- and IL-10 and elevated Foxp3 mRNA expression in the cervix are associated with CIN 2 or 3.International Journal of Cancer. In press.
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