Chao Xiaopei, Sun Tingting, Wang Shu, Tan Xianjie, Fan Qingbo, Shi Honghui, Zhu Lan, Lang Jinghe
Department of Obstetrics and Gynecology, Peking Union Medical College Hospital (PUMCH), Chinese Academy of Medical Sciences (CAMS) & Peking Union Medical College, Beijing 100730, China.
Ann Transl Med. 2020 Feb;8(4):100. doi: 10.21037/atm.2019.12.115.
Vaginal dysbiosis may paly role in increased risk of human papillomavirus (HPV) infection. This study aims to explore potential vaginal microbiome biomarkers, to predict persistent high-risk HPV (HR-HPV) infection and cervical intraepithelial neoplasia (CIN) 2+, and to find novel treatment targets for HPV infection.
A total of 329 women aged 20-69 were enrolled in this study, including 59 with cervical persistent HPV infection irrespective of cytology status (group A), 139 with incident HPV infection (group B), and 131 without HPV infection (group C). Vaginal microbiome composition was determined by sequencing of barcoded 16S rDNA gene fragments (V4) on Illumina HiSeq2500.
In genus level, the relative abundance of and were significantly the highest in group A, while was the lowest in group A. In species level, we found the relative abundance of and were the highest in group A while iners was significantly under-represented in group A than the other two, and was over-represented in group C than the other two groups.
A predominance of and with a concomitant paucity of and may relate to HPV persistent infection. Furthermore, the relative abundance of being over 0.05554% with being under 0.02196% may be a good predictor for appearance CIN2+ for those diagnosed with the other 12 types of HR-HPV persistent infection but normal ThinPrep cytology test (TCT) testing. The exact molecular mechanism of the vaginal microbiome in the course of persistent HR-HPV infection and cervical neoplasia should be further explored. Future research should include intervention of vaginal microbiome composition to reverse the course of HR-HPV infection and the natural history of cervical neoplasia.
阴道微生物群失调可能在人乳头瘤病毒（HPV）感染风险增加中起作用。本研究旨在探索潜在的阴道微生物组生物标志物，以预测持续性高危型HPV（HR-HPV）感染和宫颈上皮内瘤变（CIN）2级及以上病变，并寻找HPV感染的新治疗靶点。
本研究共纳入329名年龄在20至69岁之间的女性，包括59名无论细胞学状态如何均有宫颈持续性HPV感染的女性（A组）、139名新发HPV感染的女性（B组）和131名无HPV感染的女性（C组）。通过在Illumina HiSeq2500上对条形码化的16S rDNA基因片段（V4）进行测序来确定阴道微生物组组成。
在属水平上，A组中[具体属名1]和[具体属名2]的相对丰度显著最高，而[具体属名3]在A组中最低。在种水平上，我们发现[具体种名1]和[具体种名2]在A组中的相对丰度最高，而惰性[具体种名3]在A组中的相对丰度显著低于其他两组，且[具体种名4]在C组中的相对丰度高于其他两组。
[具体属名1]和[具体属名2]占优势且[具体属名3]和[具体种名3]缺乏可能与HPV持续感染有关。此外，对于诊断为其他12种HR-HPV持续感染但薄层液基细胞学检测（TCT）结果正常的患者，[具体种名4]相对丰度超过0.05554%且[具体种名3]相对丰度低于0.02196%可能是CIN2级及以上病变出现的良好预测指标。阴道微生物组在持续性HR-HPV感染和宫颈肿瘤形成过程中的确切分子机制应进一步探索。未来的研究应包括对阴道微生物组组成的干预，以逆转HR-HPV感染进程和宫颈肿瘤的自然史。
