Department of Obstetrics and Gynecology, Conjunto Hospitalar Mandaqui, São Paulo, Brazil.
Innovation in Cancer Laboratory, Centro de Investigação Translacional em Oncologia, Instituto do Câncer do Estado de São Paulo Octavio Frias de Oliveira, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
Pathobiology. 2021;88(2):187-197. doi: 10.1159/000511477. Epub 2020 Nov 23.
Persistent infection with some types of mucosal human papillomavirus (HPV) is the etiological factor for the development of cervical cancer and its precursor lesions. Besides, several cofactors are known to play a role in cervical disease onset and progression either by favoring or by preventing HPV infection and persistence. The microbiome of a healthy female genital tract is characterized by the presence of 1 or few varieties of lactobacilli. However, high-throughput studies addressing the bacterial diversity and abundance in the female genital tract have shown that several factors, including hormonal levels, hygiene habits, and sexually transmitted diseases may disrupt the natural balance, favoring the outgrowth of some groups of bacteria, which in turn may favor some pathological states. Recently, the vaginal microbiome has emerged as a new variable that could greatly influence the natural history of HPV infections and their clinical impact. In this context, changes in the vaginal microbiome have been detected in women infected with HPV and women with HPV-associated lesions and cancer. However, the role of specific bacteria groups in the development/progression or prevention/regression of HPV-associated pathologies is not well understood. In this review we summarize the current knowledge concerning changes in vaginal microbiome and cervical disease. We discuss the potential functional interplay between specific bacterial groups and HPV infection outcomes.
某些类型的黏膜型人乳头瘤病毒(HPV)持续感染是宫颈癌及其前体病变发展的病因。此外,还有一些已知的协同因素通过促进或防止 HPV 感染和持续感染在宫颈疾病的发生和进展中发挥作用。健康女性生殖道的微生物组的特征是存在 1 种或少数几种乳杆菌。然而,针对女性生殖道细菌多样性和丰度的高通量研究表明,包括激素水平、卫生习惯和性传播疾病在内的多种因素可能破坏自然平衡,有利于某些细菌群体的生长,进而可能有利于某些病理状态。最近,阴道微生物组作为一个新的变量出现,可能会极大地影响 HPV 感染的自然史及其临床影响。在这种情况下,HPV 感染和 HPV 相关病变及癌症妇女的阴道微生物组发生了变化。然而,特定细菌群体在 HPV 相关病变的发展/进展或预防/消退中的作用尚不清楚。在这篇综述中,我们总结了当前关于阴道微生物组和宫颈疾病变化的知识。我们讨论了特定细菌群体与 HPV 感染结果之间的潜在功能相互作用。