Frąszczak Karolina, Barczyński Bartłomiej, Kondracka Adrianna
I Chair and Department of Oncological Gynaecology and Gynaecology, Medical University in Lublin, Staszica 16, 20-081 Lublin, Poland.
Department of Obstetrics and Pathology of Pregnancy, Medical University in Lublin, Staszica 16, 20-081 Lublin, Poland.
Cancers (Basel). 2022 Oct 7;14(19):4909. doi: 10.3390/cancers14194909.
Cervical cancer is a significant health problem with increasing occurrence and mortality. This infection-associated tumour is caused by the human papillomavirus (HPV). HPV infection is cleared by the immune system within 6-18 months in most patients; however, persistent high-risk HPV (hrHPV) infections can lead to the development of cervical cancer. Virus persistence is promoted by immunodeficiency, infection, smoking, and age, as well as the imbalance of cervicovaginal microbiota and inflammation. The abundance of bacteria in the vagina favours the maintenance of a dynamic balance; their coexistence influences health or disease states. The eubiotic vaginal microbiota of reproductive-aged women is composed mostly of various species (spp.), which exert protective effects via the production of lactic acid, bacteriocins, polysaccharides, peptidoglycans, and hydrogen peroxide (HO), lowering pH, raising the viscosity of cervicovaginal mucus, and hampering both the adhesion of cells to epithelial tissue and the entry of HPV. The depletion of beneficial microorganisms could increase the risk of sexually transmitted infections. Emerging therapies involve mucosal, intranasal vaccines, which trigger systemic and mucosal immune responses, thus protecting against HPV-induced tumours. The use of probiotics has also been suggested to affect various biological processes associated with tumourigenesis (inflammation, oxidative stress, apoptosis, proliferation, and metastasis).
宫颈癌是一个日益严重的健康问题,其发病率和死亡率都在上升。这种与感染相关的肿瘤是由人乳头瘤病毒(HPV)引起的。在大多数患者中,HPV感染会在6至18个月内被免疫系统清除;然而,持续性高危HPV(hrHPV)感染会导致宫颈癌的发生。免疫缺陷、感染、吸烟、年龄以及宫颈阴道微生物群失衡和炎症都会促进病毒持续存在。阴道内细菌的丰富有助于维持动态平衡;它们的共存会影响健康或疾病状态。育龄妇女的正常阴道微生物群主要由各种菌种组成,这些菌种通过产生乳酸、细菌素、多糖、肽聚糖和过氧化氢(HO)发挥保护作用,降低pH值,提高宫颈阴道黏液的黏度,并阻碍细胞黏附于上皮组织以及HPV的进入。有益微生物的减少会增加性传播感染的风险。新兴疗法包括黏膜、鼻内疫苗,可引发全身和黏膜免疫反应,从而预防HPV诱导的肿瘤。也有人建议使用益生菌来影响与肿瘤发生相关的各种生物学过程(炎症、氧化应激、细胞凋亡、增殖和转移)。