Kazlauskaitė Justė, Žukienė Guoda, Rudaitis Vilius, Bartkevičienė Daiva
Faculty of Medicine, Vilnius University, LT-03101 Vilnius, Lithuania.
Clinic of Obstetrics and Gynaecology, Faculty of Medicine, Institute of Clinical Medicine, Vilnius University, LT-03101 Vilnius, Lithuania.
Medicina (Kaunas). 2025 May 5;61(5):847. doi: 10.3390/medicina61050847.
The relationship between the vaginal microbiota, human papillomavirus infection (HPV), and cervical precancerous lesions is a critical area of research, as it influences both the progression of HPV-related diseases and potential treatment strategies. New evidence suggests that dominance in the microbiota may protect against HPV persistence and speed the elimination of HPV. This study aims to explore the relationship between the vaginal microbiota composition and HPV infection, focusing on the impact of these factors on the development of cervical precancerous lesions. A comprehensive literature review was conducted using the PubMed database, focusing on studies that analyzed the association between the vaginal microbiota and HPV infection in the context of cervical dysplasia. This study was primarily based on clinical data on HPV integration in women with low-grade squamous intraepithelial lesions (LSILs), high-grade squamous intraepithelial lesions (HSILs), and cervical cancer. Different types of vaginal microbiota communities (CSTs) have different pathogenic or protective potential. Healthy women predominantly exhibited CST I, with as the dominant microorganism. CST IV, associated with increased anaerobic bacteria, was most common in HSIL and cervical cancer patients. Statistical analysis revealed that bacterial vaginosis (BV) was significantly associated with HPV persistence, with studies reporting a 1.8-3.4-fold increased risk ( < 0.05) of persistent HR-HPV infection in BV-positive women. Our literature review suggests that the composition of the vaginal microbiota can modulate the local immune response, the expression of viral oncogenes, and the integrity of the epithelial barrier. Furthermore, certain bacterial genes or metabolic pathways can be associated with a favorable or unfavorable outcome of the disease. Analysis of the vaginal microbiota could serve as an additional risk assessment tool, helping to distinguish between regressing and progressive precancerous conditions.
阴道微生物群、人乳头瘤病毒感染（HPV）与宫颈癌前病变之间的关系是一个关键的研究领域，因为它既影响HPV相关疾病的进展，也影响潜在的治疗策略。新证据表明，微生物群中的优势菌可能预防HPV持续感染，并加速HPV的清除。本研究旨在探讨阴道微生物群组成与HPV感染之间的关系，重点关注这些因素对宫颈高级别鳞状上皮内病变（HSIL）和宫颈癌。不同类型的阴道微生物群落（CST）具有不同的致病或保护潜力。健康女性主要表现为CST I，以 作为优势微生物。与厌氧菌增加相关的CST IV在HSIL和宫颈癌患者中最为常见。统计分析显示，细菌性阴道病（BV）与HPV持续感染显著相关，研究报告称BV阳性女性持续高危型HPV感染的风险增加1.8至3.4倍（ < 0.05）。我们的文献综述表明，阴道微生物群的组成可以调节局部免疫反应、病毒癌基因的表达以及上皮屏障的完整性。此外，某些细菌基因或代谢途径可能与疾病的有利或不利结局相关。对阴道微生物群的分析可作为一种额外的风险评估工具，有助于区分癌前病变的消退和进展情况。
