Disturbance of vaginal microbiocenosis as a cofactor in the development of HPV-associated cervical pathology

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Abstract

The development of cervical intraepithelial neoplasia (CIN) and cervical cancer is significantly associated with long-term persistence of oncogenic strains of human papillomavirus (HPV). Only 10% of cases of HPV infection are characterized by long-term persistence of the virus with the development of CIN, which indicates the presence of cofactors. One of the cofactors in the development of CIN may be vaginal dysbiosis.

Purpose. To study the relationship between disturbances in vaginal microbiocenosis and the presence of HPV-associated cervical lesions.

Material and methods. The study involved 58 women, of whom 3 groups were formed: 1st (n=18) – patients with CIN I; 2nd (n=21) – patients with CIN II–III; 3rd (n=19; control) – patients without neoplastic changes. 4 types of microbiocenosis have been formed: absolute normocenosis; conditional normocenosis; moderate dysbiosis; pronounced dysbiosis.

Results. Vaginal dysbiosis in patients with HPV infection can be considered as a marker, as well as a possible predictor of the development of dysplastic processes in the epithelium of the cervix. A relationship has been identified between disturbances in vaginal microbiocenosis and the presence of HPV-associated cervical lesions, but true cause-and-effect relationships have not been established.

Conclusion. Correction of vaginal microflora can be a decisive event in the elimination of HPV. Future studies should also consider the role of the immune system in the development of CIN.

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About the authors

A. F. Shtakh

Penza State University

Author for correspondence.
Email: alexstach@mail.ru

Candidate of Medical Sciences

Russian Federation, Penza

V. S. Sokolova

Penza State University

Email: alexstach@mail.ru
Russian Federation, Penza

D. А. Troshin

Penza State University

Email: alexstach@mail.ru
Russian Federation, Penza

Yu. А. Kandrashkina

Penza State University

Email: alexstach@mail.ru

Candidate of Medical Sciences

Russian Federation, Penza

G. I. Yuskaeva

Penza State University

Email: alexstach@mail.ru

Candidate of Biological Sciences

Russian Federation, Penza

References

  1. Шахзадова А.О., Старинский В.В., Лисичникова И.В. Состояние онкологической помощи населению России в 2022 году. Сибирский онкологический журнал. 2023; 22 (5): 5–13 [Shakhzadova A.O., Starinsky V.V., Lisichnikova I.V. Cancer care to the population of Russia in 2022. Siberian journal of oncology. 2023; 22 (5): 5–13 (in Russ.)]. doi: 10.21294/1814-4861-2023-22-5-5-13
  2. Федотова Е.И., Макеева А.В., Енькова Е.В. и др. Клинический случай цервикальной интраэпителиальной неоплазии шейки матки высокой степени. European Journal of Natural History. 2024; 1: 19–23 [Fedotova E.I., Makeeva A.V., Enkova E.V. et al. Cervical intraepithelial neoplasia of the cervix of a high degree. European Journal of Natural History. 2024; 1: 19–23 (in Russ.)].
  3. Севостьянова О.Ю., Обоскалова Т.А., Чумарная Т.В. и др. Эпидемиологические особенности заболеваемости цервикальной интраэпителиальной неоплазией в современном мегаполисе. Опухоли женской репродуктивной системы. 2023; 19 (1): 112–9 [Sevostyanova O.Yu., Oboskalova T. A., Chumarnaya T.V. et al. Epidemiological features of the incidence of cervical intraepithelial neoplasia in the modern megapolis. Tumors of female reproductive system. 2023; 19 (1): 112–9 (in Russ.)]. doi: 10.17650/1994-4098-2023-19-1-112-119
  4. Пестрикова Т.Ю., Исмайлова А.Ф., Юрасова Е.А. и др. Папилломавирусная инфекция как междисциплинарная проблема современного здравоохранения. Дальневосточный медицинский журнал. 2022; 1: 99–103 [Pestrikova T.Y., Ismaylova I.F., Yurasova E.A. et al. Papilloma virus infection as an interdisciplinary problem of current healthcare. Far Eastern medical journal. 2022; 1: 99–103 (in Russ.)]. doi: 10.35177/1994-5191-2022-1-17
  5. Дикке Г.Б., Баранов И.И., Байрамова Г.Р. Бактериальный вагиноз: парадокс XXI века. Акушерство и гинекология: Новости. Мнения. Обучения. 2021; 9 (4): 52–62 [Dikke G.B., Baranov I.I., Bayramova G.R. Bacterial vaginosis: paradox of the XXI century. Obstetrics and Gynecology: News, Opinions, Training. 2021; 9 (4): 52–62 (in Russ.)]. doi: 10.33029/2303-9698-2021-9-4-52-62
  6. Gillet E., Meys J.F., Verstraelen H. et al. Bacterial vaginosis is associated with uterine cervical human papillomavirus infection: a meta-analysis. BMC Infect Dis. 2011; 11: 10. doi: 10.1186/1471-2334-11-10
  7. Brusselaers N., Shrestha S., Wijgert J. et al. Vaginal dysbiosis and the risk of human papillomavirus and cervical cancer: systematic review and meta-analysis. Am J ObstetGynecol. 2019; 221 (1): 9–18. doi: 10.1016/j.ajog.2018.12.011
  8. Wang H., Ma Y., Li R. et al. Associations of Cervicovaginal Lactobacilli With High-Risk Human Papillomavirus Infection, Cervical Intraepithelial Neoplasia, and Cancer: A Systematic Review and Meta-Analysis. J Infect Dis. 2019; 220 (8): 1243–54. doi: 10.1093/infdis/jiz325
  9. Tamarelle J., Thiébaut A.C.M., Barbeyrac B. et al. The vaginal microbiota and its association with human papillomavirus, Chlamydia trachomatis, Neisseria gonorrhoeae and Mycoplasma genitaliuminfections: a systematic review and meta-analysis. Clin Microbiol Infect. 2019; 25 (1): 35–47. doi: 10.1016/j.cmi.2018.04.019
  10. Norenhag J., Du J., Olovsson M. et. al. The vaginal microbiota, human papillomavirus and cervical dysplasia: a systematic review and network meta-analysis. BJOG. 2020; 127 (2): 171–80. doi: 10.1111/1471-0528.15854
  11. Martins B.C.T., Guimarães R.A., Alves R.R.F. et al. Bacterial vaginosis and cervical human papillomavirus infection in young and adult women: a systematic review and meta-analysis. Rev Saude Publica. 2023; 56: 113. doi: 10.11606/s1518-8787.2022056004412
  12. Brusselaers N., Shrestha S., Wijgert J. et al. Vaginal dysbiosis and the risk of human papillomavirus and cervical cancer: systematic review and meta-analysis. Am J Obstet Gynecol. 2019; 221 (1): 9–18. doi: 10.1016/j.ajog.2018.12.011
  13. Dong M., Dong Y., Bai J. et al. Interactions between microbiota and cervical epithelial, immune, and mucus barrier. Front Cell Infect Microbiol. 2023; 13: 1124591. doi: 10.3389/fcimb.2023.1124591
  14. Шуралева С.А., Бабин В.Н., Бочков И.А. Колонизационная резистентность слизистой оболочки влагалища. Эпидемиология и инфекционные болезни. 2013; 1: 53–61 [Shuraleva S.A., Babin V.N., Bochkov I.A. Colonization resistance of the vaginal mucosa. Epidemiology and Infectious Diseases. 2013; 1: 53–61 (in Russ.)].
  15. Прилепская В.Н., Летуновская А.Б., Донников А.Е. Микробиоценоз влагалища и полиморфизм генов цитокинов как маркер здоровья женщины (обзор литературы). Гинекология. 2015; 17 (2): 4–13 [Prilepskaya V.N., Letunovskaya A.B., Donnikov А.Е. Vaginal microbiocenosis and citocine genes polymorphism as the female health marker (literature review). Ginecology. 2015; 17 (2): 4–13 (in Russ.)].
  16. Минкина Г.Н. Бактериальный вагиноз как фактор риска цервикального канцерогенеза. Вопросы гинекологии, акушерства и перинатологии. 2024; 23 (4): 71–80 [Minkina G.N. Bacterial vaginosis as a risk factor for cervical carcinogenesis. Gynecology, Obstetrics and Perinatology. 2024; 23 (4): 71–80 (in Russ.)]. doi: 10.20953/1726-1678-2024-4-71-80
  17. Гизингер О.А., Радзинский В.Е. Вирус папилломы человека: патогенез и коррекция иммунных нарушений. Доктор.Ру. 2021; 20 (6): 80–6 [Gizinger O.A., Radzinskiy V.E. Human Papillomavirus: Pathogenesis and Correction of Immune Disturbances. Doctor.Ru. 2021; 20 (6): 80–6 (in Russ.)]. doi: 10.31550/1727-2378-2021-20-6-80-86
  18. Леваков С.А., Кедрова А.Г., Ванке Н.С. и др. Иммунотерапия в комплексном лечении фоновой и предраковой патологии шейки матки. Клиническая практика. 2010; 1 (1): 42–5 [Levakov S.A., Kedrova A.G., Vanke N.S. et al. Immunotherapy in the complex treatment of background and precancerous pathology of the cervix. Clinical Practice. 2010; 1 (1): 42-5 (in Russ.)].

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