Genital Microbiota of Women From Six Ethnic Groups With and Without Human Papillomavirus Infection in Shangri-La, China

Abstract

BackgroundA diversity of microorganisms is associated with human health and exists in a state of dynamic equilibrium. This diversity has direct implications for the assessment of susceptibility to infectious diseases, especially human papillomavirus (HPV) infection.MethodsHere, we investigated the relationships between HPV infection and vaginal, cervical, and gut microbiota composition and assessed the levels of genital immune mediators. We selected a multiethnic area in Yunnan Province, China, to collect samples from healthy women of childbearing age. A total of 82 healthy women of childbearing age were included in this study. Vaginal, cervical, and rectal swabs were collected to analyze the microbial community, and cytokines were analyzed in some samples.FindingsDifferent proportions and types of HPV infection were detected in cervical (44%), vaginal (18%), and rectal (18%) swabs. HPV detected in cervical swabs was generally a high-risk type, while low-risk HPV types were primarily detected in vaginal and rectal swabs. There were some differences in this proportion as well as in the microbial community composition among different ethnic groups. Rectal samples exhibited the highest diversity index, while vaginal samples displayed the lowest diversity index. Lactobacillus dominated most of the vaginal samples, was decreased in HPV-positive samples, and differed among different ethnic groups. However, the sequence proportion of Lactobacillus in the cervix exhibited the opposite trend in those affected by HPV infection. The dynamic balance between the potential pathogens Gardnerella and Lactobacillus determines the health of the female genital system.InterpretationThis study constitutes the first step toward personalized medicine for women’s reproductive health, wherein differences between the genital microbiomes of individuals would be considered in risk assessment and for subsequent disease diagnosis and treatment.

Changes in microbial composition and interaction patterns of female urogenital tract and rectum in response to HPV infection

“…In this study, we have found a solid co-occurrence network between the cervix, vagina and urethra, in which the vaginal microbiome was the most interactive with the rest of the site in female and was most influenced by the cervical microbiome. This was consistent with previous studies, cervix and vagina have certain similarities in their microbial composition [ 30 , 38 ]. At the same time, we found that Lactobacillus and Gardnerella , the two most common probiotics and pathogenic bacteria in the reproductive tract, have positive correlations in three parts of cervix, vagina and urethra, and these two common bacteria genera in the reproductive tract may have cross-site interactions.…”

“…In this study, in addition to the common high-risk types such as HPV16, HPV18 and HPV58 detected, we also found that low-risk types such as HPV44 and HPV81 present in multiple sites with high infection rates, it may have a certain impact on the composition of the microbial community in the female urogenital tract. In one of our previous studies, we found that HPV detected in cervical swabs is high-risk, while low-risk HPV is mainly found in vaginal and rectal swabs, and multiple subtypes of infection are common [ 38 ]. Some studies have found that HPV44 is one of the common types in tumor tissues of cervical cancer patients [ 56 ], frequently detected in human intestines [ 57 , 58 ].…”

“…The composition of vaginal microbes may be influenced by the entire urogenital tract. Our previous studies detected different proportions and types of HPV infection in cervical, vaginal, and rectal swabs, with different sites exhibiting different microbial changes under HPV infection [ 38 ]. The microbial communication patterns between the urogenital tract and other sites and the microbial networks they form may also affect HPV infection.…”

Changes in microbial composition and interaction patterns of female urogenital tract and rectum in response to HPV infection

“…In this study, we have found a solid co-occurrence network between the cervix, vagina and urethra, in which the vaginal microbiome was the most interactive with the rest of the site in female and was most in uenced by the cervical microbiome. This was consistent with previous studies, cervix and vagina have certain similarities in their microbial composition (30,33). At the same time, we found that Lactobacillus and Gardnerella, the two most common probiotics and pathogenic bacteria in the reproductive tract, have positive correlations in three parts of cervix, vagina and urethra, and these two common bacteria genera in the reproductive tract may have cross-site interactions.…”

Human Papillomavirus Infections and the Role Played by Cervical and Cervico-Vaginal Microbiota—Evidence from Next-Generation Sequencing Studies

“…Based on the analyzed literature (Table 1), significant differences were observed in the cervicovaginal microbiome between the HPV-positive and HPV-negative women. Generally, a wider variety of bacterial species was observed in the HPV-positive women, primarily due to the abundance of species other than Lactobacillus and a shift towards anaerobic bacteria [31,36,41,111,117,130,133,[135][136][137]139,143]. The majority of the studies indicated that HPV-negative women had a normal cervical microbiota characterized by the abundance of Lactobacillus.…”