Role of Immunity and Vaginal Microbiome in Clearance and Persistence of Human Papillomavirus Infection

Ntuli, Lungelo; Mtshali, Andile; Mzobe, Gugulethu; Liebenberg, Lenine JP; Ngcapu, Sinaye

doi:10.3389/fcimb.2022.927131

Cited by 43 publications

(24 citation statements)

References 117 publications

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“…The main factor in cervical carcinogenesis is HPV infection, and the microbiome that accompanies HPV infection is one of the most important co-factors in cell transformation. Host defense mechanisms, including immune mediators in the female genital tract microenvironment, play a role in the clearance and persistence of HPV and the risk of developing cervical cancer 26. The composition of the microbiota is influenced by numerous factors, with ethnicity being the main intrinsic factor associated with the microbiome composition 10.…”

Section: Discussionmentioning

confidence: 99%

Microbiota unbalance in relation to high-risk human papillomavirus cervical infection

Cherey

Payalef

Fleider

et al. 2023

International Journal of Gynecological Cancer

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ObjectivesTo assess vaginal dysfunction using basic vaginal states and the presence of lactobacillary microbiota in patients with human papillomavirus (HPV) infection with no squamous intra-epithelial lesions (SIL), with low-grade squamous intra-epithelial lesions (L-SIL), and with high-grade squamous intra-epithelial lesions (H-SIL) or squamous cell carcinoma compared with a control group (HPV-negative); to establish the prevalence of bacterial vaginosis, candidiasis, and trichomoniasis in the different age groups; and to characterize the species of lactobacilli according to the type of lesion.MethodsA cross-sectional study was carried out of patients who underwent clinical examination and collection of vaginal fornixes to study basic vaginal states and culture. Species identification of lactobacilli was performed by mass spectrometry. The results were analyzed using the χ2and Fisher’s tests; p<0.05 was considered significant. High-risk viral types were determined using a multiplex real-time polymerase chain reaction test.ResultsA total of 741 patients were analyzed and divided into three age groups: Group 1 aged 18–24 years (n=138), Group 2 aged 25–50 years (n=456), and Group 3 aged >50 years (n=147). All groups were further divided into an HPV-negative (control) group and an HPV-positive group without lesions, with L-SIL, or with H-SIL/squamous cell carcinoma. The prevalence of unbalanced basic vaginal states in patients with H-SIL/squamous cell carcinoma was 72.7% (p=0.03) in Group 1, 53.1% (p=0.05) in Group 2, and no cases of unbalance were detected in Group 3. The prevalence of bacterial vaginosis in women with H-SIL/squamous cell carcinoma in Group 1 was 54.5% and in Group 2 was 43.7%. Patients with H-SIL/squamous cell carcinoma had a prevalence of 21.4% ofLactobacillus crispatus, 42.9% ofL. jensenii, and 14.3% ofL. iners.ConclusionsA greater unbalance of vaginal microbiota was observed in patients with SIL, especially in those with H-SIL/squamous cell carcinoma. In this group, an increase inL. jenseniiandL. inerscompared with control was found.L. crispatushad a similar prevalence to the control group. It is important to characterize the lactobacilli species since the unbalance alters the vaginal microenvironment and acts as a co-factor in the persistence of HPV infection.

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Section: Discussionmentioning

confidence: 99%

Microbiota unbalance in relation to high-risk human papillomavirus cervical infection

Cherey

Payalef

Fleider

et al. 2023

International Journal of Gynecological Cancer

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“…Both HPV16 and 18 can evade innate immune responses by suppressing the synthesis of interferons. Furthermore, HPV can avoid adaptive immune responses by modulating the level of T regulatory cells, leading to immune suppression 8 . In conclusion, the pathogenesis of HPV‐induced cervical cancer is a multifaceted and intricate process that involves viral DNA integration, inactivation of tumor suppressor proteins, deregulation of the cell cycle, and subsequent genetic and epigenetic modifications.…”

Section: Figurementioning

confidence: 99%

Eliminating cervical cancer in China: Opportunities come and challenges remain

Ou‐Yang,

Cao,

Leng

et al. 2024

Journal of Medical Virology

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Cervical cancer ranks as the fourth leading cause of cancer incidence and mortality among women globally, accounting for approximately 600 000 new cases and 300 000 deaths annually. Notably, China contributes to nearly 20% of its worldwide burden. 1 Between 1990 and 2019, Chinese women experienced 1 145 534 fatalities attributable to this disease. 2 In response to this significant public health challenge, China has embarked on an ambitious series of public health interventions aimed at the elimination of cervical cancer (Figure 1). Persistent infection with high-risk human papillomavirus (HPV)genotypes is the primary etiological factor for the development of precancerous lesions and invasive cervical cancer. The most prevalent high-risk HPV types in descending order of frequency are 16, 18, 45, 31, 33, 52, 58, and 35, 3 with HPV16 and 18 as the most common causes, accounting for 39%-78% of all cervical cancer cases. 4 HPVs are composed of double-stranded DNA that includes two primary functional genomic domains: (i) the early region, which encodes proteins E1, E2, E4, E5, E6, and E7 responsible for viral replication,

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“…Although most HPV infectious cases can be cleared in the first 2 years ( 2 ), the factors that promote HPV persistence and trigger carcinogenic pathways are not fully understood. In recent years, vaginal microecology has become a research hotspot for various gynecological diseases, and a variety of vaginal microbiota and related inflammation has been found to be potential drivers of HPV infection and disease severity ( 3 ). Previous studies have revealed that bacterial vaginosis (BV) and decreased Lactobacilli are associated with an increased risk of HPV infection ( 4 , 5 ), while the relationships between Trichomoniasis , vulvovaginal Candidiasis (VVC), and other vaginal microdysbiosis and HPV infection are controversial ( 5 – 7 ).…”

Section: Introductionmentioning

confidence: 99%

Correlation analysis of vaginal microecology and different types of human papillomavirus infection: a study conducted at a hospital in northwest China

et al. 2023

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BackgroundVaginal microecology has a definite influence on human papillomavirus (HPV) infection and clearance, but the specific correlation is still controversial. This research aimed to investigate the differences in the vaginal microenvironment of different types of HPV infection and also provide data supporting clinical diagnosis and treatment.MethodsAccording to strict inclusion and exclusion criteria, the case data of 2,358 female patients who underwent vaginal microecology and HPV-DNA tests at the same time in the Department of Obstetrics and Gynecology of the First Affiliated Hospital of Xi'an Jiaotong University from May 2021 to March 2022 were retrospectively analyzed. The population was divided into two groups: an HPV-positive group and an HPV-negative group. HPV-positive patients were further classified into HPV16/18-positive group and HPV other subtypes positive group. The vaginal microecology of HPV-infected patients was analyzed using the chi-square test, Fisher's exact test, and logistic regression.ResultsAmong the 2,358 female patients, the HPV infection rate was 20.27% (478/2,358), of which the HPV16/18 infection rate was 25.73% (123/478), and the HPV other subtypes infection rate was 74.27% (355/478). The difference in HPV infection rates between the age groups was statistically significant (P < 0.01). The prevalence of mixed vaginitis was 14.37% (339/2,358), with bacterial vaginosis (BV) paired with aerobic vaginitis (AV) accounting for the majority (66.37%). The difference in HPV infection rates among mixed vaginitis was not statistically significant (P > 0.05). The prevalence of single vaginitis was 24.22% (571/2,358), with the most frequent being vulvovaginal Candidiasis (VVC; 47.29%, 270/571), and there was a significant difference in HPV infection rates among single vaginitis (P < 0.001). Patients with BV had a higher risk of being positive for HPV16/18 (OR: 1.815, 95% CI: 1.050–3.139) and other subtypes (OR: 1.830, 95% CI: 1.254–2.669). Patients with Trichomoniasis were at higher odds of other HPV subtype infections (OR: 1.857, 95% CI: 1.004–3.437). On the contrary, patients with VVC had lower odds of becoming infected with other HPV subtypes (OR: 0.562, 95% CI: 0.380–0.831).ConclusionThere were disparities in HPV infection among different age groups; therefore, we should pay attention to the prevention and treatment of susceptible individuals. BV and Trichomoniasis are linked to HPV infection; hence, restoring the balance of vaginal microecology could assist in the prevention of HPV infection. As a protective factor for other HPV subtype infections, VVC may provide new insights into the development of immunotherapeutic therapies.

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Role of Immunity and Vaginal Microbiome in Clearance and Persistence of Human Papillomavirus Infection

Cited by 43 publications

References 117 publications

Microbiota unbalance in relation to high-risk human papillomavirus cervical infection

Microbiota unbalance in relation to high-risk human papillomavirus cervical infection

Eliminating cervical cancer in China: Opportunities come and challenges remain

Correlation analysis of vaginal microecology and different types of human papillomavirus infection: a study conducted at a hospital in northwest China

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