Keywords
Dysbiosis
Cervix
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Abstract
Objective: To analyze the interaction between vaginal dysbiosis and human papillomavirus (HPV) infection in the genesis of precancerous cervical lesions. Literature Review: The literature shows that a balanced vaginal microbiota, predominantly composed of Lactobacillus spp., is essential to maintain an acidic pH and inhibit pathogen colonization. Dysbiosis, characterized by a reduction of lactobacilli and an increase in anaerobes such as Gardnerella and Prevotella, promotes chronic inflammation, degrades the epithelial barrier, and facilitates persistent HPV infection. Recent studies demonstrate that microbiota profiles dominated by anaerobes (CST III and IV) are strongly associated with persistent HPV infection and the progression of high-grade cervical intraepithelial lesions. Final Considerations: It can be considered that vaginal dysbiosis acts as an important cofactor in cervical oncogenesis, contributing to the persistence of HPV and the progression of lesions. Thus, the modulation of the vaginal microbiota emerges as a promising strategy for prevention, early diagnosis, and complementary treatment of cervical cancer.
References
ARAUJO BB, COUTINHO LMTR. Uma abordagem geral das vulvovaginites: candidíase vulvovaginal e vaginose bacteriana. Revista Eletrônica Acervo Médico, 2023; 23(6): e13580.
AVITABILE E, et al. Protective mechanisms of vaginal Lactobacilli against sexually transmitted viral infections. International Journal of Molecular Sciences, 2024; 25:9168.
BRUSSELAERGS N, et al. Vaginal dysbiosis and the risk of human papillomavirus and cervical cancer: systematic review and meta-analysis. American Journal of Obstetrics and Gynecology, 2019; 221:9–18.
CHEN X, et al. The female vaginal microbiome in health and bacterial vaginosis. Frontiers in Cellular and Infection Microbiology, 2021; 11:631972.
FAN Y, et al. Analysis of the correlation between cervical HPV infection, cervical lesions and vaginal microecology. Frontiers in Cellular and Infection Microbiology, 2024; 567–574.
GAJER P, et al. Temporal dynamics of the human vaginal microbiota. Science Translational Medicine, 2012; 4(132):132ra52.
GEORGESCU SR, et al. New insights in the pathogenesis of HPV infection and the associated carcinogenic processes: the role of chronic inflammation and oxidative stress. Journal of Immunology Research, 2018; 27:1–10.
HAN Y, REN QL. Does probiotics work for bacterial vaginosis and vulvovaginal candidiasis. Current Opinion in Pharmacology, 2021; 61:83–90.
KROON SJ, et al. Microbiota cervicovaginal, saúde da mulher e resultados reprodutivos. Fertility and Sterility, 2018; 110(3):327–336.
KUMARI S, BHOR VM. Association of cervicovaginal dysbiosis mediated HPV infection with cervical carcinogenesis. Microbial Pathogenesis, 2021; 152:104780.
LEON-GOMEZ P, et al.. Human papillomavirus, vaginal microbiota and metagenomics: the interplay between development and progression of cervical cancer. Frontiers in Microbiology, 2025; 15:22.
LINHARES IM, et al. Novos conhecimentos sobre a flora bacteriana vaginal. Revista da Associação Médica Brasileira, 2010; 56(3):370–374.
LIU Y, et al. Vaginal microbiota characteristics in different cervical intraepithelial neoplasia: a cross-sectional study. Journal of Translational Medicine, 2023; 21:816.
MA B, et al. Vaginal microbiome: rethinking health and disease. Annual Review of Microbiology, 2012; 66:371–389.
MILLER EA, et al. Lactobacilli dominance and vaginal pH: why is the human vaginal microbiome unique? Frontiers in Microbiology, 2016; 7:1936.
MITRA A, et al. The vaginal microbiota, human papillomavirus infection and cervical intraepithelial neoplasia: what do we know and where are we going next? Microbiome, 2016; 4(1):58.
NELSON TM, et al. Fumar cigarro está associado a um perfil metabolômico alterado do trato vaginal. Scientific Reports, 2018; 8:852.
OLIVEIRA RC, et al. Microbiota vaginal e o uso de Lactobacillus como probiótico: evidências e controvérsias. Contribuciones a Las Ciencias Sociales, 2024; 17(10):1–23.
PAPAMENTZELOPOULOU F, PITIRIGA VC. Unlocking the interactions between the whole-body microbiome and HPV infection: A literature review. Pathogens, 2025; 14:293.
PENDHARKAR S, et al. Lactobacilli and their probiotic effects in the vagina of reproductive age women. Microorganisms, 2023; 11:636.
RAVEL J, et al. Vaginal microbiome of reproductive-age women. Proceedings of the National Academy of Sciences, 2011; 108:4680–4687.
RILEY RR, et al. Dissecção da função do papilomavírus humano E6 e E7 em modelos de camundongos transgênicos de carcinogênese cervical. Cancer Research, 2003; 63(16):4862–4871.
SHANNON B, et al. Association of HPV infection and clearance with cervicovaginal immunology and the vaginal microbiota. Mucosal Immunology, 2017; 10:1310–1319.
SHARIFIAN K, et al. The interplay between human papillomavirus and vaginal microbiota in cervical cancer development. Virology Journal, 2023; 20:73.
ZHANG Y, et al. Vaginal microbiota changes caused by HPV infection in Chinese women. Frontiers in Cellular and Infection Microbiology, 2022; 12:814668.