The vaginal microbiota, human papillomavirus and cervical dysplasia: a systematic review and network meta‐analysis

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

Persistent infection with high-risk human papillomavirus can lead to cervical dysplasia and cancer. Recent studies have suggested associations between the composition of the vaginal microbiota, infection with human papillomavirus (HPV) and progression to cervical dysplasia and cancer.

Related collections

Most cited references 33

Record: found
Abstract: found
Article: not found

Human papillomavirus and cervical cancer.

Emma J Crosbie, Mark Einstein, Silvia Franceschi … (2013)

Cervical cancer is caused by human papillomavirus infection. Most human papillomavirus infection is harmless and clears spontaneously but persistent infection with high-risk human papillomavirus (especially type 16) can cause cancer of the cervix, vulva, vagina, anus, penis, and oropharynx. The virus exclusively infects epithelium and produces new viral particles only in fully mature epithelial cells. Human papillomavirus disrupts normal cell-cycle control, promoting uncontrolled cell division and the accumulation of genetic damage. Two effective prophylactic vaccines composed of human papillomavirus type 16 and 18, and human papillomavirus type 16, 18, 6, and 11 virus-like particles have been introduced in many developed countries as a primary prevention strategy. Human papillomavirus testing is clinically valuable for secondary prevention in triaging low-grade cytology and as a test of cure after treatment. More sensitive than cytology, primary screening by human papillomavirus testing could enable screening intervals to be extended. If these prevention strategies can be implemented in developing countries, many thousands of lives could be saved. Copyright © 2013 Elsevier Ltd. All rights reserved.

0 comments Cited 448 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: found

Is Open Access

Cervical intraepithelial neoplasia disease progression is associated with increased vaginal microbiome diversity

A. N. Mitra, D. MacIntyre, Y Lee … (2015)

Persistent infection with oncogenic Human Papillomavirus (HPV) is necessary for cervical carcinogenesis. Although evidence suggests that the vaginal microbiome plays a functional role in the persistence or regression of HPV infections, this has yet to be described in women with cervical intra-epithelial neoplasia (CIN). We hypothesised that increasing microbiome diversity is associated with increasing CIN severity. llumina MiSeq sequencing of 16S rRNA gene amplicons was used to characterise the vaginal microbiota of women with low-grade squamous intra-epithelial lesions (LSIL; n = 52), high-grade (HSIL; n = 92), invasive cervical cancer (ICC; n = 5) and healthy controls (n = 20). Hierarchical clustering analysis revealed an increased prevalence of microbiomes characterised by high-diversity and low levels of Lactobacillus spp. (community state type-CST IV) with increasing disease severity, irrespective of HPV status (Normal = 2/20,10%; LSIL = 11/52,21%; HSIL = 25/92,27%; ICC = 2/5,40%). Increasing disease severity was associated with decreasing relative abundance of Lactobacillus spp. The vaginal microbiome in HSIL was characterised by higher levels of Sneathia sanguinegens (P < 0.01), Anaerococcus tetradius (P < 0.05) and Peptostreptococcus anaerobius (P < 0.05) and lower levels of Lactobacillus jensenii (P < 0.01) compared to LSIL. Our results suggest advancing CIN disease severity is associated with increasing vaginal microbiota diversity and may be involved in regulating viral persistence and disease progression.

0 comments Cited 202 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: found

Is Open Access

The Vaginal Microbiota: What Have We Learned after a Decade of Molecular Characterization?

Janneke H. H. M. van de Wijgert, Hanneke Borgdorff, Rita Verhelst … (2014)

We conducted a systematic review of the Medline database (U.S. National Library of Medicine, National Institutes of Health, Bethesda, MD, U.S.A) to determine if consistent molecular vaginal microbiota (VMB) composition patterns can be discerned after a decade of molecular testing, and to evaluate demographic, behavioral and clinical determinants of VMB compositions. Studies were eligible when published between 1 January 2008 and 15 November 2013, and if at least one molecular technique (sequencing, PCR, DNA fingerprinting, or DNA hybridization) was used to characterize the VMB. Sixty three eligible studies were identified. These studies have now conclusively shown that lactobacilli-dominated VMB are associated with a healthy vaginal micro-environment and that bacterial vaginosis (BV) is best described as a polybacterial dysbiosis. The extent of dysbiosis correlates well with Nugent score and vaginal pH but not with the other Amsel criteria. Lactobacillus crispatus is more beneficial than L. iners. Longitudinal studies have shown that a L. crispatus-dominated VMB is more likely to shift to a L. iners-dominated or mixed lactobacilli VMB than to full dysbiosis. Data on VMB determinants are scarce and inconsistent, but dysbiosis is consistently associated with HIV, human papillomavirus (HPV), and Trichomonas vaginalis infection. In contrast, vaginal colonization with Candida spp. is more common in women with a lactobacilli-dominated VMB than in women with dysbiosis. Cervicovaginal mucosal immune responses to molecular VMB compositions have not yet been properly characterized. Molecular techniques have now become more affordable, and we make a case for incorporating them into larger epidemiological studies to address knowledge gaps in etiology and pathogenesis of dysbiosis, associations of different dysbiotic states with clinical outcomes, and to evaluate interventions aimed at restoring and maintaining a lactobacilli-dominated VMB.

0 comments Cited 190 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Journal

Title: BJOG: An International Journal of Obstetrics & Gynaecology

Abbreviated Title: BJOG: Int J Obstet Gy

Publisher: Wiley

ISSN (Print): 1470-0328

ISSN (Electronic): 1471-0528

Publication date Created: December 13 2019

Publication date Created: January 2020

Publication date (Electronic): July 17 2019

Publication date (Print): January 2020

Volume: 127

Issue: 2

Pages: 171-180

Affiliations

[1 ]Department of Women's and Children's Health Uppsala University Uppsala Sweden

[2 ]Department of Microbiology, Tumour and Cell Biology Centre for Translational Microbiome Research Karolinska Hospital Karolinska Institutet Stockholm Sweden

[3 ]Science for Life Laboratory Stockholm Sweden

[4 ]Department of Obstetrics & Gynaecology Ghent University Hospital 0P4 Ghent University Ghent Belgium

Article

DOI: 10.1111/1471-0528.15854

PubMed ID: 31237400

SO-VID: d2964513-d5d3-47ee-9f5c-ae822cd77098

License:

http://onlinelibrary.wiley.com/termsAndConditions#vor

http://doi.wiley.com/10.1002/tdm_license_1.1

History

Data availability:

Comments

Comment on this article

scite_

Cited by 131

See all cited by

Most referenced authors 978

See all reference authors

The vaginal microbiota, human papillomavirus and cervical dysplasia: a systematic review and network meta‐analysis

Read this article at

Abstract

Related collections

Road 2 Open Meta

Most cited references 33

Human papillomavirus and cervical cancer.

Cervical intraepithelial neoplasia disease progression is associated with increased vaginal microbiome diversity

The Vaginal Microbiota: What Have We Learned after a Decade of Molecular Characterization?

Author and article information

Journal

Affiliations

Article

History

Comments

Comment on this article

Similar content 1,436

Cited by 131

Most referenced authors 978