阴道微生物与人乳头瘤病毒感染及宫颈上皮内肿瘤相关性研究进展

The Role of Vaginal Microbiota and Its Relationship with Cervical Human Papillomavirus Infection and Cervical Intraepithelial Neoplasia

人乳头瘤病毒(HPV)感染是宫颈癌前病变或宫颈癌发生的必要条件,阴道微生物多样性的改变可能是造成HPV持续感染继而发生宫颈病变的伴随因素。正常女性阴道微生物多样性较低,仅由少数几种乳酸杆菌(Lactobacillus)构成主要菌群。随着对细菌16SrRNA基因高通量测序技术的应用,越来越多的研究证实阴道菌群中非乳酸杆菌属微生物的多样性增加与HPV感染及宫颈病变存在密切联系。标志性的阴道微生物可能通过多种分子机制与宿主细胞及HPV相互作用,导致阴道局部免疫抑制、慢性炎症的状态,从而造成HPV持续感染及宫颈病变。重建阴道微生态平衡状态尤其是乳酸杆菌为主的阴道菌群是未来HPV感染及相关宫颈病变治疗的新途径。本文就阴道微生物多样性改变与HPV感染及宫颈病变发生的研究观点进行总结归纳。

Human papillomavirus（HPV） infection is necessary to cervical precancerous lesion or cervical cancer.Vaginal microbial diversity might be related with persistence HPV infection status. A healthy female vaginal microbiome is defined as low diversity and dominated by one or two species of Lactobacillus. After the application of deep sequencing of barcoded bacterial 16 SrRNA gene fragments, more and more researches reveal that increased vaginal microbial diversity with decreased proportion of Lactobacillus is associated with HPV infection and cervical diseases. Several microbiological biomarkers could interact with host cells and virus through different mechanisms, which lead to a local pro-inflammatory and immunosuppressive environment, thus resulting in persistence HPV infection and cervical disease. The restoration of balance of vaginal microbial environment, typically a Lactobacillus-dominated bacterial structure, could be a new approach to the treatment of HPV infection and related cervical disease in the future. This review aims to summarize the existed points of view concerning the influences of vaginal microbial diversity on HPV infection and cervical diseases.