Abstract

BackgroundIn this study, the association between human papillomavirus (HPV) infection and related cervical intraepithelial neoplasia (CIN) or cervical cancer and vaginal microbiome was evaluated in Chinese cohorts.MethodsThe vaginal bacterial composition of five groups, HPV-infected women without CINs (HPV, n = 78), women with low-grade squamous intraepithelial lesions (LSIL, n = 51), women with high-grade squamous intraepithelial lesions (HSIL, n = 23), women with invasive cervical cancer (Cancer, n = 9) and healthy women without HPV infection (Normal, n = 68), was characterized by deep sequencing of barcoded 16S rRNA gene fragments (V3–4) using Illumina MiSeq.ResultsHPV infection increased vaginal bacterial richness and diversity regardless of the status of CINs. The vaginal bacterial richness and diversity were further augmented in women with cervical cancer. Lactobacillus was the most abundant genus in all groups. HPV infection had a negative influence on the abundances of Lactobacillus, Gardnerella and Atopobium. Accordingly, HPV infection increased the relative abundance of Prevotella, Bacillus, Anaerococcus, Sneathia, Megasphaera, Streptococcus and Anaerococcus. The increased proportions of Bacillus, Anaerococcus and the reduced abundance of Gradnerella vaginalis were probably related with the progression of CINs severity. HPV infection without CINs or cancerous lesions was strongly associated with Megasphaera. The most abundant bacterium in the LSIL group was Prevotella amnii. However, Prevotella timonensis, Shuttleworthia and Streptococcaceae at the family level were three taxa related to HSIL. Furthermore, more taxa were associated with the Cancer group including Bacillus, Sneathia, Acidovorax, Oceanobacillus profundus, Fusobacterium, Veillonellaceae at the family level, Anaerococcus and Porphyromonas uenonis. Samples in the Normal group were mostly assigned to CST III. HPV infection converted the vaginal bacterial community structure from CST III to CST IV. Furthermore, the proportions of CST IV were gradually augmented with the progression of the severity of CINs.ConclusionsThis work interpreted the differential vaginal bacteria under HPV infection and various precancerous or cancerous lesions in a Chinese cohort. We distinguished the specific microbes and the vaginal bacterial structure that were related with the progression of CINs severity in Chinese women.

Highlights

  • In this study, the association between human papillomavirus (HPV) infection and related cervical intraepithelial neoplasia (CIN) or cervical cancer and vaginal microbiome was evaluated in Chinese cohorts

  • We distinguished the specific microbes and the vaginal bacterial structure that were related with the progression of CINs severity in Chinese women

  • The vaginal microbial profile of women could by classified into five community state types (CSTs) by hierarchical taxonomic clustering, in which Community state type (CST) I, II III and V are predominated by L. crispatus, L. iners, L. jensenii and L. gasseri respectively, while CST IV is depleted of Lactobacillus and enriched with anaerobic bacteria like Gardnerella, Megasphera, Sneathia, Prevotella, etc

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Summary

Introduction

The association between human papillomavirus (HPV) infection and related cervical intraepithelial neoplasia (CIN) or cervical cancer and vaginal microbiome was evaluated in Chinese cohorts. It is known that high-risk HPV infection is necessary but not sufficient for the development of CINs or cervical cancer [2,3,4]. Many other events, such as multiple sexual partners, early initiation of sexual activity and co-infection with other sexually transmitted infections, have been associated with higher risk of HPV infection in the genital tract [5,6,7]. L. iners has many properties different from other Lactobacillus spp., for example unable to produce H2O2, and it often predominates in the presence of HPV infection [4, 17, 18] and CIN [18, 19]

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