Microbial Bioactives
Microbial Bioactives | Online ISSN 2209-2161
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Volume 5 Number 1 2022
REVIEWS (Open Access)
Interwoven Ecosystems: The Vaginal Microbiome’s Role in Cervical Cancer and Preterm Birth — A Systematic Review and Meta-Analytic Introduction
Anwar Ullah 1*
Microbial Bioactives 5 (1) 1-8 https://doi.org/10.25163/microbbioacts.5110701
Submitted: 20 January 2022 Revised: 16 March 2022 Accepted: 23 March 2022 Published: 25 March 2022
Abstract
Cervical cancer and preterm birth remain major global reproductive health challenges, significantly impacting maternal and neonatal outcomes. Emerging evidence implicates the vaginal microbiome as a critical determinant in the pathogenesis of both conditions. This systematic review and meta-analysis synthesize current knowledge on how microbial composition, particularly the dominance or depletion of Lactobacillus species, influences cervical health and pregnancy outcomes. Healthy vaginal ecosystems, typically dominated by Lactobacillus crispatus, L. gasseri, and L. jensenii, maintain an acidic environment, produce antimicrobial metabolites, and modulate mucosal immunity to prevent pathogenic overgrowth. Conversely, dysbiotic states characterized by bacterial vaginosis, with overrepresentation of anaerobic species such as Gardnerella vaginalis, Atopobium vaginae, and Prevotella spp., compromise epithelial integrity, disrupt immune responses, and facilitate the persistence of high-risk human papillomavirus (HPV) infections. Meta-analytic data indicate that these dysbiotic profiles correlate with increased risks of persistent HPV infection, cervical dysplasia, and adverse pregnancy outcomes including preterm birth and intrauterine infection. Mechanistically, microbial biofilms, enzymatic activity, and immune modulation collectively underpin these associations. The findings highlight the potential of microbiome-based interventions, including probiotics and targeted antimicrobial therapies, to restore vaginal eubiosis and reduce disease burden. Integrating microbial, immunological, and clinical data into predictive models offers a promising avenue for improving reproductive health outcomes globally.
Keywords: vaginal microbiome, cervical cancer, preterm birth, bacterial vaginosis, Lactobacillus, dysbiosis, HPV, maternal-fetal health
References
Africa, C. W. J., Nel, J., & Stemmet, M. (2014). Anaerobes and bacterial vaginosis in pregnancy: Distribution of microorganisms and outcomes. Acta Obstetricia et Gynecologica Scandinavica, 93(9), 921–928. https://doi.org/10.1111/aogs.12427
Al-Mushrif, S., Eley, A., & Jones, B. M. (2000). Inhibition of chemotaxis by organic acids from anaerobes may prevent a purulent response in bacterial vaginosis. Journal of Medical Microbiology, 49(11), 1023–1030. https://doi.org/10.1099/0022-1317-49-11-1023
Biagi, E., Vitali, B., Pugliese, C., Candela, M., Donders, G. G., & Brigidi, P. (2009). Quantitative variations in the vaginal bacterial population associated with asymptomatic infections. European Journal of Clinical Microbiology & Infectious Diseases, 28(3), 281–285. https://doi.org/10.1007/s10096-008-0624-y
Birley, H., Duerden, B., & Hart, C. A. (2002). Sexually transmitted diseases: Microbiology and management. Journal of Medical Microbiology, 51(10), 793–807. https://doi.org/10.1099/0022-1317-51-10-793
Bohbot, J. M., & Lepargneur, J. P. (2012). Bacterial vaginosis in 2011: A lot of questions remain. Gynécologie Obstétrique & Fertilité, 40(1), 31–36. https://doi.org/10.1016/j.gyobfe.2011.07.034
Brotman, R. M., Shardell, M. D., Gajer, P., et al. (2014). Interplay between the temporal dynamics of the vaginal microbiota and human papillomavirus detection. Journal of Infectious Diseases, 210(11), 1723–1733. https://doi.org/10.1093/infdis/jiu297
Capoccia, R., Greub, G., & Baud, D. (2013). Ureaplasma urealyticum, Mycoplasma hominis and adverse pregnancy outcomes. Current Opinion in Infectious Diseases, 26(3), 231–240. https://doi.org/10.1097/QCO.0b013e328360db58
Cauci, S., Culhane, J. F., Di Santolo, M., & McCollum, K. (2008). Among pregnant women with bacterial vaginosis, the hydrolytic enzymes sialidase and prolidase are positively associated with interleukin-1beta. American Journal of Obstetrics and Gynecology, 198(1), 1–7. https://doi.org/10.1016/j.ajog.2007.05.029
Cha, M. K., Lee, D. K., An, H. M., et al. (2012). Antiviral activity of Bifidobacterium adolescentis SPM1005-A on human papillomavirus type 16. BMC Medicine, 10(1), 72. https://doi.org/10.1186/1741-7015-10-72
Di Vico, A., Donati, L., Labianca, A., et al. (2011). Role of vaginal infection in fetal and neonatal mortality. Minerva Ginecologica, 63(1), 25–29. https://pubmed.ncbi.nlm.nih.gov/21263412/
Donders, G. G., Vereecken, A., Bosmans, E., et al. (2002). Definition of a type of abnormal vaginal flora that is distinct from bacterial vaginosis: Aerobic vaginitis. BJOG, 109(1), 34–43. https://doi.org/10.1111/j.1471-0528.2002.00332.x
Fethers, K., Twin, J., Fairley, C. K., et al. (2012). Bacterial Vaginosis (BV) candidate bacteria: Associations with BV and behavioural practices. PLoS ONE, 7(2), e30633. https://doi.org/10.1371/journal.pone.0030633
Ishaque, S., Yakoob, M. Y., Imdad, A., et al. (2011). Effectiveness of interventions to screen and manage infections during pregnancy on reducing stillbirths. BMC Public Health, 11(Suppl 3), S3. https://doi.org/10.1186/1471-2458-11-S3-S3
Lamont, R. F., Sobel, J. D., Akins, R. A., et al. (2011). The vaginal microbiome: New information about genital tract flora. BJOG, 118(5), 533–549. https://doi.org/10.1111/j.1471-0528.2010.02840.x
Lewis, W. G., Robinson, L. S., Gilbert, N. M., et al. (2013). Degradation, foraging, and depletion of mucus sialoglycans by Gardnerella vaginalis. Journal of Biological Chemistry, 288(17), 12067–12079. https://doi.org/10.1074/jbc.M113.453654
Marrazzo, J. M. (2011). Interpreting the epidemiology and natural history of bacterial vaginosis: Are we still confused? Anaerobe, 17(4), 186–190. https://doi.org/10.1016/j.anaerobe.2011.03.016
Menard, J. P., Mazouni, C., Salem-Cherif, I., et al. (2010). High vaginal concentrations of Atopobium vaginae and Gardnerella vaginalis in women undergoing preterm labor. Obstetrics & Gynecology, 115(1), 134–140. https://doi.org/10.1097/AOG.0b013e3181c391d7
Nicolò, S., Tanturli, M., Mattiuz, G., et al. (2021). Vaginal Lactobacilli and vaginal dysbiosis-associated bacteria differently affect cervical epithelial and immune homeostasis. International Journal of Molecular Sciences, 22(12), 6487. https://doi.org/10.3390/ijms22126487
Okunade, K. S. (2020). Human papillomavirus and cervical cancer. Journal of Obstetrics and Gynaecology, 40(5), 602–608. https://doi.org/10.1080/01443615.2019.1633515
Patterson, J. L., Stull-Lane, A., Girerd, P. H., & Jefferson, K. K. (2010). Analysis of adherence, biofilm formation and cytotoxicity suggests a greater virulence potential of Gardnerella vaginalis. Microbiology, 156(2), 392–399. https://doi.org/10.1099/mic.0.034280-0
Petrova, M. I., Reid, G., Vaneechoutte, M., & Lebeer, S. (2017). Lactobacillus iners: Friend or foe? Trends in Microbiology, 25(3), 182–191. https://doi.org/10.1016/j.tim.2016.10.004
Qingqing, B., Jie, Z., Songben, Q., et al. (2021). Cervicovaginal microbiota dysbiosis correlates with HPV persistent infection. Microbial Pathogenesis, 152, 104617. https://doi.org/10.1016/j.micpath.2020.104617
Ravel, J., Gajer, P., Abdo, Z., et al. (2011). Vaginal microbiome of reproductive-age women. Proceedings of the National Academy of Sciences, 108(S1), 4680–4687. https://doi.org/10.1073/pnas.1002611107
Schwebke, J. R., Flynn, M. S., & Rivers, C. A. (2014). Prevalence of Gardnerella vaginalis among women with lactobacillus-predominant vaginal flora. Sexually Transmitted Infections, 90(1), 61–63. https://doi.org/10.1136/sextrans-2013-051189
Sgibnev, V. A., & Kremleva, A. E. (2015). Vaginal protection by H2O2-producing lactobacilli. Jundishapur Journal of Microbiology, 8(10), e22913. https://doi.org/10.5812/jjm.22913
Shipitsyna, E., Roos, A., Datcu, R., et al. (2013). Composition of the vaginal microbiota in women of reproductive age. PLoS ONE, 8(4), e60670. https://doi.org/10.1371/journal.pone.0060670
Srinivasan, S., & Fredricks, D. N. (2008). The human vaginal bacterial biota and bacterial vaginosis. Interdisciplinary Perspectives on Infectious Diseases, 2008, 750479. https://doi.org/10.1155/2008/750479
Srinivasan, S., Hoffman, N. G., Morgan, M. T., et al. (2012). Bacterial communities in women with bacterial vaginosis. PLoS ONE, 7(6), e37818. https://doi.org/10.1371/journal.pone.0037818
Turovskiy, Y., Sutyak Noll, K., & Chikindas, M. L. (2011). The aetiology of bacterial vaginosis. Journal of Applied Microbiology, 110(5), 1105–1128. https://doi.org/10.1111/j.1365-2672.2011.04977.x
Witkin, S. S., Mendes-Soares, H., Linhares, I. M., et al. (2013). Influence of vaginal bacteria and D- and L-lactic acid isomers on vaginal extracellular matrix metalloproteinase inducer. mBio, 4(4). https://doi.org/10.1128/mBio.00460-13
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