Virus papiloma humano, infecciones de transmisión sexual y microbioma vagino cervical en el desarrollo de lesiones premalignas y malignas del cuello uterino. / Human papillomavirus, sexually transmitted infections and cervicovaginal microbiome in the development of premalignant and malignant uterine cervix lesions.
Resumen
Resumen:
Estudios recientes han descrito que la alteración de la microbiota vaginal y cervical podría conllevar a un microambiente propicio para el desarrollo de lesiones neoplásicas cervicales bajo ciertas infecciones. Los cambios en las comunidades bacterianas, elevación del pH, la vaginosis bacteriana y las infecciones de transmisión sexual (ITS) pueden alterar el microambiente cervicovaginal y permitir la persistencia de microorganismos como el virus papiloma humano (VPH), promoviendo el desarrollo de displasia cervical. El presente estudio identificó evidencias bibliográficas de asociación entre la infección con VPH, otras ITS, y el microbioma vaginocervical en el desarrollo de estas lesiones. Se consultaron fuentes originales de las bases: PubMed, Sciencedirect, Springerlink, sin limitación en fechas de publicación; se utilizaron los siguientes descriptores: «Infecciones de transmisión sexual y cáncer cervical», «microbiota vaginal, infección por VPH y neoplasia cervical intraepitelial», «microbiota vaginal y cervical» y «relación entre cáncer y microbiota vaginal». La muestra final fue de 43 publicaciones. El VPH oncogénico se ha asociado significativamente con G. vaginalis (p<0,025), la cual se ha detectado hasta un 91,9% en mujeres con lesiones cervicales, mostrando mayor detección en lesiones intraepiteliales de alto grado (LIEAG). La depleción de Lactobacillus y una mayor diversidad microbiana facilitan la infección por el VPH y podrían estar involucrados en la persistencia viral y el desarrollo del cáncer. Es importante la detección de estas asociaciones microbianas, que actúan como cofactores en el desarrollo de lesiones cancerosas, facilitando la persistencia de la infección por VPH oncogénicos y, por ende, el desarrollo de cáncer
Abstract.
Recently studies have described that the alteration of the vaginal and cervical microbiota could lead to a favorable microenvironment for the development of neoplastic cervical lesions under certain infections. Changes in bacterial communities, pH elevation, bacterial vaginosis and sexually transmitted infections (STIs) can alter the cervicovaginal microenvironment and allow the persistence of microorganisms such as the human papilloma virus (HPV), promoting the development of cervical dysplasia. The present study identified bibliographic evidences of associations between infection with HPV, other STIs, and the vaginocervical microbiome in the development of these lesions. Original sources of the bases were consulted: PubMed, Sciencedirect, Springerlink, without limitation on dates of publication; were used: «Sexually transmitted infections and cervical cancer», «vaginal microbiota, HPV infection and cervical intraepithelial neoplasia», «vaginal and cervical microbiota», «Relationship between cancer and vaginal microbiota». The final sample was 43 publications. Oncogenic HPV has been significantly associated with G. vaginalis (p<0.025), and it has been detected up to 91.9% in women with cervical lesions; showing greater detection in high-grade intraepithelial lesions (LIEAG). Depletion of Lactobacillus and greater microbial diversity facilitate HPV infection and may be involved in viral persistence and cancer development. It is important to detect these microbial associations, which act as cofactors in the development of cancerous lesions, facilitating the persistence of oncogenic HPV infection, and therefore the development of cancer.
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