Relationship between vaginal and oral microbiome in patients of human papillomavirus (HPV) infection and cervical cancer

Abstract

Background This study aimed to assess the microbial variations and biomarker in the vaginal and oral environment of HPV (human papillomavirus) and cervical cancer (CC) patients and developing novel prediction models. Materials and Methods This study includes 164 samples collected from both the vaginal tract and oral subgingival plaque of 82 women. The participants were divided into four distinct groups based on their vaginal and oral samples including control group (Z/KZ, n = 22), abortion group (AB/KAB, n = 17), HPV-infected group (HP/KHP, n = 21), and cervical cancer group (CC/KCC, n = 22). Microbiota analysis was conducted using full-length 16S rDNA gene sequencing with PacBio platform. Results The vaginal bacterial community in the Z and AB groups exhibited a relatively simple structure predominantly dominated by Lactobacillus. However, CC group shows high diversity and abundances of anaerobic bacteria and alpha diversity. Biomarkers such as Bacteroides, Mycoplasma, Bacillus, Dialister, Porphyromonas, Anaerococcus, and Prevotella were identified as indicator of CC. Correlations were established between elevated blood C-reactive protein (CRP) levels and local/systemic inflammation, pregnancies, childbirths, and abortions, contributing to the unevenness in the vaginal microenvironment. The altered microbial diversity in CC group was confirmed by amino acid metabolism.The oral microbial diversity exhibited inverse pattern to the vaginal microbiome, indicating a unique relationship. The KCC group showed a significantly lower microbial diversity compared to the KZ group, pointing a link between oral health and cancer development. Several microbes including Fusobacterium, Campylobacte, Capnocytophaga, Veillonella, Streptococcus, Lachnoanaerobaculum, Propionibacterium, Prevotella, Lactobacillus, Neisseria were screened as CC biomarkers. Moreover, Periodontal pathogens were associated with blood CRP levels and oral hygiene conditions. Elevated oral microbial amino acid metabolism in CC group was closely linked to the presence of pathogens. positive correlations indicated synergy between vaginal and oral bacteria. Conclusion HPV infection and CC impact both the vaginal and oral microenvironment, affecting systemic metabolism and the synergy between bacteria. This suggests the use oral flora markers as a prospective screening tool for the diagnosis the cervical cancer.