Francesco DI Pierro, Anna A Criscuolo, Anna Dei Giudici, Roberto Senatori, Francesco Sesti, Marco Ciotti, Emilio Piccione
Journal: Minerva obstetrics and gynecology 2021;73(5):621-631
PMID: 33876901
Vaginal microbiotas are clustered into five different possible categories, according to their bacterial dominance. The aim of this study was to evaluate a possible correlation between the vaginal microbiota and the 90-day persistence of Human Papilloma Virus (HPV) infection - both high-risk (HR) and low-risk (LR) strains - in the cervical-vaginal area. The study is an observational, open, pilot study. Participants included a group of 35 women with HPV cervical infection, with normal or abnormal cervical cytology, and recurrent vaginal infections. Results show that after 90 days of treatment with L. crispatus M247, 97% of women had a vaginal microbiota that was Lactobacillus-dominated. Furthermore, after 90 days, 71% of women were HPV-negative, with respect to both HR and LR strains, and 29% were still infected by HR-HPV strains. Authors conclude that their findings are preliminary and uncontrolled, thus further investigation with a higher number of women with HPV infection would help to verify the long-term effect of L. crispatus M247.
BACKGROUND
Vaginal microbiotas can be clustered into five different possible categories (CST I to V), according to their bacterial dominance. In CST I, the dominance of Lactobacillus crispatus seems to correlate with better vaginal health and with a lower incidence of sine causa infertility, preterm delivery, bacterial vaginosis, and viral (including human papillomavirus; HPV) infection. According to the same method of classifying the vaginal microbiome, CST IV (non-Lactobacillus-dominated) demonstrates a higher incidence of disorders.
METHODS
In an open, non-controlled study, we enrolled 35 HPV-positive women who mostly (N.=24) demonstrated CST IV status, with the other individuals categorized as having either CST III (N.=10) or CST II (N.=1) microbiotas.
RESULTS
After 90 days of oral treatment with a probiotic (L. crispatus M247) we observed a reduction of approximately 70% in HPV positivity and a significant change in CST status with 94% of women now classified as CST I.
CONCLUSIONS
Despite the limitations of our study, it is the first demonstration that it is possible to intervene orally with an L. crispatus probiotic to bring about a change in CST status and, in parallel, increased HPV clearance.
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