The role of vaginal biofilms in endocervical neoplasia development: A literature review
DOI:
https://doi.org/10.37800/RM.2.2026.700Keywords:
bacterial vaginosis, biofilm, cervicovaginal microbiome, cervicovaginal mucus, human papillomavirus , cervical neoplasiaAbstract
Relevance: The persistence of infection with high-risk human papillomavirus (HPV) types is a necessary condition for the development of most precancerous lesions and cervical cancer. However, the outcome of infection is largely determined by the cervicovaginal tract microenvironment. The biofilm phenotype of bacterial vaginosis and related dysbiosis conditions are potentially modifiable cofactors for HPV persistence and neoplasia progression, including cervical canal lesions.
The study aimed to systematize current concepts regarding the roles of vaginal biofilms and the cervicovaginal barrier in the persistence of human papillomavirus and the development of cervical neoplasia.
Materials and Methods: A review of publications in PubMed/Medline and current clinical guidelines was conducted. Priority was given to systematic reviews, meta-analyses, longitudinal observational studies, and experiments describing biofilm organization, enzymatic phenotypes, properties of the mucosal barrier, and local immune signals.
Results: Dysbiosis characterized by a decrease in Lactobacillus-dominated states and an increase in anaerobic taxa is associated with impaired cervicovaginal mucus properties, altered epithelial barrier function, and enhanced local inflammation. These changes may potentially contribute to prolonged HPV persistence, delayed clearance, and maintenance of precancerous lesions. Data specifically related to cervical canal neoplasia remain limited and require further studies that account for the spatial organization of biofilms and functional barrier markers.
Conclusion: Biofilm-associated dysbiosis represents a promising approach for clarifying individual risk in women with a positive HPV test and for developing adjuvant strategies to restore a protective Lactobacillus-dominated microenvironment and the barrier function of cervicovaginal mucus.
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