Cervicovaginal Microbiome after Cervical Intraepithelial Neoplasia Treatment. A Protocol for Systematic Review and Meta-Analysis

Abstract

(1) Background: The microbiome consists of microorganisms from various kingdoms with numerous physical and chemical properties Lactobacillus species constitute the highest percentage of healthy cervical and vaginal microbiota. Dysbiosis may cause adverse outcomes, e.g., bacterial vaginosis, pelvic inflammatory disease and pregnancy complications. The cervicovaginal microbiome might contribute to the development of a persistent HPV infection—the main risk factor of cervical cancer—and influence progression to malignancy The aim is to perform a systematic review of current literature and a meta-analysis regarding microbiome changes after cervical intraepithelial neoplasia treatment. (2) Methods: We will search PubMed, Scopus, Google Scholar and Embase Database and trace citations in the reference sections. Randomized and non-randomized controlled studies, case–control and cohort studies published between January 2000 and May 2021 will be included in the study protocol. The following keywords will be used: ‘microbiome’, ‘vaginal microbiome’, ‘cervical microbiome’, ‘cervical neoplasia treatment’, ’conization’, ‘electroconization’, and ‘electrosurgical treatment’. Statistical analyses will be performed using RevMan 5.4. (3) Results: The results will be published as a peer-reviewed article. (4) Conclusions: The study will show which forms of intraepithelial neoplasia treatment change the cervicovaginal microbiome. Finding the best form of treatment by studying the cervicovaginal microbiome after various forms of treatment is essential. Patients would benefit not only from the treatment of the initial disease but also the management of dysbiosis, which might underlie other pathologies.

Host and Microbiome Interplay Shapes the Vaginal Microenvironment

“…On the contrary, another group reported that surgical treatment of CIN modulates the vaginal microbiome, resulting in an increased CST-I and concomitant decrease of CST-IV ( 127 ). To address this controversy, meta-analysis of the effect of CIN treatment on the vagina microbiome is currently in progress ( 128 ). There are also studies that reveal an association between other gynecologic cancers and the vaginal microbiome regardless of oncovirus.…”

The effects of metabolites from three vaginal bacteria on the Syndecan-1 of cervical epithelial cells

“…Present research evidence indicates that the vaginal microbiota is a novel factor in the natural progression of HPV infection [ 2 ]. The dysbiosis of microorganisms in the female reproductive system increases susceptibility to viruses and bacteria [ 3 , 4 ]. Oral intake of Lactobacillus crispatus M247 can improve the vaginal microbiota and enhance HPV clearance [ 5 ].…”