Prevotella

Bacteria

Biology

Cervical intraepithelial neoplasia

Cohort

Bacterial vaginosis

Cervical cancer

Physiology

Immunology

Biomarker

Genetics

Microbiome

Bioinformatics

Lactobacillus

Internal medicine

Gardnerella vaginalis

Gynecology

Oncology

Medicine

Disease

Cancer

Nature Communications

Emerging evidence suggests associations between the vaginal microbiota (VMB) composition, human papillomavirus (HPV) infection, and cervical intraepithelial neoplasia (CIN); however, causal inference remains uncertain. Here, we use bacterial DNA sequencing from serially collected vaginal samples from a cohort of 87 adolescent and young women aged 16–26 years with histologically confirmed, untreated CIN2 lesions to determine whether VMB composition affects rates of regression over 24 months. We show that women with a Lactobacillus- dominant microbiome at baseline are more likely to have regressive disease at 12 months. Lactobacillus spp. depletion and presence of specific anaerobic taxa including Megasphaera, Prevotella timonensis and Gardnerella vaginalis are associated with CIN2 persistence and slower regression. These findings suggest that VMB composition may be a future useful biomarker in predicting disease outcome and tailoring surveillance, whilst it may offer rational targets for the development of new prevention and treatment strategies.

The vaginal microbiota associates with the regression of untreated cervical intraepithelial neoplasia 2 lesions