Effect of chemical peeling therapy for treatment of cervical intraepithelial neoplasia on cervicovaginal microbiota
Abstract
Aim
The cervicovaginal microbiome is associated with progression and regression of cervical intraepithelial neoplasia (CIN). Chemical peeling, an investigational treatment that shows promise as a non-invasive treatment for CIN, exfoliates the human papillomavirus (HPV)-infected cervical epithelium; subsequent alterations to the cervicovaginal microbiome may be a key mechanism of its effect.
Methods and results
Using a retrospective paired-sample analysis, we investigated the cervicovaginal microbiota of 28 CIN patients, comparing pre- and post-treatment samples from the same individuals who achieved high-risk HPV clearance. We used 16S ribosomal RNA gene sequencing to detect microbial markers in liquid-based cytology solution from cervical scrapings. Enrichment of Lactobacillus hominis was significantly observed after chemical peeling by differential abundance analysis. Alterations in cervicovaginal bacteria after chemical peeling predicted multiple biochemical changes such as increased selenocompound and thiamine metabolism.
Conclusions
Chemical peeling may modulate microbiota and bacteria-derived metabolites, thereby contributing to an additional therapeutic mechanism against CIN.