To examine the role of the vaginal microbiome (VM) and its associated cytokine and metabolome profiles in a prospective study of HPV 16 acquisition, persistence and clearance.
Four visits from 13 women were selected at time of: HPV16 negativity, acquisition, persistence and prior to clearance. (--+++--) Cervicovaginal lavage samples were examined for cytokine profiling using Luminex microbiome profiling using 16S rRNA analysis and metabolome profiling. Visits excluded if noted pregnancy, STI or recent antibiotics/intravaginal medication reported. Microbiome community states types (CST) were identified.
No clear CST appeared associated with acquisition, persistence, or clearance of HPV16, however, significantly greater microbiome diversity was observed during persistence(figure 1). CST-III appeared immune activated with significantly higher levels of cytokines (figure 2).Metabolomic analysis found persistence associated with higher levels of mannose, important in innate immune responses, cadaverine, a genotoxic by-product released by anaerobes and nicotinamideribonucleotide(NMN), carcinogen metabolite of nicotine. G. vaginalis was associated with higher levels of mannose and NMN.
HPV16 persistence results in increased microbiome diversity, a hallmark of VM dysbiosis and activated innate immune states which if chronically present are associated with genotoxic products capable of inducing cancer.