References

medsovet

Медицинский Совет

Meditsinskiy sovet = Medical Council

2079-701X2658-5790

REMEDIUM GROUP Ltd.

10.21518/ms2025-084

medsovet-9021

Research Article

РЕПРОДУКТИВНОЕ ЗДОРОВЬЕ И ВРТ

REPRODUCTIVE HEALTH AND ART

Микробиота влагалища и ВПЧ-ассоциированные заболевания шейки матки: установленная взаимосвязь

Vaginal microbiota and HPV-associated cervical diseases: Established relationship

https://orcid.org/0000-0001-9499-7654

Назарова

Н. М.

Nazarova

N. M.

Назарова Нисо Мирзоевна, д.м.н., ведущий научный сотрудник

117997, Москва, ул. Академика Опарина, д. 4

Niso М. Nazarova, Dr. Sci. (Med.), Lead Research Associate

4, Academician Oparin St., Moscow, 117997

n_nazarova@oparina4.ru

https://orcid.org/0009-0006-7277-5202

Акопян

A. С.

Аkopian

A. S.

Акопян Аида Саркисовна, врач – акушер-гинеколог

142770, Москва, ул. Липовый Парк, Коммунарка, д. 5 корп. 1

Аida S. Аkopian, Obstetrician-Gynecologist

5 Bldg. 1 Lipovy Park St., Kommunarka, Moscow, 142770

aida.doctor@mail.ru

https://orcid.org/0000-0002-4126-9730

Припутневич

Т. В.

Priputnevich

T. V.

Припутневич Татьяна Валерьевна, чл.корр. РАН, д.м.н., профессор, директор института микробиологии, антимикробной терапии и эпидемиологии, Национальный медицинский исследовательский центр акушерства, гинекологии и перинатологии имени академика В.И. Кулакова; профессор кафедры микробиологии и вирусологии, Российский национальный исследовательский медицинский университет имени Н.И. Пирогова; профессор кафедры медицинской микробиологии имени академика З.В. Ермольевой, Российская медицинская академия непрерывного профессионального образования

117997, Москва, ул. Академика Опарина, д. 4,

117997, Москва, ул. Островитянова, д. 1,

125993, Москва, ул. Баррикадная, д. 2/1, стр. 1

Тatiana V. Priputnevich, Corr. Member of RAS, Dr. Sci. (Med.), Professor, Director of Institute of Microbiology, Antimicrobial Microbiology, Antimicrobial Therapy and Epidemiology, Kulakov National Medical Research Center of Obstetrics, Gynecology and Perinatology; Professor of the Department of Microbiology and Virology, Pirogov Russian National Research Medical University; Professor of Academician Z.V. Ermolyeva Medical Microbiology Department, Russian Medical Academy of Continuous Professional Education

4, Academician Oparin St., Moscow, 117997,

1, Ostrovityanov St., Moscow, 117997,

2/1, Bldg. 1, Barrikadnaya St., Moscow, 125993

t_priputnevich@oparina4.ru

https://orcid.org/0000-0003-0383-0731

Муравьева

В. В.

Muravieva

V. V.

Муравьева Вера Васильевна, к.б.н., старший научный сотрудник

117997, Москва, ул. Академика Опарина, д. 4

Vera V. Muravieva, Cand. Sci. (Bio.), Senior Research Associate

4, Academician Oparin St., Moscow, 117997

v_muravieva@oparina4.ru

https://orcid.org/0000-0002-1313-7079

Павлович

С. В.

Pavlovich

S. V.

Павлович Станислав Владиславович, к.м.н., профессор кафедры акушерства, гинекологии, перинатологии и репродуктологии Института профессионального образования, Первый Московский государственный медицинский университет имени И.М. Сеченова (Сеченовский Университет); ученый секретарь, Национальный медицинский исследовательский центр акушерства, гинекологии и перинатологии имени академика В.И. Кулакова

119991, Москва, ул. Большая Пироговская, д. 2, стр. 4,

117997, Москва, ул. Академика Опарина, д. 4

Stanislav V. Pavlovich, Cand. Sci. (Med.), Professor of Department of Obstetrics, Gynecology, Perinatology and Reproductology, Institute for Professional Education, Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University); Academic Secretary, Kulakov National Medical Research Center of Obstetrics, Gynecology and Perinatology

2, Bldg. 4, Bolshaya Pirogovskaya St., Moscow, 119991,

4, Academician Oparin St., Moscow, 117997

s_pavlovich@oparina4.ru

Национальный медицинский исследовательский центр акушерства, гинекологии и перинатологии имени академика В.И. КулаковаРоссияKulakov National Medical Research Center of Obstetrics, Gynecology and PerinatologyRussian Federation

Клиника АВС-медицинаРоссияABC-Medicina ClinicRussian Federation

Национальный медицинский исследовательский центр акушерства, гинекологии и перинатологии имени академика В.И. Кулакова; Российский национальный исследовательский медицинский университет имени Н.И. Пирогова; Российская медицинская академия непрерывного профессионального образованияРоссияKulakov National Medical Research Center of Obstetrics, Gynecology and Perinatology; Pirogov Russian National Research Medical University; Russian Medical Academy of Continuous Professional EducationRussian Federation

Национальный медицинский исследовательский центр акушерства, гинекологии и перинатологии имени академика В.И. Кулакова; Первый Московский государственный медицинский университет имени И.М. Сеченова (Сеченовский Университет)РоссияKulakov National Medical Research Center of Obstetrics, Gynecology and Perinatology; Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University)Russian Federation

2025

26042025

042634

2025

Назарова Н.М., Акопян A.С., Припутневич Т.В., Муравьева В.В., Павлович С.В.

Nazarova N.M., Аkopian A.S., Priputnevich T.V., Muravieva V.V., Pavlovich S.V.

Данная работа распространяется под лицензией Creative Commons Attribution 4.0.

This work is licensed under a Creative Commons Attribution 4.0 License.

https://www.med-sovet.pro/jour/article/view/9021

Основная цель данного обзора – проанализировать научные данные о микробиоте нижних отделов половых путей и факторах, влияющих на ее состав, а также взаимосвязь с ВПЧ-ассоциированными заболеваниями шейки матки. Современные исследования подтверждают, что определенные виды лактобацилл могут играть защитную роль, снижая вероятность инфицирования вирусом папилломы человека (ВПЧ) и способствуя его элиминации. В то же время дисбиотические изменения, включая снижение уровня лактобацилл и увеличение численности условно-патогенных микроорганизмов, ассоциируются с развитием бактериального вагиноза и других нарушений биоценоза влагалища. Эти состояния могут способствовать персистенции ВПЧ, увеличивая риск формирования цервикальной интраэпителиальной неоплазии и рака шейки матки. Большинство исследований свидетельствуют о значительных различиях в составе вагинального микробиома у женщин с цервикальной интраэпителиальной неоплазией и злокачественными новообразованиями шейки матки по сравнению со здоровыми пациентками. Важную роль в этом процессе играют анаэробные бактерии, такие как Gardnerella vaginalis, Mobiluncus spp., Peptoniphilus spp., Parvimonas micra, Prevotella spp., которые могут подавлять рост лактобацилл и нарушать нормальный баланс микрофлоры. Кроме того, снижение уровня Lactobacillus crispatus связано с более высокой вероятностью персистенции ВПЧ и прогрессирования дисплазии. Изучение механизмов взаимодействия вагинальной микробиоты и ВПЧ важно для понимания патогенеза предраковых и злокачественных процессов шейки матки. Дальнейшее изучение этих аспектов позволит разработать новые стратегии профилактики и лечения, направленные на модуляцию вагинальной микрофлоры и снижение риска прогрессирования заболеваний.

This review is aimed to analyse research data on the lower genital tract microbiome and factors effecting its composition, as well as the relationship with HPV-associated cervical diseases. Modern studies show that certain types of lactobacilli can play a protective role by reducing the likelihood of human papillomavirus (HPV) infection and contributing to its elimination. At the same time, dysbiotic changes, including decreased levels of lactobacilli and increased levels of opportunistic pathogens, are associated with the development of bacterial vaginosis and other abnormal vaginal biocenosis. These conditions can contribute to the persistence of HPV, increasing the risk of cervical intraepithelial neoplasia and cervical cancer. Most studies show significant differences in the vaginal microbiome composition in women with cervical intraepithelial neoplasia and malignant cervix neoplasms as compared to healthy patients. Anaerobic bacteria such as Gardnerella vaginalis, Mobiluncus spp., Peptoniphilus spp., Parvimonas micra, Prevotella spp. that can inhibit the growth of lactobacilli and disrupt the normal balance of microflora play an important role in this process. In addition, decreased levels of Lactobacillus crispatus are associated with a higher probability of HPV persistence and dysplasia progression. Studying mechanisms of interaction between vaginal microbiota and HPV is critically important to understand the mechanisms of pathogenesis of precancerous and malignant processes of the cervix. Further study of these aspects will allow the development of new prevention and treatment strategies to modulate vaginal microflora and reduce the risk of disease progression.

микробиота влагалищабактериальный вагиноздисбиоз влагалищавирус папилломы человека (ВПЧ)дисплазия шейки маткирак шейки матки

vaginal microbiotabacterial vaginosisvaginal dysbiosishuman papillomavirus (HPV)cervical dysplasiacervical cancer

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The authors declare that there are no conflicts of interest present.