Species composition of Lactobacilli in young women of reproductive age with squamous intraepithelial lesions of the cervix
Pinchuk T.V., Babenka A.S., Reutovich M.Yu., Kostiuk S.A.
Objective. To conduct comparative analysis of the prevalence and relative abundance of the major Lactobacillus species (L. crispatus, L. gasseri, L. jensenii, L. iners) in young women of reproductive age with low-grade squamous intraepithelial lesions (LSIL) and high-grade squamous intraepithelial lesions (HSIL) of the cervix.
Materials and methods. Initially, this case-control study analyzed medical records of 1,027 women aged 18–35 years who were referred to hospital to undergo extended colposcopy due to a positive human papillomavirus (HPV) test results. Among them, 358 women with abnormal colposcopy findings underwent colposcopy-directed biopsy of the cervix with subsequent histopathological examination. After using the exclusion criteria, 191 women with histologically confirmed cervical squamous intraepithelial lesions were included in the final analysis – 111 (58.11%) with LSIL and 80 (41.89%) with HSIL. Lactobacillus species were identified using real-time polymerase chain reaction (real-time PCR). Statistical analysis of differences between the groups was performed using the Mann–Whitney U test and Fisher’s exact test.
Results. L. iners dominance was statistically significant in patients with HSIL (p<0.001), whereas L. crispatus was dominant in women with LSIL (p<0.001). No significant differences were found between the two groups in the prevalence of L. gasseri and L. jensenii (p>0/05).
Conclusion. This study found that vaginal microbiota in young women of reproductive age with HPV-associated high-grade squamous intraepithelial lesions of the cervix is characterized by the predominance of Lactobacillus iners and reduced abundance of Lactobacillus crispatus. These findings support association between vaginal microbial dysbiosis and the severity of cervical lesions in the study sample. This justifies the need for further research on Lactobacillus species in the the vaginal microbiota of young women with HPV-associated cervical pathology.
Authors' contributions. Pinchuk T.V., Kostiuk S.A. – study concept and design; Pinchuk T.V., Babenka A.S. – material collection and processing; Babenka A.S., Pinchuk T.V. – statistical data processing; Pinchuk T.V. – manuscript writing; Reutovich M.Yu., Kostiuk S.A. – manuscript editing.
Conflicts of interest. The authors confirm that they have no conflict of interest to declare.
Funding. The study was carried out without any sponsorship.
Ethical Approval. The study was approved by the local Ethics Committee of the Biomedical Ethics Committee of Belarusian State Medical University (protocol No. 8 of May 07, 2024).
Generative Artificial Intelligence. No generative AI was used in preparing this article.
Patient Consent for Publication. The patients have signed informed consent for publication of their data.
Authors' Data Sharing Statement. The data supporting the findings of this study are available on request from the corresponding author after approval from the principal investigator.
For citation: Pinchuk T.V., Babenka A.S., Reutovich M.Yu., Kostiuk S.A. Species composition of Lactobacilli
in young women of reproductive age with squamous intraepithelial lesions of the cervix.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2026; (9): 109-116 (in Russian)
https://dx.doi.org/10.18565/aig.2026.166
Keywords
cervicovaginal microbiota
lactobacilli
L. iners
L. crispatus
cervical dysplasia
cervical neoplasia
cervical squamous intraepithelial lesions
References
- Океанов А.Е., Мохорт Т.В., Левин Л.Ф., Поляков С.Л. Рак в Беларуси: цифры и факты. Анализ данных Белорусского канцер-регистра за 2015-2024 гг. Минск: РНПЦ ОМР им. Н.Н. Александрова; 2025. 283 с. [Okeanov A.E., Mokhort T.V., Levin L.F., Polyakov S.L. Cancer in Belarus: figures and facts. Analysis of the data of the Belarusian cancer register for 2015-2024. Minsk: RNPTs OMR im. N.N. Aleksandrova; 2025. 283 p. (in Russian)].
- Głowienka-Stodolak M., Bagińska-Drabiuk K., Szubert S., Hennig E.E., Horala A., Dąbrowska M. et al. Human papillomavirus infections and the role played by cervical and cervico-vaginal microbiota-evidence from next-generation sequencing studies. Cancers. 2024; 16(2): 399. https://dx.doi.org/10.3390/cancers16020399
- Можейко Л.Ф., Пинчук Т.В. Факторы риска цервикальных интраэпителиальных плоскоклеточных поражений в раннем репродуктивном возрасте. Медицинский журнал. 2025; 4: 102-8. https://dx.doi.org/10.51922/1818-426X.2025.4.102 [Mozheiko L.F., Pinchuk T.V. Risk factors for cervical squamous intraepithelial lesions in early reproductive age. Medical Journal. 2025; 4: 102-8. (in Russian). https://dx.doi.org/10.51922/1818-426X.2025.4.102]
- Минкина Г.Н. Бактериальный вагиноз как фактор риска цервикального канцерогенеза. Вопросы гинекологии, акушерства и перинатологии. 2024; 23(4): 71-80. https://dx.doi.org/10.20953/1726-1678-2024-4-71-80 [Minkina G.N. Bacterial vaginosis as a risk factor for cervical carcinogenesis. Gynecology, Obstetrics and Perinatology. 2024; 23(4): 71-80 (in Russian). https://dx.doi.org/10.20953/1726-1678-2024-4-71-80]
- Юрова М.В., Абакарова П.Р., Межевитинова Е.А., Аксенова А.В. Вагинальный микробиом и персистенция ВПЧ: роль бактериального вагиноза в цервикальном канцерогенезе. Фарматека. 2025; 32(3): 24-9. https://dx.doi.org/10.18565/pharmateca.2025.3.24-29 [Iurova M.V., Abakarova P.R., Mezhevitinova E.A., Aksenova A.V. Vaginal microbiome and HPV persistence: the role of bacterial vaginosis in cervical carcinogenesis. Farmateka. 2025; 32(3): 24-9 (in Russian). https://dx.doi.org/10.18565/pharmateca.2025.3.24-29]
- Frąszczak K., Barczyński B., Kondracka A. Does lactobacillus exert a protective effect on the development of cervical and endometrial cancer in women? Cancers (Basel). 2022; 14(19): 4909. https://dx.doi.org/10.3390/cancers14194909
- Liu H., Liang H., Li D., Wang M., Li Y. Association of cervical dysbacteriosis, HPV oncogene expression, and cervical lesion progression. Microbiol. Spectr. 2022; 10(5): e0015122. https://dx.doi.org/10.1128/spectrum.00151-22
- Миханошина Н.В., Припутневич Т.В., Байрамова Г.Р. Роль Lactobacillus iners и ассоциированных с бактериальным вагинозом микроорганизмов в формировании микробиоты влагалища. Акушерство и гинекология. 2023; 1: 20-6. https://dx.doi.org/10.18565/aig.2022.246 [Mikhanoshina N.V., Priputnevich T.V., Bairamova G.R. The role of Lactobacillus iners and bacterial vaginosis-associated microorganisms in making up the vaginal microbiota. Obstetrics and Gynecology. 2023; (1): 20-6 (in Russian). https://dx.doi.org/10.18565/aig.2022.246]
- Kazlauskaitė J., Žukienė G., Rudaitis V., Bartkevičienė D. The vaginal microbiota, human Papillomavirus, and cervical dysplasia - a review. Medicina (Kaunas). 2025; 61(5): 847. https://dx.doi.org/10.3390/medicina61050847
- Bautista J., Altamirano-Colina A., López-Cortés A. The vaginal microbiome in HPV persistence and cervical cancer progression. Front. Cell. Infect. Microbiol. 2025; 15: 1634251. https://dx.doi.org/10.3389/fcimb.2025.1634251
- Huang R., Liu Z., Sun T., Zhu L. Cervicovaginal microbiome, high-risk HPV infection and cervical cancer: mechanisms and therapeutic potential. Microbiol. Res. 2024; 287: 127857. https://dx.doi.org/10.1016/j.micres.2024.127857
- Landolt E.F., da Conceição Mendonça J., Behler A.E., Lumsdaine S.W., Jafar T., Burcham L.R. Exploring the vaginal ecosystem: insights into host-microbe interactions and microbial community dynamics. Infect. Immun. 2025; 93(9): e00499-24. https://dx.doi.org/10.1128/iai.00499-24
- Hugerth L.W., Krog M.C., Vomstein K., Du J., Bashir Z., Kaldhusdal V. et al. Defining vaginal community dynamics: daily microbiome transitions, the role of menstruation, bacteriophages, and bacterial genes. Microbiome. 2024; 12: 153. https://dx.doi.org/10.1186/s40168-024-01870-5
- Lebeer S., Ahannach S., Gehrmann T., Wittouck S., Eilers T., Oerlemans E. et al. A citizen-science-enabled catalogue of the vaginal microbiome and associated factors. Nat. Microbiol. 2023; 8(11): 2183-95. https://dx.doi.org/10.1038/s41564-023-01500-0
- Приказ Министерства здравоохранения Республики Беларусь от 4 апреля 2025 г. № 389 «Об утверждении порядка организации и проведения ранней диагностики предопухолевых и опухолевых заболеваний отдельных локализаций». Доступно по: https://normativka.by/lib/document/131517 [Order of the Ministry of Health of the Republic of Belarus dated April 4, 2025 No. 389 "On the approval of the procedure for organizing and conducting early diagnosis of precancerous and tumor diseases of specific localizations". Available at: https://normativka.by/lib/document/131517 (in Russian)].
- Костюк С.А., Шиманская И.Г., Полуян О.С., Руденкова Т.В. Особенности видового разнообразия Lactobacillus spp. при нормоценозе, мезоценозе и дисбиозе влагалища. Медицинские новости. 2015; 10: 63-6. [Kostiuk S.A., Shimanskaya I.G., Poluyan O.S., Rudenkova T.V. The Lactobacillus spp. diversity species features at vagina normotsenoze, mezotsenoze and dysbiosis. Meditsinskie Novosti. 2015; 10: 63-6 (in Russian)].
- Primer3Plus. Wageningen University & Research. Available at: https://www.primer3plus.com/index.html (Date of access: 02.04.2026).
- BLAST: Basic Local Alignment Search Tool. National Center for Biotechnology Information (NCBI). Available at: https://blast.ncbi.nlm.nih.gov/Blast.cgi (Date of access: 06.04.2026).
- Guo C., Dai W., Zhou Q., Gui L., Cai H., Wu D. et al. Cervicovaginal microbiota significantly changed for HPV-positive women with high-grade squamous intraepithelial lesion. Front. Cell. Infect. Microbiol. 2022; 12: 973875. https://dx.doi.org/10.3389/fcimb.2022.973875
- Радзинский В.Е., Савичева А.М., ред. Биоценоз влагалища. Норма. Нарушения. Восстановление. М.: StatusPraesens; 2020: 99-102. [Radzinsky V.E., Savicheva A.M., eds. Biocenosis of the vagina. Norm. Violations. Recovery. Moscow: StatusPraesens; 2020: 99-102 (in Russian)].
- Мотылевич О.П., Тарасов И.А., Саадудинова С.М., Гришель А.С., Мавричев С.А. Влияние микробиома влагалища на персистенцию ВПЧ высокого риска и прогрессирование ВПЧ-индуцированной интраэпителиальной неоплазии шейки матки. Репродуктивное здоровье. Восточная Европа. 2024; 14(2): 285-97. https://dx.doi.org/10.34883/PI.2024.14.2.013 [Motylevich O.P., Tarasov I.A., Saadudinova S.M., Grishel A.S., Mavrichev S.A. The vaginal microbiome influence on the persistence of high-risk HPV and the progression of HPV-induced cervical intraepithelial neoplasia. Reproductive Health. Eastern Europe. 2024; 14(2): 285-97. https://dx.doi.org/10.34883/PI.2024.14.2.013 (in Russian)].
- Xu X., Zhang Y., Yu L., Shi X., Min M., Xiong L. et al. A cross-sectional analysis about bacterial vaginosis, high-risk human papillomavirus infection, and cervical intraepithelial neoplasia in Chinese women. Sci. Rep. 2022; 12: 6609. https://dx.doi.org/10.1038/s41598-022-10532-1
- Gomez Cherey J.F., Payalef S.N., Fleider L., Reyes A.P., Maldonado V.A., Losada M.O. et al. Microbiota unbalance in relation to high-risk human papillomavirus cervical infection. Int. J. Gynecol. Cancer. 2023; 33(4): 482-8. https://dx.doi.org/10.1136/ijgc-2022-003760
Received 19.05.2026
Accepted 13.08.2026
About the Authors
Tatiana V. Pinchuk, Senior Lecturer at the Department of Obstetrics and Gynecology with the Course of Advanced Training and Retraining, Belarusian State Medical University, 220013, Republic of Belarus, Minsk, Nezavisimosti Ave., 64, +375292307920, dr.tania.pinchuk@gmail.com, https://orcid.org/0009-0008-4922-2591Andrei S. Babenka, PhD in Chemistry, Associate Professor, Biologist, Republican Scientific and Practical Center "Cardiology", 220036, Republic of Belarus, Minsk,
Luxemburg str., 110B, +375293565795, labmdbt@gmail.com, https://orcid.org/0000-0002-7577-9878
Mikhail Yu. Reutovich, MD, PhD, Associate Professor, Vice-Rector for Research, Belarusian State Medical University, 220083, Republic of Belarus, Minsk, Dzerzhinsky Ave., 83 build. 1, +375447712330, scienceprorektor@bsmu.by, https://orcid.org/0000-0001-7202-6902
Svetlana A. Kostiuk, MD, PhD, Professor, Head of the Laboratory of Molecular Genetic Diagnostics, Research Institute of Experimental and Clinical Medicine, Belarusian State Medical University, 223053, Republic of Belarus, Minsk Region, Minsk District, Borovlyansky Village Council, 106-2, +375296619134, s.kostiuk@mail.ru,
https://orcid.org/0000-0002-3252-2626
Corresponding author: Tatiana V. Pinchuk, dr.tania.pinchuk@gmail.com
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