Vaginal microbiota, immune system and the Human Papillomavirus

October 22, 2021

Microbiota vaginal, sistema inmune y el Virus del Papiloma Humano

The prevalence of HPV infection is different depending on the geographical area in Spain, but it is estimated that up to 80% of the sexually active population has suffered from it throughout their lives.

Normally our immune system is able to resolve the infection itself in less than a year, however there are many different genotypes (types) of HPV. Some types can cause health problems such as genital warts and cancer that can appear years after contracting the disease, but others may not cause any symptoms and disappear within a few months. In fact, negativization of viral detection occurs in approximately 90% of cases at 18-24 months, so that only 10% of infections will be persistent.

HPV is a double-stranded DNA virus and HPV genotypes are divided into those with low oncogenic risk (6, 11, 40, 42, 53, 54 and 57) and those with high risk (16, 18, 32, 35). , 39, 45, 51, 56 and 58) 1. HPV has been identified as the cause of different head and neck cancers, with HPV-16 being the most frequently associated with laryngeal carcinoma. Infection by high-risk viral genotypes are especially 16 and 18.

A person can contract HPV by having vaginal or anal sex and, although less frequently oral, with a person who has the virus, even if they do not present symptoms.

Cervical cancer is correlated with HPV and HPV infection is found in practically 99.7% of cases of uterine cancer. In fact, if we compare it with lung cancer for example, the risk of lung cancer in a smoker to a non-smoker is 8 times more , however the risk of cervical cancer is 434 times greater in a positive woman to a non-positive woman with HPV genotypes 16 and 18.

What can we do then if we have been diagnosed with HPV?

Sexually active people should undergo a gynecological examination frequently, since early detection of the virus is key both to not infect other sexual partners and to prevent uterine cancer.

The techniques used to detect HPV are through a sample taken during cytology (PAP) that allows detecting abnormal cells in the cervix and on the other hand we have HPV tests to analyze the genetic material where the type can be differentiated. of HPV virus and its virulence in the cells of the cervix.

We can prevent it, but how?

The first protective mechanism of course is the use of contraception during vaginal, oral and anal sex to prevent contagion.

We also know that genotype will not be the only reason why we can develop cervical cancer, but that there are many other factors that come into play. Of course, persistent infection with this virus is considered a necessary condition for developing cancer, but it would not be sufficient for the oncogenic process. This means that the evolution of this virus will depend on several factors:

Viral clearance capacity and epithelial permeability

Our immune system, upon detecting this virus, will fight to eradicate it. Therefore maintaining a competent immune system is vital for both prevention and treatment.

Some strategies that we can use are:

· Have levels of vitamin D suitable, ideally between about 30/50ng/ml. In this study the odds of high-risk HPV infection were increased in women with vitamin D deficiency (aOR, 1.41; 95% CI, 1.02-1.97) compared with women with sufficient vitamin D. It is important to combine it with magnesium to be able to convert vitamin D into its active form, in addition to taking a supplement of 2,000/4,000 IU per day in winter and autumn and a minimum sun exposure of 15/20 minutes daily.

· Carry out exercise physical: according to a revision 2019 published in the Journal of Sport and Health Science, exercise mobilizes immune cells that fight pathogens and inflammation, helping to slow the effects of aging on the immune system. When performing physical exercise, body temperature will increase, dilating blood vessels, facilitating the flow of blood cells, including immune cells. In addition, exercise also increases the amount of white blood cells (leukocytes, neutrophils, natural killer...) that protect us against pathogens. Additionally, muscle cells produce myokines, reducing inflammation, regulating the immune system and impacting metabolic health.

· Keep a Adequate and healthy nutrition , rich in proteins (eggs, quality meat, fish, dairy products...), healthy fats (olive oil, coconut oil, avocado, nuts, olives...) and vegetables provides us with the vitamins and minerals necessary for our immune system is competent.

· Take moments of rest , since stress depresses the immune system, making it more prone to infections and having an inadequate and insufficient response to an infection.

Vaginal and endometrial microbiota

Although little is known at the moment, we know that the vaginal microbiota plays a decisive role in the progression of HPV (3).

When we talk about vaginal microbiota we are referring to the niche of microorganisms that inhabit the vagina and that are naturally present in all women. Most of these bacteria are bacteria of the Lactobacillus genus, which help us produce antimicrobial substances that protect us against infections. It also helps prevent them from adhering to the epithelium, producing anti-inflammatory substances and coaggregating with pathogens. Specifically, that dominated by Lactobacillus crispatus, L. jensenii and L. gasseri confers a protective ecosystem.

Miscellaneous studies show that a dysbiotic, unbalanced microbiota, with a predominance of bacteria such as Gardnerella or Ureaplasma or fungi of the Candida genus, increases the risk of HPV contraction and a worsening of its evolution.

Therefore, to maintain a healthy microbiota, it will be advisable to maintain a strong immune system to prevent infections, since the indiscriminate intake of antibiotics reduces the community of vaginal protective bacteria and therefore predisposes to the contraction of STDs such as HPV, Chlamydia, Gonorrhea, etc

Taking vaginal probiotics and prebiotics can be a great tool for both prevention and treatment of HPV, especially the days before and after menstruation. It is recommended to administer vaginal capsules 7 to 10 days a month or take oral probiotics rich in Lactobacillus 15 to 30 days a month.

If you liked it, don't hesitate to share this post to help more women prevent and treat HPV.


If you want more information about our consultations to help strengthen your immune system or/and analyze your vaginal microbiota, you can hire the  starter pack here or write to info@mpunti.es .

BIBLIOGRAPHY

  1. Muñoz N, Bosch FX, de Sanjosé S, Herrero R, Castellsaqué X, Shah KV, et al. Epidemiologic classification of human papillomavirus types associated with cervical cancer. N Engl J Med. 2003;348:518-27.
  2. Shim, Jinhee, “Association between vitamin D and the prevalence of human papillomavirus infection in women in the United States: The National Health and Nutrition Examination Survey 2003-2006” (2014). Texas Medical Center Dissertations (via ProQuest) . AAI1586836.
  3. Mitra A, MacIntyre DA, Marchesi JR, Lee YS, Bennett PR, Kyrgiou M. The vaginal microbiota, human papillomavirus infection and cervical intraepithelial neoplasia: what do we know and where are we going next? Microbiome. 2016 Nov 1;4(1):58.
  4. Lopes, R., Teixeira, JA, Marchioni, D., Villa, LL, Giuliano, AR, Luiza Baggio, M., & Fisberg, RM (2017). Dietary intake of selected nutrients and persistence of HPV infection in men. International journal of cancer , 141 (4), 757–765. https://doi.org/10.1002/ijc.30772



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