Does the Vaginal Microbiome Operate Differently by Race to Influence Risk of Precervical Cancer?
Does the Vaginal Microbiome Operate Differently by Race to Influence Risk of Precervical Cancer?
复制标题
DOI：
10.1089/jwh.2022.0309
复制
发表时间：
2023-03
期刊：
影响因子：
--
通讯作者：
K. Tossas;Bin Zhu;Robert A. Perera;Myrna G Serrano;Stephanie Sullivan;Sadia Sayeed;J. F. Strauss;R. Winn;Gregory A. Buck;V. Seewaldt
中科院分区：
文献类型：
--
作者：
K. Tossas;Bin Zhu;Robert A. Perera;Myrna G Serrano;Stephanie Sullivan;Sadia Sayeed;J. F. Strauss;R. Winn;Gregory A. Buck;V. Seewaldt
背景资料：阴道微生物组（VMB）在人乳头瘤病毒（HPV）感染的持续性中起着重要作用，并因种族和宫颈上皮内瘤变（CIN）女性而异。材料和方法：我们探讨了这些关系，使用16S rRNA VMB分类配置文件的3050主要是黑人妇女。基于指示阴道健康的分类学标志物，将VMB谱分配到三个亚组：最佳（卷曲乳杆菌，L. gasseri和L. jensenii）、中度（L. iners）和次优（Gardnerella vagulae，Atopobium vaginae，Ca. Lachnocurva vaginae等）。多变量Firth logistic回归模型校正了年龄、吸烟、VMB、HPV和妊娠状态。结果：按亚组划分的最佳、中度和次佳组的VMB患病率分别为18%、30%和51%。在完全校正的模型中，非拉丁裔（nL）黑人中CIN 3级（CIN3）的风险是nL白人的两倍（比值比[OR] = 2.0，95%置信区间[CI]：1.1，3.9，p = 0.02）。VMB修改了这种关联（p = 0.04），使得仅在具有最佳VMB的女性中，nL黑人的CIN3风险显著高于nL白人（OR = 7.8，95%CI：1.7，74.5，p = 0.007）。在种族组内，与具有最佳VMB的种族对应者相比，仅具有次佳VMB的nL白色女性的CIN3风险升高（OR = 6.0，95% CI：1.3，56.9，p = 0.02）。结论：我们的研究结果表明，种族是一个修改器的VMB在HPV致癌。与nL白色女性相比，最佳VMB似乎对nL黑人女性没有保护作用。
Background: The vaginal microbiome (VMB) plays an important role in the persistence of human papillomavirus (HPV) infection and differs by race and among women with cervical intraepithelial neoplasia (CIN). Materials and Methods: We explored these relationships using 16S rRNA VMB taxonomic profiles of 3050 predominantly Black women. VMB profiles were assigned to three subgroups based on taxonomic markers indicative of vaginal wellness: optimal (Lactobacillus crispatus, L. gasseri, and L. jensenii), moderate (L. iners), and suboptimal (Gardnerella vaginalis, Atopobium vaginae, Ca. Lachnocurva vaginae, and others). Multivariable Firth logistic regression models were adjusted for age, smoking, VMB, HPV, and pregnancy status. Results: VMB prevalence by subgroup was 18%, 30%, and 51% for the optimal, moderate, and suboptimal groups, respectively. In fully adjusted models, the risk of CIN grade 3 (CIN3) among non-Latina (nL) Blacks was twice that of nL Whites (odds ratio [OR] = 2.0, 95% confidence interval [CI]: 1.1, 3.9, p = 0.02). The VMB modified this association (p = 0.04) such that the risk of CIN3 was significantly higher for nL Blacks than for nL Whites only among women with optimal VMBs (OR = 7.8, 95% CI: 1.7, 74.5, p = 0.007). Within racial groups, the risk of CIN3 was only elevated among nL White women with suboptimal VMBs (OR = 6.0, 95% CI: 1.3, 56.9, p = 0.02) compared with their racial counterparts with optimal VMBs. Conclusions: Our findings suggest that race is a modifier of the VMB in HPV carcinogenesis. An optimal VMB does not appear to be protective for nL Black women compared with nL White women.