Probiotic effect of trichloroacetic acid on cervicovaginal microbiota in cervical intraepithelial neoplasia: A pilot study

Symbiosis of bacteria and human papillomavirus (HPV) in the cervicovaginal environment influences cervical intraepithelial neoplasia (CIN) progression or regression. In this case series, we enrolled all 10 patients who had resolved CIN after a cervical local treatment using trichloroacetic acid (TCA). Prominent changes in the cervicovaginal microbiota, such as an enrichment of the genus Bifidobacterium and genus Lactobacillus, were observed in seven of 10 patients. A decrease in cervicovaginal bacterial alpha diversity was observed in 4 patients with high-risk HPV clearance. Differential abundance analysis revealed that genus Bifidobacterium increased significantly after TCA. The dominance of a single bacteria can be characteristic of CIN cures after TCA. These results highlight the potential link of cervicovaginal bacteria such as genus Bifidobacterium and genus Lactobacillus in the clearance of CIN and high-risk HPV. This pilot study guides future research questions that specific cervicovaginal bacteria may be promising candidates for probiotic therapy to treat CIN and HPV infections.