Cervical microbiome is altered in cervical intraepithelial neoplasia after loop electrosurgical excision procedure in chinaOriginal paper
Karen Pendergrass is a microbiome researcher specializing in microbiome-targeted interventions (MBTIs). She systematically analyzes scientific literature to identify microbial patterns, develop hypotheses, and validate interventions. As the founder of the Microbiome Signatures Database, she bridges microbiome research with clinical practice. In 2012, based on her own investigative research, she became the first documented case of FMT for Celiac Disease, four years before the first published case study.
Read MoreWhat was studied?
This study asked how loop electrosurgical excision procedure (LEEP), a standard treatment for cervical precancer, changes the cervical microbiome. Researchers compared the cervical bacterial community in the same patients before and three months after LEEP. Cervical mucus was sampled by swab before and after treatment. Communities were profiled by 16S rRNA gene sequencing of the V3-V4 region on an Illumina MiSeq, then classified into cervicotypes and compared for diversity and specific taxa.
Who was studied?
The cohort was 26 women with cervical intraepithelial neoplasia grade 2 or 3 (CIN2/3), treated at an obstetrics and gynecology hospital in Shanghai, China. All were positive for high-risk HPV. Participants were Chinese, aged 25 to 68 years, and included six post-menopausal women. Fifty patients were recruited initially, but hysterectomies and missed follow-up visits left 26 with paired before and after samples. Each woman served as her own control across the two time points.
What were the most important findings?
Cervical microbial diversity and species richness fell after LEEP. The community shifted from a Prevotella-containing type lacking a consistent dominant species toward a Lactobacillus iners dominated community. The mixed community type (CT4) dropped from 53.9 percent to 26.9 percent of patients (p = 0.048), while the Lactobacillus-dominated type (CT2) rose from 23.1 to 53.9 percent (p = 0.023). Leptotrichia and Clostridium were significantly reduced after treatment (p = 0.049 and p = 0.002).
What are the greatest implications of this study?
LEEP reshapes the cervical microbiome and reduces its diversity, but a shift to Lactobacillus iners is not the same as a fully healthy state. The authors note LEEP alone was not sufficient to restore a protective community. This raises the possibility that probiotics or prebiotics could support genital health after treatment. Because the cohort was small with only three months of follow-up, the findings need larger and longer studies before guiding clinical practice.