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. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This study did not receive any funding. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Ethics committee/IRB of Kanazawa Medical University gave ethical approval for this work. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes All data produced in the present study are available upon reasonable request to the authors.