Ukrainian Journal Health of Woman. 2025. 3(178): 18-22. doi: 10.15574/HW.2025.3(178).1822
Kharenko V. V.¹, Shalko M. N.^2
1Olvytsya Family Health Center, Kyiv, Ukraine
²Shupyk National University of Healthcare of Ukraine, Kyiv

For citation: Kharenko VV, Shalko MN. (2025). Vaginal microbiocenosis and cervical immunity in women with cervical polyps. Ukrainian Journal Health of Woman. 3(178): 18-22. doi: 10.15574/HW.2025.3(178).1822
Article received: Apr 02, 2025. Accepted for publication: May 21, 2025.

Cervical polyp (СР) is a common pathology that often has an asymptomatic course, its pathogenesis and risk of oncological transformation are debatable.
Aim – to investigate the features of the vaginal biocenosis and cervical immunity in women with dysplastic СР and glandular СР of the cervix to improve treatment tactics.
Materials and methods. Cervical immunity and vaginal microflora were studied in 83 women with dysplastic СР (group I), in 55 women with glandular СР (group II) and in 40 healthy women (control group – GC). The vaginal microflora was studied according to the Hay-Ison criteria, the content of interleukins 1β (IL-1β) and 6 (IL-6), secretory inhibitor of leukocyte proteinase (SILP) and lactoferrin in cervical mucus was studied by enzyme-linked immunosorbent assay.
Results. The concentration of IL-1β is the highest in the group I, where СР was accompanied by abnormal results of cytological screening, IL-6 also had the highest value in the group I, in patients of the group II this concentration was lower, but still exceeded the indicator of the GC. Patients of the group I were distinguished by the maximum concentration of SILP, in women of the group II the content of SLPI was lower, but still exceeded the indicator of GC. The content of lactoferrin was reduced in of the group I and ІI. Women of the group I are characterized by the dominance of aerobic pathogens were distinguished by a higher frequency of grade 4 vaginal discharge, where aerobic pathogens dominate among the morphotypes of the vaginal microflora. This also correlates with the data of the study of local cervical immunity, indicating that the values of pro-inflammatory cytokines in the group 1 are higher than in the group II and GC.
Conclusions. Dysplastic СР is accompanied by inflammatory changes in the cervical epithelium and the dominance of aerobic microflora, which should be taken into account when developing treatment tactics.
The study was conducted in accordance with the principles of the Declaration of Helsinki. The study protocol was approved by the local ethics committee of the participating institution. Informed consent of the patients was obtained for the study.
The authors declare that there is no conflict of interest.
Keywords: cervical polyp, interleukin 1β, interleukin 6, lactoferrin, secretory leukocyte proteinase inhibitor, vaginal biocenosis, Hay-Ison criteria.

REFERENCES/

1. Amabebe E, Anumba DOC. (2018, Jun 13). The Vaginal Microenvironment: The Physiologic Role of Lactobacilli. Front Med (Lausanne). 5: 181. https://doi.org/10.3389/fmed.2018.00181; PMid:29951482 PMCid:PMC6008313

2. Avalos-Gómez C, Ramírez-Rico G, Ruiz-Mazón L, Sicairos NL, Serrano-Luna J, de la Garza M. (2022). Lactoferrin: An Effective Weapon in the Battle Against Bacterial Infections. Curr Pharm Des. 28(40): 3243-3260. https://doi.org/10.2174/1381612829666221025153216; PMid:36284379

3. Castrilli G, Tatone D, Diodoro MG, Rosini S, Piantelli M, Musiani P. Interleukin 1alpha and interleukin 6 promote the in vitro growth of both normal and neoplastic human cervical epithelial cells. Br J Cancer. 1997;75(6):855-9. https://doi.org/10.1038/bjc.1997.152; PMid:9062407 PMCid:PMC2063391

4. Douglas TC, Hannila SS. (2022, Feb). Working from within: how secretory leukocyte protease inhibitor regulates the expression of pro-inflammatory genes. Biochem Cell Biol. 100(1): 1-8. https://doi.org/10.1139/bcb-2021-0284; PMid:34555292

5. González-Chávez SA, Arévalo-Gallegos S, Rascón-Cruz Q. (2009, Apr). Lactoferrin: structure, function and applications. Int J Antimicrob Agents. 33(4): 301.e1-8. https://doi.org/10.1016/j.ijantimicag.2008.07.020; PMid:18842395

6. Ison CA, Hay PE. (2002, Dec). Validation of a simplified grading of Gram stained vaginal smears for use in genitourinary medicine clinics. Sex Transm Infect. 78(6): 413-415. https://doi.org/10.1136/sti.78.6.413; PMid:12473800 PMCid:PMC1758337

7. Jiang X, Wang J, Deng X, Xiong F, Zhang S, Gong Z et al. (2020, Sep 30). The role of microenvironment in tumor angiogenesis. J Exp Clin Cancer Res. 39(1): 204. https://doi.org/10.1186/s13046-020-01709-5; PMid:32993787 PMCid:PMC7526376

8. Khedkar R, Pajai S. (2022, Nov 10). Bacterial Vaginosis: A Comprehensive Narrative on the Etiology, Clinical Features, and Management Approach. Cureus. 14(11): e31314. https://doi.org/10.7759/cureus.31314

9. Liu C, Chu D, Kalantar-Zadeh K, George J, Young HA, Liu G. (2021, Aug). Cytokines: From Clinical Significance to Quantification. Adv Sci (Weinh). 8(15): e2004433. https://doi.org/10.1002/advs.202004433; PMid:34114369 PMCid:PMC8336501

10. Long ME, Dwarica DS, Kastner TM, Gallenberg MM, Chantigian PD, Marnach ML et al. (2013, Apr). Comparison of dysplastic and benign endocervical polyps. J Low Genit Tract Dis. 17(2): 142-146. https://doi.org/10.1097/LGT.0b013e318260e32f; PMid:22885648

11. Massa E, Pelusa F, Lo Celso A, Madariaga MJ, Filocco L et al. (2021, Feb). Lactoferrin levels in cervical fluid from in vitro fertilization (IVF) patients – correlation with IVF parameters. Biochem Cell Biol. 99(1): 91-96. https://doi.org/10.1139/bcb-2020-0098; PMid:32476453

12. Mazur YuYu, Pyrohova VI, Kuz NM. (2018). Vaginal biocenosis state assessment in patients with cervical ectopy relapse in the conditions of human papillomavirus infection. Health of woman. 6(132): 37-41. https://doi.org/10.15574/HW.2018.132.37

13. Moriyama A, Shimoya K, Ogata I, Kimura T, Nakamura T, Wada H et al. (1999, Jul). Secretory leukocyte protease inhibitor (SLPI) concentrations in cervical mucus of women with normal menstrual cycle. Mol Hum Reprod. 5(7): 656-661. https://doi.org/10.1093/molehr/5.7.656; PMid:10381821

14. Pegu B, Srinivas BH, Saranya TS, Murugesan R, Priyadarshini Thippeswamy S, Gaur BPS. (2020, Nov). Cervical polyp: evaluating the need of routine surgical intervention and its correlation with cervical smear cytology and endometrial pathology: a retrospective study. Obstet Gynecol Sci. 63(6): 735-742. https://doi.org/10.5468/ogs.20177; PMid:33059397 PMCid:PMC7677067

15. Sereda KV. (2023). State of local cervical immunity in women with infertility. Ukrainian Journal Health of Woman. 5(168): 28-33. https://doi.org/10.15574/HW.2023.168.28

16. Shimoya K, Zhang Q, Temma K, Kimura T, Tsujie T, Tsutsui T et al. (2006, May 20). Secretory leukocyte protease inhibitor levels in cervicovaginal secretion of elderly women. Maturitas. 54(2): 141-148. https://doi.org/10.1016/j.maturitas.2004.02.019; PMid:16289563

17. Torcia MG. (2019, Jan 11). Interplay among Vaginal Microbiome, Immune Response and Sexually Transmitted Viral Infections. Int J Mol Sci. 20(2): 266. https://doi.org/10.3390/ijms20020266; PMid:30641869 PMCid:PMC6359169

18. Uçar MG, İlhan TT, Uçar RM, Karabağli P, Çelik Ç. (2016, Oct). Diagnostic Value of Visual Examination of Cervical Polypoid Lesions and Predictors of Misdiagnosis. J Low Genit Tract Dis. 20(4): 356-359. https://doi.org/10.1097/LGT.0000000000000254; PMid:27529156

19. Wang JL, Zhang PA, Yuan J, Huang XC, Cheng JC, Bao HJ et al. (2025, Jun). Causal relationship between 91 circulating inflammatory proteins and gynecological diseases: A two-sample bidirectional Mendelian randomization study. Int J Biol Macromol. 316; Pt 1: 144729. https://doi.org/10.1016/j.ijbiomac.2025.144729; PMid:40441565

20. Zhao JH, Stacey D, Eriksson N et al. (2023, Sep). Genetics of circulating inflammatory proteins identifies drivers of immune-mediated disease risk and therapeutic targets. Nat Immunol. 24(9): 1540-1551. https://doi.org/10.1038/s41590-023-01588-w; PMid:37563310 PMCid:PMC10457199