Innate immune recognition and microenvironmental reprogramming in HPV-induced cervical cancer: from pattern recognition receptor activation to immune tolerance disruption

Innate immune recognition plays a central role in determining the outcome of human papillomavirus (HPV) infection and the subsequent development of cervical cancer. This mini-review highlights how the reproductive tract's innate immune system, particularly Pattern Recognition Receptors (PRRs) such as Toll-like receptors (TLRs), NOD-like receptors (NLRs), and RIG-I-like receptors (RLRs), detects HPV-associated molecular patterns and initiates antiviral defenses. HPV has evolved sophisticated strategies to evade these responses by suppressing PRR signaling, altering cytokine networks, reprogramming cellular metabolism, and reshaping the cervical microenvironment. These viral mechanisms contribute to the formation of a persistent post-infection microenvironment (PIM), characterized by impaired antigen presentation, regulatory immune cell infiltration, chronic inflammation, and metabolic and stromal remodeling, which collectively promote immune tolerance and carcinogenesis. Emerging evidence also highlights the roles of inflammasomes, type I interferon pathways, and extracellular vesicles in modulating innate immune responses during HPV infection. Understanding how innate immunity senses HPV and how the virus circumvents these pathways provides crucial insight into cervical cancer progression and offers opportunities for developing more effective immunotherapies, vaccines, and prevention strategies. This review synthesizes current advances in HPV-driven innate immune dysregulation within the reproductive tract and their implications for reproductive immunology and infection-associated malignancy.