The Role and Clinical Application of Vaginal Microbiota in the Progression of Cervical Diseases

Increasing evidence indicates that the vaginal microbiota (VMB) is closely associated with the development and progression of cervical diseases. Alterations in microbial composition have been observed across different stages of human papillomavirus (HPV) infection, cervical intraepithelial neoplasia (CIN), and cervical cancer. In healthy individuals, the VMB is typically dominated by Lactobacillus species, which contribute to the maintenance of an acidic environment and local immune balance. In contrast, vaginal dysbiosis is characterized by a reduction in Lactobacillus and an increased abundance of anaerobic bacteria, accompanied by elevated pH, disruption of epithelial barriers, and persistent inflammatory responses. Clinical and sequencing studies have reported that enrichment of specific bacterial genera, including Sneathia and Fusobacterium, is more frequently detected in high-grade cervical lesions, suggesting a potential association with disease severity. These microbial shifts may facilitate persistent HPV infection and promote lesion progression through multiple biological pathways. In addition, emerging evidence suggests that modulation of the VMB, particularly through probiotic supplementation with Lactobacillus crispatus, may support HPV clearance and improve microbial stability in early disease stages. By integrating findings from recent studies, this review outlines the dynamic changes of key microbial taxa during cervical disease progression and discusses their potential clinical relevance. These observations provide a quantitative reference for future investigations and highlight the possible value of microbiome-based strategies in cervical disease risk assessment and management.