Current strategies for the diagnosis, treatment, and prevention of cervical lesions associated with human papillomavirus: microbiome, CRISPR technologies, and photodynamic therapy

Abstract

Human papillomavirus (HPV) is a major factor in the etiology of cervical intraepithelial neoplasia (CIN) and cervical cancer, which ranks fourth worldwide in prevalence among cancers in women. The pathogenesis of HPV-associated lesions is based on the expression of E6 and E7 oncoproteins, which disrupt cell differentiation and proliferation. The cervicovaginal microbiome plays a crucial role in the persistence of infection. The diagnosis of CIN rely on advanced screening methods, including liquidbased cytology, molecular HPV testing, and CRISPR-Cas technologies. Promising directions include the development of prognostic models using artificial intelligence to stratify the risk of lesion progression. Organ preservation treatment methods are of particular interest, with photodynamic therapy demonstrating high efficacy in HPV eradication while maintaining reproductive potential. Vaccination prophylaxis remains the gold standard for primary prevention, with its efficacy exceeding 95%. Key words: human papillomavirus, cervical intraepithelial neoplasia, cervical cancer, screening, vaccination prophylaxis, photodynamic therapy, microbiome, CRISPR-Cas, artificial intelligence