Shikonin, Gallic Acid, and Hydroxysafflor Yellow A Decrease the Pathogenesis and Normalize the Microbiota of Cervical Erosion
Authors: Zhang Qinghong , Wang Xueting , Chang Chih-Jung , Lai Hsin-Chih , Bai Yu-Ci , Tzeng Chi-Meng 
Published: April 2022

Abstract
Background and Objective: Cervical erosion is a common gynecological disease that increases the risk of human papillomavirus (HPV) infection and causes cervical lesions. Without prompt treatment, this disease may lead to the occurrence of cervical cancer. According to previous studies, the reproductive tract microbiome is closely related to the occurrence and development of a variety of gynecological diseases, but to date, there have been few studies on the composition of the genital tract flora and the local immune microenvironment of cervical erosion. Currently, the mechanism of interaction between the reproductive tract microbiome and cervical erosion remains unknown.Materials and Methods: A total of 11 healthy individuals and 15 patients with cervical erosion (including 11 HPV+ patients) were included recruited in this study. Vaginal secretion and cervical mucus were obtained from volunteers before and after treatment. Luminex multi-factor detection technology was used to detect and analyze cytokines, chemokines, and growth factors in the local immune microenvironment of the reproductive tract. A third-generation nanopore high-throughput sequencing platform was used to explore the characteristics of the reproductive tract microbial community structure of HPV+ and HPV− cervical erosion patients. Reproductive tract metabolomics was explored by liquid chromatography-mass spectrometry (LC-MS) for characterization.Results: Following 21 days of continuous treatment with Jinchuang gel, the smoothness of the cervical surface was restored for all of the 15 patients with cervical erosion, and 4 of the 11 HPV+ patients turned HPV−. After 84 days of continuous treatment, the remaining 7 HPV+ individuals turned negative of HPV−. Furthermore, tThe gel ingredients can improve the local proteolytic environment, reduce the inflammatory response, and promote wound healing. The microbial level of vagina showed that the gel ingredients increased the abundance of Lactobacillus and decreased the relative abundance of Pseudomonas, Megasphaera, and Hungateiclostridium, as well as the overall species diversity. Metabolites of Epicatechin, protocatechuic acid, and hydroxybenzoic acid metabolites with activities of anti-bacterial microbes and anti-inflammatory inflammation were effects increased, which subsequently decreased the levels of harmful metabolites (pipecolate, m-cresol, 2-hydroxy-2-methylbutyric acid, histamine, and other metabolites). Nicotinic acid and nicotinamide metabolism and the tryptophan metabolism pathway may be related involved to the occurrenceincidence of HPV+ in cervical erosion patients, and niacin and nicotinamide metabolism and the histidine metabolism pathway may be related contributed to the positive outcomes of treatment.Conclusion: It is speculated that the active ingredients play a role in wound healing, viral clearance, and immune regulation by regulating the activity of the NF-κB and MAPK signaling pathways.