Cervicovaginal dysbiosis is an established co-factor of high-risk human papillomavirus (HPV) persistence and cervical neoplastic development, yet most studies address the bacterial compartment in isolation, leaving fungal communities and bacterial–fungal cross-kingdom interactions underexplored, particularly in Central Asian populations. We performed shotgun metagenomic sequencing (mNGS) of cervicovaginal samples from 311 Kazakhstani women undergoing routine cervical screening. HPV status was determined using combined PCR and mNGS methods, and cervical screening was completed using liquid-based cytology (NILM, ASC-US, LSIL, ASC-H). Bacterial, viral, and fungal taxa were profiled from a single shotgun dataset with Kraken2 pipeline. Bacterial community state types (CSTs) were determined based on dominant bacterial species, functional gene content was annotated against KEGG using eggNOG, and covariate-adjusted associations were estimated using MaAsLin3. Mycobiome β-diversity differed significantly by HPV status (p = 0.003). In particular, Candida positivity was significantly associated with HPV presence and with high-risk α-9 HPV in cytologically normal (NILM) samples (OR = 3.6, [1.6–9.6], p ≤ 0.001). Covariate-adjusted analysis was consistent with this positive association (q < 0.05). Concurrently, among CSTs, Lactobacillus iners-dominated CST III and dysbiotic Gardnerella vaginalis-dominated CST IV showed a 3-fold higher Candida albicans prevalence (p < 0.01). Further analysis demonstrated that, functionally, both of these CSTs had depleted capacity for lactate metabolism (ko00620, p < 0.0001) and, in particular, for the genetic capacity for pyruvate-dependent H₂O₂ generation (half that of the L. crispatus-dominated CST I). These findings support L. iners as a metabolically permissive rather than protective Lactobacillus and suggest cross-kingdom functional signatures as candidate biomarkers for HPV acquisition and persistence in Central Asia, a region previously absent from the cervicovaginal microbiome literature.

In clinical practice, heart rate variability (HRV) has not been considered an indicator for the preventive assessment of cardiovascular autonomic neuropathy (CAN). The paper studies HRV in a large, randomly selected group. A cross-sectional study included a representative sample of 5707 Kazakhs aged 20 years and older from a total population of 25,454 attached to an urban clinic in the capital of Kazakhstan. The sample was drawn from individuals who visited the clinic for a preventive examination. CAN diagnosis was confirmed using data from questionnaires, electronic medical records, HRV, and heart rate measurements. Mean values of the standard deviation of normal sinus RR intervals (SDNN) and the root mean square of successive RR interval differences (RMSSDs) from a 24 h electrocardiogram recording were assessed. CAN was identified in 17.19% of the study participants, with a ratio of the subclinical to clinical phase of 1:0.24. Diabetes mellitus was present in 30.99% of patients with CAN. The prevalence of CAN varied by sex and age, aligning with the prevalence trajectory of diabetes. It was concluded that the SDNN and RMSSD parameters in electrocardiographic studies can be used for preventive measures in the context of limited healthcare resources.

Persistent high-risk human papillomavirus (HPV) infection drives cervical cancer, a leading cause of cancer-related mortality among women in low- and middle-income countries; its clinical course is shaped by the cervicovaginal microbiome, in which Lactobacillus-dominated communities are associated with enhanced viral clearance. Despite this, vaginal probiotic interventions often demonstrate limited colonization efficiency, and autochthonous strain libraries from Central Asia remain absent. We applied a tiered functional screening workflow to a collection of 235 vaginal lactic acid bacterial isolates recovered from 400 women undergoing routine gynecological examination in Astana, Kazakhstan. The workflow sequentially filtered isolates on (i) antimicrobial activity against seven urogenital indicator pathogens using the deferred antagonism assay, (ii) surface adhesion by the Brilis erythrocyte assay, and (iii) biofilm-forming capacity by crystal violet retention and laser-capture-microdissection (LCM) microscopy. Species-level identification of the selected candidate was performed by whole-genome shotgun sequencing followed by Kraken2 taxonomic classification. From 235 isolates, three rounds of phenotypic filtering identified four broad-spectrum antimicrobial candidates (127-3, 127-4, 107-2, 107-4) with non-overlapping inhibitory profiles against seven urogenital indicator strains. Adhesion phenotyping segregated candidates into low- and moderate-adhesion groups, with none reaching the high-adhesion threshold. Among all four candidates, only strain 127-4 produced a reproducible biofilm-associated signal (crystal violet retention OD490 = 0.09 ± 0.07 at 24 h; 0.08 ± 0.03 at 48 h), consistent with early surface attachment under static conditions. Whole-genome shotgun sequencing assigned 97.81% of classified reads to Lactiplantibacillus plantarum, supporting preliminary identification of the selected isolate as L. plantarum strain 127-4. Composite ranking confirmed 127-4 as the only isolate combining broad antimicrobial activity (5/7 indicators), moderate adhesion (specific adhesion index, SPA = 2.95), and a detectable biofilm-associated phenotype. We report the first systematic functional screening of autochthonous cervicovaginal lactic acid bacteria from a Central Asian population and identify L. plantarum 127-4 as a probiotic candidate with an integrated trait profile rarely identified through single-criterion screening approaches. Beyond candidate identification, this work establishes a transferable workflow for assembling functionally annotated vaginal Lactobacillus collections from underrepresented populations, providing a foundation for future population-specific probiotic interventions targeting cervicovaginal health.

Aim. Infections caused by highly oncogenic HPV types can persist in the human body, which increases the risk of developing severe cervical lesions with their subsequent progression to invasive cervical cancer. The aim of this study was to investigate the socio-demographic characteristics of patients with precancerous diseases of the cervix and analyze the relationship between HPV infections and cervical precancerous diseases.Materials and methods. Data on the cervix and HPV infections were collected from 402 women included in the scientific project «National Program for the Study of HPV with the Development of an Integrated Approach to Effective Diagnosis and Treatment of Precancerous Conditions» between 2024 and 2026. The study is being conducted within the framework of program-targeted funding from the Ministry of Science and Education of the Republic of Kazakhstan.Results and discussion. The average age of women in our study with a positive HPV test result was 33.08±6.62 years. Among women infected with HPV, every third woman was not married – 31.2%, the divorce rate is 12.8%. The barrier method of contraception is used in 33.8% of sample population. Furthermore, among HPV-infected women the usage of barrier contraception is 1.2 times higher. HPV-16 and HPV-52 were the most common types in patients with both normal and abnormal cytology. Mild and severe dysplasia were more frequently observed in HPV types 16, 33, 52, and 58.Conclusion. Socio-demographic factors such as age and marital status have a significant impact on the risk of HPV infection. Young women and unmarried women, women with full-day work hours have a higher level of infection.