Fig. 8: Schematic representation of the proposed model.

Left In HPV-positive cells, E7 oncoprotein impairs pro-inflammatory-induced innate peptide expression through inducing NEMO degradation and subsequent p65 cytoplasmic sequestration. Right In parallel, E7 reduces E-cadherin expression and alters β-catenin degradation complex by interacting with both CK1 and β-TrCP. As a result, defense peptides (e.g., elafin and S100A7) which are used by Lactobacillus species as amino acid source are greatly down-regulated by the β-catenin target gene c-myc. An imbalance in the vaginal flora is, therefore, achieved as a consequence of HPV persistence and subsequent immune evasion.