Interplay of trichomoniasis with other sexually transmitted infections: Part I. Patterns and correlations of co-infection

Trichomoniasis is a common sexually transmitted infection with several health sequels. The present review aimed to explore updates in the interplay of trichomoniasis with other sexually-transmitted infections (STIs) and carcinogenesis in the context of the T. vaginalis life cycle, pathogenesis, diagnosis, and treatment. Trichomoniasis affects fertility, facilitates STIs such as AIDS, Mycoplasma genitalium (Mgen infection), chlamydiosis, and gonorrhea and provokes dysbiosis of microbiota including Mycoplasma hominis, Candidatus spp. and Mycoplasma girerdii. Besides, T. vaginalis enhances tumorigenesis and invasive behavior in malignant prostate cells, via cellular and immunological pathways. The triad of T. vaginalis, vaginal microbiota, and HPV infection seemed to attribute to cervical carcinogenesis. Adherence factors, trichocystatin 2 (TC-2), lysosomes, GH proteins, dysbiosis-gene transmission, NTPDase enzyme, extracellular vesicles, and protease enzymes play a key role in mediating the interactions between trichomoniasis and other STIs. Immunogenicity against T. vaginalis appeared to be affected by the local microbiome. Highlighting the virulence factors of T. vaginalis and its immunopathogenic mechanisms may provide novel therapeutic targets and assist in vaccine development to lower disease transmission and its reproductive complications.