Stanley Margaret
Department of Pathology, Tennis Court Road, Cambridge CB2 1QP, UK.
Best Pract Res Clin Obstet Gynaecol. 2006 Apr;20(2):279-93. doi: 10.1016/j.bpobgyn.2005.10.011. Epub 2005 Dec 13.
The ability to generate human papillomavirus virus (HPV)-like particles by the synthesis and self-assembly in vitro of the major virus capsid protein L1 has transformed our prospects for preventing cervical carcinoma in women. These particles provide vaccines that are immunogenic and safe, and data from proof-of-principle efficacy trials strongly suggest that they will protect against persistent HPV infection and cervical intraepithelial neoplasia. However, the duration of protection provided by these vaccines is not known, the antibody responses induced are HPV-type-specific and immunisation must occur pre-exposure to the virus. Second-generation vaccines could include an early antigen for protection post exposure and alternative delivery systems might be needed for the developing world. Therapeutic vaccines for low-grade intraepithelial disease are realistic but high-grade disease presents major hurdles for immunotherapies.
通过体外合成和自组装主要病毒衣壳蛋白L1来生成人乳头瘤病毒（HPV）样颗粒的能力，改变了我们预防女性宫颈癌的前景。这些颗粒提供了具有免疫原性且安全的疫苗，原理性疗效试验的数据有力地表明，它们将预防持续性HPV感染和宫颈上皮内瘤变。然而，这些疫苗提供的保护持续时间尚不清楚，诱导的抗体反应是HPV型特异性的，并且必须在接触病毒之前进行免疫接种。第二代疫苗可能包括用于暴露后保护的早期抗原，发展中世界可能需要替代的给药系统。针对低度上皮内疾病的治疗性疫苗是可行的，但高度疾病给免疫疗法带来了重大障碍。
