Brun J-L, Riethmuller D
Service de gynécologie-obstétrique, CHU Pellegrin, 33076 Bordeaux, France.
J Gynecol Obstet Biol Reprod (Paris). 2007 Nov;36(7):631-41. doi: 10.1016/j.jgyn.2007.06.005. Epub 2007 Sep 5.
Human papillomavirus is a necessary cause for the development of cervical cancer. Cervical cancer is attributed to 15 high-risk oncogenic HPV among the 120 genotypes present in human. The infection affects about 3 out of 4 women and is often transient thanks to immunological modulators leading to viral clearance. This characteristic made it possible to develop vaccines. Prophylactic vaccines are made of virus-like particles L1, non infectious, well tolerated and highly immunogenic. They prevent from viral infection by producing antibodies, which are secreted throughout the genital mucosa (humoral immunity). High-risk oncogenic HPV-16 and 18, responsible for 70% of cervical cancer, are included in Gardasil and Cervarix. Both vaccines prevent from HPV infection and related cervical and perineal lesions in more than 90% of the cases. Therapeutic vaccines are made of epitope peptides, recombinant proteins and bacteria, plasmid DNA or dendritic cells. All sensitize immunocompetent cells (cellular immunity). Ineffective in cervical cancers, they induce the regression of cervical dysplasia in about 50% of the cases. They are still under research and development, in opposition to prophylactic vaccines, which are available.
人乳头瘤病毒是宫颈癌发生的必要病因。宫颈癌归因于人类120种基因型中的15种高危致癌性人乳头瘤病毒。这种感染影响约四分之三的女性，由于免疫调节剂导致病毒清除，感染通常是短暂的。这一特性使得开发疫苗成为可能。预防性疫苗由病毒样颗粒L1制成，无传染性，耐受性良好且免疫原性高。它们通过产生抗体来预防病毒感染，这些抗体分泌到整个生殖黏膜中（体液免疫）。导致70%宫颈癌的高危致癌性人乳头瘤病毒16型和18型包含在加德西疫苗和卉妍康疫苗中。两种疫苗在90%以上的病例中可预防人乳头瘤病毒感染及相关的宫颈和会阴病变。治疗性疫苗由表位肽、重组蛋白、细菌、质粒DNA或树突状细胞制成。它们都能激活免疫活性细胞（细胞免疫）。它们对宫颈癌无效，但在约50%的病例中可诱导宫颈发育异常消退。它们仍在研发中，与已有的预防性疫苗不同。
