Hung Chien-Fu, Wu T C, Monie Archana, Roden Richard
Department of Pathology, The Johns Hopkins School of Medicine, Baltimore, MD 21231, USA.
Immunol Rev. 2008 Apr;222:43-69. doi: 10.1111/j.1600-065X.2008.00622.x.
We contrast the efforts to treat ovarian cancer and cervical cancer through vaccination because of their different pathobiology. A plethora of approaches have been developed for therapeutic vaccination against cancer, many of which target defined tumor-associated antigens (TAAs). Persistent infection with oncogenic human papillomavirus (HPV) types causes cervical cancer. Furthermore, cervical cancer patients frequently mount both humoral and T-cell immune responses to the HPV E6 and E7 oncoproteins, whose expression is required for the transformed phenotype. Numerous vaccine studies target these viral TAAs, including recent trials that may enhance clearance of pre-malignant disease. By contrast, little is known about the etiology of epithelial ovarian cancer. Although it is clear that p53 mutation or loss is a critical early event in the development of epithelial ovarian cancer, no precursor lesion has been described for the most common serous histotype, and even the location of its origin is debated. These issues have complicated the selection of appropriate ovarian TAAs and the design of vaccines. Here we focus on mesothelin as a promising ovarian TAA, because it is overexpressed and immunogenic at high frequency in patients, is displayed on the cell surface, and potentially contributes to ovarian cancer biology.
由于卵巢癌和宫颈癌的病理生物学不同,我们对通过疫苗接种治疗这两种癌症的努力进行了对比。针对癌症的治疗性疫苗接种已经开发出了大量方法,其中许多靶向特定的肿瘤相关抗原(TAA)。致癌性人乳头瘤病毒(HPV)的持续感染会导致宫颈癌。此外,宫颈癌患者经常对HPV E6和E7癌蛋白产生体液免疫和T细胞免疫反应,而这些蛋白的表达是转化表型所必需的。众多疫苗研究都针对这些病毒TAA,包括近期可能增强癌前病变清除率的试验。相比之下,上皮性卵巢癌的病因知之甚少。虽然很明显p53突变或缺失是上皮性卵巢癌发生过程中的关键早期事件,但对于最常见的浆液性组织学类型,尚未描述其前体病变,甚至其起源位置也存在争议。这些问题使得选择合适的卵巢TAA和设计疫苗变得复杂。在这里,我们将重点关注间皮素作为一种有前景的卵巢TAA,因为它在患者中高频率过表达且具有免疫原性,在细胞表面表达,并且可能对卵巢癌生物学产生影响。