Division of Molecular Oncology, Institute of Cytology & Preventive Oncology (ICMR), Noida, India.
Indian J Med Res. 2009 Sep;130(3):296-310.
Even after 25 years of establishing Human Papillomavirus (HPV) as the causative agent for cervical cancer, effective treatment of HPV infection still unavailable. Comprehensive efforts especially for targeting HPV infection have been made only in recent years. Conventional physical ablation of HPV-induced lesions such as cryo-therapy, photo-therapy, LEEP, laser cone-biopsy and localized radiotherapy are shown to be effective to some extent in treating localized lesions where the removal of diseased tissue is associated with removal of transforming keratinocytes harboring HPV. Apart from currently available prophylactic vaccines which prevent the viral entry and should be given prior to viral exposure, several attempts are being made to develop therapeutic vaccines that could treat prevailing HPV infection. In addition, immunomodulators like interferons and imiquimod that have been shown to elicit cytokine milieu to enhance host immune response against HPV infection. Also, antiviral approaches such as RNA interference (RNAi) nucleotide analogs, antioxidants and herbal derivatives have shown effective therapeutic potential against HPV infection. These leads are being tested in pre-clinical and clinical studies. Present article provides a brief overview of conventional therapies for HPV-associated diseases. Potential of non-ablative anti-HPV treatment modalities that could prove useful for either elimination of HPV in early stages of infection when the virus is not integrated into the host cell genome or suppression of the expression of viral oncogenes that dys-regulate the host cell cycle following transformation is discussed.
尽管已经过去了 25 年,人们已经确定人乳头瘤病毒(HPV)是导致宫颈癌的病原体,但仍然没有有效的 HPV 感染治疗方法。近年来,人们才开始进行综合努力,特别是针对 HPV 感染进行治疗。传统的 HPV 诱导病变的物理消融方法,如冷冻疗法、光疗、LEEP、激光锥切和局部放疗,在治疗局部病变方面已经证明在一定程度上是有效的,因为这些方法可以去除携带 HPV 的病变组织。除了目前可用的预防性疫苗,这些疫苗可以预防病毒进入,并应在病毒暴露之前使用外,人们还在尝试开发治疗性疫苗,以治疗现有的 HPV 感染。此外,干扰素和咪喹莫特等免疫调节剂已被证明可以引发细胞因子微环境,从而增强宿主对 HPV 感染的免疫反应。此外,抗病毒方法,如 RNA 干扰(RNAi)核苷酸类似物、抗氧化剂和草药衍生物,已显示出对 HPV 感染的有效治疗潜力。这些方法正在进行临床前和临床研究。本文简要概述了 HPV 相关疾病的常规治疗方法。还讨论了非消融性抗 HPV 治疗方法的潜力,这些方法可能有助于在感染早期消除 HPV,或者在病毒整合到宿主细胞基因组之前抑制病毒癌基因的表达,这些癌基因会失调宿主细胞周期,从而导致转化。