Department of Immunology, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, USA.
Nat Med. 2010 Jul;16(7):799-803. doi: 10.1038/nm.2161. Epub 2010 May 30.
Although vaccination is most effective when used to prevent disease, cancer vaccine development has focused predominantly on providing therapy against established growing tumors. The difficulty in developing prophylactic cancer vaccines is primarily due to the fact that tumor antigens are variations of self proteins and would probably mediate profound autoimmune complications if used in a preventive vaccine setting. Here we use several mouse breast cancer models to define a prototypic strategy for prophylactic cancer vaccination. We selected alpha-lactalbumin as our target vaccine autoantigen because it is a breast-specific differentiation protein expressed in high amounts in the majority of human breast carcinomas and in mammary epithelial cells only during lactation. We found that immunoreactivity against alpha-lactalbumin provides substantial protection and therapy against growth of autochthonous tumors in transgenic mouse models of breast cancer and against 4T1 transplantable breast tumors in BALB/c mice. Because alpha-lactalbumin is conditionally expressed only during lactation, vaccination-induced prophylaxis occurs without any detectable inflammation in normal nonlactating breast tissue. Thus, alpha-lactalbumin vaccination may provide safe and effective protection against the development of breast cancer for women in their post-child-bearing, premenopausal years, when lactation is readily avoidable and risk for developing breast cancer is high.
虽然疫苗接种在预防疾病方面最有效,但癌症疫苗的开发主要集中在提供针对已建立的生长肿瘤的治疗上。开发预防性癌症疫苗的困难主要是由于肿瘤抗原是自身蛋白的变异体,如果在预防性疫苗接种中使用,可能会导致严重的自身免疫并发症。在这里,我们使用几种小鼠乳腺癌模型来定义预防性癌症疫苗接种的典型策略。我们选择α-乳白蛋白作为我们的目标疫苗自身抗原,因为它是一种乳腺特异性分化蛋白,在大多数人类乳腺癌和哺乳期的乳腺上皮细胞中大量表达。我们发现,针对α-乳白蛋白的免疫反应提供了对同源肿瘤生长的实质性保护和治疗,在乳腺癌的转基因小鼠模型中以及在 BALB/c 小鼠中的 4T1 可移植乳腺癌中都是如此。由于α-乳白蛋白仅在哺乳期条件下表达,因此接种疫苗诱导的预防作用不会在正常非哺乳期乳腺组织中引起任何可检测到的炎症。因此,α-乳白蛋白疫苗接种可能为生育后、绝经前的女性提供安全有效的乳腺癌预防,因为此时哺乳是可以避免的,而且患乳腺癌的风险很高。