Department of Pathology, University of Cambridge, Tennis Court Road, Cambridge CB2 1QP, UK.
Infect Agent Cancer. 2010 Oct 20;5:19. doi: 10.1186/1750-9378-5-19.
HPV infection in the genital tract is common in young sexually active individuals, the majority of whom clear the infection without overt clinical disease. However most of those who develop benign lesions eventually mount an effective cell mediated immune (CMI) response and the lesions regress.Failure to develop effective CMI to clear or control infection results in persistent infection and, in the case of the oncogenic HPVs, an increased probability of progression to CIN3 and invasive carcinoma. The prolonged duration of infection associated with HPV seems to be associated with effective evasion of innate immunity thus delaying the activation of adaptive immunity.Natural infections in animals show that neutralising antibody to the virus coat protein L1 is protective suggesting that this would be an effective prophylactic vaccine strategy. The current prophylactic HPV VLP vaccines are delivered i.m. circumventing the intra-epithelial immune evasion strategies. These vaccines generate high levels of antibody and both serological and B cell memory as evidenced by persistence of antibody and robust recall responses. However there is no immune correlate - no antibody level that correlates with protection. Recent data on how HPV infects basal epithelial cells and how antibody can prevent this provides a mechanistic explanation for the effectiveness of HPV VLP vaccines.
生殖道 HPV 感染在性活跃的年轻人中很常见,大多数人在没有明显临床疾病的情况下清除了感染。然而,大多数发展为良性病变的人最终会产生有效的细胞介导免疫(CMI)反应,病变会消退。未能产生有效的 CMI 来清除或控制感染会导致持续感染,并且在致癌 HPV 的情况下,进展为 CIN3 和浸润性癌的概率增加。与 HPV 相关的感染持续时间较长似乎与固有免疫的有效逃避有关,从而延迟了适应性免疫的激活。动物的自然感染表明,对病毒外壳蛋白 L1 的中和抗体具有保护作用,这表明这将是一种有效的预防性疫苗策略。目前的预防性 HPV VLP 疫苗通过绕过上皮内免疫逃避策略来肌内给药。这些疫苗产生高水平的抗体和血清学和 B 细胞记忆,这可以通过抗体的持续存在和强大的回忆反应来证明。然而,没有免疫相关性 - 没有与保护相关的抗体水平。最近关于 HPV 如何感染基底上皮细胞以及抗体如何预防这种感染的研究数据,为 HPV VLP 疫苗的有效性提供了机制解释。