Nakagawa Mayumi, Greenfield William, Moerman-Herzog Andrea, Coleman Hannah N
Department of Pathology, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
Department of Obstetrics & Gynecology, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.
Clin Vaccine Immunol. 2015 Jul;22(7):679-87. doi: 10.1128/CVI.00149-15. Epub 2015 May 6.
Numerous versions of human papillomavirus (HPV) therapeutic vaccines designed to treat individuals with established HPV infection, including those with cervical intraepithelial neoplasia (CIN), are in development because approved prophylactic vaccines are not effective once HPV infection is established. As human papillomavirus 16 (HPV-16) is the most commonly detected type worldwide, all versions of HPV therapeutic vaccines contain HPV-16, and some also contain HPV-18. While these two HPV types are responsible for approximately 70% of cervical cancer cases, there are other high-risk HPV types known to cause malignancy. Therefore, it would be of interest to assess whether these HPV therapeutic vaccines may confer cross-protection against other high-risk HPV types. Data available from a few clinical trials that enrolled subjects with CINs regardless of the HPV type(s) present demonstrated clinical responses, as measured by CIN regression, in subjects with both vaccine-matched and nonvaccine HPV types. The currently available evidence demonstrating cross-reactivity, epitope spreading, and de novo immune stimulation as possible mechanisms of cross-protection conferred by investigational HPV therapeutic vaccines is discussed.
许多旨在治疗已感染人乳头瘤病毒（HPV）个体（包括宫颈上皮内瘤变（CIN）患者）的HPV治疗性疫苗正在研发中，因为一旦HPV感染确立，已获批的预防性疫苗就无效了。由于人乳头瘤病毒16型（HPV - 16）是全球最常检测到的类型，所有版本的HPV治疗性疫苗都包含HPV - 16，有些还包含HPV - 18。虽然这两种HPV类型约占宫颈癌病例的70%，但还有其他已知会导致恶性肿瘤的高危HPV类型。因此，评估这些HPV治疗性疫苗是否可能对其他高危HPV类型提供交叉保护将是有意义的。一些临床试验的数据显示，无论存在何种HPV类型，纳入CIN患者的试验都表明，通过CIN消退来衡量，疫苗匹配型和非疫苗型HPV患者都有临床反应。本文讨论了目前可用的证据，这些证据表明交叉反应性、表位扩展和从头免疫刺激是研究性HPV治疗性疫苗赋予交叉保护的可能机制。
