Gonçalves Ana Katherine, Giraldo Paulo César, Farias Kleber Juvenal, Machado Paula Renata, Costa Ana Paula Ferreira, de Souza Luanda Canário, Crispim Janaina Cristiana, Eleutério José, Witkin Steven S
From the *Department of Gynecology and Obstetrics, Federal University of Rio Grande do Norte, Natal, Brazil; †Department of Gynecology and Obstetrics, State University of Campinas, Campinas, Brazil; Departments of ‡Microbiology and Parasitology and §Clinical Analysis and Toxicology, Federal University of Rio Grande do Norte, Natal, Brazil; ¶Department of Gynecology and Obstetrics, Federal University of Ceará, Fortaleza, Brazil; and ∥Department of Obstetrics and Gynecology, Weill Cornell Medicine, New York, NY.
Sex Transm Dis. 2016 May;43(5):335-9. doi: 10.1097/OLQ.0000000000000429.
Individuals receiving the human papillomavirus (HPV) vaccine develop high levels of circulating neutralizing antibodies. However, data about antibody responses in the cervix are limited.
This study was designed to describe the course of IgA/IgG responses in cervical secretions and in serum after intramuscular administration of the HPV16/18 AS04-adjuvant vaccine. An enzyme-linked immunosorbent assay for detection of IgA and IgG anti-HPV-VLP was developed for this purpose.
Immunoglobulin G seroconversion after the second dose was observed in 100% of the participants and remained 1 month after the third dose. Regarding IgG reactivity in cervical secretions, conversion was observed in 85% of women after the final dose. Immunoglobulin A seroconversion was observed in 76.7% of women after the third dose. Lower levels of IgA were detected in the cervical mucus (28.3%) and decreased to 23.3% after the last dose. Comparing local and systemic IgG responses, positivity in both serum and cervical samples was observed in 85%, whereas in 15% only, the serum was IgG antibody positive. A weak agreement between local and systemic IgA responses was observed. Only 18.3% of participants were local and systemic IgA positive, 58.4% were positive only in serum, 5% were positive only in the cervix, and 18.3% were both local and systemic IgA antibody negative.
After the third vaccination, there is a strong agreement between cervical and systemic IgG antibody responses and a weak agreement between cervical and systemic IgA antibody responses. The induction of IgA antibodies seems to be secondary to that of IgG antibodies in response to HPV intramuscular vaccination.
接种人乳头瘤病毒（HPV）疫苗的个体可产生高水平的循环中和抗体。然而，关于宫颈中抗体反应的数据有限。
本研究旨在描述肌肉注射HPV16/18 AS04佐剂疫苗后宫颈分泌物和血清中IgA/IgG反应的过程。为此开发了一种用于检测抗HPV-VLP IgA和IgG的酶联免疫吸附测定法。
100%的参与者在接种第二剂后出现IgG血清转化，第三剂接种后1个月仍保持。关于宫颈分泌物中的IgG反应性，最后一剂接种后85%的女性出现转化。第三剂接种后76.7%的女性出现IgA血清转化。宫颈黏液中检测到较低水平的IgA（28.3%），最后一剂接种后降至23.3%。比较局部和全身IgG反应，血清和宫颈样本均呈阳性的占85%，而仅血清IgG抗体呈阳性的仅占15%。观察到局部和全身IgA反应之间的一致性较弱。仅18.3%的参与者局部和全身IgA呈阳性，58.4%仅血清呈阳性，5%仅宫颈呈阳性，18.3%局部和全身IgA抗体均呈阴性。
第三次接种后，宫颈和全身IgG抗体反应之间存在高度一致性，而宫颈和全身IgA抗体反应之间存在较弱的一致性。在HPV肌肉注射疫苗反应中，IgA抗体的诱导似乎继发于IgG抗体。
