Section on Translation Tumor Immunology, National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, Maryland, U.S.A.
Laryngoscope. 2021 Sep;131(9):2041-2047. doi: 10.1002/lary.29153. Epub 2021 Mar 15.
Recurrent respiratory papillomatosis (RRP) is currently treated with repeat surgical resection of papillomatous disease that does not address the fundamental underlying issue of chronic infection with low-risk human papillomavirus. Here, we review the biology and immunology of low-risk human papillomavirus (HPV) infections. Antiviral or antiangiogenic adjuvant treatments similarly address the papillomatous disease itself but do not activate HPV immunity. It is likely that only through immune-mediated clearance of low-risk HPV infection can patients with RRP be cured. In some patients, this occurs spontaneously. In others with more aggressive disease, adjuvant immunotherapy to activate immunity may be needed. Based on current understanding of antiviral immune responses, the only rational strategy to clear HPV-infected epithelial cells is through activation of the T-lymphocyte arm of the adaptive immune response. Translation of immunotherapies that are Food and Drug Administration-approved or under clinical study for cancer, such as immune checkpoint blockade or engineered therapeutic vaccines, may provide a path toward tolerable and efficacious adjuvant immunotherapy for RRP. LEVEL OF EVIDENCE: NA Laryngoscope, 131:2041-2047, 2021.
复发性呼吸道乳头瘤病（RRP）目前采用重复手术切除乳头状瘤病的方法进行治疗，但无法解决人乳头瘤病毒（HPV）慢性感染这一根本问题。本文回顾了低危型 HPV 感染的生物学和免疫学特性。抗病毒或抗血管生成的辅助治疗同样可以治疗乳头状瘤病本身，但不能激活 HPV 免疫。只有通过免疫介导清除低危型 HPV 感染，RRP 患者才能被治愈。在一些患者中，这种情况是自发发生的。对于疾病更具侵袭性的患者，则可能需要辅助免疫疗法来激活免疫。基于目前对抗病毒免疫反应的理解，清除 HPV 感染上皮细胞的唯一合理策略是激活适应性免疫反应的 T 淋巴细胞途径。将已获美国食品和药物管理局批准或正在进行癌症临床研究的免疫疗法（如免疫检查点阻断或工程化治疗性疫苗）进行转化，可能为 RRP 提供一种安全有效的辅助免疫治疗方法。证据等级：无。《喉镜》，131:2041-2047，2021 年。
