Wang Fan, Liu Rong, Ma Yan, Wu Dai-Fei, Deng Liu-Hong, Wang Sheng, Wang Gui-Yu, Zhang Chun-Fa, Qu Quan-Xin
Department of Obstetrics and Gynaecology, Tianjin First Central Hospital, Tianjin, China.
Department of Molecular Virology, SR Life Sciences Institute, Clarksburg, MD, United States.
Front Med (Lausanne). 2021 Jul 20;8:627355. doi: 10.3389/fmed.2021.627355. eCollection 2021.
High-risk human papillomavirus (hrHPV) persistent infection is the major cause of cervical cancer. Clinical intervention of hrHPV-associated high-grade squamous intraepithelial lesion (HSIL) is critical to prevent cervical cancer, and current treatment is surgery (an invasive therapy). However, some patients refuse to do so for an afraid of potential adverse effects on future fertility or other concerns which creates a critical need for development of non-invasive therapeutic strategies. Here, we report for the first time the cases of non-invasive intervention with REBACIN®, a proprietary antiviral biologics, in clinical treatment of HSIL. From 12,958 visiting patients assessed for eligibility, 18 HSIL-patients with cervical intraepithelial neoplasia-grade 2, positive of both diffused overexpression of p16 and high-risk HPV were enrolled in this non-invasive clinical intervention mainly due to concerns of future fertility. REBACIN® was administered intravaginally every other day for 3 months (one-course) except during menstrual period, and were followed up for 6-36 months for the examination of high-risk HPV DNA, cervical cytology, and histopathology. After one to three course treatments, most cases (16/18) displayed both the regression from HSIL (CIN2) to normal cervical cytology and clearance of high-risk HPV infection. Further studies demonstrated REBACIN® significantly suppressed HPV16 E7 oncoprotein expression in a human cervical cancer cell line, which is consistent with previous finding that REBACIN® inhibits the growth of tumors induced by expression of E6/E7 oncogenes of either HPV16 or HPV18. This report indicates REBACIN® as a novel effective non-invasive clinical intervention for HSIL-patients as well for high-risk HPV persistent infection, providing a new clinical option for the non-invasive treatment of hrHPV-associated high-grade squamous intraepithelial lesion, which is worthy of further research on clinical validation and application.
高危型人乳头瘤病毒(hrHPV)持续感染是宫颈癌的主要病因。对hrHPV相关的高级别鳞状上皮内病变(HSIL)进行临床干预对于预防宫颈癌至关重要,目前的治疗方法是手术(一种侵入性治疗)。然而,一些患者因担心对未来生育能力产生潜在不良影响或其他顾虑而拒绝手术,这迫切需要开发非侵入性治疗策略。在此,我们首次报告了使用专有抗病毒生物制剂REBACIN®对HSIL进行非侵入性干预的临床治疗案例。在12958名接受资格评估的就诊患者中,18名患有宫颈上皮内瘤变2级、p16弥漫性过表达且高危型HPV均呈阳性的HSIL患者被纳入这项非侵入性临床干预研究,主要原因是担心未来生育能力。除月经期外,每隔一天经阴道给予REBACIN®,持续3个月(一个疗程),并随访6 - 36个月,以检测高危型HPV DNA、宫颈细胞学和组织病理学。经过一至三个疗程的治疗后,大多数病例(16/18)显示从HSIL(CIN2)消退至正常宫颈细胞学,且高危型HPV感染清除。进一步研究表明,REBACIN®在人宫颈癌细胞系中显著抑制HPV16 E7癌蛋白表达,这与之前REBACIN®抑制由HPV16或HPV18的E6/E7癌基因表达所诱导肿瘤生长的发现一致。本报告表明REBACIN®是一种针对HSIL患者以及高危型HPV持续感染的新型有效非侵入性临床干预方法,为hrHPV相关的高级别鳞状上皮内病变的非侵入性治疗提供了一种新的临床选择,值得进一步开展临床验证和应用研究。