J Drugs Dermatol. 2022 May 1;21(5):526-528. doi: 10.36849/JDD.6536.
Immunosuppression, as seen in solid organ transplant recipients, is highly associated with the development of keratinocyte carcinomas (KCs). Reducing the level of immunosuppression lowers the incidence of KCs but at the cost of increased potential morbidity and mortality. Recent studies have revealed a greater prevalence of HPV DNA, especially that of β-HPV, in KCs of immunocompromised patients compared to KCs of immunocompetent individuals. A prior report demonstrated that the HPV vaccine was associated with reducing KC incidence in immunocompetent patients. The nonavalent HPV vaccine was administered to two immunosuppressed individuals with histories of multiple prior KCs. Both patients are male, with Patient 1 being a liver transplant recipient who was on tacrolimus for an extended period and Patient 2 having Crohn’s disease and currently being treated with mercaptopurine. The treatment was well tolerated without adverse events and was associated with dramatic reductions in average incidence of KCs/year in both patients. Patient 1 demonstrated an 88% reduction in new KCs/year (87% squamous cell carcinomas (SCCs); 100% basal cell carcinomas (BCCs) post-injection of the intramuscular vaccine and Patient 2 demonstrated a 63% reduction in incidence of KCs/year (30% SCCs; 100% BCCs). Evidence links the β-HPV genera to the development of SCCs and actinic keratoses. The nonavalent HPV vaccine, containing antigens of the α-HPV genera, may also induce humoral immunity to β-HPV due to shared expression of L1 and L2 capsid proteins. The HPV vaccine may be an effective tool in the prevention of KCs in immunosuppressed patients. J Drugs Dermatol. 2022;21(5):526-528. doi:10.36849/JDD.6536.
免疫抑制，如在实体器官移植受者中所见，与角质形成细胞癌 (KCs) 的发生高度相关。降低免疫抑制水平会降低 KCs 的发病率，但代价是增加潜在的发病率和死亡率。最近的研究表明，与免疫功能正常的个体相比，免疫功能低下患者的 KCs 中 HPV DNA 的流行率更高，尤其是β-HPV。先前的一项报告表明，HPV 疫苗与降低免疫功能正常患者的 KC 发病率有关。九价 HPV 疫苗被用于两名有多次 KC 病史的免疫抑制患者。两名患者均为男性，患者 1 为长期接受他克莫司治疗的肝移植受者，患者 2 患有克罗恩病，目前正在接受巯嘌呤治疗。治疗耐受性良好，无不良反应，并与两名患者 KC 平均发病率/年的显著降低相关。患者 1 显示新 KC/年的发病率降低了 88%（87%为鳞状细胞癌 (SCCs)；注射肌内疫苗后 100%为基底细胞癌 (BCCs)），患者 2 显示 KC/年的发病率降低了 63%（30%为 SCCs；100%为 BCCs）。有证据表明β-HPV 属与 SCCs 和光化性角化病的发生有关。包含α-HPV 属抗原的九价 HPV 疫苗也可能由于 L1 和 L2 衣壳蛋白的共同表达而诱导针对β-HPV 的体液免疫。HPV 疫苗可能是预防免疫抑制患者 KC 的有效工具。J Drugs Dermatol. 2022;21(5):526-528. doi:10.36849/JDD.6536.
