Vaccination Strategies for the Control and Treatment of HPV Infection and HPV-Associated Cancer.
Vaccination Strategies for the Control and Treatment of HPV Infection and HPV-Associated Cancer.
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控制和治疗HPV感染和HPV相关癌症的疫苗接种策略。
DOI：
10.1007/978-3-030-57362-1_8
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发表时间：
2021
期刊：
影响因子：
--
通讯作者：
Wu TC
中科院分区：
文献类型：
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作者：
Farmer E;Cheng MA;Hung CF;Wu TC
人乳头瘤病毒（HPV）是最常见的性传播感染，目前影响近8000万美国人。重要的是，HPV感染被认为是许多癌症的病因，包括宫颈癌、外阴癌、阴道癌、阴茎癌、肛门癌和口咽癌的一个子集。HPV感染及其相关疾病的流行是一个重大问题，影响着全世界数百万人。同样，HPV感染的发生率对个人和更广泛的医疗保健系统构成了重大负担。在2011年至2015年期间，仅在美国，每年估计就有42，700例HPV相关癌症新发病例。同样，HPV的全球负担很高，每年约有630，000例HPV相关癌症新发病例。在过去的十年中，总共有三种预防性的主要衣壳蛋白（L1）病毒样颗粒的HPV疫苗已被许可并推向市场，作为预防HPV感染传播的一种手段。这些预防性疫苗已被证明是安全和有效的预防HPV感染。预防性HPV疫苗的最新迭代，一种纳米价L1-VLP疫苗，可预防总共9种HPV类型（7种高危型和2种低危型HPV），包括高危型HPV 16和HPV 18，这两种类型导致大多数HPV相关癌症。尽管目前的预防性HPV疫苗在预防感染方面取得了巨大成功，但现有的疫苗获取障碍限制了其广泛使用，特别是在HPV相关疾病负担最高的低收入和中等收入国家。预防性疫苗无法为现有HPV感染或HPV相关疾病的个体提供保护。相反，需要能够产生针对HPV感染和相关疾病的T细胞介导的免疫力的治疗性HPV疫苗来减轻患有现有HPV感染的个体的疾病负担。为了产生针对HPV的细胞介导的免疫应答，大多数治疗性疫苗靶向HPV癌蛋白E6和E7。已经开发了几种类型的治疗性HPV疫苗候选物，包括活载体、蛋白质、肽、树突状细胞和基于DNA的疫苗。本章将回顾市售的预防性HPV疫苗，并讨论治疗性HPV疫苗开发的最新进展。
Human papillomavirus (HPV) is the most common sexually transmitted infection, currently affecting close to 80 million Americans. Importantly, HPV infection is recognized as the etiologic factor for numerous cancers, including cervical, vulval, vaginal, penile, anal, and a subset of oropharyngeal cancers. The prevalence of HPV infection and its associated diseases are a significant problem, affecting millions of individuals worldwide. Likewise, the incidence of HPV infection poses a significant burden on individuals and the broader healthcare system. Between 2011 and 2015, there were an estimated 42,700 new cases of HPV-associated cancers each year in the United States alone. Similarly, the global burden of HPV is high, with around 630,000 new cases of HPV-associated cancer occurring each year. In the last decade, a total of three preventive major capsid protein (L1) virus-like particle-based HPV vaccines have been licensed and brought to market as a means to prevent the spread of HPV infection. These prophylactic vaccines have been demonstrated to be safe and efficacious in preventing HPV infection. The most recent iteration of the preventive HPV vaccine, a nanovalent, L1-VLP vaccine, protects against a total of nine HPV types (seven high-risk and two low-risk HPV types), including the high-risk types HPV16 and HPV18, which are responsible for causing the majority of HPV-associated cancers. Although current prophylactic HPV vaccines have demonstrated huge success in preventing infection, existing barriers to vaccine acquisition have limited their widespread use, especially in low- and middle-income countries, where the burden of HPV-associated diseases is highest. Prophylactic vaccines are unable to provide protection to individuals with existing HPV infections or HPV-associated diseases. Instead, therapeutic HPV vaccines capable of generating T cell-mediated immunity against HPV infection and associated diseases are needed to ameliorate the burden of disease in individuals with existing HPV infection. To generate a cell-mediated immune response against HPV, most therapeutic vaccines target HPV oncoproteins E6 and E7. Several types of therapeutic HPV vaccine candidates have been developed including live-vector, protein, peptide, dendritic cell, and DNA-based vaccines. This chapter will review the commercially available prophylactic HPV vaccines and discuss the recent progress in the development of therapeutic HPV vaccines.