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Mabeya H, Odunga J, Broeck DV. Mothers of adolescent girls and Human Papilloma Virus (HPV) vaccination in Western Kenya. Pan Afr Med J 2021; 38:126. [PMID: 33912296 PMCID: PMC8051220 DOI: 10.11604/pamj.2021.38.126.21359] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 10/24/2019] [Indexed: 01/14/2023] Open
Abstract
Introduction human papilloma virus (HPV) which is preventable is the main cause of cervical cancer and it targets mostly young adolescents. The study was to determine the practice desire, attitude and knowledge of mothers of adolescent girls on HPV vaccination in Western Kenya. Methods this was a descriptive cross-sectional study design. Data was obtained using semi-structured questionnaires and analyzed using both descriptive and inferential statistics at 95% confidence level using the SPSS software version 22. A p-value ≤ 0.05 was considered statistically significant. Results ninety five percent of the mothers had intentions to vaccinate their daughters and also had a positive attitude and their response to HPV vaccination was significantly lower than those without intentions p=0.02, 95% CI, OR=0.48 (0.90-0.89). Vaccination against HPV was low at 9.4% with a mean age of 34 years. Our results found a high level of cervical cancer awareness (85.0%), HPV and vaccine awareness respectively (62.0%, and 64.0%). “Vaccination of my daughters will prompt early sexual activity and the cost of HPV vaccination being a barrier to vaccination” had a statistically significant influence on the practice of vaccination. Negative attitude to daughters´ early onset of sexual activity significantly reduced up take while positive attitude to cost of HPV vaccine significantly increased up take of HPV vaccination with p value of 0.007 and 0.04 respectively. Conclusion awareness of HPV and HPV vaccine prevention is low among mothers of adolescent girls in Western Kenya. There was a positive attitude and high desire towards the use of HPV vaccination therefore a need for awareness, policy and unify efforts to reduce cervical cancer burden.
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Affiliation(s)
- Hillary Mabeya
- Moi University, Eldoret, Kenya.,International Center of Reproductive Health, Ghent University, Ghent, Belgium
| | | | - Davy Vanden Broeck
- International Center of Reproductive Health, Ghent University, Ghent, Belgium.,Ghent University, Ghent, Belgium
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Cross-neutralizing antibody titres against non-vaccine types induced by a recombinant trivalent HPV vaccine (16/18/58) in rhesus macaques. PAPILLOMAVIRUS RESEARCH 2020; 10:100209. [PMID: 33197649 PMCID: PMC7704424 DOI: 10.1016/j.pvr.2020.100209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 11/05/2020] [Accepted: 11/06/2020] [Indexed: 12/05/2022]
Abstract
Human papillomavirus (HPV) causes not only most cervical cancers but also cancers of the vagina, vulva, penis, anus, rectum, and oropharynx. Every year, 200,000 women die of cervical cancer in the world, and China accounts for about 10%. HPV vaccines are effective in preventing HPV infections thus HPV-related cancers worldwide. Studies on the clinical trials of the 2v Cervarix™ and the 4v Gardasil® have suggested that immunization with either of these vaccines provided some level of protection against other HPV types that are closely related to the types contained in the vaccines. Here we conducted a preliminary evaluation on the ability to induce cross-neutralizing antibodies in rhesus monkeys by a 3v HPV vaccine that targets HPV16, 18, and 58 and it is specifically designed for Chinese women. We found that this vaccine is no less than Gardasil® in terms of the ability to induce NAbs against non-vaccine types of HPV in rhesus macaques. These results provided evidence from the immunogenicity point of view that the KLWS 3v HPV vaccine is a strong competitor to the imported 2v and 4v HPV vaccines currently available on the market.
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53
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Gu KJ, Li G. An Overview of Cancer Prevention: Chemoprevention and Immunoprevention. J Cancer Prev 2020; 25:127-135. [PMID: 33033707 PMCID: PMC7523034 DOI: 10.15430/jcp.2020.25.3.127] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 08/04/2020] [Accepted: 08/14/2020] [Indexed: 12/21/2022] Open
Abstract
Cancer prevention encompasses a broad spectrum of strategies designed to lower the chance of developing cancer and reduce the morbidity of established cancer. There are three levels of cancer prevention. Eliminating or mitigating cancer risk factors by adopting healthy behaviors and lifestyles, such as avoiding tobacco and alcohol use, exercising, eating a healthy diet, and applying sunscreen to protect against UV exposure, belongs to primary prevention and is the easiest and most effective way of preventing cancer for the general public. Secondary prevention includes screening to identify precancerous lesions and taking intervention measures to prevent disease progression to malignancy. Tertiary prevention refers to reducing or controlling the symptoms and morbidity of established cancer or the morbidity caused by cancer therapy. For high-risk populations, chemopreventive agents, such as selective estrogen receptor modulators (including tamoxifan and raloxifene) in breast cancer prevention and non-steroidal anti-inflammatory drugs (aspirin) in colorectal cancer prevention, and immunoprevention using human papillomavirus and hepatitis B virus vaccines in infection-related cancers have shown clear clinical benefits of reducing cancer incidences. In this review, we will summarize the current status of cancer prevention, focusing on the major agents that are clinically used for chemoprevention and immunoprevention.
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Affiliation(s)
- Kyle J Gu
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.,College of Natural Sciences, The University of Texas at Austin, Austin, TX, USA
| | - Guojun Li
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.,Division of Epidemiology, The University of Texas School of Public Health, Houston, TX, USA
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Bhatla N, Meena J, Gupta K, Pal B, Divakar H, Bhalerao S, Peedicayil A, Srivastava S, Basu P, Purandare CN. Human papillomavirus vaccination: Good clinical practice recommendations from the Federation of Obstetric and Gynecological Societies of India. J Obstet Gynaecol Res 2020; 46:1651-1660. [PMID: 32627278 DOI: 10.1111/jog.14345] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 05/07/2020] [Indexed: 12/24/2022]
Abstract
Human papillomavirus (HPV) vaccination offers an excellent prospect for the primary prevention of cervical cancer. The bivalent and quadrivalent vaccines are both available in India. The nonavalent vaccine is licensed but not yet available. However, there still remain controversies regarding the vaccination of older women, immunocompromised females and other special groups. To provide recommendations for HPV vaccination in India. The Federation of Obstetric and Gynecological Societies of India (FOGSI) convened an expert group on cervical cancer prevention to formulate good clinical practice recommendations (GCPR) with respect to vaccine efficacy and safety, target groups, optimal timing and dosing schedules. HPV vaccines are licensed for females aged 9-45 years in India and have been seen to be safe and effective. FOGSI recommends HPV vaccination of all girls <15 years of age as the best target group, in whom two-doses at an interval of 6 months, extendable to 18 months, are recommended. Three-doses are recommended in girls >15 years of age, immunocompromised persons and sexual assault survivors. Older women and women with abnormal screening results may be vaccinated with an understanding that vaccination does not protect against already acquired infections and screening has to continue. Single-dose vaccination results are promising. Increased awareness is required to reduce vaccine hesitancy. HPV vaccination should be the priority to achieve the elimination of cervical cancer. The introduction of affordable HPV vaccines and reduced dose schedules will improve coverage.
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Affiliation(s)
- Neerja Bhatla
- All India Institute of Medical Sciences, New Delhi, India
| | - Jyoti Meena
- All India Institute of Medical Sciences, New Delhi, India
| | - Krishnendu Gupta
- Ramakrishna Mission Seva Pratisthan and Vivekananda Institute of Medical Sciences, Kolkata, India
| | | | | | | | | | | | - Partha Basu
- Early Detection and Prevention Section(EDP)/Screening Group (SCR) International Agency for Research on Cancer, World Health Organization, Lyon, France
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Thistle P, Parpia R, Pain D, Lee H, Manasa J, Schnipper LE. Prevalence and Subtype Distribution of High-Risk Human Papillomavirus Among Women Presenting for Cervical Cancer Screening at Karanda Mission Hospital. JCO Glob Oncol 2020; 6:1276-1281. [PMID: 32783640 PMCID: PMC7456322 DOI: 10.1200/go.20.00286] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE High-risk human papillomaviruses (hrHPV) are the primary cause of cervical cancer. Human papillomavirus (HPV) vaccination is expected to prevent cervical cancers caused by the HPV types included in vaccines and possibly by cross-protection from other types. This study sought to determine the hrHPV type distribution in women at a rural Zimbabwe hospital. METHODS We implemented a cross-sectional study at the Karanda Mission Hospital. Using the Visual Inspection with Acetic Acid Cervicography technique, clinicians collected cervical swabs from 400 women presenting for screening for cervical cancer. Samples were initially analyzed by Cepheid GeneXpert; candidate hrHPV genotypes were further characterized using the Anyplex II HPV28 Detection Kit. RESULTS Twenty-one percent of the 400 women were positive for a high-risk genotype when using the GeneXpert analyzer; 17% were positive when using the multiplex analysis. Almost two thirds of the hrHPV women had a single DNA type identified, whereas one third had multiple genotypes, ranging from 2 to 5. hrHPV was observed more frequently in HIV-positive than in HIV-negative women (27% v 15%). Of the 113 isolates obtained, 77% were hrHPV genotypes not included in the bivalent or quadrivalent vaccines, and 47% represented DNA types not covered in the nonavalent vaccine. Forty-seven percent of the women with hrHPV harbored a single genotype that was not covered by the nonavalent vaccine. CONCLUSION A large fraction of hrHPV isolates from women participating in a cervical cancer screening program in northern Zimbabwe are DNA types not covered by the bivalent, quadrivalent, or nonavalent vaccines. These findings suggest the importance of characterizing the hrHPV DNA types isolated from cervical neoplasia in this population and determining whether cross-immunization against these genotypes develops after administration of the vaccines in current use.
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Affiliation(s)
- Paul Thistle
- Karanda Mission Hospital, Mount Darwin, Zimbabwe
| | | | | | - Hang Lee
- Massachusetts General Hospital, Boston, MA
| | - Justen Manasa
- African Institute of Biomedical Science and Technologies Laboratory, Harare, Zimbabwe
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Sasieni P, Castanon A. Evidence of HPV vaccination efficacy comes from more than clinical trials. Vaccine 2020; 38:5569-5571. [PMID: 32654905 DOI: 10.1016/j.vaccine.2020.06.080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 06/25/2020] [Accepted: 06/29/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Peter Sasieni
- King's College London, Faculty of Life Sciences & Medicine, School of Cancer & Pharmaceutical Sciences, Cancer Prevention Group, Innovation Hub, Guys Cancer Centre, Guys Hospital, Great Maze Pond, London SE1 9RT, United Kingdom
| | - Alejandra Castanon
- King's College London, Faculty of Life Sciences & Medicine, School of Cancer & Pharmaceutical Sciences, Cancer Prevention Group, Innovation Hub, Guys Cancer Centre, Guys Hospital, Great Maze Pond, London SE1 9RT, United Kingdom.
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Progress in the Production of Virus-Like Particles for Vaccination against Hepatitis E Virus. Viruses 2020; 12:v12080826. [PMID: 32751441 PMCID: PMC7472025 DOI: 10.3390/v12080826] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 07/16/2020] [Accepted: 07/28/2020] [Indexed: 12/13/2022] Open
Abstract
Hepatitis E virus (HEV), a pathogen that causes acute viral hepatitis, is a small icosahedral, quasi-enveloped, positive ssRNA virus. Its genome has three open reading frames (ORFs), with ORF1 and ORF3 encoding for nonstructural and regulatory proteins, respectively, while ORF2 is translated into the structural, capsid protein. ORF2 is most widely used for vaccine development in viral hepatitis. Hepatitis E virus-like particles (VLPs) are potential vaccine candidates against HEV infection. VLPs are composed of capsid subunits mimicking the natural configuration of the native virus but lack the genetic material needed for replication. As a result, VLPs are unable to replicate and cause disease, constituting safe vaccine platforms. Currently, the recombinant VLP-based vaccine Hecolin® against HEV is only licensed in China. Herein, systematic information about the expression of various HEV ORF2 sequences and their ability to form VLPs in different systems is provided.
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Measuring vaccine effectiveness against persistent HPV infections: a comparison of different statistical approaches. BMC Infect Dis 2020; 20:482. [PMID: 32640998 PMCID: PMC7341660 DOI: 10.1186/s12879-020-05083-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 05/12/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Persistent high-risk human papillomavirus (HPV) infection is endorsed by the World Health Organization as an intermediate endpoint for evaluating HPV vaccine effectiveness/efficacy. There are different approaches to estimate the vaccine effectiveness/efficacy against persistent HPV infections. METHODS We performed a systematic literature search in Pubmed to identify statistical approaches that have been used to estimate the vaccine effectiveness/efficacy against persistent HPV infections. We applied these methods to data of a longitudinal observational study to assess their performance and compare the obtained vaccine effectiveness (VE) estimates. RESULTS Our literature search identified four approaches: the conditional exact test for comparing two independent Poisson rates using a binomial distribution, Generalized Estimating Equations for Poisson regression, Prentice Williams and Peterson total time (PWP-TT) and Cox proportional hazards regression. These approaches differ regarding underlying assumptions and provide different effect measures. However, they provided similar effectiveness estimates against HPV16/18 and HPV31/33/45 persistent infections in a cohort of young women eligible for routine HPV vaccination (range VE 93.7-95.1% and 60.4-67.7%, respectively) and seemed robust to violations of underlying assumptions. CONCLUSIONS As the rate of subsequent infections increased in our observational cohort, we recommend PWP-TT as the optimal approach to estimate the vaccine effectiveness against persistent HPV infections in young women. Confirmation of our findings should be undertaken by applying these methods after longer follow-up in our study, as well as in different populations.
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Determinants of Acquisition and Clearance of Human Papillomavirus Infection in Previously Unexposed Young Women. Sex Transm Dis 2020; 46:663-669. [PMID: 31464859 PMCID: PMC6887628 DOI: 10.1097/olq.0000000000001053] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Global variation in human papillomavirus (HPV) prevalence and persistence may be explained by differences in risk factors, such as sexual activity, oral contraceptive use, and behavioral factors. We evaluated determinants of acquisition and clearance of HPV infection among young women previously unexposed to HPV. METHODS Five hundred thirty-four women aged 15 to 25 years who were cytology and HPV DNA negative, and seronegative for anti-HPV-16/18 antibodies, were recruited (July 2000-September 2001) from study centers in Brazil, the United States, and Canada (NCT00689741/NCT00120848). They were followed up for 76 months. Cervical samples were HPV genotyped via polymerase chain reaction. We used multivariable (forward stepwise, P = 0.15) Cox proportional hazards regression to estimate rate ratios (RR) and 95% confidence intervals (CI), separately according to length of follow-up time. RESULTS On short-term follow-up (0-27 months), 257 (48%; 8535.80 person-months; incidence rate = 30.11; 95% CI, 26.64-34.02) incident HPV infections were detected. Marital status, lifetime number of sex partners, history of any sexually transmitted disease, and occasional use of oral contraceptives were strongly associated with acquisition of any HPV. Having 2 or more lifetime sex partners (RR, 2.03; 95% CI, 1.37-3.02) and a history of any sexually transmitted disease (RR, 1.98; 95% CI, 1.19-3.29) were the most important determinants of high-risk HPV (hrHPV) incidence. During the entire follow-up (0-76 months), an increased hrHPV clearance was found among women in North America (RR, 1.38; 95% CI, 1.08-1.78) and black women (RR, 1.64; 95% CI, 1.04-2.60). Greater number of lifetime partners was associated with reduced clearance rates for any HPV (RR, 0.65; 95% CI, 0.43-0.98). CONCLUSIONS We identified variation in risk of HPV acquisition and clearance among women unexposed to HPV at baseline.
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Rosillon D, Willame C, Tavares Da Silva F, Guignard A, Caterina S, Welby S, Struyf F. Meta-analysis of the risk of autoimmune thyroiditis, Guillain-Barré syndrome, and inflammatory bowel disease following vaccination with AS04-adjuvanted human papillomavirus 16/18 vaccine. Pharmacoepidemiol Drug Saf 2020; 29:1159-1167. [PMID: 32583515 PMCID: PMC7539912 DOI: 10.1002/pds.5063] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 02/26/2020] [Accepted: 05/07/2020] [Indexed: 11/28/2022]
Abstract
Purpose To assess the risk of three autoimmune diseases ‐ autoimmune thyroiditis (AIT), Guillain‐Barré syndrome (GBS), and inflammatory bowel disease (IBD) ‐ in females following AS04‐HPV‐16/18 vaccination. Methods This meta‐analysis included data from 18 randomized controlled trials, one cluster‐randomized trial, two large observational retrospective cohort studies, and one case‐control study. Following vaccination, a risk window of 2 years was defined for AIT and IBD and 42 days for GBS. Odds ratios (ORs) were estimated using three methods: meta‐analysis inverse‐variance with continuity correction (primary analysis), pooled estimate, and beta‐binomial regression. Results In all studies apart from the case‐control study, 154 398 exposed and 1 504 322 non‐exposed subjects were included, among whom there were 141 and 1972 cases of (autoimmune) thyroiditis; 2 and 2 cases of GBS; and 43 and 401 cases of IBD, respectively. In the case‐control study, there were 97 cases of AIT and 13 of GBS; matched with 802 and 130 controls, respectively. The primary analysis OR estimates were 1.46 (95% confidence interval [CI] 1.22‐1.76), 11.14 (2.00‐61.92), and 1.11 (0.75‐1.66) for (autoimmune) thyroiditis, GBS, and IBD, respectively. Conclusions This meta‐analysis did not show an increased risk of IBD following vaccination with AS04‐HPV‐16/18. The 1.5‐fold increased risk of (autoimmune) thyroiditis does not allow us to conclude about a causal association. For GBS, the very low number of cases and wide 95% CIs negate any firm conclusion.
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Affiliation(s)
| | | | | | | | | | - Sarah Welby
- Research and Development, GSK, Wavre, Belgium
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Zepeda-Cervantes J, Ramírez-Jarquín JO, Vaca L. Interaction Between Virus-Like Particles (VLPs) and Pattern Recognition Receptors (PRRs) From Dendritic Cells (DCs): Toward Better Engineering of VLPs. Front Immunol 2020; 11:1100. [PMID: 32582186 PMCID: PMC7297083 DOI: 10.3389/fimmu.2020.01100] [Citation(s) in RCA: 103] [Impact Index Per Article: 25.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 05/06/2020] [Indexed: 12/13/2022] Open
Abstract
Virus-like particles (VLPs) have been shown to be strong activators of dendritic cells (DCs). DCs are the most potent antigen presenting cells (APCs) and their activation prompts the priming of immunity mediators based on B and T cells. The first step for the activation of DCs is the binding of VLPs to pattern recognition receptors (PRRs) on the surface of DCs, followed by VLP internalization. Like wild-type viruses, VLPs use specific PRRs from the DC; however, these recognition interactions between VLPs and PRRs from DCs have not been thoroughly reviewed. In this review, we focused on the interaction between proteins that form VLPs and PRRs from DCs. Several proteins that form VLP contain glycosylations that allow the direct interaction with PRRs sensing carbohydrates, prompting DC maturation and leading to the development of strong adaptive immune responses. We also discussed how the knowledge of the molecular interaction between VLPs and PRRs from DCs can lead to the smart design of VLPs, whether based on the fusion of foreign epitopes or their chemical conjugation, as well as other modifications that have been shown to induce a stronger adaptive immune response and protection against infectious pathogens of importance in human and veterinary medicine. Finally, we address the use of VLPs as tools against cancer and allergic diseases.
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Affiliation(s)
- Jesús Zepeda-Cervantes
- Departamento de Biología Celular y del Desarrollo, Instituto de Fisiología Celular, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Josué Orlando Ramírez-Jarquín
- Departamento de Neuropatología Molecular, Instituto de Fisiología Celular, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Luis Vaca
- Departamento de Biología Celular y del Desarrollo, Instituto de Fisiología Celular, Universidad Nacional Autónoma de México, Mexico City, Mexico.,Department of Physiology and Biophysics, University of Washington School of Medicine, Seattle, WA, United States
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Watanabe Y, Seto Y, Oikawa R, Nakazawa T, Furuya H, Matsui H, Hosono S, Noike M, Inoue A, Yamamoto H, Itoh F, Wada K. Mouthwash-Based Highly Sensitive Pyro-Genotyping for Nine Sexually Transmitted Human Papilloma Virus Genotypes. Int J Mol Sci 2020; 21:ijms21103697. [PMID: 32456291 PMCID: PMC7279261 DOI: 10.3390/ijms21103697] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 05/20/2020] [Accepted: 05/22/2020] [Indexed: 01/05/2023] Open
Abstract
Human papillomavirus (HPV) is a common sexually transmitted infection worldwide, which spreads via contact with infected genital, anal, and oral/pharyngeal areas (oral sex) owing to diverse manners of sexual intercourse. In this study, we devised an oral HPV detection method using mouthwash waste fluids that causes less psychological resistance to visiting the outpatient otolaryngology departments. We successfully detected only the specific unique reverse sequencing probe (using pyro-genotyping) and identified the nine genotypes of HPV targeted for vaccination by pyrosequencing the mouthwash waste fluids of non-head and neck cancer patient volunteers (n = 52). A relatively large number (11/52) of mouthwash waste fluids tested positive for HPV (21.2%; genotype 6, n = 1; 11, n = 1; 16, n = 1; and 18, n = 8). These results surpassed the sensitivity observed testing the same specimens using the conventional method (1/52, 1.9%). Our method (pyro-genotyping) was developed using nine HPV genotypes targeted for vaccination and the results were highly sensitive compared to those of the conventional method. This less expensive, high-throughput, and simple method can be used for detecting oral HPV infection with fewer socio-psychological barriers.
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Affiliation(s)
- Yoshiyuki Watanabe
- Department of Internal Medicine, Kawasaki Rinko General Hospital, Kawasaki 210-0806, Japan; (Y.S.); (T.N.); (H.F.); (H.M.); (S.H.); (M.N.); (A.I.)
- Department of Otolaryngology, Toho University Omori Medical Center, Tokyo 143-8540, Japan; (R.O.); (H.Y.); (F.I.)
- Correspondence: ; Tel.: +81-44-977-8111; Fax: +81-44-976-5805
| | - Yukiko Seto
- Department of Internal Medicine, Kawasaki Rinko General Hospital, Kawasaki 210-0806, Japan; (Y.S.); (T.N.); (H.F.); (H.M.); (S.H.); (M.N.); (A.I.)
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki 216-8511, Japan;
| | - Ritsuko Oikawa
- Department of Otolaryngology, Toho University Omori Medical Center, Tokyo 143-8540, Japan; (R.O.); (H.Y.); (F.I.)
| | - Takara Nakazawa
- Department of Internal Medicine, Kawasaki Rinko General Hospital, Kawasaki 210-0806, Japan; (Y.S.); (T.N.); (H.F.); (H.M.); (S.H.); (M.N.); (A.I.)
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki 216-8511, Japan;
| | - Hanae Furuya
- Department of Internal Medicine, Kawasaki Rinko General Hospital, Kawasaki 210-0806, Japan; (Y.S.); (T.N.); (H.F.); (H.M.); (S.H.); (M.N.); (A.I.)
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki 216-8511, Japan;
| | - Hidehito Matsui
- Department of Internal Medicine, Kawasaki Rinko General Hospital, Kawasaki 210-0806, Japan; (Y.S.); (T.N.); (H.F.); (H.M.); (S.H.); (M.N.); (A.I.)
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki 216-8511, Japan;
| | - Sachiko Hosono
- Department of Internal Medicine, Kawasaki Rinko General Hospital, Kawasaki 210-0806, Japan; (Y.S.); (T.N.); (H.F.); (H.M.); (S.H.); (M.N.); (A.I.)
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki 216-8511, Japan;
| | - Mika Noike
- Department of Internal Medicine, Kawasaki Rinko General Hospital, Kawasaki 210-0806, Japan; (Y.S.); (T.N.); (H.F.); (H.M.); (S.H.); (M.N.); (A.I.)
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki 216-8511, Japan;
| | - Akiko Inoue
- Department of Internal Medicine, Kawasaki Rinko General Hospital, Kawasaki 210-0806, Japan; (Y.S.); (T.N.); (H.F.); (H.M.); (S.H.); (M.N.); (A.I.)
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki 216-8511, Japan;
| | - Hiroyuki Yamamoto
- Department of Otolaryngology, Toho University Omori Medical Center, Tokyo 143-8540, Japan; (R.O.); (H.Y.); (F.I.)
| | - Fumio Itoh
- Department of Otolaryngology, Toho University Omori Medical Center, Tokyo 143-8540, Japan; (R.O.); (H.Y.); (F.I.)
| | - Kota Wada
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki 216-8511, Japan;
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Tornesello AL, Tagliamonte M, Tornesello ML, Buonaguro FM, Buonaguro L. Nanoparticles to Improve the Efficacy of Peptide-Based Cancer Vaccines. Cancers (Basel) 2020; 12:E1049. [PMID: 32340356 PMCID: PMC7226445 DOI: 10.3390/cancers12041049] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 03/24/2020] [Accepted: 04/20/2020] [Indexed: 12/11/2022] Open
Abstract
Nanoparticles represent a potent antigen presentation and delivery system to elicit an optimal immune response by effector cells targeting tumor-associated antigens expressed by cancer cells. Many types of nanoparticles have been developed, such as polymeric complexes, liposomes, micelles and protein-based structures such as virus like particles. All of them show promising results for immunotherapy approaches. In particular, the immunogenicity of peptide-based cancer vaccines can be significantly potentiated by nanoparticles. Indeed, nanoparticles are able to enhance the targeting of antigen-presenting cells (APCs) and trigger cytokine production for optimal T cell response. The present review summarizes the categories of nanoparticles and peptide cancer vaccines which are currently under pre-clinical evaluation.
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Affiliation(s)
- Anna Lucia Tornesello
- Molecular Biology and Viral Oncology Unit, Istituto Nazionale Tumori IRCCS “Fondazione G. Pascale”, via Mariano Semmola, 80131 Napoli, Italy; (M.L.T.); (F.M.B.)
| | - Maria Tagliamonte
- Innovative Immunological Models, Istituto Nazionale Tumori IRCCS “Fondazione G. Pascale”, via Mariano Semmola, 80131 Napoli, Italy;
| | - Maria Lina Tornesello
- Molecular Biology and Viral Oncology Unit, Istituto Nazionale Tumori IRCCS “Fondazione G. Pascale”, via Mariano Semmola, 80131 Napoli, Italy; (M.L.T.); (F.M.B.)
| | - Franco M. Buonaguro
- Molecular Biology and Viral Oncology Unit, Istituto Nazionale Tumori IRCCS “Fondazione G. Pascale”, via Mariano Semmola, 80131 Napoli, Italy; (M.L.T.); (F.M.B.)
| | - Luigi Buonaguro
- Innovative Immunological Models, Istituto Nazionale Tumori IRCCS “Fondazione G. Pascale”, via Mariano Semmola, 80131 Napoli, Italy;
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64
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The effectiveness of vaccination to prevent the papillomavirus infection: a systematic review and meta-analysis. Epidemiol Infect 2020; 147:e156. [PMID: 31063090 PMCID: PMC6518793 DOI: 10.1017/s0950268818003679] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Our purpose was to determine the effectiveness and harms of vaccination in patients with any sexual history to prevent the prevalence of papillomavirus infection. A search strategy was conducted in the MEDLINE, CENTRAL, EMBASE and LILACS databases. Searches were also conducted in other databases and unpublished literature. The risk of bias was evaluated with the Cochrane Collaboration's tool. Analysis of fixed effects was conducted. The primary outcome was the infection by any and each human papillomavirus (HPV) genotype, serious adverse effects and short-term adverse effects. The measure of the effect was the risk difference (RD) with a 95% confidence interval (CI). The planned interventions were bivalent vaccine/tetravalent/nonavalent vs. placebo/no intervention/other vaccines. We included 29 studies described in 35 publications. Bivalent HPV vaccine offers protection against HPV16 (RD −0.05, 95% CI −0.098 to −0.0032), HPV18 (RD −0.03, 95% CI −0.062 to −0.0004) and HPV16/18 genotypes (RD of −0.1, 95% CI −0.16 to −0.04). On the other side, tetravalent HPV vaccine offered protection against HPV6 (RD of −0.0500, 95% CI −0.0963 to −0.0230), HPV11 (RD −0.0198, 95% CI −0.0310 to −0.0085). Also, against HPV16 (RD of −0.0608, 95% CI −0.1126 to −0.0091) and HPV18 (RD of −0.0200, 95% CI −0.0408 to −0.0123). There was a reduction in the prevalence of HPV16, 18 and 16/18 genotypes when applying the bivalent vaccine, with no increase in adverse effects. Regarding the tetravalent vaccine, we found a reduction in the prevalence of HPV6, 11, 16 and 18 genotypes, with no increase in adverse effects.
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O'Leary ST, Allison MA, Vogt T, Hurley LP, Crane LA, Brtnikova M, McBurney E, Beaty BL, Crawford N, Lindley MC, Stokley SK, Kempe A. Pediatricians' Experiences With and Perceptions of the Vaccines for Children Program. Pediatrics 2020; 145:peds.2019-1207. [PMID: 32086388 DOI: 10.1542/peds.2019-1207] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/02/2019] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The Vaccines for Children Program (VFC) provides vaccines for children who may not otherwise be vaccinated because of financial barriers. Pediatrician participation is crucial to the VFC's ongoing success. Our objectives were to assess, among a national sample of pediatricians, (1) VFC program participation, (2) perceived burden versus benefit of participation, and (3) knowledge and perception of a time-limited increased payment for VFC vaccine administration under the Patient Protection and Affordable Care Act. METHODS An electronic and mail survey was conducted from June 2017 to September 2017. RESULTS Response rate was 79% (372 of 471); 86% of pediatricians reported currently participating in the VFC; among those, 85% reported never having considered stopping, 10% considered it but not seriously, and 5% seriously considered it. Among those who had considered no longer participating (n = 47), the most commonly reported reasons included difficulty meeting VFC record-keeping requirements (74%), concern about action by the VFC for noncompliance (61%), and unpredictable VFC vaccine supplies (59%). Participating pediatricians rated, on a scale from -5 (high burden) to +5 (high benefit), their overall perception of the VFC: 63% reported +4 or +5, 23% reported +1 to +3, 5% reported 0, and 9% reported -1 to -5. Of pediatricians, 39% reported awareness of temporary increased payment for VFC vaccine administration. Among those, 10% reported that their practice increased the proportion of Medicaid and/or VFC-eligible patients served on the basis of this change. CONCLUSIONS For most pediatricians, perceived benefits of VFC participation far outweigh perceived burdens. To ensure the program's ongoing success, it will be important to monitor factors influencing provider participation.
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Affiliation(s)
- Sean T O'Leary
- Adult and Child Consortium for Health Outcomes Research and Delivery Science, School of Medicine, University of Colorado and Children's Hospital Colorado, Aurora, Colorado; .,Department of Pediatrics and
| | - Mandy A Allison
- Adult and Child Consortium for Health Outcomes Research and Delivery Science, School of Medicine, University of Colorado and Children's Hospital Colorado, Aurora, Colorado.,Department of Pediatrics and
| | - Tara Vogt
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; and
| | - Laura P Hurley
- Adult and Child Consortium for Health Outcomes Research and Delivery Science, School of Medicine, University of Colorado and Children's Hospital Colorado, Aurora, Colorado.,Division of General Internal Medicine, Denver Health, Denver, Colorado
| | - Lori A Crane
- Adult and Child Consortium for Health Outcomes Research and Delivery Science, School of Medicine, University of Colorado and Children's Hospital Colorado, Aurora, Colorado.,Department of Community and Behavioral Health, School of Public Health and
| | - Michaela Brtnikova
- Adult and Child Consortium for Health Outcomes Research and Delivery Science, School of Medicine, University of Colorado and Children's Hospital Colorado, Aurora, Colorado.,Department of Pediatrics and
| | - Erin McBurney
- Adult and Child Consortium for Health Outcomes Research and Delivery Science, School of Medicine, University of Colorado and Children's Hospital Colorado, Aurora, Colorado
| | - Brenda L Beaty
- Adult and Child Consortium for Health Outcomes Research and Delivery Science, School of Medicine, University of Colorado and Children's Hospital Colorado, Aurora, Colorado
| | - Nathan Crawford
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; and
| | - Megan C Lindley
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; and
| | - Shannon K Stokley
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; and
| | - Allison Kempe
- Adult and Child Consortium for Health Outcomes Research and Delivery Science, School of Medicine, University of Colorado and Children's Hospital Colorado, Aurora, Colorado.,Department of Pediatrics and
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Abstract
We conducted a critical appraisal of published Phase 2 and 3 efficacy trials in relation to the prevention of cervical cancer in women. Our analysis shows the trials themselves generated significant uncertainties undermining claims of efficacy in these data. There were 12 randomised control trials (RCTs) of Cervarix and Gardasil. The trial populations did not reflect vaccination target groups due to differences in age and restrictive trial inclusion criteria. The use of composite and distant surrogate outcomes makes it impossible to determine effects on clinically significant outcomes. It is still uncertain whether human papillomavirus (HPV) vaccination prevents cervical cancer as trials were not designed to detect this outcome, which takes decades to develop. Although there is evidence that vaccination prevents cervical intraepithelial neoplasia grade 1 (CIN1) this is not a clinically important outcome (no treatment is given). Trials used composite surrogate outcomes which included CIN1. High efficacy against CIN1+ (CIN1, 2, 3 and adenocarcinoma in situ (AIS)) does not necessarily mean high efficacy against CIN3+ (CIN3 and AIS), which occurs much less frequently. There are too few data to clearly conclude that HPV vaccine prevents CIN3+. CIN in general is likely to have been overdiagnosed in the trials because cervical cytology was conducted at intervals of 6-12 months rather than at the normal screening interval of 36 months. This means that the trials may have overestimated the efficacy of the vaccine as some of the lesions would have regressed spontaneously. Many trials diagnosed persistent infection on the basis of frequent testing at short intervals, i.e. less than six months. There is uncertainty as to whether detected infections would clear or persist and lead to cervical changes.
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Affiliation(s)
- Claire P Rees
- Centre for Global Public Health,
Institute of Population Health Sciences, Barts and The London School of Medicine and
Dentistry, Queen Mary University, London E1 2AB, UK
| | - Petra Brhlikova
- Institute of Health and Society,
Newcastle
University, Newcastle NE2 4AX, UK
| | - Allyson M Pollock
- Institute of Health and Society,
Newcastle
University, Newcastle NE2 4AX, UK,Allyson M Pollock.
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67
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Näsman A, Du J, Dalianis T. A global epidemic increase of an HPV-induced tonsil and tongue base cancer - potential benefit from a pan-gender use of HPV vaccine. J Intern Med 2020; 287:134-152. [PMID: 31733108 DOI: 10.1111/joim.13010] [Citation(s) in RCA: 59] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 10/02/2019] [Accepted: 10/10/2019] [Indexed: 12/28/2022]
Abstract
In 2007, human papillomavirus (HPV) type 16 was finally recognized as a risk factor, besides smoking and alcohol, for oropharyngeal squamous cell carcinoma (OPSCC), including tonsillar squamous cell carcinoma (TSCC), by the International Agency for Research against Cancer. Just before, in 2006, the Food and Drug Administration had approved Gardasil, the first vaccine against HPV16, 18, 6 and 11, for preventive vaccination women against cervical cancer. Concurrently, some Western countries, where smoking was decreasing, disclosed an epidemic increase in the incidence of OPSCC, especially of TSCC and base of tongue cancer (BOTSCC), together accounting for 80-90% of all OPSCCs, and mainly affecting men. The epidemic was later revealed to be due to a rise in HPV-positive cases, and scientists in the field suggested HPV vaccination also of boys. Globally, there are roughly 96 000 incident OPSCC cases/year of which 20-24% are caused by HPV, thereby accounting for around 22 000 OPSCC cases annually. Of these cases, 80-90% are due to HPV16 infection and would be prevented with the presently registered HPV vaccines. In Western countries, such as Sweden (with almost 400 TSCC and BOTSCC cases per year) and the United States, HPV prevalence in OPSCC is higher and around 70%. HPV vaccination of girls has been initiated in many countries, and the vaccines have been efficient and their side effects limited. HPV vaccination of boys has, however, been the exception, but should definitely not be delayed any further. It would benefit both girls and boys directly, and result in better and more robust herd immunity. Today, we have the possibility to eliminate several high-risk HPV types in the younger generations and avoid more than 600 000 cancer cases annually worldwide, and this possibility should be embraced by offering global pan-gender HPV vaccination.
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Affiliation(s)
- A Näsman
- From the, Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | - J Du
- Department of Microbiology, Tumor Biology and Cell Biology, Centre for Translational Microbiome Research (CTMR), Karolinska Institutet, Stockholm, Sweden
| | - T Dalianis
- From the, Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
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68
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Hoes J, Pasmans H, Knol MJ, Donken R, van Marm-Wattimena N, Schepp RM, King AJ, van der Klis FRM, de Melker HE. Persisting Antibody Response 9 Years After Bivalent Human Papillomavirus (HPV) Vaccination in a Cohort of Dutch Women: Immune Response and the Relation to Genital HPV Infections. J Infect Dis 2020; 221:1884-1894. [DOI: 10.1093/infdis/jiaa007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Accepted: 01/08/2020] [Indexed: 01/29/2023] Open
Abstract
Abstract
The bivalent human papillomavirus (HPV) vaccine is highly effective and induces robust serological responses. Using a Dutch prospective cohort initiated in 2009, including 744 vaccinated and 294 unvaccinated girls (1993–1994) who provide a vaginal self-swab sample, serum sample, and questionnaire yearly, we report a high, persisting antibody response up to 9 years after vaccination for vaccine types HPV-16 or HPV-18. Antibodies against nonvaccine HPV types 31, 33, 45, 52, and 58 were lower but still significantly higher than in unvaccinated individuals. This was also reflected in the seroprevalence. We compared participant characteristics and antibody levels between vaccinated women with and those without HPV infections 1 year before infection (204 incident and 64 persistent infections), but we observed no consistent difference in type-specific antibody levels. Having a high-risk HPV infection was associated with sexual risk behavior and smoking 1 year before infection. Although high antibody levels are necessary for protection, our study suggests that on the individual level other factors such as HPV exposure or antibody avidity could be important.
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Affiliation(s)
- Joske Hoes
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
- Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, the Netherlands
| | - Hella Pasmans
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
- Department of Medical Oncology, Leiden University Medical Center, Leiden, the Netherlands
| | - Mirjam J Knol
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Robine Donken
- Vaccine Evaluation Center, BC Children’s Hospital Research Institute, Vancouver, British Columbia, Canada
- BC Women’s Health Research Institute, BC Women’s Hospital + Health Centre, Vancouver, British Columbia, Canada
| | - Naomi van Marm-Wattimena
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Rutger M Schepp
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Audrey J King
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Fiona R M van der Klis
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Hester E de Melker
- Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
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69
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Kalpana K, Yap S, Iyengar R, Tsuji M, Kawamura A. Cell-line-based assay for the toxicity/benefit analysis of lipopolysaccharides in plants. Chem Biol Drug Des 2019; 95:311-315. [PMID: 31733132 DOI: 10.1111/cbdd.13646] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 10/28/2019] [Accepted: 11/03/2019] [Indexed: 01/21/2023]
Abstract
There are many immune-boosting medicinal plants that can potently activate innate immune cells. Recent studies indicate that the active factors of some immune-boosting plants are lipopolysaccharides (LPSs) of plant-associated bacteria. However, little is currently known about the potential risk and benefit of LPSs in medicinal plants. To facilitate their characterization, we established a simple cell-line-based assay that can be used to screen the toxicity and benefit of LPSs in medicinal plants. The assay can distinguish endotoxic diphosphoryl lipid A (DPL) from beneficial monophosphoryl lipid A (MPL), which is a clinically used immunological adjuvant for vaccines. The established assay was used to characterize commercial supplements of Ashwagandha, which was shown to contain immunostimulatory LPSs. The study revealed that Ashwagandha activates macrophages in a manner similar to MPL. The current finding underscores the importance of further studies to characterize the LPSs in immune-boosting medicinal plants.
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Affiliation(s)
- Kriti Kalpana
- Department of Chemistry, Hunter College of CUNY, New York, NY, USA.,Biochemistry Ph.D. Program, The Graduate Center of CUNY, New York, NY, USA
| | - Shen Yap
- Department of Chemistry, Hunter College of CUNY, New York, NY, USA
| | - Revathi Iyengar
- Science Department, Borough of Manhattan Community College, CUNY, New York, NY, USA
| | - Moriya Tsuji
- HIV and Malaria Vaccine Program, Aaron Diamond AIDS Research Center, Affiliate of The Rockefeller University, New York, NY, USA
| | - Akira Kawamura
- Department of Chemistry, Hunter College of CUNY, New York, NY, USA.,Biochemistry Ph.D. Program, The Graduate Center of CUNY, New York, NY, USA.,Chemistry Ph.D. Program, The Graduate Center of CUNY, New York, NY, USA
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70
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Cramer JD, Burtness B, Le QT, Ferris RL. The changing therapeutic landscape of head and neck cancer. Nat Rev Clin Oncol 2019; 16:669-683. [PMID: 31189965 DOI: 10.1038/s41571-019-0227-z] [Citation(s) in RCA: 415] [Impact Index Per Article: 83.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/08/2019] [Indexed: 12/27/2022]
Abstract
Head and neck cancers are a heterogeneous collection of malignancies of the upper aerodigestive tract, salivary glands and thyroid. In this Review, we primarily focus on the changing therapeutic landscape of head and neck squamous cell carcinomas (HNSCCs) that can arise in the oral cavity, oropharynx, hypopharynx and larynx. We highlight developments in surgical and non-surgical therapies (mainly involving the combination of radiotherapy and chemotherapy), outlining how these treatments are being used in the current era of widespread testing for the presence of human papillomavirus infection in patients with HNSCC. Finally, we describe the clinical trials that led to the approval of the first immunotherapeutic agents for HNSCC, and discuss the development of strategies to decrease the toxicity of different treatment modalities.
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Affiliation(s)
- John D Cramer
- Department of Otolaryngology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Barbara Burtness
- Department of Medicine and Yale Cancer Center, Yale School of Medicine, New Haven, CT, USA
| | - Quynh Thu Le
- Department of Radiation Oncology, Stanford University, Palo Alto, CA, USA
| | - Robert L Ferris
- Department of Otolaryngology, University of Pittsburgh, Pittsburgh, PA, USA.
- Department of Immunology, University of Pittsburgh, Pittsburgh, PA, USA.
- UPMC Hillman Cancer Center, Pittsburgh, PA, USA.
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71
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Wheeler BS, Rositch AF, Poole C, Taylor SM, Smith JS. Patterns of incident genital human papillomavirus infection in women: A literature review and meta-analysis. Int J STD AIDS 2019; 30:1246-1256. [PMID: 31640474 DOI: 10.1177/0956462418824441] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Human papillomavirus (HPV) infection acquisition is a necessary step in the development of cervical cancer. No study has systematically quantified the rate of newly acquired HPV infections from the published literature and determined its relationship with age. We performed a systematic review and meta-analysis to describe incident HPV infections in women. Medline® and Thomson Reuters Web of Science via PubMed® databases were searched. A total of 46 of 5136 studies met inclusion criteria and contributed results. We conducted a meta-regression analysis of 13 studies, which reported incidence rate estimates on over 13 high-risk HPV types, to provide pooled stratum-specific incidence rates and rate ratios for key population and study characteristics among 8488 women. Studies with mean age < 30 years had relatively higher HPV incidence rates compared to studies with mean age ≥30 years: relative risk = 3.12; 95% CI: 1.41–6.93. HPV-16 was most frequently detected, followed by HPV-18: relative risk = 0.47; 95% CI: 0.33–0.67, and by HPV-58: relative risk = 0.45; 95% CI: 0.27–0.74. Younger age is a key predictor of genital HPV incidence in women. These data on the relative distribution of incident HPV infections will provide a baseline comparison for monitoring of changes in HPV incidence following the implementation of population-level HPV vaccination.
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Affiliation(s)
- Bradford S Wheeler
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Anne F Rositch
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Charles Poole
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | | | - Jennifer S Smith
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA.,SALineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
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72
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Cervical cancer and HPV infection: ongoing therapeutic research to counteract the action of E6 and E7 oncoproteins. Drug Discov Today 2019; 24:2044-2057. [DOI: 10.1016/j.drudis.2019.07.011] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 07/09/2019] [Accepted: 07/29/2019] [Indexed: 12/21/2022]
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73
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Keshavarz M, Namdari H, Arjeini Y, Mirzaei H, Salimi V, Sadeghi A, Mokhtari-Azad T, Rezaei F. Induction of protective immune response to intranasal administration of influenza virus-like particles in a mouse model. J Cell Physiol 2019; 234:16643-16652. [PMID: 30784082 DOI: 10.1002/jcp.28339] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Revised: 01/29/2019] [Accepted: 01/30/2019] [Indexed: 01/24/2023]
Abstract
Human influenza A viruses (IAVs) cause global pandemics and epidemics, which remains a nonignorable serious concern for public health worldwide. To combat the surge of viral outbreaks, new treatments are urgently needed. Here, we design a new vaccine based on virus-like particles (VLPs) and show how intranasal administration of this vaccine triggers protective immunity, which can be exploited for the development of new therapies. H1N1 VLPs were produced in baculovirus vectors and were injected into BALB/c mice by the intramuscular (IM) or intranasal (IN) route. We found that there were significantly higher inflammatory cell and lymphocyte concentrations in bronchoalveolar lavage samples and the lungs of IN immunized mice; however, the IM group had little signs of inflammatory responses. On the basis of our results, immunization with H1N1 influenza VLP elicited a strong T cell immunity in BALB/c mice. Despite T cell immunity amplification after both IN and IM vaccination methods in mice, IN-induced T cell responses were significantly more intense than IM-induced responses, and this was likely related to an increased number of both CD11bhigh and CD103+ dendritic cells in mice lungs after IN administration of VLP. Furthermore, evaluation of interleukin-4 and interferon gamma cytokines along with several chemokine receptors showed that VLP vaccination via IN and IM routes leads to a greater CD4+ Th1 and Th2 response, respectively. Our findings indicated that VLPs represent a potential strategy for the development of an effective influenza vaccine; however, employing relevant routes for vaccination can be another important part of the universal influenza vaccine puzzle.
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Affiliation(s)
- Mohsen Keshavarz
- Department of Virology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.,The Persian Gulf Tropical Medicine Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Haideh Namdari
- Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Yaser Arjeini
- Virology Department, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamed Mirzaei
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran
| | - Vahid Salimi
- Virology Department, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmadreza Sadeghi
- Iranian Tissue Bank and Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Talat Mokhtari-Azad
- Virology Department, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.,National Influenza Center, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Farhad Rezaei
- Virology Department, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.,National Influenza Center, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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74
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van Schalkwyk C, Moodley J, Welte A, Johnson LF. Estimated impact of human papillomavirus vaccines on infection burden: The effect of structural assumptions. Vaccine 2019; 37:5460-5465. [DOI: 10.1016/j.vaccine.2019.06.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 05/24/2019] [Accepted: 06/07/2019] [Indexed: 01/11/2023]
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75
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Schwarz TF, Huang LM, Valencia A, Panzer F, Chiu CH, Decreux A, Poncelet S, Karkada N, Folschweiller N, Lin L, Dubin G, Struyf F. A ten-year study of immunogenicity and safety of the AS04-HPV-16/18 vaccine in adolescent girls aged 10-14 years. Hum Vaccin Immunother 2019; 15:1970-1979. [PMID: 31268383 PMCID: PMC6746471 DOI: 10.1080/21645515.2019.1625644] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
This study assessed long-term immunogenicity and safety following 3 doses of AS04-adjuvanted human papillomavirus (HPV)-16/18 L1 virus-like particle (VLP) vaccine in females 10–14 years old. Girls included in the immunogenicity subset in the primary controlled, observer-blinded, randomized study (NCT00196924) who received 3 doses were invited for a 10-year follow-up (NCT00316706 and NCT00877877). Serum antibody responses against HPV-16/18 (vaccine types) and HPV-31/45 (non-vaccine types) were measured by enzyme-linked immunosorbent assay (ELISA) using type-specific VLP as coating antigens. Serious adverse events (SAEs) and pregnancy information were recorded. At Month (M) 120, all subjects (N = 418, according-to-protocol immunogenicity cohort) were seropositive for anti-HPV-16/18 antibodies. Geometric mean titers (GMTs) were 1589.9 ELISA Units [EU]/mL (95% confidence interval [CI]: 1459.8–1731.6) for anti-HPV-16 and 597.2 EU/mL (95% CI: 541.7–658.5) for anti-HPV-18 in subjects seronegative at baseline for the type analyzed. Post hoc mathematical modeling predicted a durability ≥50 years for anti-HPV-16 and anti-HPV-18. For the non-vaccine humoral type response, all initially seronegative subjects had seroconverted at M7, with anti-HPV-31 GMT of 2030.5 EU/mL (95% CI: 1766.2–2334.4) and anti-HPV-45 GMT of 2300.8 EU/mL (95% CI: 2036.8–2599.0). At M120, 87.7% and 85.1% remained seropositive for anti-HPV-31 with GMT of 242.9 EU/mL (95% CI: 201.4–293.0) and anti-HPV-45 with GMT of 204.7 EU/mL (95% CI: 170.0–246.6). During the 10-year follow-up, no SAEs or abnormal pregnancy outcomes were causally related to vaccination. Three doses of the AS04-HPV-16/18 vaccine induced high and sustained antibody response against HPV-16,18,31 and 45 in girls aged 10–14 years during the 10-year follow-up, with an acceptable long-term safety profile.
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Affiliation(s)
- Tino F Schwarz
- a Institute of Laboratory Medicine and Vaccination Centre, Klinikum Würzburg Mitte, Standort Juliusspital , Würzburg , Germany
| | - Li-Min Huang
- b Department of Pediatrics, National Taiwan University Hospital , Taipei , Taiwan
| | - Alejandra Valencia
- c Department of Pediatrics, Fundación de Santa Fe de Bogotá , Bogota , Colombia
| | - Falko Panzer
- d Practice for Pediatric and Adolescent Medicine , Mannheim , Germany
| | - Cheng-Hsun Chiu
- e Department of Pediatrics, Chang Gung Memorial Hospital, Chang Gung University College of Medicine , Taoyuan , Taiwan
| | | | | | | | | | - Lan Lin
- f GSK , Wavre/Rixensart , Belgium
| | - Gary Dubin
- g GSK , King of Prussia , PA , USA.,h Takeda Pharmaceuticals , Glattpark-Opfikon, Zurich , Switzerland
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Karube A, Saito F, Nakamura E, Shitara A, Ono N, Konno M, Tamura D, Nagao D. Reduction in HPV 16/18 prevalence among young women following HPV vaccine introduction in a highly vaccinated district, Japan, 2008-2017. J Rural Med 2019; 14:48-57. [PMID: 31191766 PMCID: PMC6545435 DOI: 10.2185/jrm.2986] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 10/01/2018] [Indexed: 11/27/2022] Open
Abstract
Objective: Human papillomavirus (HPV) vaccination was introduced in Japan in
April 2013, as a national immunization program for girls aged 12–16 years, after an
initial introduction in 2010 as a public-aid program for girls aged 13–16 years. The
Yuri-Honjo district had the highest vaccine coverage among women aged 17–51 years in 2017,
due to the original public-aid program. The aim of this study was to evaluate the
differences in the vaccine types of HPV16/18 infections between 2008–2012 (pre-vaccine
era) and 2013–2017 (vaccine era). Materials and Methods: We evaluated whether HPV vaccination was associated
with a decrease in the prevalence of HPV16/18 and high-risk HPV and the incidence of
HPV-associated cervical lesions. A total of 1,342 women aged 18–49 years, covering both
the pre-vaccine and vaccine eras, who visited Yuri Kumiai General Hospital and underwent
HPV genotype tests from June 2008 to December 2017 were compared. Results: Among women aged 18–24 years with higher vaccine coverage (68.2%),
the prevalence of HPV16/18 and high-risk HPV decreased from 36.7% and 69.4%, respectively,
in the pre-vaccine era to 5.8% and 50.0%, respectively, in the vaccine era (p=0.00013 and
p=0.047, respectively). Among those with cervical intraepithelial neoplasia grade 2− and
grade 2+, HPV16/18 prevalence decreased from 30.0% to 2.7% (p=0.0018) and from 81.8% to
36.4% (p=0.030), respectively. In this age group, the rate of HPV16/18 positivity
decreased significantly. Among age groups with lower vaccine coverage, HPV prevalence did
not significantly differ between the two eras. Conclusion: The prevalence of HPV16/18 and high-risk HPV significantly
decreased in women aged 18–24 years, most of whom were vaccinated. HPV vaccination
effectively reduced the prevalence of HPV16/18 infections in the Yuri-Honjo district.
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Affiliation(s)
- Akihiro Karube
- Department of Obstetrics and Gynecology, Yuri Kumiai General Hospital, Japan
| | - Fumiko Saito
- Department of Obstetrics and Gynecology, Yuri Kumiai General Hospital, Japan
| | - Enami Nakamura
- Department of Obstetrics and Gynecology, Yuri Kumiai General Hospital, Japan
| | - Akihiro Shitara
- Department of Obstetrics and Gynecology, Akita University School of Medicine, Japan
| | - Natsuki Ono
- Department of Obstetrics and Gynecology, Akita University School of Medicine, Japan
| | - Megumi Konno
- Department of Obstetrics and Gynecology, Akita University School of Medicine, Japan
| | - Daisuke Tamura
- Department of Obstetrics and Gynecology, Akita University School of Medicine, Japan
| | - Daisuke Nagao
- Department of Obstetrics and Gynecology, Omagari Kosei Medical Center, Japan
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Baptista AD, Simão CX, Santos VCGD, Melgaço JG, Cavalcanti SMB, Fonseca SC, Vitral CL. Knowledge of human papillomavirus and Pap test among Brazilian university students. Rev Assoc Med Bras (1992) 2019; 65:625-632. [DOI: 10.1590/1806-9282.65.5.625] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2018] [Accepted: 11/24/2018] [Indexed: 11/21/2022] Open
Abstract
SUMMARY OBJECTIVE: Human papillomavirus (HPV) is the most prevalent sexually transmitted virus in the world and is associated with an increased risk of cervical cancer. The most effective approach to cervical cancer control continues to be screening through the preventive Papanicolaou test (Pap test). This study analyzes the knowledge of university students of health science programs as well as undergraduate courses in other areas of knowledge on important questions regarding HPV. METHOD: Four hundred and seventy-three university students completed a questionnaire assessing their overall knowledge regarding HPV infection, cervical cancer, and the Pap test. A descriptive analysis is presented, and multivariate analysis using logistic regression identified factors associated with HPV/cervical cancer information. RESULTS: Knowledge was higher for simple HPV-related and Pap test questions but was lower for HPV interrelations with genital warts and cervical cancer. Being from the health science fields and having high income were factors associated with greater knowledge. Only the minority of the participants recognized all the situations that increased the risk of virus infection presented in the questionnaire. CONCLUSIONS: These findings highlight the need for educational campaigns regarding HPV infection, its potential as a cervical cancer agent and the forms of prevention available.
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Yang Y, Meng YL, Duan SM, Zhan SB, Guan RL, Yue TF, Kong LH, Zhou L, Deng LH, Huang C, Wang S, Wang GY, Wu DF, Zhang CF, Chen F. REBACIN® as a noninvasive clinical intervention for high-risk human papillomavirus persistent infection. Int J Cancer 2019; 145:2712-2719. [PMID: 30989655 DOI: 10.1002/ijc.32344] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 03/18/2019] [Accepted: 04/08/2019] [Indexed: 12/21/2022]
Abstract
The development of highly sensitive HPV-genotyping tests has opened the possibility of treating HPV-infected women before high-grade lesions appear. The lack of efficient intervention for persistent high-risk HPV infection necessitates the need for development of novel therapeutic strategy. Here we demonstrate that REBACIN®, a proprietary antiviral biologics, has shown potent efficacy in the clearance of persistent HPV infections. Two independent parallel clinical studies were investigated, which a total of 199 patients were enrolled and randomly divided into a REBACIN®-test group and a control group without treatment. The viral clearance rates for the REBACIN® groups were 61.5% (24/39) and 62.5% (35/56), respectively, for the two independent parallel studies. In contrast, the nontreatment groups showed self-clearance rates at 20.0% (8/40) and 12.5% (8/64). We further found that REBACIN® was able to significantly repress the expression of HPV E6 and E7 oncogenes in TC-1 and Hela cells. The two viral genes are well known for the development of high-grade premalignancy lesion and cervical cancer. In a mouse model, REBACIN® was indicated to notably suppress E6/E7-induced tumor growth, suggesting E6 and E7 oncogenes as a potential target of REBACIN®. Taken together, our studies shed light into the development of a novel noninvasive therapeutic intervention for clearance of persistent HPV infection with significant efficacy.
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Affiliation(s)
- Yi Yang
- Department of Obstetrics and Gynaecology, Peking Union Medical College Hospital, Beijing, China
| | - Ya-Li Meng
- Department of Obstetrics and Gynaecology, Tianjin Medical University General Hospital, Tianjin, China.,Department of Obstetrics and Gynaecology, Tianjin Port Hospital, Tianjin, China
| | - Shu-Min Duan
- National Institute for Viral Disease Control and Prevention, Beijing, China
| | - Shao-Bing Zhan
- National Institute for Viral Disease Control and Prevention, Beijing, China
| | - Ruo-Li Guan
- Department of Obstetrics and Gynaecology, Peking Union Medical College Hospital, Beijing, China
| | - Tian-Fu Yue
- Department of Obstetrics and Gynaecology, Tianjin Medical University General Hospital, Tianjin, China
| | - Ling-Hua Kong
- Department of Obstetrics and Gynaecology, Peking Union Medical College Hospital, Beijing, China
| | - Ling Zhou
- National Institute for Viral Disease Control and Prevention, Beijing, China
| | - Liu-Hong Deng
- Division of Medical Biology, Key Laboratory of Protein Engineering and Drug Development of Hainan, Haikou, Hainan, China
| | - Chao Huang
- Division of Medical Biology, Key Laboratory of Protein Engineering and Drug Development of Hainan, Haikou, Hainan, China
| | - Sheng Wang
- Division of Medical Biology, Key Laboratory of Protein Engineering and Drug Development of Hainan, Haikou, Hainan, China
| | - Gui-Yu Wang
- Division of Medical Biology, Key Laboratory of Protein Engineering and Drug Development of Hainan, Haikou, Hainan, China
| | - Dai-Fei Wu
- SR Life Sciences Institute, Clarksburg, MD
| | | | - Fei Chen
- Department of Obstetrics and Gynaecology, Peking Union Medical College Hospital, Beijing, China
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Neha R, Subeesh V, Beulah E, Gouri N, Maheswari E. Postlicensure surveillance of human papillomavirus vaccine using the Vaccine Adverse Event Reporting System, 2006-2017. Perspect Clin Res 2019; 11:24-30. [PMID: 32154146 PMCID: PMC7034135 DOI: 10.4103/picr.picr_140_18] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 11/26/2018] [Accepted: 12/19/2018] [Indexed: 12/28/2022] Open
Abstract
Background: The United States Food and Drug Administration (FDA) has licensed three HPV (Human papilloma virus) vaccines. The centers for disease control and prevention (CDC) and advisory committee on immunization practices (ACIP) recommends routine HPV vaccination at age 11 or 12 years. This study aimed to summarize and characterize adverse events following HPV vaccination reported to VAERS database from July 2006 to May 2017. Methods: A systematic data mining was performed in the VAERS database for reports associated with HPV vaccine. Clinically relevant Vaccine Event Combinations (VEC) were identified in the VAERS database following HPV vaccination. A VEC was considered for analysis only if a minimum of hundred reports were present in database for the given Adverse Event (AE). The data mining algorithm used in this study was reporting odds ratio. A value of ROR-1.96SE >1 was considered as positive signal. Results: VAERS received 49444 reports after receipt of HPV vaccine during the study period. Out of 49444, 2307 unique reactions were identified. A total of 177 death reports and 3526 non death serious reactions were reported to VAERS. ROR showed positive signals for abdominal pain, syncope, dizziness, convulsion, abortion spontaneous, alopecia, amenorrhea, anogenital warts, cervical dysplasia, anaemia, dyskinesia, migrane, blood pressure decreased, fall, head injury, loss of consciousness, pallor, presyncope, seizures. Conclusion: The present analysis did not identify any new/unexpected safety concern and was consistent with the safety data from prelicensure trials. Further epidemiological studies are required to systematically validate the data provided by VAERS.
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Affiliation(s)
- Reddy Neha
- Department of Pharmacy Practice, Faculty of Pharmacy, M.S. Ramaiah University of Applied Sciences, Bangalore, India
| | - Viswam Subeesh
- Department of Pharmacy Practice, Faculty of Pharmacy, M.S. Ramaiah University of Applied Sciences, Bangalore, India
| | - Elsa Beulah
- Department of Pharmacy Practice, Faculty of Pharmacy, M.S. Ramaiah University of Applied Sciences, Bangalore, India
| | - Nair Gouri
- Department of Pharmacology, Faculty of Pharmacy, M.S. Ramaiah University of Applied Sciences, Bangalore, India
| | - Eswaran Maheswari
- Department of Pharmacy Practice, Faculty of Pharmacy, M.S. Ramaiah University of Applied Sciences, Bangalore, India
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80
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Wang J, Tang D, Wang J, Zhang Z, Chen Y, Wang K, Zhang X, Ma C. Genotype distribution and prevalence of human papillomavirus among women with cervical cytological abnormalities in Xinjiang, China. Hum Vaccin Immunother 2019; 15:1889-1896. [PMID: 30735478 PMCID: PMC6746534 DOI: 10.1080/21645515.2019.1578598] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Revised: 01/11/2019] [Accepted: 01/26/2019] [Indexed: 01/07/2023] Open
Abstract
Background: Genotype distribution and prevalence of human papillomavirus (HPV) among women vary from different regions and crowds, prophylactic HPV vaccin could prevent some diseases related to HPV, which include cervical precancerous lesions and cancer. Baseline surveys prior to mass HPV vaccination are critical to determine vaccine efficacy and detect changes in HPV type after vaccination. Objective: The aim of this study is to study the HPV type-specific prevalence in 698 women with cytological abnormalities, aging from 18 to 77 years old. Additionally, the association between HPV infection and cervical disease was investigated as well. Methods: A total of 698 cervical specimens of cytological abnormalities were collected from the First Affiliated Hospital of Xinjiang Medical University. The Thinprep liquid-based cytologic test (TCT) was performed and the cytological status was classified according to Bethesda 2001. The samples were tested HPV genotype by the PCR-based hybridization gene chip assay. Results: Overall, the HPV prevalence was 54.87%, and it was shown to be age dependent, and with the decreasing and zigzag prevalence until the age of 55 years. 204 patients (53.26%) were infected with pure high-risk HPV, 139 (36.30%) with pure low-risk HPV, and 40 (10.44%) with mixed HPV types. HPV16 was the most common type (35.36%), followed by HPV58 (13.62%) and HPV52 (9.15%). In this study, 386 (55.30%) were affected by ASCUS, 11 (1.58%) by ASC-H, 137 (19.63%) by L-SIL and 151 (21.63%) by H-SIL. Women with a cytology result of ASCUS, ASC-H, L-SIL and H-SIL had the infection of HPV 39.12%, 54.17%, 70.80% and 80.79% respectively. Conclusions: In conclusion, this study presents the first investigation about the prevalence of HPV infection and HPV genotype distribution in Xinjiang women who have abnormal cytological tests. Prior to HPV immunization in Xinjiang's population, our results could be baseline data and validation set, which provide robust available estimates of the prevalence of type-specific HPV.
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Affiliation(s)
- Jing Wang
- Department of Gynecology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Dandan Tang
- College of Public Health, Xinjiang Medical University, Urumqi, China
| | - Jialu Wang
- Department of Medical laboratory, First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Zhaoxia Zhang
- Department of Medical laboratory, First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Yanxia Chen
- Department of Gynecology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Kai Wang
- Department for College of Medical Engineering and Technology, Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Xueliang Zhang
- Department for College of Medical Engineering and Technology, Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Cailing Ma
- Department of Gynecology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
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Loenenbach AD, Poethko-Müller C, Pawlita M, Thamm M, Harder T, Waterboer T, Schröter J, Deleré Y, Wichmann O, Wiese-Posselt M. Mucosal and cutaneous Human Papillomavirus seroprevalence among adults in the prevaccine era in Germany - Results from a nationwide population-based survey. Int J Infect Dis 2019; 83:3-11. [PMID: 30904676 DOI: 10.1016/j.ijid.2019.03.022] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Revised: 03/13/2019] [Accepted: 03/14/2019] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Human Papillomavirus (HPV) vaccination of girls was introduced in Germany in 2007. However, data on the distribution of vaccine-relevant HPV types in the general population in Germany in the prevaccine era are limited. METHODS Serum samples collected during the German National Health Interview and Examination Survey 1998 (GNHIES98), a nationally representative study including men and women aged 18-79 years, were tested for antibodies to 19 mucosal and cutaneous HPV types. Multivariable regression models were developed to identify associations between demographic and behavioral characteristics and HPV seropositivity. RESULTS Of the 6517 serum samples tested, almost a quarter was seropositive for at least one of the nine HPV vaccine types with no clear age-pattern. HPV-6 and HPV-59 were the most common mucosal types, while HPV-1 and HPV-4 were the most common cutaneous HPV types. Factors independently associated with HPV-16 seroprevalence were seropositive to other sexually transmitted infections and lifetime number of sex partners, as well as urbanity (only among females). CONCLUSIONS Prevalence of naturally acquired antibodies to HPV types which can be prevented by vaccination is high in both sexes and all age groups. These data can serve as baseline estimates to evaluate the population-level impact of the current vaccination strategy.
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Affiliation(s)
- Anna D Loenenbach
- Department for Infectious Disease Epidemiology, Immunization Unit, Robert Koch-Institute, Berlin, Germany; Charité - University Medicine Berlin, Berlin, Germany.
| | | | - Michael Pawlita
- Division of Molecular Diagnostics of Oncogenic Infections, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Michael Thamm
- Department of Epidemiology and Health Monitoring, Robert Koch-Institute, Berlin, Germany
| | - Thomas Harder
- Department for Infectious Disease Epidemiology, Immunization Unit, Robert Koch-Institute, Berlin, Germany
| | - Tim Waterboer
- Division of Molecular Diagnostics of Oncogenic Infections, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Juliane Schröter
- Division of Molecular Diagnostics of Oncogenic Infections, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Yvonne Deleré
- Department for Infectious Disease Epidemiology, Immunization Unit, Robert Koch-Institute, Berlin, Germany
| | - Ole Wichmann
- Department for Infectious Disease Epidemiology, Immunization Unit, Robert Koch-Institute, Berlin, Germany
| | - Miriam Wiese-Posselt
- Department for Infectious Disease Epidemiology, Immunization Unit, Robert Koch-Institute, Berlin, Germany
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82
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Bonaldo G, Vaccheri A, D'Annibali O, Motola D. Safety profile of human papilloma virus vaccines: an analysis of the US Vaccine Adverse Event Reporting System from 2007 to 2017. Br J Clin Pharmacol 2019; 85:634-643. [PMID: 30569481 PMCID: PMC6379209 DOI: 10.1111/bcp.13841] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 12/11/2018] [Accepted: 12/13/2018] [Indexed: 11/27/2022] Open
Abstract
AIMS Human papilloma virus (HPV) is the cause of different types of carcinoma. Despite the remarkable effectiveness of the HPV vaccines, there have been many complaints about their risk-benefit profile due to adverse events following immunization (AEFI). The purpose of this study is to analyse the safety profile of the HPV vaccine basing on real-life data derived from reports of suspected AEFIs collected in the US Vaccine Adverse Events Reporting System (VAERS) and assess if the searches on Google overlap with spontaneous reporting. METHODS We collected all the reports in VAERS between January 2007 to December 2017 related to the HPV vaccines. A disproportionality analysis using reporting odds ratio (ROR) with 95% confidence interval was performed. RESULTS Over the 10-year period, 55 356 reports of AEFI related to HPV vaccines were retrieved in VAERS, corresponding to 224 863 vaccine-event pairs. The highest number of reports was related to Gardasil (n = 42 244). The two events more frequently reported and statistically significant for HPV vaccines were dizziness (n = 6259; ROR = 2.60; 95% confidence interval 2.53-2.66) and syncope (n = 6004; ROR = 6.28; 95% confidence interval 6.12-6.44). The trends of spontaneous reporting and Google searches overlap. CONCLUSION The AEFI analysis showed that the events most frequently reported were non-serious and listed in the corresponding summary of product characteristics. Potential safety signals arose regarding less frequent AEFIs that would deserve further investigation. It is extremely important to disseminate correct and evidence-based scientific information.
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Affiliation(s)
- Giulia Bonaldo
- Unit of Pharmacology, Department of Medical and Surgical SciencesUniversity of Bolognavia Irnerio 4840126BolognaItaly
| | - Alberto Vaccheri
- Unit of Pharmacology, Department of Medical and Surgical SciencesUniversity of Bolognavia Irnerio 4840126BolognaItaly
| | - Ottavio D'Annibali
- Unit of Pharmacology, Department of Medical and Surgical SciencesUniversity of Bolognavia Irnerio 4840126BolognaItaly
| | - Domenico Motola
- Unit of Pharmacology, Department of Medical and Surgical SciencesUniversity of Bolognavia Irnerio 4840126BolognaItaly
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83
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Rema P. Gynecological Cancers-the Changing Paradigm. Indian J Surg Oncol 2019; 10:156-161. [PMID: 30948892 PMCID: PMC6414572 DOI: 10.1007/s13193-018-0842-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2018] [Accepted: 11/23/2018] [Indexed: 10/27/2022] Open
Abstract
Outstanding research in the last few decades led to newer insights into the management of gynecological cancers. In the preventive arena, the efficacy and safety of HPV vaccination are well accepted and is now in addition to bi- and quadrivalent vaccines; there is a nonavalent vaccine against nine oncogenic HPV strains. Recent studies also looked into the dosaging schedules and age of vaccination against HPV to improve the vaccine efficacy and coverage. HPV testing is now approved as a primary screening test for cervical cancer in women aged more than 30 years with better sensitivity than the traditional cytology. Opportunistic salpingectomy for ovarian cancer prevention and neoadjuvant chemotherapy for advanced ovarian cancers are accepted practices. The role of personalized medicine in ovarian cancer and comprehensive genomic analysis of endometrial cancers are also covered in this review.
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Affiliation(s)
- P. Rema
- Division of Gynaeoncology, Regional Cancer Centre, Trivandrum, Kerala India
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84
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Wen R, Umeano AC, Kou Y, Xu J, Farooqi AA. Nanoparticle systems for cancer vaccine. Nanomedicine (Lond) 2019; 14:627-648. [PMID: 30806568 PMCID: PMC6439506 DOI: 10.2217/nnm-2018-0147] [Citation(s) in RCA: 74] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 11/28/2018] [Indexed: 01/01/2023] Open
Abstract
As effective tools for public health, vaccines prevent disease by priming the body's adaptive and innate immune responses against an infection. Due to advances in understanding cancers and their relationship with the immune system, there is a growing interest in priming host immune defenses for a targeted and complete antitumor response. Nanoparticle systems have shown to be promising tools for effective antigen delivery as vaccines and/or for potentiating immune response as adjuvants. Here, we highlight relevant physiological processes involved in vaccine delivery, review recent advances in the use of nanoparticle systems for vaccines and discuss pertinent challenges to viably translate nanoparticle-based vaccines and adjuvants for public use.
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Affiliation(s)
- Ru Wen
- Department of Chemistry, University of Georgia, Athens, GA 30602, USA
| | - Afoma C Umeano
- Department of Molecular & Cellular Pharmacology, University of Miami, Miller School of Medicine, Miami, FL 33136, USA
| | - Yi Kou
- Department of Molecular & Computational Biology, University of Southern California, Los Angeles, CA 90089, USA
| | - Jian Xu
- Laboratory of Cancer Biology & Genetics, Center for Cancer Research, National Cancer Institute, Bethesda, MD 20892, USA
| | - Ammad Ahmad Farooqi
- Institute of Biomedical and Genetic Engineering (IBGE), Islamabad, 54000, Pakistan
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85
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Checchi M, Mesher D, Mohammed H, Soldan K. Declines in anogenital warts diagnoses since the change in 2012 to use the quadrivalent HPV vaccine in England: data to end 2017. Sex Transm Infect 2019; 95:368-373. [PMID: 30723186 DOI: 10.1136/sextrans-2018-053751] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 11/01/2018] [Accepted: 11/29/2018] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVES In 2008, a national human papillomavirus (HPV) vaccination programme for females was introduced in England using the bivalent vaccine (HPV16 and 18 only). In 2012, the programme changed to offer the quadrivalent vaccine that includes protection against the two HPV types that cause the majority of anogenital warts (AGW; HPV6 and 11). We present data reporting AGW diagnoses in sexual health clinics (SHCs) in England to the end of 2017, including diagnoses among birth cohorts offered the quadrivalent vaccine. METHODS Using data from all SHCs across England, we performed ecological analyses to consider rates of AGW diagnoses by age, gender and sexual orientation. We tested for trends over time of diagnoses of AGW in young females, heterosexual males, and men who have sex with men (MSM) between the ages of 15 and 24 years during both bivalent (2009 to 2013) and quadrivalent (2014 to 2017) vaccine time periods using Poisson regression. RESULTS Between 2014 and 2017, there was strong evidence for a decreasing trend in the rate of AGW diagnoses at SHC among females aged 15-17 years from 257.5 to 45.7 per 100 000 population (82.3% decline) and same aged heterosexual males from 59.1 to 19.1 per 100 000 population (67.7% decline). The reductions in the incidence of AGW diagnoses in MSM aged 15-17 years were less clear (decreased by 13.6% between 2014 and 2017, from 129.9 to 112.2 per 100 000 population). CONCLUSIONS The moderate, unexpected declines in AGW seen since the introduction of a high-coverage HPV vaccination programme using the bivalent vaccine are being followed, as expected, by much larger declines among females offered the quadrivalent vaccine and same-aged heterosexual males. Surveillance plans are in place to continue to monitor AGW diagnoses to evaluate the impact of both female and targeted MSM HPV vaccination on early disease outcomes.
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Affiliation(s)
- Marta Checchi
- Blood Safety, Hepatitis, Sexually Transmitted Infections (STI) and HIV Service, National Infection Service, Public Health England, London, UK
| | - David Mesher
- Blood Safety, Hepatitis, Sexually Transmitted Infections (STI) and HIV Service, National Infection Service, Public Health England, London, UK
| | - Hamish Mohammed
- Blood Safety, Hepatitis, Sexually Transmitted Infections (STI) and HIV Service, National Infection Service, Public Health England, London, UK
| | - Kate Soldan
- Blood Safety, Hepatitis, Sexually Transmitted Infections (STI) and HIV Service, National Infection Service, Public Health England, London, UK
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86
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Spinner C, Ding L, Bernstein DI, Brown DR, Franco EL, Covert C, Kahn JA. Human Papillomavirus Vaccine Effectiveness and Herd Protection in Young Women. Pediatrics 2019; 143:peds.2018-1902. [PMID: 30670582 PMCID: PMC6361347 DOI: 10.1542/peds.2018-1902] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/03/2018] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Clinical trials of the 4-valent human papillomavirus (HPV) vaccine demonstrate high efficacy, but surveillance studies are essential to examine the long-term impact of vaccine introduction on HPV prevalence in community settings. The aims of this study were to determine during the 11 years after vaccine introduction the prevalence of (1) vaccine-type HPV in adolescent and young adult women who were vaccinated (to assess vaccine effectiveness) and (2) vaccine-type HPV in women who were unvaccinated (to assess herd protection). METHODS Young women 13 to 26 years of age were recruited from hospital-based and community health clinics for 4 surveillance studies from 2006 to 2017. We determined the proportion of vaccinated and unvaccinated women who were positive for vaccine-type HPV across the studies, and the odds of positivity for vaccine-type HPV using logistic regression; all analyses were propensity score-adjusted to control for between-wave differences in participant characteristics. RESULTS Vaccination rates increased from 0% to 84.3% (97% of study participants received the 4-valent vaccine). Among women who were vaccinated, 4-valent vaccine-type HPV detection decreased from 35% to 6.7% (80.9% decline; odds ratio 0.13, 95% confidence interval 0.08 to 0.22). Among women who were unvaccinated, 4-valent vaccine-type HPV detection decreased from 32.4% to 19.4% (40% decline; odds ratio 0.50, 95% confidence interval 0.26 to 0.97). Estimated vaccine effectiveness was 90.6% in wave 3 and 80.1% in wave 4. CONCLUSIONS In this study in which trends in HPV in a US community >10 years after 4-valent HPV vaccine introduction and after 9-valent vaccine introduction were examined, we found evidence of vaccine effectiveness and herd protection. Further research is needed to examine trends in 9-valent vaccine-type HPV after higher rates of vaccination are achieved.
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Affiliation(s)
| | - Lili Ding
- College of Medicine, Cincinnati, Ohio;,Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| | - David I. Bernstein
- College of Medicine, Cincinnati, Ohio;,Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| | | | | | - Courtney Covert
- Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| | - Jessica A. Kahn
- College of Medicine, Cincinnati, Ohio;,Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
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Lee H, Park H, Yu HS, Na K, Oh KT, Lee ES. Dendritic Cell-Targeted pH-Responsive Extracellular Vesicles for Anticancer Vaccination. Pharmaceutics 2019; 11:pharmaceutics11020054. [PMID: 30691225 PMCID: PMC6410067 DOI: 10.3390/pharmaceutics11020054] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 01/22/2019] [Accepted: 01/24/2019] [Indexed: 12/20/2022] Open
Abstract
Immunotherapy can potentially treat cancers on a patient-dependent manner. Most of the efforts expended on anticancer vaccination parallel the efforts expended on prototypical immunization in infectious diseases. In this study, we designed and synthesized pH-responsive extracellular vesicles (EVs) coupled with hyaluronic acid (HA), 3-(diethylamino)propylamine (DEAP), monophosphoryl lipid A (MPLA), and mucin 1 peptide (MUC1), referred to as HDEA@EVAT. HDEA@EVAT potentiated the differentiation and maturation of monocytes into dendritic cells (DCs) and the priming of CD8+ T-cells for cancer therapy. MPLA and HA enabled HDEA@EVAT to interact with the toll-like receptor 4 and the CD44 receptor on DCs, followed by endosomal escape, owing to the protonation of pH-sensitive DEAP on the EV in conjunction with MUC1 release. The MUC1 was then processed and presented to DCs to activate CD8+ T-cells for additional anticancer-related immune reactions. Our findings support the anticancer vaccine activity by which HDEA@EVAT expedites the interaction between DCs and CD8+ T-cells by inducing DC-targeted maturation and by presenting the cancer-associated peptide MUC1.
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Affiliation(s)
- Hyuk Lee
- Department of Biotechnology, The Catholic University of Korea, 43 Jibong-ro, Bucheon-si, Gyeonggi-do 14662, Korea.
| | - Hongsuk Park
- Division of Endocrinology, Metabolism & Lipid Research, Washington University School of Medicine, Saint Louis, MO 63110, USA.
| | - Hyeong Sup Yu
- Department of Biotechnology, The Catholic University of Korea, 43 Jibong-ro, Bucheon-si, Gyeonggi-do 14662, Korea.
| | - Kun Na
- Department of Biotechnology, The Catholic University of Korea, 43 Jibong-ro, Bucheon-si, Gyeonggi-do 14662, Korea.
| | - Kyung Taek Oh
- College of Pharmacy, Chung-Ang University, 84 Heukseok-ro, Dongjak-gu, Seoul 06974, Korea.
| | - Eun Seong Lee
- Department of Biotechnology, The Catholic University of Korea, 43 Jibong-ro, Bucheon-si, Gyeonggi-do 14662, Korea.
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88
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Fehintola O, Fehintola A, Ogundele O, Adegbenro C, Olowookere S, Afolabi O. Predictors and acceptability of human papilloma virus vaccine uptake among senior secondary school students in Ile-Ife. SANAMED 2019. [DOI: 10.24125/sanamed.v14i2.316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Introduction: Cervical cancer is the second most common cancer in women worldwide and in Nigeria. Human papilloma virus (HPV), has been implicated as the causative agent of cervical cancer. The fact that HPV vaccination can prevent the occurrence of this deadly cancer is well established. Though the vaccine has been licensed in Nigeria since 2009 with widespread availability, it is yet to be included in National immunization program in Nigeria. This study aimed to assess the predictors and acceptability of the HPV vaccine among senior secondary girls in Ile-Ife. Methods: This descriptive cross-sectional study recruited 400 students randomly selected from various secondary schools in Ife central-local government. The data was collected with the use of a pre-tested interviewer-administered questionnaire on knowledge, attitude, and acceptability of cervical cancer, HPV and HPV vaccine. Data were analyzed using descriptive and inferential statistics. Results: Most respondents (93.2%) had poor knowledge of cervical cancer, HPV and HPV vaccine. Attitude towards cervical cancer and HPV vaccine was good and the majority (74.5%) had high acceptability for the HPV vaccine. Only 2.8% of the respondents have been vaccinated. Predictors of acceptability of HPV vaccine were younger age group ((AOR) 4.05, CI = 2.30-5.45), good knowledge ((AOR = 2.50, CI = 2.31-6.83), mother' higher level of education (AOR = 1.55, CI = 2.62-4.58), perceived fatality of cervical cancer (AOR = 4.13, CI = 1.49 - 4.19) and perceived efficacy of the HPV vaccine (AOR = 1.57, CI = 0.49 - 3.18). Conclusions: The knowledge of secondary school girls in the study area on cervical cancer, HPV and HPV vaccine is poor though the HPV vaccine acceptability is high. The high acceptability of the vaccine in this study is a reflection of the willingness of this vulnerable group to learn more about the subject matter. There is the need to create school health programs that will focus on health educating the students on this preventable cancer and the available vaccine. Including HPV vaccine into National immunization program in Nigeria may also improve awareness of cervical cancer and the vaccine uptake.
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89
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Xu J, Xu S, Fang Y, Chen T, Xie X, Lu W. Cyclin-dependent kinase 9 promotes cervical cancer development via AKT2/p53 pathway. IUBMB Life 2018; 71:347-356. [PMID: 30536701 DOI: 10.1002/iub.1983] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 10/27/2018] [Accepted: 11/12/2018] [Indexed: 12/24/2022]
Abstract
Aberrant activation of cyclin-dependent kinase 9 (CDK9) is widespread in human cancers. However, the underlying mechanisms of CDK9 activation and the therapeutic potential of CDK9 inhibition in cervical cancer remain largely unknown. Here, we report that CDK9 is gradually upregulated during cervical lesion progression and regulated by HPV16 E6. CDK9 levels are highly correlated with FIGO stage, pathological grade, deep-stromal invasion, tumor size, and lymph nodes metastasis. Knockdown of CDK9 by specific siRNA inhibits cervical cancer cell proliferation in vitro, as well as tumorigenesis in vivo. CDK9 inhibition causes a significant decreased AKT2 and increased p53 protein expression revealing novel CDK9-regulatory mechanisms. Overexpression of AKT2 rescued the suppressive effects caused by CDK9 knockdown, suggesting that AKT2 induction is essential for CDK9-induced transformation. Moreover, CDK9 expression was positively correlated with AKT2 and negatively correlated with p53 in cervical cancer tissues with HPV16 infection. Our findings demonstrate for the first time that CDK9 acts as a proto-oncogene in cervical cancer, modulating cell proliferation and apoptosis through AKT2/p53 pathway. Therefore, our data provide novel mechanistic insights into the role of CDK9 in cervical cancer development. © 2018 IUBMB Life, 71(3):347-356, 2019.
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Affiliation(s)
- Junfen Xu
- Department of Gynecologic Oncology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Shanshan Xu
- Department of Gynecologic Oncology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yifeng Fang
- Department of General Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Tingting Chen
- Department of Gynecologic Oncology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xing Xie
- Department of Gynecologic Oncology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Weiguo Lu
- Department of Gynecologic Oncology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China.,Center of Uterine Cancer Diagnosis & Therapy of Zhejiang Province, Hangzhou, Zhejiang, China
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90
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Arbyn M, Xu L. Efficacy and safety of prophylactic HPV vaccines. A Cochrane review of randomized trials. Expert Rev Vaccines 2018; 17:1085-1091. [PMID: 30495978 DOI: 10.1080/14760584.2018.1548282] [Citation(s) in RCA: 99] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Recently, the evidence on efficacy and safety of prophylactic HPV vaccines derived from randomized trials was published in the Cochrane database of Systematic reviews. A summary of this Cochrane review is presented below. AREAS COVERED Only trials involving mono-, bi-, and quadrivalent HPV vaccines were included. Trials evaluating the nonavalent vaccine were excluded since women in the control group received the quadrivalent vaccine. Main efficacy outcomes were: histologically confirmed cervical precancer lesions distinguishing those associated with vaccine HPV types and any cervical precancer. Exposure groups were: women aged: 15-26 or 24-45 years being initially negative for high-risk HPV (hrHPV) or negative for the vaccine types and women unselected by HPV status. EXPERT COMMENTARY All evaluated vaccines offered excellent protection against cervical intraepithelial neoplasia of grade 2 or 3 (CIN2 or CIN3) and adenocarcinoma in situ associated with HPV16/18 infection in young women who were not initially infected with hrHPV or HPV16/18. Vaccine efficacy was lower when all women regardless of HPV DNA status at enrollment were included. In young women, HPV vaccination protected also against any cervical precancer but the magnitude of protection was lower than against HPV16/18 associated cervical precancer. Vaccine efficacy was lower in mid-adult (aged 24-45 years) women. No protection against cervical precancer was found in mid-adult women unselected by HPV DNA status at enrollment. Trials were not empowered to address protection against cervical cancer. Occurrence of severe adverse events or adverse pregnancy outcomes was not significantly higher in recipients of HPV vaccines than in women included in the control arms.
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Affiliation(s)
- M Arbyn
- a Sciensano , Unit of Cancer Epidemiology/Belgian Cancer Centre , Brussels , Belgium
| | - L Xu
- a Sciensano , Unit of Cancer Epidemiology/Belgian Cancer Centre , Brussels , Belgium
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91
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Qendri V, Schurink-Van 't Klooster TM, Bogaards JA, Berkhof J. Ten years of HPV vaccination in the Netherlands: current evidence and future challenges in HPV-related disease prevention. Expert Rev Vaccines 2018; 17:1093-1104. [PMID: 30417704 DOI: 10.1080/14760584.2018.1547196] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Girls-only vaccination against human papillomavirus (HPV) type 16 and 18 was implemented in the Netherlands in 2009. Despite the evidence of the efficacy against precancerous lesions, cross-protection induced by the vaccine and a greater potential for cancer prevention than cervical cancer only, vaccine coverage in the girls-only program has remained below target levels. AREAS COVERED In this paper, we review the literature from the Netherlands on the effectiveness and cost-effectiveness of HPV vaccination since vaccine introduction, give an account of the coverage, safety and effectiveness of HPV vaccination as has been reported in the Dutch surveillance program and discuss challenges of the current HPV vaccination program. EXPERT COMMENTARY Girls-only HPV vaccination may confer a substantial health gain in HPV-related disease prevention. However, vaccine coverage declined remarkably recently possibly related to safety concerns, limiting the benefits from girls' vaccination and increasing the potential additional benefit of sex-neutral HPV vaccination. Considering the emergence of novel vaccination and screening options and the change from cytology- to HPV-based screening in 2017, further research is required to inform decisions on the optimization of an integrated vaccination and screening program.
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Affiliation(s)
- V Qendri
- a Department of Epidemiology and Biostatistics , Amsterdam UMC, Vrije Universiteit Amsterdam , Amsterdam , Netherlands
| | - T M Schurink-Van 't Klooster
- b Center for Infectious Disease Control , National Institute for Public Health and the Environment , Bilthoven , Netherlands
| | - J A Bogaards
- a Department of Epidemiology and Biostatistics , Amsterdam UMC, Vrije Universiteit Amsterdam , Amsterdam , Netherlands.,b Center for Infectious Disease Control , National Institute for Public Health and the Environment , Bilthoven , Netherlands
| | - J Berkhof
- a Department of Epidemiology and Biostatistics , Amsterdam UMC, Vrije Universiteit Amsterdam , Amsterdam , Netherlands
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92
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Berry J, Glasgow SC. Vaccinations for Anal Squamous Cancer: Current and Emerging Therapies. Clin Colon Rectal Surg 2018; 31:321-327. [PMID: 30397391 DOI: 10.1055/s-0038-1668101] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Human papillomavirus (HPV) infection is responsible for 4.3% of the global cancer burden. Since 2006, current HPV vaccines have reduced the prevalence of the virus in adolescent girls, reduced the prevalence of genital warts, and been proven to reduce the progression of anal intraepithelial neoplasia in men. Herein, we review the epidemiology, virology, and immunology behind the prophylactic HPV vaccines and current recommendations for its use. We also review future immune therapies being trialed for use against HPV-related cancers including anal cancer.
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Affiliation(s)
- John Berry
- Division of Colon and Rectal Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri
| | - Sean C Glasgow
- Division of Colon and Rectal Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri
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93
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Abstract
Head and neck cancers comprise 4% of the cancer burden in the United States each year. Many types of head and neck cancers present as an asymptomatic, nontender neck mass or nonspecific symptoms, such as hoarseness, sore throat, and pain. Head and neck cancers are frequently diagnosed incidentally by the primary care physician or dentist. This review summarizes the epidemiology, clinical manifestations, diagnosis, and treatment of several common head and neck cancers in order to provide an increased awareness for the internist to facilitate early detection of these diseases.
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Affiliation(s)
- Kenneth Yan
- Section of Otolaryngology, Department of Surgery, University of Chicago Medicine, Chicago, IL, USA
| | - Nishant Agrawal
- Section of Otolaryngology, Department of Surgery, University of Chicago Medicine, Chicago, IL, USA
| | - Zhen Gooi
- Section of Otolaryngology, Department of Surgery, University of Chicago Medicine, Chicago, IL, USA.
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94
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Prevalence and Genotype Distribution of Human Papillomavirus in Invasive Cervical Cancer, Cervical Intraepithelial Neoplasia, and Asymptomatic Women in Southeast China. BIOMED RESEARCH INTERNATIONAL 2018; 2018:2897937. [PMID: 30402468 PMCID: PMC6196990 DOI: 10.1155/2018/2897937] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2017] [Accepted: 02/14/2018] [Indexed: 01/12/2023]
Abstract
Cervical cancer is one of the leading causes of cancer-related deaths among women and it is caused by the human papillomavirus (HPV). High variation has been reported in the attribution of specific HPV genotypes to cervical neoplasia among various geographic regions. For effective control of cervical cancer through HPV vaccination, it is essential to estimate the cost-effectiveness of vaccination, to monitor the potential transition into other HPV genotypes, and to understand the distribution of specific HPV genotypes across a specific geographic region. In this study, the distribution of HPV genotypes was investigated in southeast China, from 2011 to 2016. The 12,816 cervical swabs collected from women (age 18–78 years, median 43.6 years) outpatients were analyzed. HPV prevalence among 12,816 cervical swabs analyzed was 22.3% (2,856/12,816). Among these positive cases, 2,216 had only one HPV genotype while 640 had multiple HPV genotypes. The cases with multiple types revealed 23 different HPV genotypes with the five most prevalent being HPV18 (18.2%), HPV52 (14.1%), HPV16 (11.9%), HPV58 (10.6%), and HPV33 (5.5%). The rates of HPV infection in patients with cervical inflammation, CIN-1, CIN-2, CIN-3, squamous carcinoma, and adenocarcinoma were 38.4%, 80.5%, 82.6%, 92.3%, 97.5%, and 93.4%, respectively. Four HPV genotypes, HPV18, HPV16, HPV52, and HPV58, were more prevalent in patients with CIN-2-CIN-3 and invasive cervical cancer. A comparison of HPV genotypes attribution to cervical cancer between southeast China and global incidences revealed distinct differences. Due to this unique prevalence, it is essential to streamline the vaccination development protocol prior to administering vaccines based on global data.
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95
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Kamimura K, Matsumoto Y, Zhou Q, Moriyama M, Saijo Y. Cancers among adolescents and young adults at one institution in Japan. Oncol Lett 2018; 16:7212-7222. [PMID: 30546459 PMCID: PMC6256324 DOI: 10.3892/ol.2018.9535] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 09/25/2018] [Indexed: 12/26/2022] Open
Abstract
Adolescents and young adults (AYAs) with cancer often live long lives following treatment and face many life events. No detailed studies of cancers in AYAs have described the epidemiology, treatment outcome, and social status in Japan. The present study defined AYAs as those aged 15–29 years old based on the US National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) program. Data was collected from the hospital-based cancer registry and electronic medical charts at Niigata University Medical and Dental Hospital from 2007 to 2015. The present study analyzed the types of cancer, treatment methods and outcomes, fertility preservation, marital status, raising children, school admission, and employment status. A total of 362 (1.9%) cancer cases in AYAs (males 119, females 243) were identified. Carcinoma was the most common type of cancer in both sexes. Females had a high incidence of carcinoma of the genitourinary tract (28.0%). Fertility-sparing surgery (16.0%) was the most common method of fertility preservation. The 5-year survival was better in females (88.4%) than in males (79.9%). The percentage of married AYAs increased following cancer treatment. The proportion of unemployment increased following cancer treatment in all age groups and was greatest (12.6%) in those aged 20–24 years old. Compared with SEER data from the United States, the incidence of carcinoma was high among AYAs, particularly genitourinary tract carcinomas in females, while the incidence of melanoma and skin carcinomas was low. Therefore, AYAs with cancer requires social and economic support.
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Affiliation(s)
- Kensuke Kamimura
- Department of Medical Oncology, Niigata University Graduate School of Medical and Dental Sciences, Niigata 951-8510, Japan.,Department of Pharmacy, Saiseikai Niigata Daini Hospital, Niigata 950-1104, Japan
| | - Yoshifumi Matsumoto
- Department of Medical Oncology, Niigata University Graduate School of Medical and Dental Sciences, Niigata 951-8510, Japan
| | - Qiliang Zhou
- Department of Medical Oncology, Niigata University Graduate School of Medical and Dental Sciences, Niigata 951-8510, Japan
| | - Masato Moriyama
- Department of Medical Oncology, Niigata University Graduate School of Medical and Dental Sciences, Niigata 951-8510, Japan
| | - Yasuo Saijo
- Department of Medical Oncology, Niigata University Graduate School of Medical and Dental Sciences, Niigata 951-8510, Japan
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96
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Phillips A, Patel C, Pillsbury A, Brotherton J, Macartney K. Safety of Human Papillomavirus Vaccines: An Updated Review. Drug Saf 2018; 41:329-346. [PMID: 29280070 DOI: 10.1007/s40264-017-0625-z] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Human papillomavirus (HPV) vaccines are now included in immunisation programmes in 71 countries. Unfortunately, uptake has been impacted in some countries by reduced confidence in the safety of the HPV vaccine. In 2013, we published an extensive review demonstrating a reassuring safety profile for bivalent (2vHPV) and quadrivalent (4vHPV) vaccines. A nonavalent (9vHPV) vaccine is now available and HPV immunisation programmes have been extended to males in 11 countries. The aim of this updated narrative review was to examine the evidence on HPV vaccine safety, focusing on the 9vHPV vaccine, special populations and adverse events of special interest (AESI). The previous searches were replicated to identify studies to August 2016, including additional search terms for AESI. We identified 109 studies, including 15 population-based studies in over 2.5 million vaccinated individuals across six countries. All vaccines demonstrated an acceptable safety profile; injection-site reactions were slightly more common for 9vHPV vaccine than for 4vHPV vaccine. There was no consistent evidence of an increased risk of any AESI, including demyelinating syndromes or neurological conditions such as complex regional pain or postural orthostatic tachycardia syndromes. The risk-benefit profile for HPV vaccines remains highly favourable.
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Affiliation(s)
| | - Cyra Patel
- National Centre for Immunisation Research and Surveillance, Kids Research Institute, The Sydney Children's Hospitals Network, Cnr Hawkesbury Road and Hainsworth Street, Westmead, NSW, 2145, Australia
| | - Alexis Pillsbury
- National Centre for Immunisation Research and Surveillance, Kids Research Institute, The Sydney Children's Hospitals Network, Cnr Hawkesbury Road and Hainsworth Street, Westmead, NSW, 2145, Australia
| | - Julia Brotherton
- National HPV Vaccination Program Register, Victorian Cytology Service, Level 6, 176 Wellington Parade, East Melbourne, Carlton, VIC, 3002, Australia
- The University of Melbourne, Melbourne, VIC, Australia
| | - Kristine Macartney
- The University of Sydney, Sydney, NSW, Australia.
- National Centre for Immunisation Research and Surveillance, Kids Research Institute, The Sydney Children's Hospitals Network, Cnr Hawkesbury Road and Hainsworth Street, Westmead, NSW, 2145, Australia.
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97
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Hirth J. Disparities in HPV vaccination rates and HPV prevalence in the United States: a review of the literature. Hum Vaccin Immunother 2018; 15:146-155. [PMID: 30148974 DOI: 10.1080/21645515.2018.1512453] [Citation(s) in RCA: 109] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Human papillomavirus (HPV) is a common sexually transmitted infection which is the cause of several cancers, including cervical cancer, and genital warts. Although cervical cancer can be prevented through screening, this cancer persists in the US. More recently, HPV vaccination has the potential to decrease the burden of HPV-related disease among young HPV-unexposed adolescents. Several initiatives aimed to encourage HPV vaccination have been adopted. Unfortunately, uptake of the HPV vaccine remains modest, despite evidence that vaccine-type HPV prevalence is decreasing as a result of HPV vaccination. Further, geographic disparities in vaccination uptake across different US regions and by race/ethnicity may contribute to continuing disparities in HPV-related cancers. More data are needed to evaluate impact of HPV vaccination on HPV prevalence in smaller geographic areas. Further, more information is needed on the impact of individual vaccination programs and policy on population level vaccination and HPV prevalence.
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Affiliation(s)
- Jacqueline Hirth
- a Center for Interdisciplinary Research in Women's Health, Department of Obstetrics & Gynecology , University of Texas Medical Branch , Galveston, TX , USA
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98
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Zaveckas M, Goda K, Ziogiene D, Gedvilaite A. Purification of recombinant trichodysplasia spinulosa–associated polyomavirus VP1-derived virus-like particles using chromatographic techniques. J Chromatogr B Analyt Technol Biomed Life Sci 2018; 1090:7-13. [DOI: 10.1016/j.jchromb.2018.05.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 04/27/2018] [Accepted: 05/08/2018] [Indexed: 12/26/2022]
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99
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Akuzum B, Kim S, Nguyen TT, Hong J, Lee S, Kim E, Kim J, Choi Y, Jhun H, Lee Y, Kim H, Sohn DH, Kim S. L1 Recombinant Proteins of HPV Tested for Antibody Forming Using Sera of HPV Quadrivalent Vaccine. Immune Netw 2018; 18:e19. [PMID: 29984037 PMCID: PMC6026689 DOI: 10.4110/in.2018.18.e19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2018] [Revised: 05/10/2018] [Accepted: 05/27/2018] [Indexed: 12/01/2022] Open
Abstract
Virus-like particles (VLPs) derived from human papillomavirus (HPV) L1 capsid proteins were used for HPV quadrivalent recombinant vaccine. The HPV quadrivalent vaccine is administrated in a 3-dose regimen of initial injection followed by subsequent doses at 2 and 6 months to prevent cervical cancer, vulvar, and vaginal cancers. The type 6, 11, 16, or 18 of HPV infection is associated with precancerous lesions and genital warts in adolescents and young women. The HPV vaccine is composed of viral L1 capsid proteins are produced in eukaryotic expression systems and purified in the form of VLPs. Four different the L1 protein of 3 different subtypes of HPV: HPV11, HPV16, and HPV18 were expressed in Escherichia coli divided into 2 fragments as N- and C-terminal of each protein in order to examine the efficacy of HPV vaccine. Vaccinated sera failed to recognize N-terminal L1 HPV type 16 and type 18 by western blot while they detected N-terminal L1 protein of HPV type 11. Moreover, the recombinant C-terminal L1 proteins of type 16 was non-specifically recognized by the secondary antibody conjugated with horseradish peroxidase. This expression and purification system may provide simple method to obtain robust recombinant L1 protein of HPV subtypes to improve biochemical analysis of antigens with immunized sera.
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Affiliation(s)
- Begum Akuzum
- Laboratory of Cytokine Immunology, Department of Biomedical Science and Technology, Konkuk University, Seoul 05029, Korea
| | - Sinae Kim
- College of Veterinary Medicine, Konkuk University, Seoul 05029, Korea.,YbdYbiotech Research Center, Seoul 08589, Korea
| | - Tam Thanh Nguyen
- College of Veterinary Medicine, Konkuk University, Seoul 05029, Korea.,YbdYbiotech Research Center, Seoul 08589, Korea
| | - Jeawoo Hong
- Laboratory of Cytokine Immunology, Department of Biomedical Science and Technology, Konkuk University, Seoul 05029, Korea
| | - Siyoung Lee
- YbdYbiotech Research Center, Seoul 08589, Korea
| | - Eunhye Kim
- College of Veterinary Medicine, Konkuk University, Seoul 05029, Korea.,YbdYbiotech Research Center, Seoul 08589, Korea
| | - Joohee Kim
- Laboratory of Cytokine Immunology, Department of Biomedical Science and Technology, Konkuk University, Seoul 05029, Korea
| | - Yeook Choi
- Laboratory of Cytokine Immunology, Department of Biomedical Science and Technology, Konkuk University, Seoul 05029, Korea
| | - Hyunjhung Jhun
- YbdYbiotech Research Center, Seoul 08589, Korea.,Research Group of Nutraceuticals for Metabolic Syndrome, Korea Food Research Institute, Wanju 55365, Korea
| | - Youngmin Lee
- Department of Medicine, Pusan Paik Hospital, Inje University College of Medicine, Busan 47392, Korea
| | - Hyunwoo Kim
- Division of Nephrology, Department of Internal Medicine, Jeju National University School of Medicine, Jeju 63243, Korea
| | - Dong Hyun Sohn
- Department of Microbiology and Immunology, Pusan National University School of Medicine, Yangsan 50612, Korea
| | - Soohyun Kim
- Laboratory of Cytokine Immunology, Department of Biomedical Science and Technology, Konkuk University, Seoul 05029, Korea.,College of Veterinary Medicine, Konkuk University, Seoul 05029, Korea
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100
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Bretagne CH, Jooste V, Guenat D, Riethmuller D, Bouvier AM, Bedgedjian I, Prétet JL, Valmary-Degano S, Mougin C. Prevalence and distribution of HPV genotypes and cervical-associated lesions in sexually active young French women following HPV vaccine. J Gynecol Obstet Hum Reprod 2018; 47:525-531. [PMID: 29807205 DOI: 10.1016/j.jogoh.2018.05.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 05/21/2018] [Accepted: 05/23/2018] [Indexed: 01/22/2023]
Abstract
BACKGROUND Despite the availability of safe and effective HPV vaccines in France, more than 80% of girls remain unvaccinated. SETTING A regional university hospital referral center in France. OBJECTIVE To estimate the overall prevalence and distribution of HPV in vaccinated, sexually active young French women who were screened for cervical cancer by cytology and HPV testing. METHODS High-risk HPV (HR-HPV) prevalence, genotype-specific prevalence and extent of multiple infections were assessed in 125 cervical samples from females with available vaccine data using hc2 assay and INNO-LiPA assay. HPV status was analyzed in accordance with cytological data. RESULTS In our series, mean age was 23 years, overall prevalence of HR-HPV was 52% and was correlated with the lesion grade. The diversity of HPV genotypes was broad. Single HR-HPV infections were identified in 11%, 21% and 47% of women with NILM, ASC-US/-H and LSIL respectively. Multiple infections with HR-HPV were detected in 28% of the specimens. Only 24.5% of women with NILM presented infections with 2 genotypes or more, vs 28% of women with ASC-US/-H and 35% of women with LSIL. The overall prevalence of genotypes covered by the quadrivalent vaccine was low (5.9%); with 4.2%, 0%, 0.8% and 0.8% for HPV 16, HPV 18, HPV 6 and HPV 11 respectively. CONCLUSION Among HPV-vaccinated young women, HR-HPV are detected at a high rate, and an association with the grade of cytological abnormalities was observed. However, HPV 16 and 18, both targeted by the vaccines, are remarkably rare among young French women since program implementation.
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Affiliation(s)
- C H Bretagne
- Service d'Anatomie et cytologie pathologiques, CHU Besançon, Bd Fleming, 25000 Besançon, France.
| | - V Jooste
- Registre Bourguignon des Cancers Digestifs, Hôpital Universitaire Dijon-Bourgogne, 21000 Dijon, France; INSERM, U1231, EPICAD Team, Université Bourgogne-Franche-Comté, 21000 Dijon, France.
| | - D Guenat
- EA 3181, UFR SMP, Université Bourgogne Franche-Comté, LabEx LipSTIC ANR-11-LABX-0021, rue Ambroise Paré, 25000 Besançon, France; Centre National de Référence Papillomavirus, CHU Besançon, Bd Fleming, 25000 Besançon, France.
| | - D Riethmuller
- EA 3181, UFR SMP, Université Bourgogne Franche-Comté, LabEx LipSTIC ANR-11-LABX-0021, rue Ambroise Paré, 25000 Besançon, France; Service de gynécologie obstétrique, CHU Besançon, Bd Fleming, 25000 Besançon, France.
| | - A M Bouvier
- Registre Bourguignon des Cancers Digestifs, Hôpital Universitaire Dijon-Bourgogne, 21000 Dijon, France; INSERM, U1231, EPICAD Team, Université Bourgogne-Franche-Comté, 21000 Dijon, France.
| | - I Bedgedjian
- Service d'Anatomie et cytologie pathologiques, CHU Besançon, Bd Fleming, 25000 Besançon, France.
| | - J L Prétet
- EA 3181, UFR SMP, Université Bourgogne Franche-Comté, LabEx LipSTIC ANR-11-LABX-0021, rue Ambroise Paré, 25000 Besançon, France; Centre National de Référence Papillomavirus, CHU Besançon, Bd Fleming, 25000 Besançon, France.
| | - S Valmary-Degano
- Service d'Anatomie et cytologie pathologiques, CHU Besançon, Bd Fleming, 25000 Besançon, France; EA 3181, UFR SMP, Université Bourgogne Franche-Comté, LabEx LipSTIC ANR-11-LABX-0021, rue Ambroise Paré, 25000 Besançon, France.
| | - C Mougin
- EA 3181, UFR SMP, Université Bourgogne Franche-Comté, LabEx LipSTIC ANR-11-LABX-0021, rue Ambroise Paré, 25000 Besançon, France; Centre National de Référence Papillomavirus, CHU Besançon, Bd Fleming, 25000 Besançon, France.
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