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Wang R, Huang H, Yu C, Li X, Wang Y, Xie L. Current status and future directions for the development of human papillomavirus vaccines. Front Immunol 2024; 15:1362770. [PMID: 38983849 PMCID: PMC11231394 DOI: 10.3389/fimmu.2024.1362770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 06/11/2024] [Indexed: 07/11/2024] Open
Abstract
The development of human papillomavirus (HPV) vaccines has made substantive progress, as represented by the approval of five prophylactic vaccines since 2006. Generally, the deployment of prophylactic HPV vaccines is effective in preventing newly acquired infections and incidences of HPV-related malignancies. However, there is still a long way to go regarding the prevention of all HPV infections and the eradication of established HPV infections, as well as the subsequent progression to cancer. Optimizing prophylactic HPV vaccines by incorporating L1 proteins from more HPV subtypes, exploring adjuvants that reinforce cellular immune responses to eradicate HPV-infected cells, and developing therapeutic HPV vaccines used either alone or in combination with other cancer therapeutic modalities might bring about a new era getting closer to the vision to get rid of HPV infection and related diseases. Herein, we summarize strategies for the development of HPV vaccines, both prophylactic and therapeutic, with an emphasis on the selection of antigens and adjuvants, as well as implications for vaccine efficacy based on preclinical studies and clinical trials. Additionally, we outline current cutting-edge insights on formulation strategies, dosing schedules, and age expansion among HPV vaccine recipients, which might play important roles in addressing barriers to vaccine uptake, such as vaccine hesitancy and vaccine availability.
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Affiliation(s)
- Rui Wang
- Beijing Engineering Research Center of Protein and Antibody, Sinocelltech Ltd., Beijing, China
| | - Hongpeng Huang
- Beijing Engineering Research Center of Protein and Antibody, Sinocelltech Ltd., Beijing, China
| | - Chulin Yu
- Beijing Engineering Research Center of Protein and Antibody, Sinocelltech Ltd., Beijing, China
| | - Xuefeng Li
- Beijing Engineering Research Center of Protein and Antibody, Sinocelltech Ltd., Beijing, China
| | - Yang Wang
- Beijing Engineering Research Center of Protein and Antibody, Sinocelltech Ltd., Beijing, China
| | - Liangzhi Xie
- Beijing Engineering Research Center of Protein and Antibody, Sinocelltech Ltd., Beijing, China
- Cell Culture Engineering Center, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
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2
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O’Hara MP, Yanamandra AV, Sastry KJ. Immunity from NK Cell Subsets Is Important for Vaccine-Mediated Protection in HPV+ Cancers. Vaccines (Basel) 2024; 12:206. [PMID: 38400189 PMCID: PMC10892709 DOI: 10.3390/vaccines12020206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Revised: 02/07/2024] [Accepted: 02/14/2024] [Indexed: 02/25/2024] Open
Abstract
High-risk human papillomaviruses (HPVs) are associated with genital and oral cancers, and the incidence of HPV+ head and neck squamous cell cancers is fast increasing in the USA and worldwide. Survival rates for patients with locally advanced disease are poor after standard-of-care chemoradiation treatment. Identifying the antitumor host immune mediators important for treatment response and designing strategies to promote them are essential. We reported earlier that in a syngeneic immunocompetent preclinical HPV tumor mouse model, intranasal immunization with an HPV peptide therapeutic vaccine containing the combination of aGalCer and CpG-ODN adjuvants (TVAC) promoted clearance of HPV vaginal tumors via induction of a strong cytotoxic T cell response. However, TVAC was insufficient in the clearance of HPV oral tumors. To overcome this deficiency, we tested substituting aGalCer with a clinically relevant adjuvant QS21 (TVQC) and observed sustained, complete regression of over 70% of oral and 80% of vaginal HPV tumors. The TVQC-mediated protection in the oral tumor model correlated with not only strong total and HPV-antigen-specific CD8 T cells, but also natural killer dendritic cells (NKDCs), a novel subset of NK cells expressing the DC marker CD11c. Notably, we observed induction of significantly higher overall innate NK effector responses by TVQC relative to TVAC. Furthermore, in mice treated with TVQC, the frequencies of total and functional CD11c+ NK cell populations were significantly higher than the CD11c- subset, highlighting the importance of the contributions of NKDCs to the vaccine response. These results emphasize the importance of NK-mediated innate immune effector responses in total antitumor immunity to treat HPV+ cancers.
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Affiliation(s)
- Madison P. O’Hara
- Department of Thoracic Head and Neck Medical Oncology, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (M.P.O.); (A.V.Y.)
- UTHealth Graduate School of Biomedical Sciences, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Ananta V. Yanamandra
- Department of Thoracic Head and Neck Medical Oncology, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (M.P.O.); (A.V.Y.)
| | - K. Jagannadha Sastry
- Department of Thoracic Head and Neck Medical Oncology, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (M.P.O.); (A.V.Y.)
- UTHealth Graduate School of Biomedical Sciences, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
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3
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Zhang L, Shi X, Zhang Q, Mao Z, Shi X, Zhou J, Jian A, Zhu R, Jiang S, Lu W. HPV-16 E7-Specific Cellular Immune Response in Women With Cervical Intraepithelial Lesion Contributes to Viral Clearance: A Cross-Sectional and Longitudinal Clinical Study. Front Immunol 2022; 12:768144. [PMID: 35095843 PMCID: PMC8793279 DOI: 10.3389/fimmu.2021.768144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 12/17/2021] [Indexed: 11/13/2022] Open
Abstract
High-risk human papillomavirus (HPV) infection is the cause of almost all cervical cancers. HPV16 is one of the main risk subtypes. Although screening programs have greatly reduced the prevalence of cervical cancer in developed countries, current diagnostic tests cannot predict if mild lesions may progress into invasive lesions or not. In the current cross-sectional and longitudinal clinical study, we found that the HPV16 E7-specific T cell response in peripheral blood mononuclear cells of HPV16-infected patients is related to HPV16 clearance. It contributes to protecting the squamous interaepithelial lesion (SIL) from further malignant development. Of the HPV16 infected women enrolled (n = 131), 42 had neither intraepithelial lesion nor malignancy (NILM), 33 had low-grade SIL, 39 had high-grade SIL, and 17 had cervical cancer. Only one of 17 (5.9%) cancer patients had a positive HPV16 E7-specific T cell response, dramatically lower than the groups of precancer patients. After one year of follow-up, most women (28/33, 84.8%) with persistent HPV infection did not exhibit a HPV16 E7-specific T cell response. Furthermore, 3 malignantly progressed women, one progressed to high-grade SIL and two progressed to low-grade SIL, were negative to the HPV16 E7-specific T cell response. None of the patients with a positive HPV16 E7-specific T cell response progressed to further deterioration. Our observation suggests that HPV16 E7-specific T cell immunity is significant in viral clearance and contributes in protection against progression to malignancy.
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Affiliation(s)
- Lina Zhang
- Center for Diagnosis and Treatment of Cervical Diseases, Changzhou Maternal and Child Health Care Hospital, Nanjing Medical University, Changzhou, China
| | - Xinyi Shi
- R & D Department, Oxford Vacmedix (Changzhou) Co. Ltd., Changzhou, China
| | - Qing Zhang
- R & D Department, Oxford Vacmedix (Changzhou) Co. Ltd., Changzhou, China
| | - Zhilei Mao
- Center for Diagnosis and Treatment of Cervical Diseases, Changzhou Maternal and Child Health Care Hospital, Nanjing Medical University, Changzhou, China
| | - Xiaoyu Shi
- Center for Diagnosis and Treatment of Cervical Diseases, Changzhou Maternal and Child Health Care Hospital, Nanjing Medical University, Changzhou, China
| | - Jun Zhou
- Center for Diagnosis and Treatment of Cervical Diseases, Changzhou Maternal and Child Health Care Hospital, Nanjing Medical University, Changzhou, China
| | - Aili Jian
- R & D Department, Oxford Vacmedix (Changzhou) Co. Ltd., Changzhou, China.,Department of Microbiology and Immunology, School of Basic Medicine, Dali University, Dali, China
| | - Renying Zhu
- R & D Department, Oxford Vacmedix (Changzhou) Co. Ltd., Changzhou, China
| | - Shisong Jiang
- Department of Oncology, University of Oxford, Oxford, United Kingdom
| | - Wenshu Lu
- R & D Department, Oxford Vacmedix (Changzhou) Co. Ltd., Changzhou, China.,Department of Oncology, University of Oxford, Oxford, United Kingdom.,R & D Department, Shanghai Jia Wen (JW) Inflinhix Co. Ltd., Shanghai, China
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4
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Aggarwal C, Cohen RB, Morrow MP, Kraynyak KA, Sylvester AJ, Knoblock DM, Bauml JM, Weinstein GS, Lin A, Boyer J, Sakata L, Tan S, Anton A, Dickerson K, Mangrolia D, Vang R, Dallas M, Oyola S, Duff S, Esser M, Kumar R, Weiner D, Csiki I, Bagarazzi ML. Immunotherapy Targeting HPV16/18 Generates Potent Immune Responses in HPV-Associated Head and Neck Cancer. Clin Cancer Res 2018; 25:110-124. [PMID: 30242022 DOI: 10.1158/1078-0432.ccr-18-1763] [Citation(s) in RCA: 91] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 08/10/2018] [Accepted: 09/19/2018] [Indexed: 12/11/2022]
Abstract
PURPOSE Clinical responses with programmed death (PD-1) receptor-directed antibodies occur in about 20% of patients with advanced head and neck squamous cell cancer (HNSCCa). Viral neoantigens, such as the E6/E7 proteins of HPV16/18, are attractive targets for therapeutic immunization and offer an immune activation strategy that may be complementary to PD-1 inhibition. PATIENTS AND METHODS We report phase Ib/II safety, tolerability, and immunogenicity results of immunotherapy with MEDI0457 (DNA immunotherapy targeting HPV16/18 E6/E7 with IL12 encoding plasmids) delivered by electroporation with CELLECTRA constant current device. Twenty-two patients with locally advanced, p16+ HNSCCa received MEDI0457. RESULTS MEDI0457 was associated with mild injection site reactions, but no treatment-related grade 3-5 adverse events (AE) were noted. Eighteen of 21 evaluable patients showed elevated antigen-specific T-cell activity by IFNγ ELISpot, and persistent cellular responses surpassing 100 spot-forming units (SFUs)/106 peripheral blood mononuclear cells (PBMCs) were noted out to 1 year. Induction of HPV-specific CD8+ T cells was observed. MEDI0457 shifted the CD8+/FoxP3+ ratio in 4 of 5 post immunotherapy tumor samples and increased the number of perforin+ immune infiltrates in all 5 patients. One patient developed metastatic disease and was treated with anti-PD-1 therapy with a rapid and durable complete response. Flow-cytometric analyses revealed induction of HPV16-specific PD-1+ CD8+ T cells that were not found prior to MEDI0547 (0% vs. 1.8%). CONCLUSIONS These data demonstrate that MEDI0457 can generate durable HPV16/18 antigen-specific peripheral and tumor immune responses. This approach may be used as a complementary strategy to PD-1/PD-L1 inhibition in HPV-associated HNSCCa to improve therapeutic outcomes.
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Affiliation(s)
- Charu Aggarwal
- Division of Hematology-Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
| | - Roger B Cohen
- Division of Hematology-Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | | | | | | | | | - Joshua M Bauml
- Division of Hematology-Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Gregory S Weinstein
- Department of Otorhinolaryngology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Alexander Lin
- Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Jean Boyer
- Inovio Pharmaceuticals, Inc., Plymouth Meeting, Pennsylvania
| | - Lindsay Sakata
- Inovio Pharmaceuticals, Inc., Plymouth Meeting, Pennsylvania
| | - Sophie Tan
- Inovio Pharmaceuticals, Inc., Plymouth Meeting, Pennsylvania
| | - Aubrey Anton
- Inovio Pharmaceuticals, Inc., Plymouth Meeting, Pennsylvania
| | | | | | | | - Michael Dallas
- Inovio Pharmaceuticals, Inc., Plymouth Meeting, Pennsylvania
| | - Sandra Oyola
- Inovio Pharmaceuticals, Inc., Plymouth Meeting, Pennsylvania
| | - Susan Duff
- Inovio Pharmaceuticals, Inc., Plymouth Meeting, Pennsylvania
| | | | | | | | - Ildiko Csiki
- Inovio Pharmaceuticals, Inc., Plymouth Meeting, Pennsylvania
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5
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Huang CG, Lee LA, Liao CT, Yen TC, Yang SL, Liu YC, Li JC, Gong YN, Kang CJ, Huang SF, Fang KH, Chang KP, Lee LY, Hsueh C, Shih SR, Tsao KC. Molecular and serologic markers of HPV 16 infection are associated with local recurrence in patients with oral cavity squamous cell carcinoma. Oncotarget 2018; 8:34820-34835. [PMID: 28422732 PMCID: PMC5471014 DOI: 10.18632/oncotarget.16747] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Accepted: 03/20/2017] [Indexed: 01/11/2023] Open
Abstract
Human papillomavirus (HPV) infections predict mortality in Taiwanese patients with oral cavity squamous cell carcinoma (OCSCC). To address their prognostic significance for local recurrence (LR), in this retrospective cohort study we investigated different serologic and molecular markers of HPV 16 infection in 85 consecutive patients with primary OCSCC who received standard treatment and had their sera stored before treatment. Resected tumor specimens were examined with PCR-based assays for HPV 16 E6/E7 mRNA expression. Sera were tested with suspension arrays for the presence of HPV-specific antibodies using synthetic L1 and E6 peptides as well as a synthetic E7 protein. HPV 16 E6/E7 mRNA, anti-L1, anti-E6, and anti-E7 antibodies tested positive in 12%, 25%, 38%, and 41% of the study patients, respectively. Multivariate analysis identified pathological T3/T4, E6/E7 mRNA, and anti-E7 antibodies as independent risk factors for LR, whereas anti-E6 antibodies were an independent protective factor. In patients with ≥ 3 (high-risk group), 2 (intermediate-risk), and ≤ 1 (low-risk) independent risk factors (predictors), the 5-year LR rates were 75%, 42%, and 4%, respectively. Results were validated in an independent cohort. Together, our preliminary data indicate that HPV 16 infections as well as low and high serum levels of anti-E6 and anti-E7 antibodies, respectively, can serve as biomarkers of LR in patients with OCSCC, whereas the clinical usefulness of anti-HPV 16 antibodies for risk stratification of newly diagnosed cases deserves further scrutiny.
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Affiliation(s)
- Chung-Guei Huang
- Department of Laboratory Medicine, Head and Neck Oncology Group, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan, ROC.,Department of Medical Biotechnology and Laboratory Science, Chang Gung University, Taoyuan, Taiwan, ROC.,Graduate Institute of Biomedical Sciences, Chang Gung University, Taoyuan, Taiwan, ROC
| | - Li-Ang Lee
- Faculty of Medicine, Chang Gung University, Taoyuan, Taiwan, ROC.,Department of Otorhinolaryngology - Head and Neck Surgery, Head and Neck Oncology Group, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan, ROC
| | - Chun-Ta Liao
- Faculty of Medicine, Chang Gung University, Taoyuan, Taiwan, ROC.,Department of Otorhinolaryngology - Head and Neck Surgery, Head and Neck Oncology Group, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan, ROC
| | - Tzu-Chen Yen
- Faculty of Medicine, Chang Gung University, Taoyuan, Taiwan, ROC.,Molecular Imaging Center, Head and Neck Oncology Group, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan, ROC
| | - Shu-Li Yang
- Department of Laboratory Medicine, Head and Neck Oncology Group, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan, ROC.,Department of Medical Biotechnology and Laboratory Science, Chang Gung University, Taoyuan, Taiwan, ROC
| | - Yi-Chun Liu
- Department of Laboratory Medicine, Head and Neck Oncology Group, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan, ROC
| | - Jung-Chin Li
- Faculty of Medicine, Chang Gung University, Taoyuan, Taiwan, ROC
| | - Yu-Nong Gong
- Department of Laboratory Medicine, Head and Neck Oncology Group, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan, ROC
| | - Chung-Jan Kang
- Faculty of Medicine, Chang Gung University, Taoyuan, Taiwan, ROC.,Department of Otorhinolaryngology - Head and Neck Surgery, Head and Neck Oncology Group, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan, ROC
| | - Shiang-Fu Huang
- Faculty of Medicine, Chang Gung University, Taoyuan, Taiwan, ROC.,Department of Otorhinolaryngology - Head and Neck Surgery, Head and Neck Oncology Group, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan, ROC
| | - Ku-Hao Fang
- Faculty of Medicine, Chang Gung University, Taoyuan, Taiwan, ROC.,Department of Otorhinolaryngology - Head and Neck Surgery, Head and Neck Oncology Group, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan, ROC
| | - Kai-Ping Chang
- Faculty of Medicine, Chang Gung University, Taoyuan, Taiwan, ROC.,Department of Otorhinolaryngology - Head and Neck Surgery, Head and Neck Oncology Group, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan, ROC
| | - Li-Yu Lee
- Faculty of Medicine, Chang Gung University, Taoyuan, Taiwan, ROC.,Department of Pathology, Head and Neck Oncology Group, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan, ROC
| | - Chuen Hsueh
- Faculty of Medicine, Chang Gung University, Taoyuan, Taiwan, ROC.,Department of Pathology, Head and Neck Oncology Group, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan, ROC
| | - Shin-Ru Shih
- Department of Laboratory Medicine, Head and Neck Oncology Group, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan, ROC.,Department of Medical Biotechnology and Laboratory Science, Chang Gung University, Taoyuan, Taiwan, ROC.,Graduate Institute of Biomedical Sciences, Chang Gung University, Taoyuan, Taiwan, ROC
| | - Kuo-Chien Tsao
- Department of Laboratory Medicine, Head and Neck Oncology Group, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan, ROC.,Department of Medical Biotechnology and Laboratory Science, Chang Gung University, Taoyuan, Taiwan, ROC
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6
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Wang X, Che Y, Chen B, Zhang Y, Nakagawa M, Wang X. Evaluation of immune responses induced by a novel human papillomavirus type 16 E7 peptide-based vaccine with Candida skin test reagent as an adjuvant in C57BL/6 mice. Int Immunopharmacol 2018; 56:249-260. [PMID: 29414659 DOI: 10.1016/j.intimp.2018.01.037] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 01/21/2018] [Accepted: 01/22/2018] [Indexed: 12/30/2022]
Abstract
Cell mediated immune (CMI) responses are crucial for the clearance of human papillomavirus (HPV) infection and HPV-associated lesions. Activated CD8 T cells are critical effector cells in recognizing and killing HPV-infected or HPV-transformed cells. CD4 T cells provide help for priming the generation and maintenance of CD8 T cells as well as for tumors immunity. An ideal therapeutic HPV peptide-based vaccine should induce both a robust CD8 T-cell response as well as a CD4 T-cell response for ensuring their efficiency. Candida skin test reagent was demonstrated to be able to induce the secretion of IL-12 by Langerhans cells and T-cell proliferation in vitro by our group, which indicated the potential of Candida to enhance CMI response. In this current study, we designed a novel HPV peptide-based vaccine which includes HPV16 E7 peptides and Candida as an adjuvant. The immune responses induced by the vaccine were comprehensively evaluated. The results showed that the vaccine induced significant HPV-specific CD8 T-cell and Th1 CD4 T-cell responses as well as humoral immune response. It is interesting that Candida alone induced a significant polarization of Th1 response an production of IFN-γ, which indicated Candida alone may be used as a potential immunotherapeutic reagent not only for HPV-associated lesions but also for other viral infection or even cancers.
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Affiliation(s)
- Xingxuan Wang
- Department of Microbiology and Parasitology, College of Basic Medical Sciences, China Medical University, Shenyang, China
| | - Yuxin Che
- Department of Microbiology and Parasitology, College of Basic Medical Sciences, China Medical University, Shenyang, China
| | - Bingnan Chen
- The 3rd Clinical Department, China Medical University, Shenyang, China
| | - Yao Zhang
- The 3rd Clinical Department, China Medical University, Shenyang, China
| | - Mayumi Nakagawa
- Department of Pathology, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
| | - Xuelian Wang
- Department of Microbiology and Parasitology, College of Basic Medical Sciences, China Medical University, Shenyang, China.
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7
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Unique potential of 4-1BB agonist antibody to promote durable regression of HPV+ tumors when combined with an E6/E7 peptide vaccine. Proc Natl Acad Sci U S A 2015; 112:E5290-9. [PMID: 26351680 DOI: 10.1073/pnas.1514418112] [Citation(s) in RCA: 72] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Antibody modulation of T-cell coinhibitory (e.g., CTLA-4) or costimulatory (e.g., 4-1BB) receptors promotes clinical responses to a variety of cancers. Therapeutic cancer vaccination, in contrast, has produced limited clinical benefit and no curative therapies. The E6 and E7 oncoproteins of human papilloma virus (HPV) drive the majority of genital cancers, and many oropharyngeal tumors. We discovered 15-19 amino acid peptides from HPV-16 E6/E7 for which induction of T-cell immunity correlates with disease-free survival in patients treated for high-grade cervical neoplasia. We report here that intranasal vaccination with these peptides and the adjuvant alpha-galactosylceramide elicits systemic and mucosal T-cell responses leading to reduced HPV(+) TC-1 tumor growth and prolonged survival in mice. We hypothesized that the inability of these T cells to fully reject established tumors resulted from suppression in the tumor microenvironment which could be ameliorated through checkpoint modulation. Combining this E6/E7 peptide vaccine with checkpoint blockade produced only modest benefit; however, coadministration with a 4-1BB agonist antibody promoted durable regression of established genital TC-1 tumors. Relative to other therapies tested, this combination of vaccine and α4-1BB promoted the highest CD8(+) versus regulatory FoxP3(+) T-cell ratios, elicited 2- to 5-fold higher infiltration by E7-specific CTL, and evoked higher densities of highly cytotoxic TcEO (T cytotoxic Eomesodermin) CD8 (>70-fold) and ThEO (T helper Eomesodermin) CD4 (>17-fold) T cells. These findings have immediate clinical relevance both in terms of the direct clinical utility of the vaccine studied and in illustrating the potential of 4-1BB antibody to convert therapeutic E6/E7 vaccines already in clinical trials into curative therapies.
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8
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Kumar A, Yadav IS, Hussain S, Das BC, Bharadwaj M. Identification of immunotherapeutic epitope of E5 protein of human papillomavirus-16: An in silico approach. Biologicals 2015. [PMID: 26212000 DOI: 10.1016/j.biologicals.2015.07.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Cervical cancer is one of the most common gynaecological cancer in India and contributes 1/3rd of global burden. High risk-human papillomavirus (HR-HPV) is the major etiological factor for development of cervical cancer. Two available HPV vaccines provide protection against HPV induced cervical malignancy. However, vaccines having therapeutic values are of utmost priority. Till date, most of HPV therapeutic vaccines are focused on two major HPV oncoproteins (E6/E7). HPV-E5 which acts by altering the activity of cellular proteins, mainly growth factor pathways emerges as a new therapeutic target. In present study, we predicted the candidate B-cell and T-cell epitopes of HPV16-E5, which can be used for HPV immunotherapy. We identified that epitope SAFRCFIVYIIFVY as most potent peptide for HLA-A*11:01 having percentile value of 0.5 and immunogenicity score of 0.69558. For MHC-II, epitopes IPLFLIHTHARFLIT for HLA-DRB1*14:01 alleles have the lowest IC50 value (18.13 nM). The identification of structural feature and immunogenic epitopes provides the best information for development of drugs or vaccine. In conclusion, the expression of E5 protein was detected in the early phase of the HPV infection, which gives an opportunity to target HPV-E5 that would help in the prevention and progression of the precancerous lesion to invasive carcinomas.
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Affiliation(s)
- Anoop Kumar
- Division of Molecular Genetics & Biochemistry, Institute of Cytology & Preventive Oncology (ICMR), Noida, Uttar Pradesh, India; Dr. B.R. Ambedkar Center for Biomedical Research, University of Delhi (North Campus), New Delhi, India
| | - Inderjit Singh Yadav
- School of Agricultural Biotechnology, Punjab Agricultural University, Ludhiana, Punjab, India
| | - Showket Hussain
- Division of Molecular Genetics & Biochemistry, Institute of Cytology & Preventive Oncology (ICMR), Noida, Uttar Pradesh, India
| | - Bhudev C Das
- Dr. B.R. Ambedkar Center for Biomedical Research, University of Delhi (North Campus), New Delhi, India
| | - Mausumi Bharadwaj
- Division of Molecular Genetics & Biochemistry, Institute of Cytology & Preventive Oncology (ICMR), Noida, Uttar Pradesh, India.
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9
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Sin JI. Promises and challenges of human papillomavirus vaccines for cervical cancer. Expert Rev Anticancer Ther 2014; 9:1-5. [DOI: 10.1586/14737140.9.1.1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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10
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Abstract
Human papillomavirus (HPV) infection is a major cause of cervical cancer, the second most common cancer in women worldwide. Currently, a HPV L1-based virus-like particle has been approved as a prophylactic vaccine against HPV infection, which will probably lead to a reduction in cervical cancer incidence within a few decades. Therapeutic vaccines, however, are expected to have an impact on cervical cancer or its precursor lesions, by taking advantage of the fact that the regulatory proteins (E6 and E7) of HPV are expressed constantly in HPV-associated cervical cancer cells. Vaccine types targeting these regulatory proteins include the recombinant protein and DNA vaccines, peptide vaccines, dendritic-cell vaccines, and viral and bacterial vector deliveries of vaccines, and these may provide an opportunity to control cervical cancer. Further approaches incorporating these vaccine types with either conventional therapy modalities or the modulation of CD4(+) regulatory T cells appear to be more promising in achieving increased therapeutic efficacy. In this review, we summarize current and future therapeutic vaccine strategies against HPV-associated malignancies at the animal and clinical levels.
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Affiliation(s)
- Jeong-Im Sin
- Catholic University of Daegu, Department of Microbiology, School of Medicine, 3056-6, Daemyung-4-Dong, Namgu, Daegu, 705-718, Korea.
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11
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Saharia KK, Koup RA. T cell susceptibility to HIV influences outcome of opportunistic infections. Cell 2013; 155:505-14. [PMID: 24243010 DOI: 10.1016/j.cell.2013.09.045] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2013] [Indexed: 12/18/2022]
Abstract
During HIV infection, the timing of opportunistic infections is not always associated with severity of CD4 T cell depletion, and different opportunistic pathogens reactivate at different CD4 T cell thresholds. Here, we examine how differences in the phenotype and function of pathogen-specific CD4 T cells influence susceptibility to HIV infection. By focusing on three common opportunistic infections (Mycobacterium tuberculosis, human papillomavirus, and cytomegalovirus), we investigate how differential depletion of pathogen-specific CD4 T cells impacts the natural history of these pathogens in HIV infection. A broader understanding of this relationship can better inform treatment strategies against copathogens.
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Affiliation(s)
- Kapil K Saharia
- Institute of Human Virology and Division of Infectious Diseases, University of Maryland School of Medicine, Baltimore, MD 21201, USA
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12
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HPV16 E5 peptide vaccine in treatment of cervical cancer in vitro and in vivo. ACTA ACUST UNITED AC 2013; 33:735-742. [DOI: 10.1007/s11596-013-1189-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2013] [Revised: 08/13/2013] [Indexed: 11/24/2022]
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13
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Morrow MP, Yan J, Sardesai NY. Human papillomavirus therapeutic vaccines: targeting viral antigens as immunotherapy for precancerous disease and cancer. Expert Rev Vaccines 2013; 12:271-83. [PMID: 23496667 DOI: 10.1586/erv.13.23] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Infections with oncogenic HPV types have the potential to lead to the induction of several types of cancer, notably cervical, vulvar, anal, and head and neck cancer. While prophylactic vaccines are currently available and show high efficacy against the establishment of HPV infection, low rates of initiation and lower rates of completion of the vaccination regimen, as well as the lack of an opportunity to be vaccinated prior to infection, has lead to the development of a patient population for whom no immune-based therapy for infection is available. In the current review the authors examine clinical approaches to HPV-targeted immune therapies, the bulk of which target the regulatory proteins E6 and E7 that are constitutively expressed in HPV-associated cancer cells. Early studies demonstrate a correlation between induction of T-cell responses and clearance of HPV-associated precancerous lesions. The clinical data corroborates these findings and highlight the importance of Th1 skewing. Improvements in our understanding of tumor immunology and development of more potent Th1-directed vaccine platforms make it feasible to foresee a HPV therapeutic vaccine in the coming years.
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Affiliation(s)
- Matthew P Morrow
- Inovio Pharmaceuticals, Inc., 1787 Sentry Parkway West, Blue Bell, PA 19422, USA
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14
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Han KT, Sin JI. DNA vaccines targeting human papillomavirus-associated diseases: progresses in animal and clinical studies. Clin Exp Vaccine Res 2013; 2:106-14. [PMID: 23858401 PMCID: PMC3710918 DOI: 10.7774/cevr.2013.2.2.106] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2013] [Revised: 05/30/2013] [Accepted: 06/15/2013] [Indexed: 01/18/2023] Open
Abstract
Human papillomavirus (HPV) infection is a major cause of cervical cancer and its precancerous diseases. Cervical cancer is the second deadliest cancer killer among women worldwide. Moreover, HPV is also known to be a causative agent of oral, pharyngeal, anal and genital cancer. Recent application of HPV structural protein (L1)-targeted prophylactic vaccines (Gardasil® and Cervarix®) is expected to reduce the incidence of HPV infection and cervical cancer, and possibly other HPV-associated cancers. However, the benefit of the prophylactic vaccines for treating HPV-infected patients is unlikely, underscoring the importance of developing therapeutic vaccines against HPV infection. In this regard, numerous types of therapeutic vaccine approaches targeting the HPV regulatory proteins, E6 and E7, have been tested for their efficacy in animals and clinically. In this communication, we review HPV vaccine types, in particular DNA vaccines, their designs and delivery by electroporation and their immunologic and antitumor efficacy in animals and humans, along with the basics of HPV and its pathogenesis.
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Affiliation(s)
- Kyusun Torque Han
- Department of Microbiology, School of Medicine, Kangwon National University, Chuncheon, Korea
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15
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Bagarazzi ML, Yan J, Morrow MP, Shen X, Parker RL, Lee JC, Giffear M, Pankhong P, Khan AS, Broderick KE, Knott C, Lin F, Boyer JD, Draghia-Akli R, White CJ, Kim JJ, Weiner DB, Sardesai NY. Immunotherapy against HPV16/18 generates potent TH1 and cytotoxic cellular immune responses. Sci Transl Med 2013; 4:155ra138. [PMID: 23052295 DOI: 10.1126/scitranslmed.3004414] [Citation(s) in RCA: 235] [Impact Index Per Article: 21.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Despite the development of highly effective prophylactic vaccines against human papillomavirus (HPV) serotypes 16 and 18, prevention of cervical dysplasia and cancer in women infected with high-risk HPV serotypes remains an unmet medical need. We report encouraging phase 1 safety, tolerability, and immunogenicity results for a therapeutic HPV16/18 candidate vaccine, VGX-3100, delivered by in vivo electroporation (EP). Eighteen women previously treated for cervical intraepithelial neoplasia grade 2 or 3 (CIN2/3) received a three-dose (intramuscular) regimen of highly engineered plasmid DNA encoding HPV16 and HPV18 E6/E7 antigens followed by EP in a dose escalation study (0.3, 1, and 3 mg per plasmid). Immunization was well tolerated with reports of mild injection site reactions and no study-related serious or grade 3 and 4 adverse events. No dose-limiting toxicity was noted, and pain was assessed by visual analog scale, with average scores decreasing from 6.2/10 to 1.4 within 10 min. Average peak interferon-γ enzyme-linked immunospot magnitudes were highest in the 3 mg cohort in comparison to the 0.3 and 1 mg cohorts, suggesting a trend toward a dose effect. Flow cytometric analysis revealed the induction of HPV-specific CD8(+) T cells that efficiently loaded granzyme B and perforin and exhibited full cytolytic functionality in all cohorts. These data indicate that VGX-3100 is capable of driving robust immune responses to antigens from high-risk HPV serotypes and could contribute to elimination of HPV-infected cells and subsequent regression of the dysplastic process.
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Affiliation(s)
- Mark L Bagarazzi
- Inovio Pharmaceuticals Inc., 1787 Sentry Parkway West, Building 18, Suite 400, Blue Bell, PA 19422, USA
| | - Jian Yan
- Inovio Pharmaceuticals Inc., 1787 Sentry Parkway West, Building 18, Suite 400, Blue Bell, PA 19422, USA
| | - Matthew P Morrow
- Inovio Pharmaceuticals Inc., 1787 Sentry Parkway West, Building 18, Suite 400, Blue Bell, PA 19422, USA
| | - Xuefei Shen
- Inovio Pharmaceuticals Inc., 1787 Sentry Parkway West, Building 18, Suite 400, Blue Bell, PA 19422, USA
| | - R Lamar Parker
- Lyndhurst Clinical Research, Winston-Salem, NC 27103, USA
| | - Jessica C Lee
- Inovio Pharmaceuticals Inc., 1787 Sentry Parkway West, Building 18, Suite 400, Blue Bell, PA 19422, USA
| | - Mary Giffear
- Inovio Pharmaceuticals Inc., 1787 Sentry Parkway West, Building 18, Suite 400, Blue Bell, PA 19422, USA
| | - Panyupa Pankhong
- Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Amir S Khan
- Inovio Pharmaceuticals Inc., 1787 Sentry Parkway West, Building 18, Suite 400, Blue Bell, PA 19422, USA
| | - Kate E Broderick
- Inovio Pharmaceuticals Inc., 1787 Sentry Parkway West, Building 18, Suite 400, Blue Bell, PA 19422, USA
| | - Christine Knott
- Inovio Pharmaceuticals Inc., 1787 Sentry Parkway West, Building 18, Suite 400, Blue Bell, PA 19422, USA
| | - Feng Lin
- Inovio Pharmaceuticals Inc., 1787 Sentry Parkway West, Building 18, Suite 400, Blue Bell, PA 19422, USA
| | - Jean D Boyer
- Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Ruxandra Draghia-Akli
- Inovio Pharmaceuticals Inc., 1787 Sentry Parkway West, Building 18, Suite 400, Blue Bell, PA 19422, USA
| | - C Jo White
- Inovio Pharmaceuticals Inc., 1787 Sentry Parkway West, Building 18, Suite 400, Blue Bell, PA 19422, USA
| | - J Joseph Kim
- Inovio Pharmaceuticals Inc., 1787 Sentry Parkway West, Building 18, Suite 400, Blue Bell, PA 19422, USA
| | - David B Weiner
- Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Niranjan Y Sardesai
- Inovio Pharmaceuticals Inc., 1787 Sentry Parkway West, Building 18, Suite 400, Blue Bell, PA 19422, USA
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16
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Jayasinghe YL, Moore EE, Tabrizi SN, Grover SR, Garland SM. Human papillomavirus in adolescents: lessons learned from decades of evaluation. J Paediatr Child Health 2013; 49:99-104. [PMID: 21883616 DOI: 10.1111/j.1440-1754.2011.02073.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Knowledge regarding the natural history of human papillomavirus (HPV) infection and its clinical sequelae in adolescents has increased significantly over the last decade; as a result, there have been world-wide recommendations for less aggressive Pap screening and management of cervical dysplasias in young women. It is important that adolescent health providers understand these issues, as knowledge of HPV and its sequelae in the Australian community is limited, despite the introduction of a national immunisation programme. Parents and young women have expressed a desire for further information to make informed choices. This paper reviews the natural history of HPV infection in adolescents and the evidence behind new conservative guidelines for cervical screening, plus prophylactic vaccination in young women.
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Affiliation(s)
- Yasmin L Jayasinghe
- Department of Microbiology and Infectious Diseases, Royal Women's Hospital, Melbourne, Victoria, Australia.
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17
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van der Burg SH. Immunotherapy of human papilloma virus induced disease. Open Virol J 2012; 6:257-63. [PMID: 23341861 PMCID: PMC3547504 DOI: 10.2174/1874357901206010257] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2012] [Revised: 04/28/2012] [Accepted: 08/17/2012] [Indexed: 01/08/2023] Open
Abstract
Immunotherapy is the generic name for treatment modalities aiming to reinforce the immune system against diseases in which the immune system plays a role. The design of an optimal immunotherapeutic treatment against chronic viruses and associated diseases requires a detailed understanding of the interactions between the target virus and its host, in order to define the specific strategies that may have the best chance to deliver success at each stage of disease. Recently, a first series of successes was reported for the immunotherapy of Human Papilloma Virus (HPV)-induced premalignant diseases but there is definitely room for improvement. Here I discuss a number of topics that in my opinion require more study as the answers to these questions allows us to better understand the underlying mechanisms of disease and as such to tailor treatment.
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Affiliation(s)
- Sjoerd H van der Burg
- Department of Clinical Oncology, Leiden University Medical Center, Leiden, The Netherlands
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Stern PL, van der Burg SH, Hampson IN, Broker TR, Fiander A, Lacey CJ, Kitchener HC, Einstein MH. Therapy of human papillomavirus-related disease. Vaccine 2012; 30 Suppl 5:F71-82. [PMID: 23199967 PMCID: PMC4155500 DOI: 10.1016/j.vaccine.2012.05.091] [Citation(s) in RCA: 107] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2011] [Revised: 04/10/2012] [Accepted: 05/03/2012] [Indexed: 12/18/2022]
Abstract
This chapter reviews the current treatment of chronic and neoplastic human papillomavirus (HPV)-associated conditions and the development of novel therapeutic approaches. Surgical excision of HPV-associated lower genital tract neoplasia is very successful but largely depends on secondary prevention programmes for identification of disease. Only high-risk HPV-driven chronic, pre-neoplastic lesions and some very early cancers cannot be successfully treated by surgical procedures alone. Chemoradiation therapy of cervical cancer contributes to the 66-79% cervical cancer survival at 5 years. Outlook for those patients with persistent or recurrent cervical cancer following treatment is very poor. Topical agents such as imiquimod (immune response modifier), cidofovir (inhibition of viral replication; induction apoptosis) or photodynamic therapy (direct damage of tumour and augmentation of anti-tumour immunity) have all shown some useful efficacy (~50-60%) in treatment of high grade vulvar intraepithelial neoplasia (VIN). Provider administered treatments of genital warts include cryotherapy, trichloracetic acid, or surgical removal which has the highest primary clearance rate. Patient applied therapies include podophyllotoxin and imiquimod. Recurrence after "successful" treatment is 30-40%. Further improvements could derive from a rational combination of current therapy with new drugs targeting molecular pathways mediated by HPV in cancer. Small molecule inhibitors targeting the DNA binding activities of HPV E1/E2 or the anti-apoptotic consequences of E6/E7 oncogenes are in preclinical development. Proteasome and histone deacetylase inhibitors, which can enhance apoptosis in HPV positive tumour cells, are being tested in early clinical trials. Chronic high-risk HPV infection/neoplasia is characterised by systemic and/or local immune suppressive regulatory or escape factors. Recently two E6/E7 vaccines have shown some clinical efficacy in high grade VIN patients and this correlated with strong and broad systemic HPV-specific T cell response and modulation of key local immune factors. Treatments that can shift the balance of immune effectors locally in combination with vaccination are now being tested. This article forms part of a special supplement entitled "Comprehensive Control of HPV Infections and Related Diseases" Vaccine Volume 30, Supplement 5, 2012.
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Affiliation(s)
- Peter L Stern
- Paterson Institute for Cancer Research, University of Manchester, Manchester M20 4BX, UK.
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19
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Lee YS, Lee CW, Song MJ, Ho EM, Kim CJ, Park TC, Kim TG, Park JS. Cell-mediated immune response to human papillomavirus 16 E7 peptide pools in patients with cervical neoplasia. Acta Obstet Gynecol Scand 2011; 90:1350-6. [PMID: 21916856 DOI: 10.1111/j.1600-0412.2011.01277.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To identify characteristics of the cell-mediated immune (CMI) response to human papillomavirus-16 (HPV) E7 viral peptide pools to help the formulation of therapeutic vaccines. DESIGN Prospective study. Population. Korean women. SETTING University hospital. METHODS From December 2008 to August 2010, 33 HPV-16-positive patients, seven patients exhibiting a high-risk HPV infection other than HPV-16 with grade 2/3 cervical intraepithelial neoplasm (CIN2/3), and nine healthy control donors were enrolled. MAIN OUTCOME MEASURES CMI response to synthetic HPV-16 E7 overlapping peptide pools using the IFN-γ ELISPOT assay. RESULTS The E7 sequence comprising amino acids 16-55 was a major immunogenic region. The CMI response to HPV-16 E7 is highly type-specific. The follow-up CMI response may last longer than expected after the lesion is resected. CONCLUSIONS We found that the E7 sequence comprising amino acids 16-55 is a major immunogenic region that is critical for the T-cell-mediated immune response with CIN2/3 or cervical cancer. The identification of CMI responses to HPV-16 E7 peptide pools may provide insight into therapeutic vaccine trials for the control of HPV-associated diseases.
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Affiliation(s)
- Yong Seok Lee
- Department of Obstetrics and Gynecology, College of Medicine, The Catholic University of Korea, Seoul, Korea
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20
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Singh AK, Rath SK, Misra K. Identification of epitopes in Indian human papilloma virus 16 E6: a bioinformatics approach. J Virol Methods 2011; 177:26-30. [PMID: 21699918 DOI: 10.1016/j.jviromet.2011.06.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2011] [Revised: 05/31/2011] [Accepted: 06/07/2011] [Indexed: 11/16/2022]
Abstract
HPV-16 is reported as the cause of cervical and other related carcinomas. The early expressed protein E6 in cancer cells is found to be the target for immune therapeutic methods. The sequence of HPV-16 E6 (Accession No: ABK32509) from NCBI databank has been taken for this study. Hydrophilicity, flexibility, accessibility, turns, exposed surface, polarity and antigenic propensity scales were used for the B cell epitope prediction. MHC Class I and Class II alleles for the accession were predicted by the MHCPred 2.0 Program. The epitope sequences were also found out. Computer-based prediction program results show, A0203 and DRB0101 lower IC50 than other alleles. The best peptide binding affinity was 21HLCTELQTT30 of A0203 allele. In DRB0101 allele the peptide found was 39YCKQQLLRR48. Different structural features of the protein have also been predicted including glycosylation, kinase C phosphorylation, casein kinase II phosphorylation and N-myristylation sites. These computational prediction programs show four glycosylation, five kinase C phosphorylation, two casein kinase II phosphorylation, zero N-myristylation sites and seven disulphide sites. Development and approval of new vaccines are the keys for control of cancer. Epitopes and other structural features of protein prediction could be the best source of information and can help in molecular and medical studies of viral infection and development of HPV associated cancer drugs.
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Affiliation(s)
- Ajay Kumar Singh
- Centre for Biomedical Magnetic Research, SGPGI Campus, Lucknow, India.
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21
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Riemer AB, Keskin DB, Zhang G, Handley M, Anderson KS, Brusic V, Reinhold B, Reinherz EL. A conserved E7-derived cytotoxic T lymphocyte epitope expressed on human papillomavirus 16-transformed HLA-A2+ epithelial cancers. J Biol Chem 2010; 285:29608-22. [PMID: 20615877 PMCID: PMC2937992 DOI: 10.1074/jbc.m110.126722] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2010] [Revised: 05/20/2010] [Indexed: 11/06/2022] Open
Abstract
Human Papillomavirus 16 (HPV-16) has been identified as the causative agent of 50% of cervical cancers and many other HPV-associated tumors. The transforming potential/tumor maintenance capacity of this high risk HPV is mediated by two viral oncoproteins, E6 and E7, making them attractive targets for therapeutic vaccines. Of 21 E6 and E7 peptides computed to bind HLA-A*0201, 10 were confirmed through TAP-deficient T2 cell HLA stabilization assay. Those scoring positive were investigated to ascertain which were naturally processed and presented by surface HLA molecules for CTL recognition. Because IFNγ ELISpot frequencies from healthy HPV-exposed blood donors against HLA-A*0201-binding peptides were unable to identify specificities for tumor targeting, their physical presence among peptides eluted from HPV-16-transformed epithelial tumor HLA-A*0201 immunoprecipitates was analyzed by MS(3) Poisson detection mass spectrometry. Only one epitope (E7(11-19)) highly conserved among HPV-16 strains was detected. This 9-mer serves to direct cytolysis by T cell lines, whereas a related 10-mer (E7(11-20)), previously used as a vaccine candidate, was neither detected by MS(3) on HPV-transformed tumor cells nor effectively recognized by 9-mer specific CTL. These data underscore the importance of precisely defining CTL epitopes on tumor cells and offer a paradigm for T cell-based vaccine design.
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Affiliation(s)
- Angelika B. Riemer
- From the Cancer Vaccine Center and
- Laboratory of Immunobiology, Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts 02115
| | - Derin B. Keskin
- Laboratory of Immunobiology, Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts 02115
| | | | - Maris Handley
- From the Cancer Vaccine Center and
- Laboratory of Immunobiology, Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts 02115
| | | | | | - Bruce Reinhold
- From the Cancer Vaccine Center and
- Laboratory of Immunobiology, Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts 02115
| | - Ellis L. Reinherz
- From the Cancer Vaccine Center and
- Laboratory of Immunobiology, Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts 02115
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22
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Mutyaba T, Mirembe F, Sandin S, Weiderpass E. Evaluation of 'see-see and treat' strategy and role of HIV on cervical cancer prevention in Uganda. Reprod Health 2010; 7:4. [PMID: 20459733 PMCID: PMC2882355 DOI: 10.1186/1742-4755-7-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2009] [Accepted: 05/10/2010] [Indexed: 12/31/2022] Open
Abstract
Background There is scant information on whether Human Immunodeficiency Virus (HIV) seropositivity has an influence on the outcome of treatment of precancerous cervical lesions using cryotherapy. We studied the prevalence of cervical abnormalities detectable by visual inspection and cervical lesions diagnosed by colposcopy according to HIV serostatus and described the outcomes of cryotherapy treatment. Methods Trained nurses examined women not previously screened for cervical cancer using visual inspection with acetic acid (VIA) and Lugol's iodine (VILI) in two family planning/post natal clinics in Kampala, Uganda, from February 2007 to August 2008. Women with abnormal visual inspection findings were referred for colposcopic evaluation and HIV testing. Women with precancerous cervical lesions detected at colposcopy were treated mainly by cryotherapy, and were evaluated for treatment outcome after 3 months by a second colposcopy. Results Of the 5 105 women screened, 834 presented a positive screening test and were referred for colposcopy. Of these 625 (75%) returned for the colposcopic evaluation and were tested for HIV. For the 608 (97.5%) women in the age range 20-60 years, colposcopy revealed 169 women with cervical lesions: 128 had inflammation, 19 had low grade squamous intraepithelial lesion (LGSIL), 13 had high grade squamous intraepithelial lesion (HGSIL), 9 had invasive cervical cancer and 2 had inconclusive findings. Detection rates per 1 000 women screened were higher among the older women (41-60 years) compared to women aged 20-40 years. They were accordingly 55% and 20% for inflammation, 10% and 2% for LGSIL, 5% and 2% for HGSIL, 6% and 1% for invasive cervical cancer. Of the 608 women, 103 (16%) were HIV positive. HIV positivity was associated with higher likelihood of inflammation (RR = 1.7; 95% CI: 1.2-2.4). Conclusions Detection rates were higher among older women 41-60 years. Visual inspection of the cervix uteri with acetic acid (VIA) and Lugol's iodine (VILI) used as a sole method for cervical cancer screening would entail significant false positive results. HIV seropositivity was associated with a higher prevalence of inflammatory cervical lesions. In view of the small numbers and the relatively short follow up time of 3 months, we could not make an emphatic conclusion about the effect of HIV serostatus on cryotherapy treatment outcome.
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Affiliation(s)
- Twaha Mutyaba
- Department of Obstetrics and Gynecology, Makerere University, Medical School, P,O, Box 7072, Kampala, Uganda.
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23
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Jandová A, Pokorný J, Kobilková J, Janousek M, Masata J, Trojan S, Nedbalová M, Dohnalová A, Beková A, Slavík V, Cocek A, Sanitrák J. Cell-mediated immunity in cervical cancer evolution. Electromagn Biol Med 2009; 28:1-14. [PMID: 19337890 DOI: 10.1080/15368370802708868] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Cell-mediated immunity (CMI) response to different antigens was examined in healthy women, in patients with cervical precancerous lesions, and in patients with cervical cancer. Cervical lesions were diagnosed by cytological (PAP) smears, from examination by colposcopy, and from "punch" biopsy material by histology. CMI response is related to specific processes in healthy and cancer cells. CMI was investigated by leukocyte adherence inhibition (LAI) assay using specific antigen (prepared from cervical carcinoma tissue) and non specific antigen (prepared from blood of mice infected by LDH--lactate dehydrogenase--virus). The CMI responses of healthy women and cancer patients to the antigens used are different: the majority of T lymphocytes display adherence and non adherence, respectively (but the CMI responses elicited by the antigens are not equal and small quantitative differences are observed). Regardless of the CIN (cervical intraepithelial neoplasia) grades, CMI responses correspond either to healthy women or to cervical carcinoma patients (at about similar ratio of cases in all the CIN groups). Effect of non specific antigen suggests that cervical carcinoma transformation may be connected with reduction of mitochondrial activity similar to processes in LDH virus infection.
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Affiliation(s)
- A Jandová
- Institute of Photonics and Electronics, Academy of Sciences, Prague, Czech Republic
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24
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Brandsma JL, Shlyankevich M, Su Y, Zelterman D, Rose JK, Buonocore L. Reversal of papilloma growth in rabbits therapeutically vaccinated against E6 with naked DNA and/or vesicular stomatitis virus vectors. Vaccine 2009; 28:8345-51. [PMID: 19615481 DOI: 10.1016/j.vaccine.2009.04.082] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2009] [Revised: 03/27/2009] [Accepted: 04/03/2009] [Indexed: 02/02/2023]
Abstract
Persistent infection with high-risk human papillomaviruses (HPVs) is the greatest risk factor for the development of HPV-associated cancers. In this study rabbits bearing persistent and potentially malignant papillomas were used to test the efficacy of vaccination with a recombinant DNA and/or vesicular stomatitis virus (VSV) targeting the cottontail rabbit papillomavirus (CRPV) E6 protein. Immune responses were primed with either vector and boosted twice with the homologous or heterologous E6 vector. Over the course of 18 weeks, E6 vaccination reduced papilloma volumes to one third the volume in the controls, and the rabbits boosted with an heterologous vector tended to mount stronger responses. Small and medium-sized papillomas responded significantly but only slightly better than large papillomas. Finally the initial papilloma burden per rabbit, ranging from <100 mm(3) to >1000 mm(3), was not prognostic of antitumor efficacy. In summary both E6 vaccines elicited significant therapeutic immunity, and their sequential use tended to be advantageous.
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Affiliation(s)
- Janet L Brandsma
- Section of Comparative Medicine, Yale University School of Medicine, New Haven, CT 06520, USA.
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25
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Guzman VB, Yambartsev A, Goncalves-Primo A, Silva IDCG, Carvalho CRN, Ribalta JCL, Goulart LR, Shulzhenko N, Gerbase-Delima M, Morgun A. New approach reveals CD28 and IFNG gene interaction in the susceptibility to cervical cancer. Hum Mol Genet 2008; 17:1838-44. [PMID: 18337305 DOI: 10.1093/hmg/ddn077] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Cervical cancer is a complex disease with multiple environmental and genetic determinants. In this study, we sought an association between polymorphisms in immune response genes and cervical cancer using both single-locus and multi-locus analysis approaches. A total of 14 single nucleotide polymorphisms (SNPs) distributed in CD28, CTLA4, ICOS, PDCD1, FAS, TNFA, IL6, IFNG, TGFB1 and IL10 genes were determined in patients and healthy individuals from three independent case/control sets. The first two sets comprised White individuals (one group with 82 cases and 85 controls, the other with 83 cases and 85 controls) and the third was constituted by non-white individuals (64 cases and 75 controls). The multi-locus analysis revealed higher frequencies in cancer patients of three three-genotype combinations [CD28+17(TT)/IFNG+874(AA)/TNFA-308(GG), CD28+17(TT)/IFN+847(AA)/PDCD1+7785(CT), and CD28 +17(TT)/IFNG+874(AA)/ICOS+1564(TT)] (P < 0.01, Monte Carlo simulation). We hypothesized that this two-genotype [CD28(TT) and IFNG(AA)] combination could have a major contribution to the observed association. To address this question, we analyzed the frequency of the CD28(TT), IFNG(AA) genotype combination in the three groups combined, and observed its increase in patients (P = 0.0011 by Fisher's exact test). The contribution of a third polymorphism did not reach statistical significance (P = 0.1). Further analysis suggested that gene-gene interaction between CD28 and IFNG might contribute to susceptibility to cervical cancer. Our results showed an epistatic effect between CD28 and IFNG genes in susceptibility to cervical cancer, a finding that might be relevant for a better understanding of the disease pathogenesis. In addition, the novel analytical approach herein proposed might be useful for increasing the statistical power of future genome-wide multi-locus studies.
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Affiliation(s)
- Valeska B Guzman
- Immunogenetics Division, Pediatrics Department, Federal University of São Paulo, SP, Brazil
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26
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Fang CY, Miller SM, Bovbjerg DH, Bergman C, Edelson MI, Rosenblum NG, Bove BA, Godwin AK, Campbell DE, Douglas SD. Perceived stress is associated with impaired T-cell response to HPV16 in women with cervical dysplasia. Ann Behav Med 2008; 35:87-96. [PMID: 18347908 DOI: 10.1007/s12160-007-9007-6] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2007] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Infection with high-risk subtypes of human papillomavirus (HPV) is a central factor in the development of cervical neoplasia. Cell-mediated immunity against HPV16 plays an important role in the resolution of HPV infection and in controlling cervical disease progression. Research suggests that stress is associated with cervical disease progression, but few studies have examined the biological mechanisms that may be driving this association. PURPOSE This study examines whether stress is associated with immune response to HPV16 among women with cervical dysplasia. METHODS Seventy-four women presenting for colposcopy completed measures of health behaviors, stressful life events and perceived stress. A blood sample was obtained to evaluate proliferative T-cell response to HPV16, and a cervical sample was obtained during gynecologic exam for HPV-typing. RESULTS More than 55% tested positive for one or more HPV subtypes. Women who did not show proliferative responses to HPV (i.e. non-responders) were more likely to be HPV(+) compared to women who had a response (i.e. responders). Consistent with study hypotheses, logistic regression revealed that higher levels of perceived stress were associated with a non-response to HPV16, controlling for relevant covariates. Stressful life events were not associated with T-cell response to HPV. CONCLUSIONS Higher levels of perceived stress are associated with impaired HPV-specific immune response in women with cervical dysplasia, suggesting a potential mechanism by which stress may influence cervical disease progression.
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Affiliation(s)
- Carolyn Y Fang
- Division of Population Science, Fox Chase Cancer Center, Cheltenham, PA 19012, USA.
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Saldivar JS, Lopez D, Feldman RA, Tharappel-Jacob R, de la Rosa A, Terreros D, Baldwin WS. COX-2 overexpression as a biomarker of early cervical carcinogenesis: a pilot study. Gynecol Oncol 2007; 107:S155-62. [PMID: 17826825 DOI: 10.1016/j.ygyno.2007.07.023] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2007] [Accepted: 07/06/2007] [Indexed: 12/17/2022]
Abstract
BACKGROUND Recent studies have demonstrated that cyclooxygenase-2 (COX-2) expression is up-regulated in a number of cancers. Selective inhibition of COX-2 offers a potential pharmacological strategy for cancer prevention. The COX-2 isoform is induced in response to inflammatory factors and is expressed in premalignant lesions, including cervical tissues. Few studies have investigated COX-2 expression as a biomarker for early cervical carcinogenesis. In this preliminary study, we assessed the variability of COX-2 overexpression in cervical premalignant lesions. METHODS Fifty-two patients were recruited and consented. Paired abnormal and control (normal) cervical biopsies were obtained and evaluated for high-risk human papillomavirus (HPV), inflammation, histopathological diagnosis, and COX-2 protein concentration by ELISA. Paired Student's t-test and general linear regression models were used to compare mean COX-2 protein concentrations among biopsy samples and selected risk variables. RESULTS Forty-seven of fifty-two paired biopsies were evaluated. COX-2 protein concentrations were 4.9-fold greater in abnormal biopsies (CIN 1 and CIN 2) than normal biopsies. COX-2 was also significantly increased in inflammation-positive biopsies. No significant association was found between COX-2 levels and HPV high-risk positivity, age, parity, STI history, or hormonal contraceptive use, but the sample size was small. CONCLUSIONS These results suggest that COX-2 induction begins in the premalignant phase of cervical carcinogenesis and is correlated with inflammation. A trial using a much larger number of specimens will allow further development of our understanding of COX-2 as a biomarker for use in chemoprevention trials.
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Roman LD, Wilczynski S, Muderspach LI, Burnett AF, O'Meara A, Brinkman JA, Kast WM, Facio G, Felix JC, Aldana M, Weber JS. A phase II study of Hsp-7 (SGN-00101) in women with high-grade cervical intraepithelial neoplasia. Gynecol Oncol 2007; 106:558-66. [PMID: 17631950 DOI: 10.1016/j.ygyno.2007.05.038] [Citation(s) in RCA: 81] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2006] [Revised: 04/27/2007] [Accepted: 05/07/2007] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Approximately 2 million women worldwide are infected with high-risk human papillomaviruses (HPV), resulting in a substantial risk for the development of invasive lower genital malignancies. This study was undertaken to determine the effects of vaccination with a protein encoding a bacterial heat shock protein fused to sequences from the oncogenic E7 protein of HPV-16 in women with high-grade cervical intraepithelial neoplasia. Endpoints included lesion regression, immune response, and viral clearance. METHODS Twenty-one women were prospectively entered into an IRB-approved Phase II study. All women had biopsy-proven high-grade cervical intraepithelial neoplasia and persistent post-biopsy lesions visible by colposcopy. Four injections of HPV-16 Hsp E7 fusion protein at a dose of 500 mug were given 3 weeks apart after which Loop Electrosurgical Excision of the Transformation Zone (LLETZ) was performed. Immune parameters were evaluated pre-vaccine and at the time of LLETZ, and HPV testing was performed at intervals before and after LLETZ. Study subjects were followed for 1 year after LLETZ. RESULTS Seven of 20 women (35%) evaluable for response had complete regression of their intraepithelial neoplasia at the time of LLETZ, 1 (5%) had regression to CIN I, 11 (55%) had stable disease and 1 (5%) had progression due to enlargement of her lesion. Immune responses were seen in 9 of the 17 women tested; 5 of the 7 complete responders had an immune response. Only 5 of 21 women had HPV-16 or -18. HPV clearance was not associated with lesion regression. CONCLUSION Hsp-7 (SGN-00101), at this dose and schedule induced lesion regression in women with high-grade intraepithelial neoplasia. The fact that regression was correlated with immune response suggests that enhancing the immunogenicity of this vaccine may lead to improvement in the rate of lesion eradication.
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Affiliation(s)
- L D Roman
- Department of Obstetrics and Gynecology, Keck School of Medicine of the University of Southern California, Los Angeles, CA 90089, USA.
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Sheu BC, Chang WC, Lin HH, Chow SN, Huang SC. Immune concept of human papillomaviruses and related antigens in local cancer milieu of human cervical neoplasia. J Obstet Gynaecol Res 2007; 33:103-13. [PMID: 17441881 DOI: 10.1111/j.1447-0756.2007.00492.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
It is presently the right time for clarifying human papillomavirus (HPV)-associated cellular immunity and clinical implications before global HPV vaccination programs begin. Infection with oncogenic HPV associates with the progression of cervical neoplasia. Both cellular and humoral immune responses are essential for the clearance of HPV-associated cervical lesions. There is increasing evidence that the immune system plays a pivotal role in determining the outcome of HPV infection. Viruses and associated neoplastic cells are proposed to have evolved mechanisms to avoid immune attack. T-cell-mediated immune responses against oncogenic HPV are believed to play a central role in cervical carcinogenesis. The presence of HPV-specific cytotoxic T lymphocytes (CTL) in a majority of human cervical cancer patients provides an approach for further study of their functional role in modulating this malignancy. Tumor-infiltrating lymphocytes (TIL) develop as manifestations of the recognition and defense against malignant cells by the host immune system. Cancer cells may overcome immune surveillance, either by downregulating the proliferation of HPV-specific CTL, or altering the effector compositions of immune cells against HPV infections. TIL in the tumor microenvironment can be functionally inhibited and lose the ability of clonal proliferation as a result of depressed expression of IL-2Ralpha. The upregulation of inhibitory signaling relates to the modulation of the virus- and/or tumor-specific immune responses. Alteration of host genetic susceptibility may also lead to abnormal immune response as a general genomic instability resulting from virus persistence. Induction of HPV-specific immune responses is anticipated as an intimate point for the treatment of cervical neoplasia.
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Affiliation(s)
- Bor-Ching Sheu
- Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan.
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30
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Ye GW, Park JB, Park YJ, Choi YS, Sin JI. Increased sensitivity of radiated murine cervical cancer tumors to E7 subunit vaccine-driven CTL-mediated killing induces synergistic anti-tumor activity. Mol Ther 2007; 15:1564-70. [PMID: 17505485 DOI: 10.1038/sj.mt.6300149] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
The development of therapeutic vaccines has important implications for the treatment of cancer patients. Here we investigate whether human papillomavirus (HPV) E7 subunit vaccines can enhance tumor radioresponse using an established cervical cancer animal model. Radiation plus E7 subunit vaccines improved complete response, cure, and recurrence rates of tumors dramatically compared with single therapy alone. In particular, both components of the E7 subunit vaccines (E7 protein and CpG-oligodeoxynucleotide) were required for the induction of antigen (Ag)-specific cytotoxic T-lymphocyte (CTL) responses and for therapeutic synergy with radiotherapy. Moreover, with combined therapy the radiation dose could be reduced by 16 Gy to achieve an equivalent anti-tumor efficacy to radiation treatment alone. This therapeutic synergy was found to be mediated by CD8(+) CTLs and was concomitant with histological changes (presence of apoptotic bodies and multinucleated giant cells; heavy infiltration of lymphocytes), as determined by in vivo T-cell depletion and histological analysis. Finally, phenotypic changes of radiated tumors and their increased sensitivity to CTL-mediated killing appeared to be responsible for therapeutic synergy. These results show that E7 subunit vaccines act as a potent enhancer of tumor radioresponse and that this is mediated by increased sensitivity of radiated tumors to CTL-mediated killing. This study further suggests that E7-targeted therapeutic vaccines have the potential to improve radiotherapy in patients with cervical cancer.
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Affiliation(s)
- Gi Won Ye
- Department of Radiation Oncology, Catholic University of Daegu, Namgu, Daegu, South Korea
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Bae SH, Park YJ, Park JB, Choi YS, Kim MS, Sin JI. Therapeutic synergy of human papillomavirus E7 subunit vaccines plus cisplatin in an animal tumor model: causal involvement of increased sensitivity of cisplatin-treated tumors to CTL-mediated killing in therapeutic synergy. Clin Cancer Res 2007; 13:341-9. [PMID: 17200373 DOI: 10.1158/1078-0432.ccr-06-1838] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE The goal of this study was to investigate the therapeutic potentials of combining chemotherapy with human papillomavirus (HPV) E7 subunit vaccines in an animal tumor model and to determine the underlying therapeutic mechanisms. EXPERIMENTAL DESIGN Animals bearing HPV E6/E7-expressing tumors were treated intratumorally with a selected cytotoxic drug, cisplatin, twice at 1-week interval and s.c. with E7 subunit vaccines thrice at 1-week interval. Tumor chemoimmunoresponse was measured by tumor size. Ag-specific CTL activities and tumor histology were checked in mice under treatments. Apoptosis, in vivo T-cell subset depletion, adoptive CTL transfer, and tumor regression were used to determine the mechanisms for antitumor therapeutic effects. RESULTS Combined therapy using cisplatin plus E7 subunit vaccines improved cure and recurrence rates of tumors and long-term antitumor immunity dramatically more than single therapy alone. In particular, both components of E7 subunit vaccines were required for induction of Ag-specific CTL as well as therapeutic synergy when combined with cisplatin. This therapeutic synergy was abrogated by depletion of CD8(+) T cells in vivo and was concomitant with histologic changes (such as heavy infiltration of lymphocytes and reduced tumor cell density). Finally, the increased sensitivity of cisplatin-treated tumors to CTL-mediated killing was found to be responsible for therapeutic synergy. CONCLUSIONS E7 subunit vaccines plus cisplatin mediate antitumor therapeutic synergy through the increased sensitivity of cisplatin-treated tumors to CTL-mediated killing. Moreover, E7-based therapeutic vaccines have the potential to improve chemotherapy in patients with cervical cancer.
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Affiliation(s)
- Sung Hwa Bae
- Department of Hematology-Oncology, Catholic University of Daegu, Namgu, Korea
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Dillon S, Sasagawa T, Crawford A, Prestidge J, Inder MK, Jerram J, Mercer AA, Hibma M. Resolution of cervical dysplasia is associated with T-cell proliferative responses to human papillomavirus type 16 E2. J Gen Virol 2007; 88:803-813. [PMID: 17325352 DOI: 10.1099/vir.0.82678-0] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The 'high-risk' human papillomaviruses (HPVs) cause persistent infections of the anogenital region that may resolve spontaneously following activation of a protective immune response. The aim of this study was to determine whether cell-mediated immunity (CMI) to the early protein E2 was associated with disease regression and to establish whether E2 CMI and antibodies to L1 virus-like particles (VLPs) were associated markers of immunity to HPV. Lymphoproliferative responses to histidine-tagged E2 and antibody responses to VLPs were measured in patients with persistent cervical dysplasia, those whose disease had recently resolved and normal controls. Resolvers had significantly higher E2-specific lymphoproliferative responses when compared with normal controls or persisters, whereas there was no significant difference between the persisters and the normal controls. The T cells stimulated by E2 secreted high levels of gamma interferon (IFN-gamma), consistent with a type 1 helper (Th1) phenotype. VLP IgG responses were associated with current or previous HPV infection, but not with disease regression or a lymphoproliferative response to E2. Major histocompatibility complex class I-restricted T cells secreted IFN-gamma following stimulation with E1, and E2 peptides were detected more frequently in the persister group. The data showed that lymphoproliferative responses to E2 with a cytokine profile indicative of Th1 are associated with disease resolution, supporting the development of a therapeutic vaccine that activates this type of response for the treatment of individuals with pre-existing disease.
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Affiliation(s)
- Stephanie Dillon
- Virus Research Unit, Dept Microbiology and Immunology, University of Otago, PO Box 56, Dunedin, New Zealand
| | - Toshiyuki Sasagawa
- Faculty of Medicine, Kanazawa University, Kodatsuno, Kanazawa, Ishikawa 920-0942, Japan
| | - Anna Crawford
- Virus Research Unit, Dept Microbiology and Immunology, University of Otago, PO Box 56, Dunedin, New Zealand
| | - Jan Prestidge
- Student Health Services, University of Otago, PO Box 56, Dunedin, New Zealand
| | - Marie K Inder
- Virus Research Unit, Dept Microbiology and Immunology, University of Otago, PO Box 56, Dunedin, New Zealand
| | - Jim Jerram
- Student Health Services, University of Otago, PO Box 56, Dunedin, New Zealand
| | - Andrew A Mercer
- Virus Research Unit, Dept Microbiology and Immunology, University of Otago, PO Box 56, Dunedin, New Zealand
| | - Merilyn Hibma
- Virus Research Unit, Dept Microbiology and Immunology, University of Otago, PO Box 56, Dunedin, New Zealand
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Brulet JM, Maudoux F, Thomas S, Thielemans K, Burny A, Leo O, Bex F, Hallez S. DNA vaccine encoding endosome-targeted human papillomavirus type 16 E7 protein generates CD4+ T cell-dependent protection. Eur J Immunol 2007; 37:376-84. [PMID: 17274002 DOI: 10.1002/eji.200636233] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Human papillomavirus type 16 is commonly implicated in cervical cancers. The viral genome encodes potential targets like the oncoprotein E7, expressed in transformed cells but thought to represent a poorly immunogenic antigen. We describe in this work a DNA-based vaccination protocol aimed at inducing an efficient anti-E7 immune response in vivo. Plasmids allowing the expression of the E7 protein in distinct cellular compartments were generated and assayed in an in vivo model of tumor growth. Our data demonstrate that mice vaccinated with a plasmid encoding for an E7 protein fused to a domain of the MHC class II-associated invariant chain (IiE7) were protected against tumor challenge. Mice immunized against an ubiquitinated form of E7 (Ub(Ala)E7) failed to control tumor growth. Protection induced by IiE7 was correlated with the development of CD8+ CTL and required the presence of CD4+ cells. In vitro studies confirmed that the IiE7 fusion protein was expressed at high levels in the endosomal compartment of transfected cells, while the natural and the ubiquitin-modified form of E7 were mainly nuclear. The present study suggests that an efficient anti-tumor response can be induced in vivo by DNA constructs encoding for E7 protein forms localizing at the endosomal compartment.
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Affiliation(s)
- Jean-Marc Brulet
- Laboratory of Chemical Biology, Institut de Biologie et de Médecine Moléculaires, Université Libre de Bruxelles, Gosselies, Belgium.
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Lee BN, Follen M, Rodriquez G, Shen DY, Malpica A, Shearer WT, Reuben JM. Deficiencies in myeloid antigen-presenting cells in women with cervical squamous intraepithelial lesions. Cancer 2006; 107:999-1007. [PMID: 16874820 DOI: 10.1002/cncr.22092] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND There is little information on the function of dendritic cells in women with human papillomavirus (HPV)-related cervical squamous intraepithelial lesions (SILs). In the current study the functions of dendritic cells in the development of T-cell immunity in women with cervical SILs were assessed. METHODS The percentage of myeloid dendritic cells (MDCs) and plasmacytoid dendritic cells (PDCs) in peripheral blood were enumerated of 44 patients with SIL (low-grade, 19; high-grade, 25), 19 patients with atypical squamous cells of undetermined significance (ASCUS), and 18 controls. The expression of costimulatory receptors was assessed and the ability of monocyte-derived dendritic cells (MDDC) to present HPV16-E6 and HPV16-E7 antigens to autologous T cells. RESULTS Patients with either low (L)-grade or high (H)-grade SIL had significantly lower median plasma levels of interferon-gamma than did the controls (P = .038 and .031, respectively). Compared with the controls, patients with ASCUS or LSILs had significantly lower median percentages of MDCs (P = .002 and P < .001, respectively), and significantly lower median percentages of MDDCs that expressed CD86 (P < .001 and P = .003, respectively) and major histocompatability complex class-II antigen human leukocyte antigen DR (HLA-DR) (P = .012 and P < .001, respectively). T cells of patients with ASCUS or LSILs proliferated less than those of the controls in response to HPV16-E7 (P = .002 and .046, respectively). CONCLUSIONS Low levels of peripheral blood MDCs and of MDDCs expressing CD86 and HLA-DR suggest that deficiencies in the ability of MDDC to present antigen to autologous T cells may lead to persistent infection with HPV and the development of cervical SILs in HPV-infected women.
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Affiliation(s)
- Bang-Ning Lee
- Department of Hematopathology, University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030, USA.
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Moscicki AB, Schiffman M, Kjaer S, Villa LL. Chapter 5: Updating the natural history of HPV and anogenital cancer. Vaccine 2006; 24 Suppl 3:S3/42-51. [PMID: 16950017 DOI: 10.1016/j.vaccine.2006.06.018] [Citation(s) in RCA: 240] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2006] [Accepted: 06/06/2006] [Indexed: 11/17/2022]
Abstract
The major steps in cervical carcinogenesis include infection of the metaplastic epithelium of the cervical transformation zone with one or more of the 12-18 carcinogenic types of human papillomavirus (HPV) infection, viral persistence, clonal progression of the persistently-infected epithelium to cervical precancer, and invasion. Although these fundamental steps are established, several new epidemiologic studies have shed light on the factors that influence each of these transitions. The importance of the transformation zone in cervical cancer has been extended to other HPV-induced cancers such as anal or tonsillar cancers. Natural history studies show that HPV with normal cervical cytology and cervical intraepithelial neoplasia (CIN) grade 1 behave similarly, with the majority of both showing regression. Although these studies have demonstrated the importance of HPV persistence in the development of precancer CIN-3, the timing from infection to evidence of CIN-3 varies from 1 to 10 years. Whether equivalent lesions diagnosed later differ in their natural history remains unknown. Several factors have been implicated in enhancing persistence and/or progression. However, none are consistently associated with both except age: young women are less likely to show persistence and older women with persistence are more likely to be at risk of invasive cancer. Recent studies have also underscored the importance of the host immune response in clearance of established infections. Finally, data on non-cervical HPV infections, such as penile infections are limited to date compared to cervical infections. Several ongoing cohort studies should give us further insight into male infections in the near future.
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Affiliation(s)
- Anna-Barbara Moscicki
- Department of Pediatrics, Division of Adolescent Medicine, University of California-San Francisco, 3333 California Avenue, San Francisco, CA, USA.
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