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Téblick L, Lipovac M, Molenberghs F, Delputte P, De Vos WH, Vorsters A. HPV-specific antibodies in female genital tract secretions captured via first-void urine retain their neutralizing capacity. Hum Vaccin Immunother 2024; 20:2330168. [PMID: 38567541 PMCID: PMC10993920 DOI: 10.1080/21645515.2024.2330168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 03/11/2024] [Indexed: 04/04/2024] Open
Abstract
Human papillomavirus (HPV) vaccines, primarily relying on neutralizing antibodies, have proven highly effective. Recently, HPV-specific antibodies have been detected in the female genital tract secretions captured by first-void urine (FVU), offering a minimally invasive diagnostic approach. In this study, we investigated whether HPV16-specific antibodies present in FVU samples retain their neutralizing capacity by using pseudovirion-based neutralization assays. Paired FVU and serum samples (vaccinated n = 25, unvaccinated n = 25, aged 18-25) were analyzed using two orthogonal pseudovirion-based neutralization assays, one using fluorescence microscopy and the other using luminescence-based spectrophotometry. Results were compared with HPV16-specific IgG concentrations and correlations between neutralizing antibodies in FVU and serum were explored. The study demonstrated the presence of neutralizing antibodies in FVU using both pseudovirion-based neutralization assays, with the luminescence-based assay showing higher sensitivity for FVU samples, while the fluorescence microscopy-based assay exhibited better specificity for serum and overall higher reproducibility. High Spearman correlation values were calculated between HPV16-IgG and HPV16-neutralizing antibodies for both protocols (rs: 0.54-0.94, p < .001). Significant Spearman correlations between FVU and serum concentrations were also established for all assays (rs: 0.44-0.91, p < .01). This study demonstrates the continued neutralizing ability of antibodies captured with FVU, supporting the hypothesis that HPV vaccination may reduce autoinoculation and transmission risk to the sexual partner. Although further protocol optimizations are warranted, these findings provide a foundation for future research and larger cohort studies that could have implications for the optimal design, evaluation, and implementation of HPV vaccination programs.
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Affiliation(s)
- Laura Téblick
- Centre for the Evaluation of Vaccination, Vaccine & Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - Marijana Lipovac
- Centre for the Evaluation of Vaccination, Vaccine & Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - Freya Molenberghs
- Laboratory of Cell Biology and Histology, University of Antwerp, Antwerp, Belgium
| | - Peter Delputte
- Laboratory for Microbiology, Parasitology and Hygiene, University of Antwerp, Antwerp, Belgium
| | - Winnok H. De Vos
- Laboratory of Cell Biology and Histology, University of Antwerp, Antwerp, Belgium
- Antwerp Centre for Advanced Microscopy, University of Antwerp, Antwerp, Belgium
- µNEURO Centre of Research Excellence, University of Antwerp, Antwerp, Belgium
| | - Alex Vorsters
- Centre for the Evaluation of Vaccination, Vaccine & Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
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López-Codony V, de Andrés-Pablo Á, Ferrando-Díez A, Fernández-Montolí ME, López-Querol M, Tous S, Ortega-Expósito C, Torrejón-Becerra JC, Pérez Y, Ferrer-Artola A, Sole-Sedeno JM, Grau C, Rupérez B, Saumoy M, Sánchez M, Peremiquel-Trillas P, Bruni L, Alemany L, Bosch FX, Pavón MA. Assessing the reduction of viral infectivity in HPV16/18-positive women after one, two, and three doses of Gardasil-9 (RIFT): Study protocol. PLoS One 2024; 19:e0304080. [PMID: 38768231 PMCID: PMC11104652 DOI: 10.1371/journal.pone.0304080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 04/30/2024] [Indexed: 05/22/2024] Open
Abstract
Human Papillomavirus (HPV) prophylactic vaccination has proven effective in preventing new infections, but it does not treat existing HPV infections or associated diseases. Hence, there is still an important reservoir of HPV in adults, as vaccination programs are mainly focused on young women. The primary objective of this non-randomized, open-label trial is to evaluate if a 3-dose regimen of Gardasil-9 in HPV16/18-positive women could reduce the infective capacity of their body fluids. We aim to assess if vaccine-induced antibodies could neutralize virions present in the mucosa, thus preventing the release of infective particles and HPV transmission to sexual partners. As our main endpoint, the E1^E4-HaCaT model will be used to assess the infectivity rate of cervical, anal and oral samples, obtained from women before and after vaccination. HPV DNA positivity, virion production, seroconversion, and the presence of antibodies in the exudates, will be evaluated to attribute infectivity reduction to vaccination. Our study will recruit two different cohorts (RIFT-HPV1 and RIFT-HPV2) of non-vaccinated adult women. RIFT-HPV1 will include subjects with an HPV16/18 positive cervical test and no apparent cervical lesions or cervical lesions eligible for conservative treatment. RIFT-HPV2 will include subjects with an HPV16/18 positive anal test and no apparent anal lesions or anal lesions eligible for conservative treatment, as well as women with an HPV16/18 positive cervical test and HPV-associated vulvar lesions. Subjects complying with inclusion criteria for both cohorts will be recruited to the main cohort, RIFT-HPV1. Three doses of Gardasil-9 will be administered intramuscularly at visit 1 (0 months), visit 2 (2 months) and visit 3 (6 months). Even though prophylactic HPV vaccines would not eliminate a pre-existing infection, our results will determine if HPV vaccination could be considered as a new complementary strategy to prevent HPV-associated diseases by reducing viral spread. Trial registration: https://clinicaltrials.gov/ct2/show/NCT05334706.
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MESH Headings
- Humans
- Female
- Papillomavirus Infections/prevention & control
- Papillomavirus Infections/virology
- Papillomavirus Infections/immunology
- Human Papillomavirus Recombinant Vaccine Quadrivalent, Types 6, 11, 16, 18/administration & dosage
- Human Papillomavirus Recombinant Vaccine Quadrivalent, Types 6, 11, 16, 18/immunology
- Human papillomavirus 16/immunology
- Human papillomavirus 18/immunology
- Adult
- Young Adult
- Adolescent
- Antibodies, Viral/immunology
- Papillomavirus Vaccines/administration & dosage
- Papillomavirus Vaccines/immunology
- DNA, Viral
- Vaccination/methods
- Cervix Uteri/virology
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Affiliation(s)
- Victoria López-Codony
- Catalan Institute of Oncology, Bellvitge Biomedical Research Institute (IDIBELL), Cancer Epidemiology Research Programme, L’Hospitalet de Llobregat, Barcelona, Spain
- Programa de Doctorat en Biomedicina, Universitat de Barcelona (UB), Barcelona, Spain
| | - Álvaro de Andrés-Pablo
- Catalan Institute of Oncology, Bellvitge Biomedical Research Institute (IDIBELL), Cancer Epidemiology Research Programme, L’Hospitalet de Llobregat, Barcelona, Spain
- Programa de Doctorat en Biomedicina, Universitat de Barcelona (UB), Barcelona, Spain
| | - Angelica Ferrando-Díez
- Medical Oncology Department, Catalan Institute of Oncology, Germans Trias i Pujol University Hospital (HGTiP), Badalona, Barcelona, Spain
| | | | - Marta López-Querol
- Catalan Institute of Oncology, Bellvitge Biomedical Research Institute (IDIBELL), Cancer Epidemiology Research Programme, L’Hospitalet de Llobregat, Barcelona, Spain
| | - Sara Tous
- Catalan Institute of Oncology, Bellvitge Biomedical Research Institute (IDIBELL), Cancer Epidemiology Research Programme, L’Hospitalet de Llobregat, Barcelona, Spain
- Biomedical Research Networking Center for Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Carlos Ortega-Expósito
- Department of Gynaecology, Bellvitge University Hospital (HUB), L’Hospitalet de Llobregat, Barcelona, Spain
| | | | - Yolanda Pérez
- Department of Gynaecology, Bellvitge University Hospital (HUB), L’Hospitalet de Llobregat, Barcelona, Spain
| | - Anna Ferrer-Artola
- Bellvitge Biomedical Research Institute (IDIBELL), Pharmacy Unit, Bellvitge University Hospital (HUB), L’Hospitalet de Llobregat, Barcelona, Spain
| | - Josep Maria Sole-Sedeno
- Department of Obstetrics and Gynaecology, Hospital del Mar–Mar Health Park, Barcelona, Spain
| | - Clara Grau
- Sexual and Reproductive Health Care Center–ASSIR, Delta del Llobregat, Barcelona, Spain
| | - Blas Rupérez
- Sexual and Reproductive Health Care Center–ASSIR, Delta del Llobregat, Barcelona, Spain
| | - Maria Saumoy
- HIV and STD Unit, Bellvitge University Hospital (HUB), Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, Barcelona, Spain
| | - Mónica Sánchez
- HIV and STD Unit, Bellvitge University Hospital (HUB), Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, Barcelona, Spain
| | - Paula Peremiquel-Trillas
- Catalan Institute of Oncology, Bellvitge Biomedical Research Institute (IDIBELL), Cancer Epidemiology Research Programme, L’Hospitalet de Llobregat, Barcelona, Spain
- Programa de Doctorat en Biomedicina, Universitat de Barcelona (UB), Barcelona, Spain
- Biomedical Research Networking Center for Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Laia Bruni
- Catalan Institute of Oncology, Bellvitge Biomedical Research Institute (IDIBELL), Cancer Epidemiology Research Programme, L’Hospitalet de Llobregat, Barcelona, Spain
- Biomedical Research Networking Center for Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Laia Alemany
- Catalan Institute of Oncology, Bellvitge Biomedical Research Institute (IDIBELL), Cancer Epidemiology Research Programme, L’Hospitalet de Llobregat, Barcelona, Spain
- Biomedical Research Networking Center for Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Francesc Xavier Bosch
- Catalan Institute of Oncology, Bellvitge Biomedical Research Institute (IDIBELL), Cancer Epidemiology Research Programme, L’Hospitalet de Llobregat, Barcelona, Spain
- Biomedical Research Networking Center for Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Faculty of Health Sciences, Open University of Catalonia (UOC), Barcelona, Spain
| | - Miquel Angel Pavón
- Catalan Institute of Oncology, Bellvitge Biomedical Research Institute (IDIBELL), Cancer Epidemiology Research Programme, L’Hospitalet de Llobregat, Barcelona, Spain
- Biomedical Research Networking Center for Epidemiology and Public Health (CIBERESP), Madrid, Spain
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Waheed DEN, Burdier FR, Eklund C, Baussano I, Mariz FC, Téblick L, Mugo N, Watson-Jones D, Stanley M, Baay M, Vorsters A. An update on one-dose HPV vaccine studies, immunobridging and humoral immune responses - A meeting report. Prev Med Rep 2023; 35:102368. [PMID: 37680853 PMCID: PMC10480621 DOI: 10.1016/j.pmedr.2023.102368] [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: 04/21/2023] [Revised: 08/09/2023] [Accepted: 08/13/2023] [Indexed: 09/09/2023] Open
Abstract
The 12th HPV Prevention and Control meeting was held on June 2-3, 2022, in Antwerp, Belgium. This technical meeting focused on several topics. This report summarises the discussions and lessons learned on two topics: an update on one-dose HPV vaccination studies and humoral immune responses upon HPV vaccination. Long-term follow-up studies from Costa Rica (eleven years) and India (ten years) report stable levels of antibodies after a single HPV vaccination. High vaccine effectiveness against incident persistent HPV 16/18 infection was seen in India (95.4%, 85.0-99.9) ten years postvaccination and in Kenya (97.5%, 81.7-99.7) eighteen months postvaccination, an important observation in a setting with a higher HPV prevalence. The potential impact of HPV vaccination using a one-dose schedule in India was modelled and showed that implementation of one-dose schedule can contribute towards achieving WHO Cervical Cancer elimination goals. These data support the WHO SAGE recommendations for adopting a one-dose schedule for females aged 9-20 years. Immunobridging studies were discussed during the meeting. General agreement was reached that when thoughtfully applied, they can support and accelerate the expanded use of HPV vaccine with new vaccine schedules, age cohorts, or vaccine formulations. Internationally standardised measurements of HPV immune responses important for the progress of HPV vaccinology field. Humoral immune responses upon HPV vaccination plateau at 24 months regardless of number of doses, therefore, data should be analysed after at least 24 months of follow-up to bridge studies accurately.
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Affiliation(s)
- Dur-e-Nayab Waheed
- Centre for Evaluation of Vaccination, Vaccine and Infectious Disease Institute, University of Antwerp, Belgium
| | - F. Ricardo Burdier
- Centre for Evaluation of Vaccination, Vaccine and Infectious Disease Institute, University of Antwerp, Belgium
| | - Carina Eklund
- Karolinska Institutet, Department of Laboratory Medicine, Huddinge, Sweden
| | - Iacopo Baussano
- International Agency for Research on Cancer, Early Detection, Prevention and Infections Branch Lyon, France
| | - Filipe Colaço Mariz
- German Cancer Research Center, DKFZ, Tumorvirus-Specific Vaccination Strategies, Heidelberg, Germany
| | - Laura Téblick
- Centre for Evaluation of Vaccination, Vaccine and Infectious Disease Institute, University of Antwerp, Belgium
| | - Nelly Mugo
- Kenya Medical Research Institute, Nairobi, Kenya
| | - Deborah Watson-Jones
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Margaret Stanley
- Department of Pathology, University of Cambridge, Cambridge, United Kingdom
| | - Marc Baay
- P95 Epidemiology & Pharmacovigilance, Leuven, Belgium
| | - Alex Vorsters
- Centre for Evaluation of Vaccination, Vaccine and Infectious Disease Institute, University of Antwerp, Belgium
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Poljak M, Cuschieri K, Alemany L, Vorsters A. Testing for Human Papillomaviruses in Urine, Blood, and Oral Specimens: an Update for the Laboratory. J Clin Microbiol 2023; 61:e0140322. [PMID: 37439692 PMCID: PMC10446865 DOI: 10.1128/jcm.01403-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/14/2023] Open
Abstract
Twelve high-risk alpha human papillomavirus (HPV) genotypes cause approximately 690,000 cancer cases annually, with cervical and oropharyngeal cancer being the two most prominent types. HPV testing is performed in laboratory settings for various applications of a clinical, epidemiological, and research nature using a range of clinical specimens collected by clinicians or by individuals (self-collected specimens). Here, we reflect on the importance and justification of using the right test for the right application and provide practical updates for laboratories either participating in or anticipating involvement in HPV testing in three specimen types, namely, urine, blood, and oral specimens, which are considered "alternative" specimens by many. In addition to clinician-collected cervical samples and self-collected cervicovaginal samples, first-void urine is emerging as a credible specimen for HPV-based cervical cancer screening, triage of HPV screen-positive women, monitoring HPV vaccine impact, and HPV testing in groups for which a less invasive sample is preferred. Detection of cell-free DNA (including HPV DNA) in blood has great promise for the early detection of HPV-attributable oropharyngeal cancer (HPV-AOC) and potentially other HPV-driven cancers and as an adjunct prognostic marker in long-term tumor surveillance, including treatment response. The moderate sensitivity of HPV testing in oral rinses or swabs at HPV-AOC diagnosis prevents its use in HPV-AOC secondary prevention but represents a promising prognostic tool in HPV-AOC tertiary prevention, where the HPV persistence in oral rinses throughout treatment may predict early HPV-AOC recurrences and/or the development of secondary HPV-AOC. The increasing sophistication of specific collection devices designed for alternative samples and the enhanced precision of novel molecular technologies are likely to support the evolution of this field and catalyze potential translation into routine practice.
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Affiliation(s)
- Mario Poljak
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Kate Cuschieri
- Scottish HPV Reference Laboratory, Royal Infirmary of Edinburgh, Edinburgh, Scotland, United Kingdom
| | - Laia Alemany
- Cancer Epidemiology Research Program, Catalan Institute of Oncology, L’Hospitalet de Llobregat, Barcelona, Spain
- Centro de Investigación Biomédica en Red: Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Alex Vorsters
- Centre for Evaluation of Vaccination, Vaccine & Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
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Lamsisi M, Li G, Chauleur C, Ennaji MM, Bourlet T. The potential of urine for human papillomavirus-related cervical cancer prevention. Future Virol 2022. [DOI: 10.2217/fvl-2021-0246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Cervical cancer is one of the most preventable cancers. The introduction of human papillomavirus (HPV) vaccines and the adaptation of regular screening programs are key actions that need to be generalized globally to achieve the goal of cervical cancer elimination. However, it is still challenging to achieve satisfactory coverage rate, and many women are reluctant to participate in gynecologic examination. In this article, we review the research on the application of HPV detection in urine samples for cervical cancer screening and vaccine monitoring, as well as discuss the technical challenges and new technological advancements in urine-based tests. HPV detection in urine is an excellent noninvasive alternative that is widely accepted by women, relatively affordable, and provides the potential to reach women without the necessity for clinical visits. Thus, it is an attractive tool for both cervical cancer screening and vaccine monitoring.
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Affiliation(s)
- Maryame Lamsisi
- Team of Virology, Oncology & Medical Biotechnologies, Laboratory of Virology, Microbiology, Quality, & Biotechnologies/ETB, Faculty of Science & Techniques Mohammedia, Hassan II University of Casablanca, 20650, Mohammedia, Morocco
| | - Guorong Li
- Department of Urology/Biology Pathology Lab, North Hospital, CHU Saint-Etienne, 42000, Saint Etienne, France
| | - Celine Chauleur
- Deparment of Gynecology & Obstetrics, North Hospital, CHU Saint-Etienne, 42000, Saint Etienne, France
| | - Moulay Mustapha Ennaji
- Team of Virology, Oncology & Medical Biotechnologies, Laboratory of Virology, Microbiology, Quality, & Biotechnologies/ETB, Faculty of Science & Techniques Mohammedia, Hassan II University of Casablanca, 20650, Mohammedia, Morocco
| | - Thomas Bourlet
- Department of Infectious Agents and Hygiene, University Hospital of Saint-Etienne, 42000, Saint Etienne, France
- Centre International de Recherche en Infectiologie, GIMAP Team 15, Inserm, U1111, CNRS, UMR5308, University of Saint-Etienne, University of Lyon, 42000, Saint Etienne, France
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Urine HPV in the Context of Genital and Cervical Cancer Screening-An Update of Current Literature. Cancers (Basel) 2021; 13:cancers13071640. [PMID: 33915878 PMCID: PMC8036396 DOI: 10.3390/cancers13071640] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 03/14/2021] [Accepted: 03/29/2021] [Indexed: 02/07/2023] Open
Abstract
Simple Summary Despite the substantial scientific evolution in cervical cancer prevention and related infrastructures, a plethora of women still miss the opportunity to detect their precancerous lesions at a curable stage by not participating in existing screening programs. Implementing sensitive screening modalities combined with easy sampling methods with minimal pain or discomfort such as self-sampling of vaginal and urine samples is increasingly applied. Self-sampling HPV modalities aimed to address this inequity, besides facilitating HPV genotyping as well as the measurement of related biomarkers in HPV-caused lesions and genital cancer. The low costs inflicted, the non-invasive nature, and the favorable acceptability profile of urine HPV detection give the potential to become a most promising tool that could expand the possibilities in changing genital and cervical cancer prevention strategies as well as in the surveillance and management of genital precancer. Abstract Within the previous decades, following the widespread implementation of HPV-related biomarkers and computerization in liquid-based cytology, screening for lower genital tract malignancies has been optimized in several parts of the world. Many organized anogenital cancer prevention systems have reached a point at which efficacy is more a matter of population coverage and less of available infrastructures. Meanwhile, self-sampling modalities in which biologic material (vaginal secretions, urine, etc.) is obtained by the individual and not the clinician and subsequently undergoes examination for HPV biomarkers enjoy appreciating acceptance. Bygone the initial skepticism that vaginal or urine HPV represents “passenger” transient infections, extensive scientific work has been conducted to optimize high-risk HPV (hrHPV) detection from this “novel” biologic material. Nowadays, several state-of-the-art meta-analyses have illustrated that self-sampling techniques involving urine self-sampling represent a feasible alternative strategy with potentially enhanced population coverage possessing excellent performance and sensitivity. Recently published scientific work focusing on urine HPV was reviewed, and after a critical appraisal, the following points should be considered in the clinical application of hrHPV urine measurements; (i) use of first-void urine (FVU) and purpose-designed collection devices; (ii) using a preservation medium to avoid human/HPV DNA degradation during extraction and storage; (iii) using polymerase chain reaction (PCR) based assays, ideally with genotyping capabilities; (iv) processing of a sufficient volume of whole urine; and (v) the use of an analytically sensitive HPV test/recovery of cell-free HPV DNA in addition to cell-associated DNA.
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