Möglichkeiten der Vakzinierung gegen HPV-Infektionen beim Zervixkarzinom

Zusammenfassung

Aufgrund epidemiologisch/klinischer Beobachtungen und tierexperimenteller Befunde ist zu erwarten, dass eine HPV-spezifische Immunisierung zur Verhinderung des Zervixkarzinoms sowohl als Immunprophylaxe durch Induktion neutralisierender Antikörper als auch als therapeutische Immunisierung (Induktion zytotoxischer T-Zellen bei Frauen mit CIN) denkbar ist. Eine Immuntherapie von bereits bestehenden Karzinomen ist wahrscheinlich nur als adjuvante Maßnahme möglich. Als prophylaktische Impfstoffe werden virus-like particles (VLP) entwickelt, die sich durch Expression des L1 Proteins in rekombinanten Systemen herstellen lassen. Zur Immuntherapie kommen in erster Linie die viralen Onkoproteine E6 und E7 in Frage, die entweder in gereinigter Form oder mit Hilfe rekombinanter Vektoren (z. B. Vakzinia Virus) appliziert werden. Erste klinische Studien mit den häufigsten beim Zervixkarzinom gefundenen HPV-Typen (HPV 16 und 18) zeigen vielversprechende Ergebnisse, wenn auch bereits heute Impfstoffe der nächsten Generation entwickelt werden.

Immunization against HPV-infection in the prevention of cervical cancer

Summary

According to epidemiologic and clinical observations as well as from animal experiments it is expected that prevention of cervical cancer based upon an HPV-specific immunization can be achieved by prophylactic vaccination (induction of neutralizing antibodies) or by immune therapy (induction of cytotoxic T cells in women with CIN). Immune therapy of already existing tumors is most likely only possible as an adjuvant treatment. Virus-like particles (VLP) are currently being developed as prophylactic vaccine that can be obtained by expression of the L1 protein. The viral oncoproteins E6 and E7 are prime candidates for therapeutic vaccines administered either as purified molecules or carried by recombinant vectors such as vaccinia virus. Initial clinical trials with the HPV types which are most prevalent in cervical cancer exhibited promising results, yet next generation vaccines are already under development.

Schlüsselwörter

Humapathogene Papillomviren (HPV) - Prophylaxe - Immuntherapie - virus-like particles (VLP) - klinische Studien

Key words

Human papillomaviruses (HPV) - prophylaxis - immune therapy - virus-like particles (VLP) - clinical trials

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