Taiwanese Journal of Obstetrics and Gynecology
Volume 44, Issue 3 , Pages 232-241, September 2005

Human Papillomavirus Vaccine for Cervical Cancer: Where Are We Now?

  • Wen-Fang Cheng

      Affiliations

    • Corresponding Author InformationCorrespondence to: Dr. Wen-Fang Cheng, Department of Obstetrics and Gynecology, National Taiwan University Hospital, 7 Chung-Shan South Road, Taipei, Taiwan

Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan

Received 28 July 2005; received in revised form 1 August 2005; accepted 4 August 2005.

Article Outline

Summary

Globally, cervical cancer is one of the most common cancers in women, representing up to 25% of all female cancers, and is the most common cancer in developing countries. It kills around 250,000 women every year worldwide and around 1,000 in Taiwan. Cervical cancer is largely preventable through screening programs to diagnose cervical lesions that may progress to invasive cancer. It has recently been definitively linked to genital human papillomavirus (HPV) infections. HPV fulfills the criteria for a carcinogenic agent defined by the International Agency for Research on Cancer. More than 200 types of HPV have been identified by DNA sequence data, and 85 HPV genotypes have been well characterized to date. HPV can infect the basal epithelial cells of the skin or inner tissue linings and is, accordingly, categorized as either cutaneous or mucosal. Genital HPV infections are now recognized as a major risk factor in at least 95% of cervical cancers. Thirty different HPV genotypes have been identified as causative of sexually transmitted diseases, most of which induce lesions in the cervix, vagina, vulva, penis, and anus. The main aim of this review is to evaluate the current literature regarding the relationship between HPV and cervical neoplasm, host immune responses to HPV, and the current status of preventive and therapeutic HPV vaccines.

Key Words:  cervical cancer , human papillomavirus , vaccine

No full text is available. To read the body of this article, please view the PDF online.

 

Back to Article Outline

References 

  1. Harro CD , Pang YY , Roden RB , et al.   Safety and immunogenicity trial in adult volunteers of a human papillomavirus 16 L1 virus-like particle vaccine . J Natl Cancer Inst . 2001;93:284–292
  2. 2004, W.H.R. Changing History. Statistical annex. World Health Organization, http://www.who.int/whr/2004/en/index.htm
  3. 2000 Cancer Registration Report. Department of Health, Executive Yuan, Taiwan.
  4. Miller AB , Sankaranarayanan R , Bosch FX , Sepulveda C . Can screening for cervical cancer be improved, especially in developing countries? . Int J Cancer . 2003;107:337–340
  5. IARC Monographs on the Evaluation of Carcinogenic Risks to Humans: Human Papillomaviruses, Volume 64 . Lyon: International Agency for Research on Cancer Press; 1995;
  6. Smith HO , Tiffany MF , Qualls CR , Key CR . The rising incidence of adenocarcinoma relative to squamous cell carcinoma of the uterine cervix in the United States-a 24-year population-based study . Gynecol Oncol . 2000;78:97–105
  7. Mohar A , Frias-Mendivil M . Epidemiology of cervical cancer . Cancer Invest . 2000;18:584–590
  8. Bosch FX , Manos MM , Munoz N , et al.   Prevalence of human papillomavirus in cervical cancer: a worldwide perspective. International biological study on cervical cancer (IBSCC) Study Group . J Natl Cancer Inst . 1995;87:796–802
  9. Wang PD , Lin RS . Epidemiology of cervical cancer in Taiwan . Gynecol Oncol . 1996;62:344–352
  10. Lai MY , Chou P . Effectiveness of screening for cervical cancer in Taiwan. A case-control study . Zhonghua Yi Xue Za Zhi (Taipei) . 1992;49:81–85 [In Chinese]
  11. Lin HH , Cheng WF , Chan KW , Chang DY , Chen CK , Huang SC . Risk factors for recurrence in patients with stage IB, IIA, and IIB cervical carcinoma after radical hysterectomy and postoperative pelvic irradiation . Obstet Gynecol . 1996;88:274–279
  12. Chen TM , Chen CA , Wu CC , Huang SC , Chang CF , Hsieh CY . The genotypes and prognostic significance of human papillomaviruses in cervical cancer . Int J Cancer . 1994;57:181–184
  13. Chang TC , Lai CH , Hong JH , et al.   Randomized trial of neoadjuvant cisplatin, vincristine, bleomycin, and radical hysterectomy versus radiation therapy for bulky stage IB and IIA cervical cancer . J Clin Oncol . 2000;18:1740–1747
  14. Rotkin ID . A comparison review of key epidemiological studies in cervical cancer related to current searches for transmissible agents . Cancer Res . 1973;33:1353–1367
  15. Bosch FX , Castellsague X , Munoz N , et al.   Male sexual behavior and human papillomavirus DNA: key risk factors for cervical cancer in Spain . J Natl Cancer Inst . 1996;88:1060–1067
  16. Bosch FX , de Sanjose S . Chapter 1: Human papillomavirus and cervical cancer-burden and assessment of causality . J Natl Cancer Inst Monogr . 2003;3–13
  17. Bosch FX , Lorincz A , Munoz N , Meijer CJ , Shah KV . The causal relation between human papillomavirus and cervical cancer . J Clin Pathol . 2002;55:244–265
  18. Koskela P , Anttila T , Bjorge T , et al.   Chlamydia trachomatis infection as a risk factor for invasive cervical cancer . Int J Cancer . 2000;85:35–39
  19. Torres Lobaton A , Rojo Herrera G , Torres Rojo A , Hurtado Estrada G , Roman Bassaure E . Cervical cancer. Current view of its epidemiology and risk factors . Ginecol Obstet Mex . 2004;72:466–474 [In Spanish]
  20. Moore MA , Tajima K . Cervical cancer in the Asia Pacific-epidemiology, screening and treatment . Asian Pac J Cancer Prev . 2004;5:349–361
  21. Doll R , Peto R . The causes of cancer: quantitative estimates of avoidable risks of cancer in the United States today . J Natl Cancer Inst . 1981;66:1191–1308
  22. Orth G , Jablonska S , Breitburd F , Favre M , Croissant O . The human papillomaviruses . Bull Cancer . 1978;65:151–164
  23. Wu TC . Immunology of the human papilloma virus in relation to cancer . Curr Opin Immunol . 1994;6:746–754
  24. Sedman SA, Barbosa MS, Vass WC, Hubbert NL, Haas JA, Lowy DR, et al. The full-length E6 protein of human papillomavirus type 16 has transforming and trans-activating activities and cooperates with E7 to immortalize keratinocytes in culture . J Virol . 1991;65:4860–4866
  25. von Knebel Doeberitz M , Oltersdorf T , Schwarz E , Gissmann L . Correlation of modified human papilloma virus early gene expression with altered growth properties in C4–1 cervical carcinoma cells . Cancer Res . 1988;48:3780–3786
  26. Halbert CL , Demers GW , Galloway DA . The E6 and E7 genes of human papillomavirus type 6 have weak immortalizing activity in human epithelial cells . J Virol . 1992;66:2125–2134
  27. Munger K , Howley PM . Human papillomavirus immortalization and transformation functions . Virus Res . 2002;89:213–228
  28. Halpert R , Fruchter RG , Sedlis A , Butt K , Boyce JG , Sillman FH . Human papillomavirus and lower genital neoplasia in renal transplant patients . Obstet Gynecol . 1986;68:251–258
  29. Schafer A , Friedmann W , Mielke M , Schwartlander B , Koch MA . The increased frequency of cervical dysplasia-neoplasia in women infected with the human immunodeficiency virus is related to the degree of immunosuppression . Am J Obstet Gynecol . 1991;164:593–599
  30. Laga M , Icenogle JP , Marsella R , et al.   Genital papillomavirus infection and cervical dysplasia-opportunistic complications of HIV infection . Int J Cancer . 1992;50:45–48
  31. Brandsma JL . Animal models for HPV vaccine development . Papillomavirus Report . 1994;5:105–111
  32. Selvakumar R , Schmitt A , Iftner T , Ahmed R , Wettstein FO . Regression of papillomas induced by cottontail rabbit papillomavirus is associated with infiltration of CD8+ cells and persistence of viral DNA after regression . J Virol . 1997;71:5540–5548
  33. Suzich JA , Ghim SJ , Palmer-Hill FJ , et al.   Systemic immunization with papillomavirus L1 protein completely prevents the development of viral mucosal papillomas . Proc Natl Acad Sci USA . 1995;92:11553–11557
  34. Tagami H , Aiba S , Rokugo M . Regression of flat warts and common warts . Clin Dermatol . 1985;3:170–178
  35. Benton C , Shahidullah H , Hunter JAA . Human papilloma-virus in the immunosuppressed . Papillomavirus Report . 1992;3:23–26
  36. Davies DH , Hill CM , Rothbard JB , Chain BM . Definition of murine T helper cell determinants in the major capsid protein of human papillomavirus type 16 . J Gen Virol . 1990;71:2691–2698
  37. Comerford SA , McCance DJ , Dougan G , Tite JP . Identification of T- and B-cell epitopes of the E7 protein of human papillomavirus type 16 . J Virol . 1991;65:4681–4690
  38. Tindle RW , Fernando GJ , Sterling JC , Frazer IH . A “public” T-helper epitope of the E7 transforming protein of human papillomavirus 16 provides cognate help for several E7 B-cell epitopes from cervical cancer-associated human papillomavirus genotypes . Proc Natl Acad Sci USA . 1991;88:5887–5891
  39. Steller MA , Gurski KJ , Murakami M , et al.   Cell-mediated immunological responses in cervical and vaginal cancer patients immunized with a lipidated epitope of human papillomavirus type 16 E7 . Clin Cancer Res . 1998;4:2103–2109
  40. Altmann A, Jochmus KI, Frank R, Gausepohl H, Moebius U, Gissmann L, et al. Definition of immunogenic determinants of the human papillomavirus type 16 nucleoprotein E7 . Eur J Cancer . 1992;28:326–333
  41. Kadish AS, Ho GYF, Burk RD, Wang Y, Romney SL, Ledwidge R, et al. Lymphoproliferative responses to human papillomavirus (HPV) type 16 proteins E6 and E7: outcome of HPV infection and associated neoplasia . J Natl Cancer Inst . 1997;89:1285–1293
  42. Stauss HJ , Davies H , Sadovnikova E , Chain B , Horowitz N , Sinclair C . Induction of cytotoxic T lymphocytes with peptides in vitro: identification of candidate T-cell epitopes in human papilloma virus . Proc Natl Acad Sci USA . 1992;89:7871–7875
  43. Feltkamp MC , Smits HL , Vierboom MP , et al.   Vaccination with cytotoxic T lymphocyte epitope-containing peptide protects against a tumor induced by human papillomavirus type 16-transformed cells . Eur J Immunol . 1993;23:2242–2249
  44. Sadovnikova E , Stauss HJ . T cell epitopes in human papilloma virus proteins . Behring Inst Mitt . 1994;87–93
  45. Gao L , Chain B , Sinclair C , et al.   Immune response to human papillomavirus type 16 E6 gene in a live vaccinia vector . J Gen Virol . 1994;75:157–164
  46. Bauer S , Heeg K , Wagner H , Lipford GB . Identification of H-2Kb binding and immunogenic peptides from human papilloma virus tumour antigens E6 and E7 . Scand J Immunol . 1995;42:317–323
  47. Kast WM , Brandt RM , Drijfhout JW , Melief CJ . Human leukocyte antigen-A2.1 restricted candidate cytotoxic T lymphocyte epitopes of human papillomavirus type 16 E6 and E7 proteins identified by using the processing-defective human cell line T2 . J Immunother . 1993;14:115–120
  48. Kast W , Brandt R , Sidney J , et al.   Role of HLA-A motifs in identification of potential CTL epitopes in human papilloma-virus type 16 E6 and E7 proteins . J Immunology . 1994;152:3904–3912
  49. Tarpey I, Stacey S, Hickling J, Birley H, Renton A, McIndoe A, et al. Human cytotoxic T lymphocytes stimulated by endogenously processed human papillomavirus type 11 E7 recognize a peptide containing a HLA-A2(A*0201) motif . Immunology . 1994;81:222–227
  50. Ressing ME , Sette A , Brandt RM , et al.   Human CTL epitopes encoded by human papillomavirus type 16 E6 and E7 identified through in vivo and in vitro immunogenicity studies of HLA-A*0201-binding peptides . J Immunol . 1995;154:5934–5943
  51. Borysiewicz LK , Fiander A , Nimako M , et al.   A recombinant vaccinia virus encoding human papillomavirus types 16 and 18, E6 and E7 proteins as immunotherapy for cervical cancer . Lancet . 1996;347:1523–1527
  52. Ressing ME , van Driel WJ , Celis E , et al.   Occasional memory cytotoxic T-cell responses of patients with human papilloma-virus type 16-positive cervical lesions against a human leukocyte antigen-A *0201-restricted E7-encoded epitope . Cancer Res . 1996;56:582–588
  53. Evans C , Bauer S , Grubert T , et al.   HLA-A2-restricted peripheral blood cytolytic T lymphocyte response to HPV type 16 proteins E6 and E7 from patients with neoplastic cervical lesions . Cancer Immunol Immunother . 1996;42:151–160
  54. Nakagawa M , Stites DP , Farhat S , et al.   Cytotoxic T lymphocyte responses to E6 and E7 proteins of human papillomavirus type 16: relationship to cervical intraepithelial neoplasia . J Infect Dis . 1997;175:927–931
  55. Evans EM , Man S , Evans AS , Borysiewicz LK . Infiltration of cervical cancer tissue with human papillomavirus-specific cytotoxic T-lymphocytes . Cancer Res . 1997;57:2943–2950
  56. Cubie HA , Norval M , Crawford L , Banks L , Crook T . Lymphoproliferative response to fusion proteins of human papillomaviruses in patients with cervical intraepithelial neoplasia . Epidemiol Infect . 1989;103:625–632
  57. Charleson FC , Norval M , Benton EC , Hunter JA . Lymphoproliferative responses to human papillomaviruses in patients with cutaneous warts . Br J Dermatol . 1992;127:551–559
  58. Strang G, Hickling JK, McIndoe GA, Howland K, Wilkinson D, Ikeda H, et al. Human T cell responses to human papillomavirus type 16 L1 and E6 synthetic peptides: identification of T cell determinants, HLA-DR restriction and virus type specificity . J Gen Virol . 1990;71:423–431
  59. Steele JC , Stankovic T , Gallimore PH . Production and characterization of human proliferative T-cell clones specific for human papillomavirus type 1 E4 protein . J Virol . 1993;67:2799–2806
  60. Kadish AS , Romney SL , Ledwidge R , et al.   Cell-mediated immune responses to E7 peptides of human papillomavirus (HPV) type 16 are dependent on the HPV type infecting the cervix whereas serological reactivity is not type-specific . J Gen Virol . 1994;75:2277–2284
  61. de Gruijl TD , Bontkes HJ , Stukart MJ , et al.   T cell proliferative responses against human papillomavirus type 16 E7 oncoprotein are most prominent in cervical intraepithelial neoplasia with a persistent viral infection . J Gen Virol . 1996;77:2183–2191
  62. Shepherd PS , Rowe AJ , Cridland JC , Coletart T , Wilson P , Luxton JC . Proliferative T cell responses to human papillomavirus type 16 L1 peptides in patients with cervical dysplasia . J Gen Virol . 1996;77:593–602
  63. Shepherd PS, Tran TT, Rowe AJ, Cridland JC, Comerford SA, Chapman MG, et al. T cell responses to the human papillomavirus type 16 E7 protein in mice of different haplotypes . J Gen Virol . 1992;73:1269–1274
  64. Golumbek PT, Lazenby AJ, Levitsky HI, Jaffee LM, Karasuyama H, Baker M, et al. Treatment of established renal cancer by tumor cells engineered to secrete interleukin-4 . Science . 1991;254:713–716
  65. Topalian SL, Rivoltini L, Mancini M, Markus NR, Robbins PF, Kawakami Y, et al. Human CD4+ T cells specifically recognize a shared melanoma-associated antigen encoded by the tyrosine gene . Proc Natl Acad Sci USA . 1994;91:9461–9465
  66. Topalian SL , Rivoltini L , Mancini M , Ng J , Hartzman RJ , Rosenberg SA . Melanoma-specific CD4+ T lymphocytes recognize human melanoma antigens processed and presented by Epstein-Barr virus-transformed B cells . Int J Cancer . 1994;58:69–79
  67. Ostrand-Rosenberg S , Thakur A , Clements V . Rejection of mouse sarcoma cells after transfection of MHC class II genes . J Immunol . 1990;144:4068–4071
  68. James RF , Edwards S , Hui KM , Bassett PD , Grosveld F . The effect of class II gene transfection on the tumorigenicity of the H-2K-negative mouse leukaemia cell line K36.16 . Immunology . 1991;72:213–218
  69. Chen PW , Ananthaswamy HN . Rejection of K1735 murine melanoma in syngeneic hosts requires expression of MHC class I antigens and either class II antigens or IL-2 . J Immunol . 1993;151:244–255
  70. Tew JG , Kosco MH , Burton GF , Szakal AK . Follicular dendritic cells as accessory cells . Immunol Rev . 1990;117:111–185
  71. Sprent J . T and B memory cells . Cell . 1994;76:315–322
  72. Kataja V , Syrjanen S , Yliskoski M , et al.   Risk factors associated with cervical human papillomavirus infections: a case-control study . Am J Epidemiol . 1993;138:735–745
  73. Feldman JG , Chirgwin K , Dehovitz JA , Minkoff H . The association of smoking and risk of condyloma acuminatum in women . Obstet Gynecol . 1997;89:346–350
  74. Sanda MG, Restifo NP, Walsh JC, Kawakami Y, Nelson WG, Pardoll DM, et al. Molecular characterization of defective antigen processing in human prostate cancer . J Natl Cancer Inst . 1995;87:280–285
  75. Vegh Z , Wang P , Vanky F , Klein E . Selectively down-regulated expression of major histocompatibility complex class I alleles in human solid tumors . Cancer Res . 1993;53:2416–2420
  76. Ryu KS , Lee YS , Kim BK , et al.   Alterations of HLA class I and II antigen expression in preinvasive, invasive and metastatic cervical cancers . Exp Mol Med . 2001;33:136–144
  77. Serrano A , Brady CS , Jimenez P , et al.   A mutation determining the loss of HLA-A2 antigen expression in a cervical carcinoma reveals novel splicing of human MHC class I classical transcripts in both tumoral and normal cells . Immunogenetics . 2000;51:1047–1052
  78. Koopman LA , Corver WE , van der Slik AR , Giphart MJ , Fleuren GJ . Multiple genetic alterations cause frequent and heterogeneous human histocompatibility leukocyte antigen class I loss in cervical cancer . J Exp Med . 2000;191:961–976
  79. Koopman LA , van Der Slik AR , Giphart MJ , Fleuren GJ . Human leukocyte antigen class I gene mutations in cervical cancer . J Natl Cancer Inst . 1999;91:1669–1677
  80. Connor ME , Stern PL . Loss of MHC class-I expression in cervical carcinomas . Int J Cancer . 1990;46:1029–1034
  81. Cromme FV , Airey J , Heemels MT , et al.   Loss of transporter protein, encoded by the TAP-1 gene, is highly correlated with loss of HLA expression in cervical carcinomas . J Exp Med . 1994;179:335–340
  82. Cromme F , Meijer C , Snijders P , et al.   Analysis of MHC Class I and II expression in relation to presence of HPV genotypes in premalignant and malignant cervical lesions . Br J Cancer . 1993;67:1372–1980
  83. Walboomers JM , Jacobs MV , Manos MM , et al.   Human papillomavirus is a necessary cause of invasive cervical cancer worldwide . J Pathol . 1999;189:12–19
  84. Winer RL , Lee SK , Hughes JP , Adam DE , Kiviat NB , Koutsky LA . Genital human papillomavirus infection: incidence and risk factors in a cohort of female university students . Am J Epidemiol . 2003;157:218–226
  85. Franco EL , Duarte-Franco E , Ferencz A . Cervical cancer: epidemiology, prevention and the role of human papillomavirus infection . CMAJ . 2001;164:1017–1025
  86. Franco EL , Harper DM . Vaccination against human papillomavirus infection: a new paradigm in cervical cancer control . Vaccine . 2005;23:2388–2394
  87. Munoz N , Bosch FX , de Sanjose S , et al.   Epidemiologic classification of human papillomavirus types associated with cervical cancer . N Engl J Med . 2003;348:518–527
  88. Zielinski GD , Snijders PJ , Rozendaal L , et al.   HPV presence precedes abnormal cytology in women developing cervical cancer and signals false negative smears . Br J Cancer . 2001;85:398–404
  89. Cheng WF , Hung CF , Chen CA , et al.   Characterization of DNA vaccines encoding the domains of calreticulin for their ability to elicit tumor-specific immunity and antiangiogenesis . Vaccine . 2005;23:3864–3874
  90. Cheng WF, Hung CF, Pai SI, Hsu KF, He L, Ling M, et al. Repeated DNA vaccinations elicited qualitatively different cytotoxic T lymphocytes and improved protective antitumor effects . J Biomed Sci . 2002;9:675–687
  91. Cheng WF, Hung CF, Chai CY, Hsu KF, He L, Ling M, et al. Tumor-specific immunity and antiangiogenesis generated by a DNA vaccine encoding calreticulin linked to a tumor antigen . J Clin Invest . 2001;108:669–678
  92. Munoz N . Human papillomavirus and cancer: the epidemiological evidence . J Clin Virol . 2000;19:1–5
  93. Goldie SJ , Grima D , Kohli M , Wright TC , Weinstein M , Franco E . A comprehensive natural history model of HPV infection and cervical cancer to estimate the clinical impact of a prophylactic HPV-16/18 vaccine . Int J Cancer . 2003;106:896–904
  94. Kang M , Lagakos SW . Evaluating the role of human papillomavirus vaccine in cervical cancer prevention . Stat Methods Med Res . 2004;13:139–155
  95. Muderspach L , Wilczynski S , Roman L , et al.   A phase I trial of a human papillomavirus (HPV) peptide vaccine for women with high-grade cervical and vulvar intraepithelial neoplasia who are HPV 16 positive . Clin Cancer Res . 2000;6:3406–3416
  96. Ault KA , Giuliano AR , Edwards RP , et al.   A phase I study to evaluate a human papillomavirus (HPV) type 18 L1 VLP vaccine . Vaccine . 2004;22:3004–3007
  97. Harper DM , Franco EL , Wheeler C , et al.   Efficacy of a bivalent L1 virus-like particle vaccine in prevention of infection with human papillomavirus types 16 and 18 in young women: a randomised controlled trial . Lancet . 2004;364:1757–1765
  98. Villa LL , Costa RL , Petta CA , et al.   Prophylactic quadrivalent human papillomavirus (types 6, 11, 16, and 18) L1 virus-like particle vaccine in young women: a randomised double-blind placebo-controlled multicentre phase II efficacy trial . Lancet Oncol . 2005;6:271–278
  99. Koutsky LA , Ault KA , Wheeler CM , et al.   A controlled trial of a human papillomavirus type 16 vaccine . N Engl J Med . 2002;347:1645–1651
  100. Evans TG , Bonnez W , Rose RC , et al.   A Phase 1 study of a recombinant virus-like particle vaccine against human papillomavirus type 11 in healthy adult volunteers . J Infect Dis . 2001;183:1485–1493
  101. Emeny RT , Wheeler CM , Jansen KU , et al.   Priming of human papillomavirus type 11-specific humoral and cellular immune responses in college-aged women with a virus-like particle vaccine . J Virol . 2002;76:7832–7842
  102. Pinto LA , Edwards J , Castle PE , et al.   Cellular immune responses to human papillomavirus (HPV)-16 L1 in healthy volunteers immunized with recombinant HPV-16 L1 virus-like particles . J Infect Dis . 2003;188:327–338
  103. Muller M , Zhou J , Reed TD , et al.   Chimeric papillomavirus-like particles . Virology . 1997;234:93–111
  104. Greenstone HL , Nieland JD , de Visser KE , et al.   Chimeric papillomavirus virus-like particles elicit antitumor immunity against the E7 oncoprotein in an HPV16 tumor model . Proc Natl Acad Sci USA . 1998;95:1800–1805
  105. Hines JF, Ghim SJ, Christensen ND, Kreider JW, Barnes WA, Schlegel R, et al. The expressed L1 proteins of HPV-1, HPV-6, and HPV-11 display type-specific epitopes with native conformation and reactivity with neutralizing and nonneutralizing antibodies . Pathobiology . 1994;62:165–171
  106. Christensen ND , Kreider JW , Cladel NM , Galloway DA . Immunological cross-reactivity to laboratory-produced HPV-11 virions of polysera raised against bacterially derived fusion proteins and synthetic peptides of HPV- 6b and HPV-16 capsid proteins . Virology . 1990;175:1–9
  107. Roden RB , Yutzy WH , Fallon R , Inglis S , Lowy DR , Schiller JT . Minor capsid protein of human genital papillomaviruses contains subdominant, cross-neutralizing epitopes . Virology . 2000;270:254–257
  108. Dupuy C , Buzoni-Gatel D , Touze A , Bout D , Coursaget P . Nasal immunization of mice with human papillomavirus type 16 (HPV-16) virus-like particles or with the HPV-16 L1 gene elicits specific cytotoxic T lymphocytes in vaginal draining lymph nodes . J Virol . 1999;73:9063–9071
  109. Liu Y, Chiriva-Internati M, Grizzi F, Salati E, Roman JJ, Lim S, et al. Rapid induction of cytotoxic T-cell response against cervical cancer cells by human papillomavirus type 16 E6 antigen gene delivery into human dendritic cells by an adeno-associated virus vector . Cancer Gene Ther . 2001;8:948–957
  110. Hung CF, Cheng WF, Chai CY, Hsu KF, He L, Ling M, et al. Improving vaccine potency through intercellular spreading and enhanced MHC class I presentation of antigen . J Immunol . 2001;166:5733–5740
  111. Hung CF, Cheng WF, He L, Ling M, Juang J, Lin CT, et al. Enhancing major histocompatibility complex class I antigen presentation by targeting antigen to centrosomes . Cancer Res . 2003;63:2393–2398
  112. Hung CF, Cheng WF, Hsu KF, Chai CY, He L, Ling M, et al. Cancer immunotherapy using a DNA vaccine encoding the translocation domain of a bacterial toxin linked to a tumor antigen . Cancer Res . 2001;61:3698–3703
  113. Hung CF, Hsu KF, Cheng WF, Chai CY, He L, Ling M, et al. Enhancement of DNA vaccine potency by linkage of antigen gene to a gene encoding the extracellular domain of Fms-like tyrosine kinase 3-ligand . Cancer Res . 2001;61:1080–1088
  114. Cheng WF , Hung CF , Lin KY , et al.   CD8+ T cells, NK cells and IFN-gamma are important for control of tumor with down-regulated MHC class I expression by DNA vaccination . Gene Ther . 2003;10:1311–1320
  115. de Jong A , O'Neill T , Khan AY , et al.   Enhancement of human papillomavirus (HPV) type 16 E6 and E7-specific T-cell immunity in healthy volunteers through vaccination with TA-CIN, an HPV16 L2E7E6 fusion protein vaccine . Vaccine . 2002;20:3456–3464
  116. Hallez S , Simon P , Maudoux F , et al.   Phase I/II trial of immunogenicity of a human papillomavirus (HPV) type 16 E7 protein-based vaccine in women with oncogenic HPV-positive cervical intraepithelial neoplasia . Cancer Immunol Immunother . 2004;53:642–650
  117. Ferrara A , Nonn M , Sehr P , et al.   Dendritic cell-based tumor vaccine for cervical cancer II: results of a clinical pilot study in 15 individual patients . J Cancer Res Clin Oncol . 2003;129:521–530
  118. Kawana K , Yasugi T , Kanda T , et al.   Safety and immunogenicity of a peptide containing the cross-neutralization epitope of HPV16 L2 administered nasally in healthy volunteers . Vaccine . 2003;21:4256–4260

PII: S1028-4559(09)60145-5

doi:10.1016/S1028-4559(09)60145-5

Taiwanese Journal of Obstetrics and Gynecology
Volume 44, Issue 3 , Pages 232-241, September 2005