臨床婦人科産科78巻1号

2024年01月発行

合併増大号　今月の臨床 産婦人科医のための感染症最新レクチャー

各論 : 腫瘍学

CIN治療薬としてのHPV治療ワクチンと免疫療法

著者： 川名敬¹

所属機関： ¹日本大学医学部産婦人科学系産婦人科学分野

ページ範囲：P.148 - P.154

文献概要

●ヒトパピローマウイルス（HPV）ワクチンには治療効果はなく，既感染者や有病者には無効である．

●子宮頸がんとその前がん病変は，HPVに対する免疫療法が期待される．

●HPV治療ワクチン（IGMKK16E7）経口投与でHPV16型によるCIN2〜3の40％が正常化した．

参考文献

1）Bruni L, et al : Global estimates of human papillomavirus vaccination coverage by region and income level : a pooled analysis. Lancet Glob Health 4 : e453-e463, 2016

2）Kyrgiou M, et al : Obstetric outcomes after conservative treatment for intraepithelial or early invasive cervical lesions : systematic review and meta-analysis. Lancet 367 : 489-498, 2006

3）Trimble CL, et al : Safety, efficacy, and immunogenicity of VGX-3100, a therapeutic synthetic DNA vaccine targeting human papillomavirus 16 and 18 E6 and E7 proteins for cervical intraepithelial neoplasia 2/3 : a randomised, double-blind, placebo-controlled phase 2b trial. Lancet 386 : 2078-2088, 2015

4）Kojima S, et al : Characterization of gut-derived intraepithelial lymphocyte（IEL）residing in human papillomavirus（HPV）-infected intraepithelial neoplastic lesions. Am J Reprod Immunol 66 : 435-443, 2011

5）Adachi K, et al : Oral immunization with Lactobacillus casei vaccine expressing human papillomavirus（HPV）type 16 E7 is an effective strategy to induce mucosal cytotoxic lymphocyte against HPV16 E7. Vaccine 28 : 2810-2817, 2010

6）Kawana K, et al : Oral vaccination against HPV E7 for treatment of cervical intraepithelial neoplasia grade 3（CIN3）elicits E7-specific mucosal immunity in the cervix of CIN3 patients. Vaccine 32 : 6233-6239, 2014

7）Ikeda Y, et al : A placebo-controlled, double-blind randomized（Phase IIB）trial of oral administration with HPV16 E7-expressing Lactobacillus, GLBL101c, for the treatment of cervical intraepithelial neoplasia grade 2（CIN2）. Vaccines（Basel）9 : 329, 2021

8）Komatsu A, et al : Optimization of human papillomavirus（HPV）type 16 E7-expressing lactobacillus-based vaccine for induction of mucosal E7-specific IFNγ-producing cells. Vaccine 36 : 3423-3426, 2018

9）Ikeda Y, et al : Safety and efficacy of mucosal immunotherapy using human papillomavirus（HPV） type 16 E7-expressing Lactobacillus-based vaccine for the treatment of high-grade squamous intraepithelial lesion（HSIL） : the study protocol of a randomized placebo-controlled clinical trial（MILACLE study）. Jap J Clin Oncol 49 : 877-880, 2019