Vaccines for HPV-associated diseases

• Published in: Molecular aspects of medicine Vol. 94; p. 101224
• Main Authors: Skolnik, Jeffrey M., Morrow, Matthew P.
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.12.2023
• Subjects: Adolescent; Cervical cancer; DNA vaccine; Female; Human papillomavirus; Human Papillomavirus Viruses; Humans; Immune response; Male; Papillomavirus Infections - complications; Papillomavirus Infections - prevention & control; Papillomavirus Vaccines - therapeutic use; Squamous intraepithelial lesion; Therapeutic vaccine; Uterine Cervical Neoplasms - complications; Uterine Cervical Neoplasms - prevention & control; Vaccines, DNA; DNA vaccine; Squamous intraepithelial lesion; Human papillomavirus; Immune response; Therapeutic vaccine; Cervical cancer
• ISSN: 0098-2997; 1872-9452
• DOI: 10.1016/j.mam.2023.101224

Human papillomavirus (HPV) infection represents a significant global health concern owing to its role in the etiology of conditions ranging from benign low-grade lesions to cancers of the cervix, head and neck, anus, vagina, vulva, and penis. Prophylactic vaccination programs, primarily targeting adolescent girls, have achieved dramatic reductions in rates of HPV infection and cervical cancer in recent years. However, there is a clear demand for a strategy to manage the needs of the many people who are already living with persistent HPV infection and/or HPV-associated conditions. Unlike prophylactic vaccines, which act to prevent HPV infection, therapeutic vaccination presents an opportunity to induce cellular immunity against established HPV infections and lesions and prevent progression to cancer. Several HPV vaccines are undergoing clinical development, using a range of platforms. Peptide- or protein-based vaccines, vector-based vaccines, whole-cell vaccines, and nucleic acid vaccines each offer relative merits and limitations for the delivery of HPV antigens and the subsequent generation of targeted immune responses. There has been particular interest in DNA-based vaccines, which elicit both cellular and humoral immune responses to provide long-lasting immunity. DNA vaccines offer several practical advantages over other vaccine platforms, including the potential for rapid and scalable manufacturing, targeting of many different antigens, and potential for repeat boosting. Furthermore, unlike vectored approaches, DNA vaccines are thermostable over extended time periods, which may enable shipping and storage. Several delivery strategies are available to address the main challenge of DNA vaccines, namely their relatively low transfection efficiency. We review the latest clinical data supporting the development of DNA vaccines and reflect on this exciting prospect in the management of HPV-related disease. •HPV-associated diseases present a significant ongoing global health concern.•Prophylactic vaccines cannot eliminate pre-existing HPV infections.•Therapeutic vaccines stimulate immune responses against established infections.•Therapeutic DNA vaccines represent an innovative approach to eliminating infection.•Several DNA vaccines against HPV-associated disorders are in clinical development.