Licensed Human Papillomavirus (HPV) vaccines are comprised of Virus-like Particles (VLP) assembled from the major capsid protein L1 and provide type-restricted protection against the incorporated vaccine types. However, they do not target cutaneous HPV types causing common, palmo-plantar and plane skin warts, which are a frequent nuisance in children and immunosuppressed individuals. Although benign, cutaneous warts can be painful, aesthetically unpleasant, recalcitrant to treatment and are a common cause of medical consultations burdening health care systems. Timely vaccination targeting cutaneous HPV types might greatly reduce incidence of cutaneous warts. HPV1 and HPV63 are closely related cutaneous types frequently found in plantar warts. Previous attempts to generate self-assembled HPV1 and HPV63 VLP as vaccine antigens by expressing L1 have been unsuccessful, contrary to many other cutaneous types.As an alternative strategy, the highly conserved N-terminus of minor capsid protein L2 can induce (cross-)neutralizing antisera that protect against experimental challenge. Thus, VLP assembled from HPV16 L1 (16 L1) were utilized as scaffold to repetitively present a L2 cross-neutralization epitope (‘RG1’) of HPV1 or HPV63 on 16 L1 VLP surface loops. Both chimeric 16 L1-1RG1 and 16 L1-63RG1 fusion proteins assembled into VLP. Immunizations of mice induced a functional antibody response, reacting with and (cross-)neutralizing both HPV1 and HPV63 by ELISA and Pseudovirion (PsV) neutralization assays, respectively. Immune sera also neutralized HPV16 PsV, indicating retained ability of chimeric 16 L1 VLP to induce a functional L1-mediated response despite epitope insertion. Immune sera also sterilized native HPV1 virions isolated from children's foot warts, preventing infection of keratinocytes in vitro. In an in vivo challenge model, immune sera to 16 L1-1RG1 protected mice against HPV1 hybrid PsV challenge, while sera to 16 L1-63RG1 conferred partial protection.In conclusion, chimeric VLP appear as promising vaccine candidates to target prevalent cutaneous HPV1, and possibly HPV63, with the potential to reduce the burden of HPV-induced skin warts.

Evidence on the contribution of human papillomaviruses (HPVs) to the development of esophageal papillomas is still controversial. Esophageal papillomatosis (EP) is considered an exceedingly rare, but distinct entity within esophageal proliferations, with about 57 cases published so far. Tissues derived from an EP case and from non-EP esophageal papillomas were investigated for the presence of HPVs and virus-positive specimens were subsequently analyzed for transcriptional activity and surrogate markers of infection. Low-risk type HPV6 DNA was detected in a subset of the esophageal papillomatous tissues, including EP, and a variant isolate belonging to lineage A. In the EP tissue, the abundant expression of the viral E6/E7 mRNA and the presence of HPV6-specific E1^E4 transcripts, the latter indicative of productive viral infection, were detected. An analysis of HPV-specific neutralizing antibodies in sera obtained from the EP case during natural infection as well as after HPV vaccination revealed that, despite extensive manifestation, HPV6-specific antibodies were absent during natural infection and only elicited after repeated HPV immunizations. Although limited by a small sample size, this exploratory study suggests a possible involvement of HPV6 in the development of EP. Furthermore, this study may contribute to the evidence distinguishing EP from less extensive forms of non-EP esophageal squamous papillomas.

Background Human papillomaviruses (HPVs) have been implicated in the development of papillomatous proliferations in the esophagus. In 2013, the HPV detection rate in esophageal squamous papillomas (ESPs) was estimated at 30.9%. However, the current prevalence of ESPs and the contemporary HPV-positivity rate remain unclear. Esophageal papillomatosis was proposed as an exceedingly rare entity, distinct from ESPs. Methods This study includes three novel cases with extensive esophageal proliferations, including one case with esophageal papillomatosis, and an updated scoping review of ESP and esophageal papillomatosis cases reported between 2013 and 2025. The main objective was to synthesize the available evidence on potential associations between esophageal papillomatous proliferations, HPV infection and malignant transformation. Results A total of 911 patients with ESP and esophageal papillomatosis were identified, comprising 869 adults and 42 children. The overall HPV detection rate was 11.7%, lower than reported previously. HPV-positivity was lowest in solitary ESPs (6.9%), higher in multiple ESPs (14.8%), and highest in extensive esophageal papillomatosis (21.4%). Dysplastic and malignant features were observed in 0.8% and 1.4% of the solitary and multiple ESPs, respectively, and were most frequent in esophageal papillomatosis (25.9%). A significant association was found between HPV-positivity and dysplasia or malignancy (p=0.001963). Conclusions HPV-positivity appears to increase with the extent of papillomatous disease and is highest in esophageal papillomatosis. Although rare, HPV-associated esophageal dysplasia and malignancy may occur, particularly in esophageal papillomatosis. In cases with confirmed HPV infection and extensive disease, timely intervention - e.g., by endoscopic mucosal resection - may represent a pro-active, therapeutic strategy.

Licensed human papillomavirus (HPV) vaccines do not target cutaneous ßHPV types implicated in skin cancer development in immunosuppressed individuals. The conserved N-terminus of minor capsid protein L2 contains cross-neutralization epitopes, offering the opportunity to develop broad-spectrum vaccine candidates. A sequential immunization strategy using N-terminal L2 fragments of five ßHPVs induced type-common humoral immunity. Four monoclonal antibodies (mAb) were generated that cross-neutralized multiple ßHPV types and conferred in vivo protection against potentially oncogenic HPV5/38/24. MAb epitopes were inserted individually into the DE-surface loop of HPV16 L1 virus-like particles (VLP). Immunizations with chimeric VLPs induced cross-neutralizing antibodies against multiple ßHPV types and conferred in vivo protection against HPV5 infection. Chimeric VLPs displaying ßHPV-L2 cross-neutralizing epitopes are promising broad-spectrum vaccine candidates against the plethora of ßHPVs. Immunization of patients prior to immunosuppression may reduce the burden of ßHPV infection and thus lower their highly increased risk to develop keratinocytic skin cancer.

Secondary lymphoid organs (SLOs) provide the confined microenvironment required for stromal cells to interact with immune cells to initiate adaptive immune responses resulting in B cell differentiation. Here, we studied three patients from two families with functional hyposplenism, absence of tonsils, and complete lymph node aplasia, leading to recurrent bacterial and viral infections. We identified biallelic loss-of-function mutations in LTBR, encoding the lymphotoxin beta receptor (LTβR), primarily expressed on stromal cells. Patients with LTβR deficiency had hypogammaglobulinemia, diminished memory B cells, regulatory and follicular T helper cells, and dysregulated expression of several tumor necrosis factor family members. B cell differentiation in an ex vivo coculture system was intact, implying that the observed B cell defects were not intrinsic in nature and instead resulted from LTβR-dependent stromal cell interaction signaling critical for SLO formation. Collectively, we define a human inborn error of immunity caused primarily by a stromal defect affecting the development and function of SLOs.

Our study illustrates a predisposition to cancer upon cutaneous β genus human papillomavirus (HPV) infection as part of human polymerase-δ deficiency. In addition, polymerase-δ deficiency infers susceptibility to the development of large cutaneous warts and progression to squamous cell carcinoma associated with HPV63, which usually causes benign papillomas. Our findings warrant close monitoring for viral skin oncogenesis in individuals with syndromic polymerase-δ deficiency.

Experimental autoimmune encephalomyelitis (EAE) is a T cell-mediated inflammatory demyelinating disorder of the central nervous system (CNS) which serves as a prime animal model for the human disease multiple sclerosis. Previous studies from these laboratories demonstrated excess nitric oxide (NO) in the CNS of EAE-affected mice, and amelioration of EAE with a selective inhibitor of the inducible nitric oxide synthase (iNOS). Recent studies from other laboratories have indicated that prostaglandin PGE2 is increased in CNS tissues of EAE-affected rodents and that EAE is prevented by the inhibition of cyclooxygenase activity. The present study investigated the ability of encephalitogenic lymphoid cells to induce NOS and cyclooxygenase (COX-2) in the murine macrophage line, RAW 264.7. In order to mimic the extracellular milieu present in EAE lesions, conditioned medium (CM) of activated EAE-inducer cells was added to this macrophage line. CM caused a time-dependent increase in nitrite, indicating NO production. Reverse-transcriptase PCR demonstrated iNOS mRNA in RAW 264.7 cells, first detected at 3 h, and Western blots confirmed the induction in RAW cells of the 130-kDa iNOS protein. Production of nitrite by CM-exposed RAW 264.7 cells was blocked by inhibitors of NOS (L-N-methylarginine or aminoguanidine) or by antibodies to murine IFN-gamma or IL-1 beta. CM of activated encephalitogenic cells induced production of PGE2 by RAW 264.7 cells, as determined by ELISA, and Western blots identified the presence of the 70-80-kDa inducible COX (COX-2) protein. Induction of COX-2 could be inhibited by antibody to IFN-gamma. Thus, encephalitogenic cells are capable of inducing the expression of the inflammatory enzymes iNOS and COX-2 in a murine macrophage line via the T cell cytokine IFN-gamma, alone or in combination with IL-1 beta.

Licensed L1-VLP-based immunizations against high-risk mucosal human papillomavirus (HPV) types have been a great success in reducing anogenital cancers, although they are limited in their cross-protection against HPV types not covered by the vaccine. Further, their utility in protection against cutaneous HPV types, of which some contribute to non-melanoma skin cancer (NMSC) development, is rather low. Next generation vaccines achieve broadly cross-protective immunity against highly conserved sequences of L2. In this exploratory study, we tested two novel HPV vaccine candidates, HPV16 RG1-VLP and CUT-PANHPVAX, in the preclinical natural infection model Mastomys coucha . After immunization with either vaccines, a mock control or MnPV L1-VLPs, the animals were experimentally infected and monitored. Besides vaccine-specific seroconversion against HPV L2 peptides, the animals also developed cross-reactive antibodies against the cutaneous Mastomys natalensis papillomavirus (MnPV) L2, which were cross-neutralizing MnPV pseudovirions in vitro . Further, both L2-based vaccines also conferred in vivo protection as the viral loads in plucked hair after experimental infection were lower compared to mock-vaccinated control animals. Importantly, the formation of neutralizing antibodies, whether directed against L1-VLPs or L2, was able to prevent skin tumor formation and even microscopical signs of MnPV infection in the skin. For the first time, our study shows the proof-of-principle of next generation L2-based vaccines even across different PV genera in an infection animal model with its genuine PV. It provides fundamental insights into the humoral immunity elicited by L2-based vaccines against PV-induced skin tumors, with important implications to the design of next generation HPV vaccines.

Zusammenfassung Infektionen mit >12 sexuell übertragbaren genitalen „high-risk“ (hr) humanen Papillomviren (HPV) sind hauptverantwortlich für anogenitale Karzinome, insbesondere Zervix- und Analkarzinome sowie oropharyngeale Karzinome, insgesamt für 5 % der Karzinome weltweit. Genitale „low-risk“ (lr) HPV und kutane HPV verursachen Anogenitalwarzen (Kondylome) bzw. Hautwarzen, kutane Genus β‑HPV sind ein potenzieller Kofaktor für die Entwicklung nichtmelanozytärer Hautkarzinome in Immunsupprimierten. Die zugelassenen HPV-Vakzinen sind Spaltimpfstoffe bestehend aus leeren Hauptkapsidproteinhüllen (L1-virus-like particles, VLP). Die prophylaktische Impfung mit dem modernen nonavalenten Impfstoff Gardasil‑9 (HPV6/11/16/18/31/33/45/52/58) verhindert persistierende Infektionen mit Typen, die bis zu 90 % der Zervixkarzinome und Kondylome verursachen. Der Impfschutz ist vorwiegend typenspezifisch, daher besteht kein Schutz gegen Infektionen mit den übrigen genitalen hrHPV oder Hauttypen. RG1-VLP ist ein experimenteller „next generation“-Impfstoff, bestehend aus HPV16L1-VLP, welche ein Kreuzneutralisierungs-Epitop des HPV16 Nebenkapsidproteins L2 („RG1“; Aminosäuren 17–36) repetitiv (360×) an der Oberfläche tragen. Eine Vakzinierung mit RG1-VLP schützt im Tierversuch gegen experimentelle Infektionen mit allen relevanten genitalen hrHPV (~96 % aller Zervixkarzinome), lrHPV (~90 % der Kondylome) sowie gegen einige kutane und β‑HPV. Präklinische Daten zeigen langanhaltende Protektion ohne Boosterimmunisierung ein Jahr nach der Impfung sowie Wirksamkeit nach nur 2 Dosen. Auch in lyophilisierter, thermostabiler Form bleibt die Immunogenität der RG1-VLP erhalten. Eine Phase-I-Studie ist mit Unterstützung des US NCI/NIH in Vorbereitung. Der vorliegende Artikel diskutiert Fragestellungen zur HPV-Impfstoffoptimierung und präsentiert den pan-HPV-Impfstoffkandidat RG1-VLP.

Licensed human papillomavirus (HPV) vaccines contain virus-like particles (VLPs) self-assembled from L1 major-capsid proteins that are remarkably effective prophylactic immunogens. However, the induced type-restricted immune response limits coverage to the included vaccine types, and costly multiplex formulations, restrictive storage and distribution conditions drive the need for next generation HPV vaccines. Vaccine candidates based upon the minor structural protein L2 are particularly promising because conserved N-terminal epitopes induce broadly cross-type neutralizing and protective antibodies. Several strategies to increase the immunological potency of such epitopes are being investigated, including concatemeric multimers, fusion to toll-like receptors ligands or T cell epitopes, as well as immunodominant presentation by different nanoparticle or VLP structures. Several promising L2-based vaccine candidates have reached or will soon enter first-in-man clinical studies. RG1-VLP present the HPV16L2 amino-acid 17–36 conserved neutralization epitope “RG1” repetitively and closely spaced on an immunodominant surface loop of HPV16 L1-VLP and small animal immunizations provide cross-protection against challenge with all medically-significant high-risk and several low-risk HPV types. With a successful current good manufacturing practice (cGMP) campaign and this promising breadth of activity, even encompassing cross-neutralization of several cutaneous HPV types, RG1-VLP are ready for a first-in-human clinical study. This review aims to provide a general overview of these candidates with a special focus on the RG1-VLP vaccine and its road to the clinic.

The candidate pan-Human Papillomavirus (HPV) vaccine RG1-VLP are HPV16 major capsid protein L1 virus-like-particles (VLP) comprising a type-common epitope of HPV16 minor capsid protein L2 (RG1; aa17-36). Vaccinations have previously demonstrated efficacy against genital high-risk (hr), low-risk (1r) and cutaneous HPV. To compare RG1-VLP to licensed vaccines, rabbits (n = 3) were immunized thrice with 1 mu g, 5 mu g, 25 mu g, or 125 mu g of RG1-VLP or a 1/4 dose of Cervarix (R). 5 mu g of RG1-VLP or 16L1-VLP (Cervarix) induced comparable HPV16 capsid-reactive and neutralizing antibodies titers (62,500/12,500-62,500 or 1000/10,000). 25 mu g RG1-VLP induced robust cross-neutralization titers (50-1000) against hrHPV18/31/33/45/52/58/26/70. To mimic reduced immunization schedules in adolescents, mice (n = 10) were immunized twice with RG1-VLP (5 mu g) plus 18L1-VLP (5 mu g). HPV16 neutralization (titers of 10,000) similar to Cervarix and Gardasil and cross-protection against hrHPV58 vaginal challenge was observed. RG1-VLP vaccination induces hrHPV16 neutralization comparable to similar doses of licensed vaccines, plus cross-neutralization to heterologous hrHPV even when combined with HPV18L1-VLP. (C) 2019 Published by Elsevier Ltd.

JDDG: Journal der Deutschen Dermatologischen GesellschaftVolume 16, Issue 10 p. 1298-1299 ÖGDV ÖGDV Preisträger stellen sich vor: Der MEDA Non Melanoma Skin Cancer Forschungspreis 2017 ging an Mag. rer. nat. Bettina Huber, PhD, aus Wien Bettina Huber, Corresponding Author Bettina Huber bettina.huber@meduniwien.ac.at Korrespondenzanschrift Mag. rer. nat Bettina Huber, PhD Laboratory of Viral Oncology (LVO), Dept. of Dermatology Medical University Vienna Währinger Gürtel 18-20 1090 Wien E-Mail: bettina.huber@meduniwien.ac.atSearch for more papers by this author Bettina Huber, Corresponding Author Bettina Huber bettina.huber@meduniwien.ac.at Korrespondenzanschrift Mag. rer. nat Bettina Huber, PhD Laboratory of Viral Oncology (LVO), Dept. of Dermatology Medical University Vienna Währinger Gürtel 18-20 1090 Wien E-Mail: bettina.huber@meduniwien.ac.atSearch for more papers by this author First published: 09 October 2018 https://doi.org/10.1111/ddg.13650Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume16, Issue10October 2018Pages 1298-1299 RelatedInformation

Common cutaneous human papillomavirus (HPV) types induce skin warts, whereas species beta HPV are implicated, together with UV-radiation, in the development of non-melanoma skin cancer (NMSC) in immunosuppressed patients. Licensed HPV vaccines contain virus-like particles (VLP) self-assembled from L1 major capsid proteins that provide type-restricted protection against mucosal HPV infections causing cervical and other ano-genital and oro-pharyngeal carcinomas and warts (condylomas), but do not target heterologous HPV. Experimental papillomavirus vaccines have been designed based on L2 minor capsid proteins that contain type-common neutralization epitopes, to broaden protection to heterologous mucosal and cutaneous HPV types. Repetitive display of the HPV16 L2 cross-neutralization epitope RG1 (amino acids (aa) 17-36) on the surface of HPV16 L1 VLP has greatly enhanced immunogenicity of the L2 peptide. To more directly target cutaneous HPV, L1 fusion proteins were designed that incorporate the RG1 homolog of beta HPV17, the beta HPV5 L2 peptide aa53-72, or the common cutaneous HPV4 RG1 homolog, inserted into DE surface loops of HPV1, 5, 16 or 18 L1 VLP scaffolds. Baculovirus expressed chimeric proteins self-assembled into VLP and VLP-raised NZW rabbit immune sera were evaluated by ELISA and L1- and L2-based pseudovirion (PsV) neutralizing assays, including 12 novel beta PsV types. Chimeric VLP displaying the HPV17 RG1 epitope, but not the HPV5L2 aa53-72 epitope, induced cross-neutralizing humoral immune responses to beta HPV. In vivo cross-protection was evaluated by passive serum transfer in a murine PsV challenge model. Immune sera to HPV16L1-17RG1 VLP (cross-) protected against beta HPV5/20/24/38/96/16 (but not type 76), while antisera to HPV5L1-17RG1 VLP cross-protected against HPV20/24/96 only, and sera to HPV1L1-4RG1 VLP cross-protected against HPV4 challenge. In conclusion, RG1-based VLP are promising next generation vaccine candidates to target cutaneous HPV infections.

Persistent infection with oncogenic human papillomaviruses (HPV) types causes all cervical and a subset of other anogenital and oropharyngeal carcinomas. Four high-risk (hr) mucosal types HPV16, 18, 45, or 59 cause almost all cervical adenocarcinomas (AC), a subset of cervical cancer (CxC). Although the incidence of cervical squamous cell carcinoma (SCC) has dramatically decreased following introduction of Papanicolaou (PAP) screening, the proportion of AC has relatively increased. Cervical SCC arise mainly from the ectocervix, whereas AC originate primarily from the endocervical canal, which is less accessible to obtain viable PAP smears. Licensed (bivalent and quadrivalent) HPV vaccines comprise virus-like particles (VLP) of the most important hr HPV16 and 18, self-assembled from the major capsid protein L1. Due to mainly type-restricted efficacy, both vaccines do not target 13 additional hr mucosal types causing 30% of CxC. The papillomavirus genus alpha species 7 (α7) includes a group of hr types of which HPV18, 45, 59 are proportionally overrepresented in cervical AC and only partially (HPV18) targeted by current vaccines. To target these types, we generated a chimeric vaccine antigen that consists of a cross-neutralizing epitope (homologue of HPV16 RG1) of the L2 minor capsid protein of HPV45 genetically inserted into a surface loop of HPV18 L1 VLP (18L1-45RG1). Vaccination of NZW rabbits with 18L1-45RG1 VLP plus alum-MPL adjuvant induced high-titer neutralizing antibodies against homologous HPV18, that cross-neutralized non-cognate hr α7 types HPV39, 45, 68, but not HPV59, and low risk HPV70 in vitro, and induced a robust L1-specific cellular immune response. Passive immunization protected mice against experimental vaginal challenge with pseudovirions of HPV18, 39, 45 and 68, but not HPV59 or the distantly related α9 type HPV16. 18L1-45RG1 VLP might be combined with our previously described 16L1-16RG1 VLP to develop a second generation bivalent vaccine with extended spectrum against hr HPV.

The consistent and specific presence of Equus caballus papillomavirus type 2 (EcPV2) DNA and mRNA in equine genital squamous cell carcinoma (gSCC) is suggestive of an etiological role in tumor development. To further validate this concept, EcPV2-neutralizing serum antibody titers were determined by an EcPV2 pseudovirion (PsV) neutralization assay. Furthermore, an EcPV2 L1 virus-like particle (VLP)-based vaccine was generated and its prophylactic efficacy evaluated in vivo. All 6/6 gSCC-affected, but only 3/20 tumor-free age-matched animals revealed EcPV2-neutralizing serum antibody titers by PsV assay. Vaccination of NZW rabbits and BalbC mice with EcPV2 L1 VLP using Freund׳s or alum respectively as adjuvant induced high-titer neutralizing serum antibodies (1600-12,800). Passive transfer with rabbit EcPV2-VLP immune sera completely protected mice from experimental vaginal EcPV2 PsV infection. These findings support the impact of EcPV2 in equine gSCC development and recommend EcPV2 L1 VLP as prophylactic vaccine against EcPV2 infection and associated disease in equids.

Persistent infection with high-risk human papillomavirus (HPV) types, most often HPV16 and HPV18, causes all cervical and most anal cancers, and a subset of vulvar, vaginal, penile and oropharyngeal carcinomas. Two prophylactic virus-like particle (VLPs)-based vaccines, are available that protect against vaccine type-associated persistent infection and associated disease, yet have no therapeutic effect on existing lesions or infections. We have generated recombinant live-attenuated influenza A viruses expressing the HPV16 oncogenes E6 and E7 as experimental immunotherapeutic vaccine candidates. The influenza A virus life cycle lacks DNA intermediates as important safety feature. Different serotypes were generated to ensure efficient prime and boost immunizations. The immune response to vaccination in C57BL/6 mice was characterized by peptide ELISA and IFN-γ ELISpot, demonstrating induction of cell-mediated immunity to HPV16 E6 and E7 oncoproteins. Prophylactic and therapeutic vaccine efficacy was analyzed in the murine HPV16-positive TC-1 tumor challenge model. Subcutaneous (s.c.) prime and boost vaccinations of mice with recombinant influenza A serotypes H1N1 and H3N2, followed by challenge with TC-1 cells resulted in complete protection or significantly reduced tumor growth as compared to control animals. In a therapeutic setting, s.c. vaccination of mice with established TC-1 tumors decelerated tumor growth and significantly prolonged survival. Importantly, intralesional vaccine administration induced complete tumor regression in 25% of animals, and significantly reduced tumor growth in 50% of mice. These results suggest recombinant E6E7 influenza viruses as a promising new approach for the development of a therapeutic vaccine against HPV-induced disease.