© 2003 by Oxford University Press
© 2003 Oxford University Press
ARTICLE |
Specific Antibody Levels at the Cervix During the Menstrual Cycle of Women Vaccinated With Human Papillomavirus 16 Virus–Like Particles
Affiliations of authors: D. Nardelli-Haefliger, D. Wirthner, F. Ponci, P. De Grandi, Department of Gynecology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland; J. T. Schiller, D. R. Lowy (Laboratory of Cellular Oncology, Center for Cancer Research), A. Hildesheim (Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics), National Cancer Institute, Bethesda, MD.
Correspondence to: Douglas R. Lowy, MD, Laboratory of Cellular Oncology, Bldg. 37, Rm. 4106, National Cancer Institute, Bethesda, MD 20892 (e-mail: drl{at}helix.nih.gov).
Background: In early-phase trials, a human papillomavirus 16 (HPV16) virus–like particle (VLP) vaccine has been shown to be well tolerated, immunogenic, and protective against HPV16 in women, most of whom were taking oral contraceptives. Previous studies have not determined whether HPV immunization results in specific antibody levels in the human genital tract or whether these levels might vary during contraceptive or ovulatory cycles. Therefore, we determined the levels of total and specific antibodies in the cervical secretions of women who had been immunized with HPV16 VLPs and examined the influence of the menstrual cycle and oral contraceptive use on these levels. Methods: Two groups of women were immunized, seven who were taking oral contraceptives and 11 who were ovulating. After seroconversion, serum and cervical secretions were collected twice weekly for 5 weeks. Total immunoglobulins (IgG and IgA) and vaccine-specific IgGs were determined by enzyme-linked immunosorbent assay. Nonparametric statistical analyses were used to determine the statistical significance of differences in IgG levels between groups, and correlations between serum- and cervical-specific IgG levels were determined by the Spearman correlation coefficient. Results: All participants developed detectable titers of anti-HPV16 VLP IgGs in their cervical secretions after immunization. The cervical titers of specific IgG and total IgGs and IgAs among participants in the contraceptive group were relatively constant throughout the contraceptive cycle. In contrast, the cervical titers of specific IgG and total IgGs and IgAs among participants in the ovulatory group varied during the menstrual cycle, being highest during the proliferative phase, decreasing approximately ninefold around ovulation, and increasing approximately threefold during the luteal phase. Serum- and cervical-specific IgG levels were correlated (r = .86) in women in the contraceptive group but not in women in the ovulatory group (r = .27). Conclusions: The relatively high titer of anti-HPV16 antibodies at the cervix is promising in terms of vaccine efficacy; however, the decrease in antibody titer around ovulation raises the possibility that the HPV16 VLP vaccine might be less effective during the peri-ovulatory phase.
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- Re: Specific Antibody Levels at the Cervix During the Menstrual Cycle of Women Vaccinated With Human Papillomavirus 16 Virus-Like Particles
- Eliav Barr and Laura A. Koutsky
J Natl Cancer Inst 2004 96: 412-413.[Extract] [Full Text] [PDF]
- RESPONSE: Re: Specific Antibody Levels at the Cervix During the Menstrual Cycle of Women Vaccinated With Human Papillomavirus 16 Virus-Like Particles
- Douglas R. Lowy, Denise Nardelli-Haefliger, Allan Hildesheim, and John T. Schiller
J Natl Cancer Inst 2004 96: 413-414.[Extract] [Full Text] [PDF]
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