Reviews in Medical Virology
EDITORIAL
Rev. Med. Virol. 2015; 25: 1. Published online in Wiley Online Library (wileyonlinelibrary.com) DOI: 10.1002/rmv.1829
Still lots to learn about human papillomaviruses
One might imagine that the story about human papillomaviruses (HPVs) is complete. Painstaking work has shown that they cause cervical cancer and led to the award of a Nobel Prize. Two vaccines have been licensed following evidence of virtually 100% protection against cervical intraepithelial neoplasia so that cervical cancer itself should ultimately be brought under control. Admittedly, only two oncogenic strains of virus and two strains of viruses that cause warts are currently protected against, but breadth of cover will improve with newer vaccines, with a 9-valent one in the pipeline providing protection against an additional five oncogenic types. However, at least 12 types of HPVs have been identified to be oncogenic, based upon differences in oncoproteins E6 and E7, so more may need to be added to the list. What more is there to say about the HPVs? In this supplement, authors discuss several current areas of interest. Even if boys are routinely immunised as well as girls, prophylactic HPV vaccines will take decades to bring cervical cancer under control. Meanwhile, there is significant unmet medical need for those with persisting HPV infections, cervical intraepithelial neoplasia and cervical cancers. Therapeutic vaccination aiming to stimulate an antitumour immune response, especially activation of cytotoxic T-cells, is one potential approach and could provide important information about vaccines against cancer in general. The immunosuppressive environment caused by HPV
Copyright © 2015 John Wiley & Sons, Ltd.
oncogene E7 reduces the potential effectiveness of therapeutic vaccines and remains to be overcome, but the combination of immunotherapy and chemotherapy is a promising contemporary approach for the treatment of cervical cancer. Human papillomaviruses do not just cause cervical cancer; they are implicated in neoplasias arising from transformation zones in the head, neck and anus areas where columnar epithelium gives way to squamous epithelium. Additional detailed description of HPV biology and associations of each type of HPV with specific cancers would be helpful. A better understanding of how HPVs transform key cells to cause cancer would be of great benefit, especially because perturbations of molecularly defined signalling pathways could identify additional therapeutic targets. Nanotechnology may provide novel delivery methods to greatly improve treatment efficacy for HPV-associated cancers. It can concentrate anti-cancer drugs at a tumour site and deliver several drugs simultaneously. Nanotechnology can also bring early diagnosis, which could increase the chance of curing cancers. The four articles show that there is still much to be learned about HPVs and much to be done before the multiple diseases they cause are brought under control. We hope you enjoy reading the reviews, grouped together into a supplement for convenience. Jiezhong Chen Paul Griffiths
EDITORIAL
Rev. Med. Virol. 2015; 25: 1. Published online in Wiley Online Library (wileyonlinelibrary.com) DOI: 10.1002/rmv.1829
Still lots to learn about human papillomaviruses
One might imagine that the story about human papillomaviruses (HPVs) is complete. Painstaking work has shown that they cause cervical cancer and led to the award of a Nobel Prize. Two vaccines have been licensed following evidence of virtually 100% protection against cervical intraepithelial neoplasia so that cervical cancer itself should ultimately be brought under control. Admittedly, only two oncogenic strains of virus and two strains of viruses that cause warts are currently protected against, but breadth of cover will improve with newer vaccines, with a 9-valent one in the pipeline providing protection against an additional five oncogenic types. However, at least 12 types of HPVs have been identified to be oncogenic, based upon differences in oncoproteins E6 and E7, so more may need to be added to the list. What more is there to say about the HPVs? In this supplement, authors discuss several current areas of interest. Even if boys are routinely immunised as well as girls, prophylactic HPV vaccines will take decades to bring cervical cancer under control. Meanwhile, there is significant unmet medical need for those with persisting HPV infections, cervical intraepithelial neoplasia and cervical cancers. Therapeutic vaccination aiming to stimulate an antitumour immune response, especially activation of cytotoxic T-cells, is one potential approach and could provide important information about vaccines against cancer in general. The immunosuppressive environment caused by HPV
Copyright © 2015 John Wiley & Sons, Ltd.
oncogene E7 reduces the potential effectiveness of therapeutic vaccines and remains to be overcome, but the combination of immunotherapy and chemotherapy is a promising contemporary approach for the treatment of cervical cancer. Human papillomaviruses do not just cause cervical cancer; they are implicated in neoplasias arising from transformation zones in the head, neck and anus areas where columnar epithelium gives way to squamous epithelium. Additional detailed description of HPV biology and associations of each type of HPV with specific cancers would be helpful. A better understanding of how HPVs transform key cells to cause cancer would be of great benefit, especially because perturbations of molecularly defined signalling pathways could identify additional therapeutic targets. Nanotechnology may provide novel delivery methods to greatly improve treatment efficacy for HPV-associated cancers. It can concentrate anti-cancer drugs at a tumour site and deliver several drugs simultaneously. Nanotechnology can also bring early diagnosis, which could increase the chance of curing cancers. The four articles show that there is still much to be learned about HPVs and much to be done before the multiple diseases they cause are brought under control. We hope you enjoy reading the reviews, grouped together into a supplement for convenience. Jiezhong Chen Paul Griffiths
