REBACIN® as a noninvasive clinical intervention for high-risk human papillomavirus persistent infection

Yi Yang, Ya-Li Meng, Shu-Min Duan, Shao-Bing Zhan, Ruo-Li Guan, Tian-Fu Yue, Ling-Hua Kong, Ling Zhou, Liu-Hong Deng, Chao Huang, Sheng Wang, Gui-Yu Wang, Dai-Fei Wu, Chun-Fa Zhang, Fei Chen, Yi Yang, Ya-Li Meng, Shu-Min Duan, Shao-Bing Zhan, Ruo-Li Guan, Tian-Fu Yue, Ling-Hua Kong, Ling Zhou, Liu-Hong Deng, Chao Huang, Sheng Wang, Gui-Yu Wang, Dai-Fei Wu, Chun-Fa Zhang, Fei Chen

Abstract

The development of highly sensitive HPV-genotyping tests has opened the possibility of treating HPV-infected women before high-grade lesions appear. The lack of efficient intervention for persistent high-risk HPV infection necessitates the need for development of novel therapeutic strategy. Here we demonstrate that REBACIN®, a proprietary antiviral biologics, has shown potent efficacy in the clearance of persistent HPV infections. Two independent parallel clinical studies were investigated, which a total of 199 patients were enrolled and randomly divided into a REBACIN®-test group and a control group without treatment. The viral clearance rates for the REBACIN® groups were 61.5% (24/39) and 62.5% (35/56), respectively, for the two independent parallel studies. In contrast, the nontreatment groups showed self-clearance rates at 20.0% (8/40) and 12.5% (8/64). We further found that REBACIN® was able to significantly repress the expression of HPV E6 and E7 oncogenes in TC-1 and Hela cells. The two viral genes are well known for the development of high-grade premalignancy lesion and cervical cancer. In a mouse model, REBACIN® was indicated to notably suppress E6/E7-induced tumor growth, suggesting E6 and E7 oncogenes as a potential target of REBACIN®. Taken together, our studies shed light into the development of a novel noninvasive therapeutic intervention for clearance of persistent HPV infection with significant efficacy.

Keywords: HPV; REBACIN®; cervical cancer; clearance; human papillomavirus.

© 2019 UICC.

References

    1. Insinga RP, Dasbach EJ, Elbasha EH, et al. Incidence and duration of cervical human papillomavirus 6, 11, 16, and 18 infections in young women: an evaluation from multiple analytic perspectives. Cancer Epidemiol Biomarkers Prev 2007;16:709-15.
    1. de Sanjosé S, Brotons M, Pavón MA. The natural history of human papillomavirus infection. Best Pract Res Clin Obstet Gynaecol 2018;47:2-13.
    1. Trottier H, Mahmud S, Prado JC, et al. Type-specific duration of human papillomavirus infection: implications for human papillomavirus screening and vaccination. J Infect Dis 2008;197:1436-47.
    1. Bulkmans NW, Berkhof J, Bulk S, et al. High-risk HPV type-specific clearance rates in cervical screening. Br J Cancer 2007;9:1419-24.
    1. Trevisan A, Schlecht NF, Ramanakumar AV, et al. Human papillomavirus type 16 viral load measurement as a predictor of infection clearance. J Gen Virol 2013;94(Pt 8):1850-7.
    1. Carter JR, Ding Z, Rose BR. HPV infection and cervical disease: a review. Aust N Z J Obstet Gynaecol 2011;51:103-8.
    1. Day PM, Schelhaas M. Concepts of papillomavirus entry into host cells. Curr Opin Virol 2014;4:24-31.
    1. Clifford GM, Smith JS, Plummer M, et al. Human papillomavirus types in invasive cervical cancer worldwide: a meta-analysis. Br J Cancer 2003;88:63-73.
    1. Bosch FX, Broker TR, Forman D, et al. Authors of ICO MonographComprehensive control of HPV infections and related diseases vaccine volume 30, supplement 5, 2012. Comprehensive control of human papillomavirus infections and related diseases. Vaccine 2013;31(Suppl 7):H1-31.
    1. He J, He L. Knowledge of HPV and acceptability of HPV vaccine among women in western China: a cross-sectional survey. BMC Womens Health 2018;18:130.
    1. Xiao J, Huang Y, Zhao H. Limitations and adverse events of HPV vaccine. Negative 2018;9:37-40.
    1. Stanley M, Pinto LA, Trimble C. Human papillomavirus vaccines--immune responses. Vaccine 2012;30(Suppl 5):F83-7.
    1. Harper DM, Franco EL, Wheeler CM, et al. Sustained efficacy up to 4.5 years of a bivalent L1 virus-like particle vaccine against human papillomavirus types 16 and 18: follow-up from a randomised control trial. Lancet 2006;367:1247-55.
    1. Hildesheim A1, Herrero R, Wacholder S, et al. Effect of human papillomavirus 16/18 L1 virus-like particle vaccine among young women with preexisting infection: a randomized trial. JAMA 2007;298:743-53.
    1. Moody CA, Laimins LA. Human papillomavirus oncoproteins: pathways to transformation. Nat Rev Cancer 2010;10:550-60.
    1. Yang A, Farmer E, Wu TC, et al. Perspectives for therapeutic HPV vaccine development. J Biomed Sci 2016;23:75.
    1. Zhao Y, Zhao F, Hu S, et al. Multi-center cross-sectional study on type-specific human papillomavirus infection among Chinese women. Chin J Epidemiol 2015;36:1351-6.
    1. Zeng Z, Austin RM, He X, et al. Prevalence of high-risk human papillomavirus infection in China: analysis of 671,163 human papillomavirus test results from China's largest College of American Pathologists-Certified Laboratory. Am J Clin Pathol 2016;145:622-5.
    1. Wu RF, Dai M, Qiao YL, et al. Human papillomavirus infection in women in Shenzhen City, People's Republic of China, a population typical of recent Chinese urbanisation. Int J Cancer 2007;121:1306-11.
    1. Wu X, Zhao J, Cui XL, et al. Prevalence of type-specific human papillomavirus infection among 18-45 year-old women from the general population in Liuzhou, Guangxi Zhuang autonomous region: a cross-sectional study. Zhonghua Liu Xing Bing Xue Za Zhi 2017;38:467-71.
    1. Zhou HL, Zhang W, Zhang CJ, et al. Prevalence and distribution of human papillomavirus genotypes in Chinese women between 1991 and 2016: a systematic review. J Infect 2018;76:522-8.
    1. Shan W, Zhang T, Zhang TJ, et al. The epidemiological situation of human papillomavirus infection among woman in China. Chin J Dis Control Prev 2017;21:89-93.
    1. Hutter JN, Decker CF. Human papillomavirus infection. Dis Mon 2016;62:294-300.
    1. Wilting SM, Steenbergen RDM. Molecular events leading to HPV-induced high grade neoplasia. Papillomavirus Res. 2016;2:85-8.
    1. Olmedo-Nieva L, Muñoz-Bello JO, Contreras-Paredes A, et al. The role of E6 spliced isoforms (E6*) in human papillomavirus-induced carcinogenesis. Viruses 2018;10:1-20.
    1. Martínez-Ramírez I, Carrillo-García A, Contreras-Paredes A, et al. Regulation of cellular metabolism by high-risk human papillomaviruses. Int J Mol Sci 2018;19:E1839.
    1. Yeo-Teh NSL, Ito Y, Jha S. High-risk human Papillomaviral oncogenes E6 and E7 target key cellular pathways to achieve oncogenesis. Int J Mol Sci 2018;19:E1706.
    1. Pańczyszyn A, Boniewska-Bernacka E, Głąb G. Telomeres and telomerase during human papillomavirus-induced carcinogenesis. Mol Diagn Ther 2018;22:421-30.
    1. Chabeda A, Yanez RJR, Lamprecht R, et al. Therapeutic vaccines for high-risk HPV-associated diseases. Papillomavirus Res 2018;5:46-58.
    1. Yoshinouchi M, Yamada T, Kizaki M, et al. In vitro and in vivo growth suppression of human papillomavirus 16-positive cervical cancer cells by E6 siRNA. Mol Ther 2003;8:762-8.
    1. Lu Y, Zhang Z, Liu Q, et al. Immunological protection against HPV16 E7-expressing human esophageal cancer cell challenge by a novel HPV16-E6/E7 fusion protein based-vaccine in a Hu-PBL-SCID mouse model. Biol Pharm Bull 2007;30:150-6.
    1. Gupta S, Kumar P, Das BC. HPV: molecular pathways and targets. Curr Probl Cancer 2018;42:161-74.
    1. Song D, Li H, Li H, et al. Effect of human papillomavirus infection on the immune system and its role in the course of cervical cancer. Oncol Lett 2015;10:600-6.
    1. de Villiers EM, Fauquet C, Broker TR, et al. Classification of papillomaviruses. Virology 2004;324:17-27.
    1. Petry KU, Menton S, Menton M, et al. Inclusion of HPV testing in routine cervical cancer screening for women above 29 years in Germany: result s for 8466 patients. Br J Cancer 2003;88:1570-7.
    1. McBride AA, Warburton A. The role of integration in oncogenic progression of HPV-associated cancers. PLoS Pathog 2017;13:e1006211.
    1. Oyervides-Muñoz MA, Pérez-Maya AA, Rodríguez-Gutiérrez HF, et al. Understanding the HPV integration and its progression to cervical cancer. Infect Genet Evol 2018;61:134-44.
    1. Huang SS, Hao DZ, Zhang Y, et al. Progress in studies of the mechanisms and clinical diagnosis of cervical carcinoma associated with genomic integration of high-risk human papillomavirus DNA. Yi Chuan 2017;39:775-83.
    1. Graham SV. The human papillomavirus replication cycle, and its links to cancer progression: a comprehensive. Clin Sci (Lond) 2017;131:2201-21.
    1. Mittal S, Banks L. Molecular mechanisms underlying human papillomavirus E6 and E7 oncoprotein-induced cell transformation. Mutat Res Rev Mutat Res 2017;772:23-35.
    1. Schiffman M, Castle PE, Jeronimo J, et al. Human papillomavirus and cervical cancer. Lancet 2007;370:890-907.
    1. Narisawa-Saito M, Kiyono T. Basic mechanisms of high-risk human papillomavirus-induced carcinogenesis: roles of E6 and E7 proteins. Cancer Sci 2007;98:1505-11.
    1. Schiller JT, Day PM, Kines RC. Current understanding of the mechanism of HPV infection. Gynecol Oncol 2010;118(1 Suppl):S12-7.
    1. Wallace NA, Galloway DA. Novel functions of the human papillomavirus E6 oncoproteins. Annu Rev Virol 2015;2:403-23.
    1. Origoni M, Cristoforoni P, Carminati G, et al. E6/E7 mRNA testing for human papilloma virus-induced high-grade cervical intraepithelial disease (CIN2/CIN3): a promising perspective. Ecancermedicalscience 2015;9:533.
    1. Peralta-Zaragoza O, Deas J, Gómez-Cerón C, et al. HPV-based screening, triage, treatment and followup strategies in the management of cervical intraepithelial neoplasia. Obstet Gynecol Int 2013;2013:1-15.
    1. Casagrande DC, Ribalta JC, Leite KD, et al. Expression of human papillomavirus E6 and E7 oncoprotein mRNA in women with low-grade squamous intraepithelial lesions or less. GenetMol Res 2016;15:1-9.
    1. Ganguly N, Parihar SP. Human papillomavirus E6 and E7 oncoproteins as risk factors for tumorigenesis. J Biosci 2009;34:113-23.
    1. Cheng L, Wang GY, Zhang CF. Effects of REBACIN in treatment of cervical Intraepithelial neoplasia (CIN) following LEEP procedure. The 28th International Papillomavious Conference with Clinical and Public Health Workshops, San Juan, Puerto Rico. Abstract. 225, 2012.
    1. Yang Y, Wang GY, Huang C, et al. Efficacy of REBACIN combination with ALA-PDT on the treatment of HPV-induced intraepithelial neoplasia. The 32nd International Papillomavirus Conference. Sydney, Australia. Abstract IPVC8-0271, 2018.

Source: PubMed

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