Papilomavírus humano: resposta imune e vacinação
Human papillomavirus (HPV) infection often does not induce inflammation or production of immune mediators capable of inhibiting viral replication. The proinflammatory and humoral immune response is required to break HPV-induced tolerance. The systematic review aimed to compare the safety of the n...
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Imunoglobulina G-imunoglobulina A-HPV-vacina CNPQ::CIENCIAS DA SAUDE |
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Imunoglobulina G-imunoglobulina A-HPV-vacina CNPQ::CIENCIAS DA SAUDE Costa, Ana Paula Ferreira Papilomavírus humano: resposta imune e vacinação |
| description |
Human papillomavirus (HPV) infection often does not induce inflammation or
production of immune mediators capable of inhibiting viral replication. The
proinflammatory and humoral immune response is required to break HPV-induced
tolerance. The systematic review aimed to compare the safety of the nonavalent
(HPV9) versus tetravalent (HPV4) vaccine and both clinical trials aimed to describe the
course of the immune response to immunoglobulin G/A (IgG/IgA) in immunized
women, with the bivalent vaccine (HPV2), one year after vaccination and the other in
women with / without HPV-induced intraepithelial lesion, non-immunized / immunized
with HPV2. An electronic search for randomized controlled trials (RCTs) evaluating
adverse effects was performed through PubMed, Embase, Scopus, Web of Science,
and SciELO. Regarding clinical trials, serum and cervical mucus samples were
collected for detection of anti-HPV IgG / IgA by enzyme linked immunosorbent assay
(ELISA). The selected RCTs analyzed 27,465 women who received one of the two
vaccines and results as pain (OR 1.72; 95% CI 1.62-1.82) and erythema (OR 1.29;
95% CI 1.21-1.36) occurred significantly more in the HPV9 group. However, adverse
effects such as headache (OR 1.07; 95% CI 0.99-1.15), dizziness (OR 1.09; 95% CI
0.93-1.27) and fatigue (OR 1, 09; 95% CI 0.91-1.30) were equally rare between the
HPV4 and HPV9 groups. In clinical trials, with vaccinated women, IgG reactivated one
month and one year after immunization (100%), while IgA was 95% one month and
79% one year later and although significant (P <0.0001), both antibodies decreased in
cervical and serum samples one year after immunization. In the second clinical trial,
there were significant results regarding the presence of IgA produced by women with
HPV-induced (unvaccinated) lesions when compared to immunized and uninjured
women (p <0.01). IgG detection was higher in immunized serum (p <0.01). Therefore,
our findings demonstrate that the HPV9 vaccine in female patients is as safe as the
HPV4 vaccine. The immune response, although significant, decreases one year after
immunization, suggestive of a booster needed to increase antibody titers. IgA in
unvaccinated women is characterized as a possible transudation of the systemic
circulation to the cervical mucosa. Memory antibody IgG proves the efficacy of the
bivalent vaccine in protecting against HPV infection. |
| author2 |
Oliveira, Ana Katherine da Silveira Gonçalves de |
| author_facet |
Oliveira, Ana Katherine da Silveira Gonçalves de Costa, Ana Paula Ferreira |
| format |
doctoralThesis |
| author |
Costa, Ana Paula Ferreira |
| author_sort |
Costa, Ana Paula Ferreira |
| title |
Papilomavírus humano: resposta imune e vacinação |
| title_short |
Papilomavírus humano: resposta imune e vacinação |
| title_full |
Papilomavírus humano: resposta imune e vacinação |
| title_fullStr |
Papilomavírus humano: resposta imune e vacinação |
| title_full_unstemmed |
Papilomavírus humano: resposta imune e vacinação |
| title_sort |
papilomavírus humano: resposta imune e vacinação |
| publisher |
Brasil |
| publishDate |
2020 |
| url |
https://repositorio.ufrn.br/jspui/handle/123456789/28876 |
| work_keys_str_mv |
AT costaanapaulaferreira papilomavirushumanorespostaimuneevacinacao |
| _version_ |
1773962609883611136 |
| spelling |
ri-123456789-288762020-05-10T07:30:06Z Papilomavírus humano: resposta imune e vacinação Costa, Ana Paula Ferreira Oliveira, Ana Katherine da Silveira Gonçalves de Giraldo, Paulo César Chaves, Guilherme Maranhão Soares, Gustavo Mafaldo Eleutério Júnior, José Chaves, José Humberto Belmino Imunoglobulina G-imunoglobulina A-HPV-vacina CNPQ::CIENCIAS DA SAUDE Human papillomavirus (HPV) infection often does not induce inflammation or production of immune mediators capable of inhibiting viral replication. The proinflammatory and humoral immune response is required to break HPV-induced tolerance. The systematic review aimed to compare the safety of the nonavalent (HPV9) versus tetravalent (HPV4) vaccine and both clinical trials aimed to describe the course of the immune response to immunoglobulin G/A (IgG/IgA) in immunized women, with the bivalent vaccine (HPV2), one year after vaccination and the other in women with / without HPV-induced intraepithelial lesion, non-immunized / immunized with HPV2. An electronic search for randomized controlled trials (RCTs) evaluating adverse effects was performed through PubMed, Embase, Scopus, Web of Science, and SciELO. Regarding clinical trials, serum and cervical mucus samples were collected for detection of anti-HPV IgG / IgA by enzyme linked immunosorbent assay (ELISA). The selected RCTs analyzed 27,465 women who received one of the two vaccines and results as pain (OR 1.72; 95% CI 1.62-1.82) and erythema (OR 1.29; 95% CI 1.21-1.36) occurred significantly more in the HPV9 group. However, adverse effects such as headache (OR 1.07; 95% CI 0.99-1.15), dizziness (OR 1.09; 95% CI 0.93-1.27) and fatigue (OR 1, 09; 95% CI 0.91-1.30) were equally rare between the HPV4 and HPV9 groups. In clinical trials, with vaccinated women, IgG reactivated one month and one year after immunization (100%), while IgA was 95% one month and 79% one year later and although significant (P <0.0001), both antibodies decreased in cervical and serum samples one year after immunization. In the second clinical trial, there were significant results regarding the presence of IgA produced by women with HPV-induced (unvaccinated) lesions when compared to immunized and uninjured women (p <0.01). IgG detection was higher in immunized serum (p <0.01). Therefore, our findings demonstrate that the HPV9 vaccine in female patients is as safe as the HPV4 vaccine. The immune response, although significant, decreases one year after immunization, suggestive of a booster needed to increase antibody titers. IgA in unvaccinated women is characterized as a possible transudation of the systemic circulation to the cervical mucosa. Memory antibody IgG proves the efficacy of the bivalent vaccine in protecting against HPV infection. A infecção pelo Papilomavírus Humano (HPV) muitas vezes não induz inflamação ou produção de mediadores imunológicos capazes de inibir a replicação viral. A resposta imune pró-inflamatória e humoral é necessária para romper a tolerância induzida pelo HPV. A revisão sistemática teve como objetivo comparar a segurança da vacina nonavalente (HPV9) versus tetravalente (HPV4) e, os dois ensaios clínicos, tiveram como objetivo descrever o curso da resposta imune a imunoglobulina G/A (IgG/IgA), em mulheres imunizadas, com a vacina bivalente (HPV2), um ano após a vacinação e o outro em mulheres com/sem lesão intraepitelial induzida pelo HPV, nãoimunizadas/imunizadas com HPV2. Uma busca eletrônica, por ensaios clínicos randomizados (ECR), que avaliaram efeitos adversos, foi realizada através do PubMed, Embase, Scopus, Web of Science e SciELO. Em relação aos ensaios clínicos, amostras de soro e muco cervical foram coletadas para detecção de IgG/IgA anti-HPV, por ensaio imunoenzimático (ELISA). Os ECR selecionados analisaram 27.465 mulheres que receberam uma das duas vacinas e resultados como dor (OR 1,72; IC95% 1,62-1,82) e eritema (OR 1,29; IC95% 1,21-1,36) ocorreram significativamente mais no grupo HPV9. No entanto, efeitos adversos como: dor de cabeça (OR 1,07; IC95% 0,99-1,15), tontura (OR 1,09; IC95% 0,93-1,27) e fadiga (OR 1,09; IC95% 0,91-1,30), foram igualmente raros entre os grupos HPV4 e HPV9. Nos ensaios clínicos, com mulheres vacinadas, houve reativação de IgG um mês e um ano após a imunização (100%), enquanto o IgA, foi de 95% um mês e 79% um ano depois e embora significativo (P< 0,0001), ambos os anticorpos, diminuíram em amostras cervicais e séricas, um ano após a imunização. No segundo ensaio clínico, houve resultados significativos, quanto a presença de IgA, produzidas pelas mulheres com lesões induzidas pelo HPV (não vacinadas) quando comparadas às mulheres imunizadas e sem lesão (p <0,01). Já a detecção de IgG foi maior no soro imunizado (p <0,01). Portanto, nossas descobertas demonstram que a vacina HPV9 em pacientes do sexo feminino é tão segura quanto a vacina HPV4. A resposta imune, embora significativa, diminui um ano após a imunização, sugestivo de um reforço vacinal, necessário para aumentar os títulos de anticorpos. A IgA em mulheres não vacinadas caracteriza-se como uma possível transudação da circulação sistêmica para a mucosa cervical. O IgG, anticorpo de memória, prova a eficácia da vacina bivalente ao proteger contra a infecção pelo HPV. 2020-05-04T18:30:56Z 2020-05-04T18:30:56Z 2019-12-10 doctoralThesis COSTA, Ana Paula Ferreira. Papilomavírus humano: resposta imune e vacinação. 2019. 64f. Tese (Doutorado em Ciências da Saúde) - Centro de Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Natal, 2019. https://repositorio.ufrn.br/jspui/handle/123456789/28876 pt_BR Acesso Aberto application/pdf Brasil UFRN PROGRAMA DE PÓS-GRADUAÇÃO EM CIÊNCIAS DA SAÚDE |