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Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán

2006, Número 6

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Rev Invest Clin 2006; 58 (6)


Hacia la prevención del cáncer cérvico-uterino: estrategias empleadas en el desarrollo de vacunas contra el VPH

Cruz-Hernández E, Contreras-Paredes A, Lizano-Soberón M

Idioma: Español
Referencias bibliográficas: 74
Paginas: 586-597
Archivo PDF: 132.15 Kb.


RESUMEN

La infección persistente del VPH es, sin duda, el factor más importante para el desarrollo del cáncer cérvico-uterino. La mayoría de las infecciones por VPH son eliminadas y sólo una pequeña proporción de infecciones con VPH de alto riesgo progresan a una lesión de alto grado o a cáncer. Por mecanismos de evasión de la respuesta inmune, en algunos casos la respuesta contra el VPH no es efectiva, lo que permite el establecimiento de una infección persistente. La promesa de una vacuna que neutralice la infección por VPH y por lo tanto elimine la incidencia del cáncer cérvico-uterino, ha causado gran interés y entusiasmo en la búsqueda de diferentes estrategias para obtener una vacuna efectiva. A la fecha, se han desarrollado vacunas profilácticas contra VPH basadas en partículas tipo-virus (VLPs) generadas a partir de las proteínas virales L1. Los resultados de estas vacunas en mujeres de 16 a 23 años de edad muestran una elevada tolerabilidad e inmunogenicidad con títulos de anticuerpos mucho más altos que los observados en una infección natural por VPH. Si bien estas vacunas no son capaces de evitar completamente las infecciones por los tipos virales incluidos en la vacuna (VPH16 y 18), son muy eficaces para eliminar las infecciones persistentes y prevenir el desarrollo de neoplasias intraepiteliales del cervix. Estas vacunas se encuentran en fase III de pruebas clínicas, cuyos resultados determinarán el impacto en la población abierta. Los estudios de vacunas terapéuticas contra VPH, cuyo objetivo es lograr eliminar lesiones de cervix ya establecidas, aún no muestran la eficacia necesaria, para su implementación en la clínica.


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