To determine the systemic cytokine pattern induced by vaccination with human papillomavirus (HPV) L1 virus-like particles (VLP), we analyzed 22 different cytokines in culture supernatants of L1 VLP-stimulated peripheral blood mononuclear cells from vaccine (n ؍ 19) and placebo (n ؍ 7) recipients at months 0 and 2 after vaccination, using a multiplex cytokine bead array. In vaccine recipients, incubation with L1 VLP in vitro led to a statistically significant increase in production of Th1 (granulocyte-macrophage colony-stimulating factor, interleukin-2 [IL-2], gamma interferon; P < 0.0007) and Th2 (IL-4, IL-5, IL-10, IL-13; P < 0.0017) cytokines and the chemokine IP-10 (P ؍ 0.0021) at month 2 after immunization, compared to levels seen prior to vaccination. These responses were not seen in placebo recipients. Cytokine and neutralizing antibody responses to vaccination followed the same pattern, with the highest antibody responses seen for subjects with higher cytokine responses. Cytokine profiling studies using samples from efficacy trials may provide important information about discriminators of long-term protection against HPV.Noninfectious L1 human papillomavirus (HPV) virus-like particles (VLP) are the lead candidate vaccines to prevent HPV and associated disease (13,14). A quadrivalent HPV VLP has recently been licensed. Clinical trials have shown a strong induction of humoral responses after vaccination (1,7,10,15,22) and near-complete protection against infection with homologous HPV types (9,18,26). Neutralizing antibodies are believed to be the main effector of protection.In previous studies, we and others demonstrated that vaccination with HPV L1 VLP is also associated with an increase in T-cell proliferation and cytokine production (4, 5, 21). Recently, we used an 11-plex cytokine system that revealed that HPV type 16 (HPV16) L1 VLP vaccination induced a wide spectrum of cytokines in whole blood and peripheral blood mononuclear cells (PBMCs) (20,21). Cytokine responses are important for both the induction and maintenance of humoral responses (28, 29) and might play a role in the efficacy of HPV VLP vaccines. Therefore, characterization of cytokine/chemokine patterns produced upon vaccination can contribute to the identification of biomarkers of vaccine response.Here, we have further characterized the systemic cytokine and chemokine profiles induced by L1 VLP vaccination using the multiplex technology (22-plex) and evaluated their correlation with serum HPV16-neutralizing antibody titers. We also performed a cluster analysis to identify cytokine patterns of response to the vaccine.
MATERIALS AND METHODS
Study design.A phase II clinical trial of the HPV16 L1 VLP vaccine without adjuvant (Novavax, Rockville, MD) was conducted with a total of 220 healthy, adult, female volunteers 18 to 25 years of age, as previously described (10, 21). Briefly, subjects were enrolled at The Johns Hopkins University Center for Immunization Research (Baltimore). Participants received three intramuscular doses of either ...