Therapy of Human Papillomavirus Infection and Associated Epithelial Tumors

Abstract

Papillomavirus infections are very common and cause various benign and malignant lesions, most notably condyloma acuminatum, anogenital cancer, laryngeal papilloma and skin warts. Unfortunately, effective therapy is currently not available. Therapeutic options are limited, expensive and often ineffective. They comprise cytodestructive and cytotoxic substances, surgical methods, laser and cryotherapy. Immunotherapy seems to be one of the more promising options. Interferons combined with ablative methods such as CO2 laser can prevent recurrence of disease. Cytokine enhancement is an old concept that has shown effectiveness with imidazoquinolinamine derivatives (imiquimod). Imiquimod was released recently for therapy of genital warts. Currently, HPV vaccines are being developed to protect against infection with HPV and to treat existing warts and other HPV-associated lesions. Some processes in the HPV infection cycle have been determined as possible targets for the development of specific antiviral agents. Cidofovir is a primordial antiviral substance active against HPV. Unfortunately, there is a potential risk for side effects.

SOC1 inhibits HPV-E7-mediated transformation by inducing degradation of E7 protein

“…Our study suggests that SOCS1 induced by IFNg is, at least in part, responsible for the reduction of E7 and suppression of proliferation. At a clinical level, IFNs have been used in the treatment of HPV-associated cervical intraepithelial neoplasia or cervical cancers with mixed results (Gross, 1997;Koromilas et al, 2001). The success of the treatment is largely dependent on the subtype of HPV and the immune responses of the patients.…”

Sexually transmitted papillomavirus infections: epidemiology pathogenesis, clinic, morphology, important differential diagnostic aspects, current diagnostic and treatment options

“…27 Bearing in mind that cervical carcinoma is considered and recorded as a sexually transmitted disease, according to the World Health Organization, the determination of cervical or vaginal intra-epithelial neoplasia (VAIN/CIN) and the application of the respective therapeutic concepts according to the location and dimensions of the lesions is of paramount importance for the patient's prognosis. 28,29 Non-invasive therapeutic Methods Podophyllotoxin Podophyllotoxin (0.5 and 0.15%), in the form of solution or an ointment, is an easily applicable method providing good results. 30 The substance represents a purified extract from the podophyllon plant and has the property to combine with cellular microtubules, blocking mitosis, which is in the root of the formation of necrosis in the wart itself.…”

“…29 Some intra-epithelial neoplasias, such as Bowen's disease, bowenoid papulosis and Queyrat's erythroplasia, are an exception and need surgical removal and, occasionally, a primary closure of the operative wound edges. 1,4,26,29 Circumcision in some cases provides good results. 26,50 The primary therapy of bowenoid papulosis (i.e.…”

“…29 The application of local anesthesia makes this method painless and easily accessible. Hemostasis is achieved by diathermy and wounds heal secondarily.…”

“…These closed-type systems allow the multiple application of the catheter in the area of the anogenital warts, and this in a high rate of the cases guarantees a good therapeutic result. 29 Cryosurgery has many advantages in some type of patients; the treatment is performed on an ambulatory basis, is easy, the method is accessible, and there are no serious complications. However, standardization of the different forms of cryosurgery is problematic.…”