mimmunМедицинская иммунологияMedical Immunology (Russia)1563-06252313-741XSPb RAACI10.15789/1563-0625-ROB-3315mimmun-3315Research ArticleОБЗОРЫREVIEWSРоль B-клеток и формирование иммунологической памяти после вакцинации против вируса папилломы человекаRole of B cells and formation of immunological memory after vaccination against human papillomavirushttps://orcid.org/0009-0005-9693-5461ЗагидуллинаЭ. Р.ZagidullinaE. R.

Загидуллина Эмилия Рафилевна - студент 

295051, Руспублика Крым, г. Симферополь, бул. Ленина, 5/7

Emiliya R. Zagidullina - student

5/7 Lenin Blvd Simferopol, Republic of Crimea 295051

m.igarasi@yandex.ruhttps://orcid.org/0000-0003-1693-3190КалиберденкоВ. Б.KaliberdenkoV. B.

К.м.н., доцент кафедры внутренней медицины № 2 

Симферополь

PhD (Medicine), Associate Professor, Department of Internal Medicine No. 2

Simferopol

vit_boris@mail.ruhttps://orcid.org/0009-0002-2744-670XЭминовЭ. Э.EminovE. E.

Студент 

Симферополь

Student

Simferopol

eminov.elvis@mail.ruhttps://orcid.org/0009-0000-7701-1291ГальченкоА. А.GalchenkoA. A.

Студент 

Симферополь

Student

Simferopol

ngalcheno@mail.ruhttps://orcid.org/0009-0007-0670-5895ПеретокинаО. В.PeretokinaO. V.

Студент 

Симферополь

Student

Simferopol

gavrish_0102@mail.ruhttps://orcid.org/0009-0004-1766-7757ЯкубоваГ. А.YakubovaG. A.

Студент 

Симферополь

Student

Simferopol

gulnaz.yakubova.04@mail.ruhttps://orcid.org/0009-0001-6188-5039ОнипкоВ. В.OnipkoV. V.

Студент 

Симферополь

Student

Simferopol

arhideya.v@mail.ruhttps://orcid.org/0009-0006-1746-9464КирюхинаК. П.KiryukhinaK. P.

Студент 

Симферополь

Student

Simferopol

kiryukhina.ks@yandex.ruhttps://orcid.org/0009-0002-9234-075XХименкоА. Ю.KhimenkoA. Yu.

Студент 

Симферополь

Student

Simferopol

alisa.tk02@gmail.comhttps://orcid.org/0009-0007-7072-0993ЗиновьевМ. В.ZinovievM. V.

Студент 

Симферополь

Student

Simferopol

maksimzinovev367@gmail.comhttps://orcid.org/0009-0000-0910-3469РазмановаД. Г.RazmanovaD. G.

Студент 

Симферополь

Student

Simferopol

Dasha.razmanova2003@mail.ruhttps://orcid.org/0009-0009-4733-5338ОлиферукА. А.OliferukA. A.

Студент 

Симферополь

Student

Simferopol

alenaoliferuk@gmail.comhttps://orcid.org/0009-0007-4834-1161ЛиникВ. В.LinikV. V.

Студент 

Симферополь

Student

Simferopol

vlinik05@mail.ruhttps://orcid.org/0009-0007-5395-1159СамилыкЕ. А.SamilykE. A.

Студент 

Симферополь

Student

Simferopol

Ekaterina.Samilyk@mail.ruhttps://orcid.org/0009-0005-4715-145XБондаренкоА. И.BondarenkoA. I.

Студент 

Симферополь

Student

Simferopol

abondarenko_87@mail.ruОрдена Трудового Красного Знамени Медицинский институт имени С.И. Георгиевского ФГАОУ ВО «Крымский федеральный университет имени В.И. Вернадского»РоссияS.I.Georgievsky Medical Institute, V.I. Vernadsky Crimean Federal UniversityRussian Federation202620062026282253264Copyright © Загидуллина Э.Р., Калиберденко В.Б., Эминов Э.Э., Гальченко А.А., Перетокина О.В., Якубова Г.А., Онипко В.В., Кирюхина К.П., Хименко А.Ю., Зиновьев М.В., Разманова Д.Г., Олиферук А.А., Линик В.В., Самилык Е.А., Бондаренко А.И., 20262026Загидуллина Э.Р., Калиберденко В.Б., Эминов Э.Э., Гальченко А.А., Перетокина О.В., Якубова Г.А., Онипко В.В., Кирюхина К.П., Хименко А.Ю., Зиновьев М.В., Разманова Д.Г., Олиферук А.А., Линик В.В., Самилык Е.А., Бондаренко А.И.Zagidullina E.R., Kaliberdenko V.B., Eminov E.E., Galchenko A.A., Peretokina O.V., Yakubova G.A., Onipko V.V., Kiryukhina K.P., Khimenko A.Y., Zinoviev M.V., Razmanova D.G., Oliferuk A.A., Linik V.V., Samilyk E.A., Bondarenko A.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.mimmun.ru/mimmun/article/view/3315

Цель работы – проанализировать особенности В-клеточного иммунного ответа и формирование иммунологической памяти у людей после вакцинации против вируса папилломы человека (ВПЧ) и при естественном заражении, а также оценить эффективность различных типов вакцин, режимов вакцинации и факторов, влияющих на длительность защиты от вируса папилломы человека. Литературный обзор включает анализ научных работ из баз данных PubMed, Embase, eLIBRARY, «КиберЛенинка» и Web of Science, CNKI и MEDLINE. Период поиска охватывал публикации с 2000 по 2023 год с упором на последнее десятилетие. Использовались ключевые слова и их комбинации: HPV vaccine, B cell memory, memory B cells, humoral immunity, long-term immunity, immunological memory, plasma cells, Gardasil, Cervarix. Критерии включения и исключения: в анализ включались оригинальные исследования (рандомизированные контролируемые, когортные исследования) и систематические обзоры, посвященные изучению гуморального иммунного ответа, динамики специфических антител и популяций B-лимфоцитов памяти после вакцинации против ВПЧ у людей. Критериями исключения служили: публикации не на английском или русском языках; исследования, сфокусированные исключительно на T-клеточном иммунитете; работы, выполненные только на животных моделях; тезисы конференций и нерецензируемые статьи. Процедура отбора: отбор проводился в два этапа. На первом этапе производилась оценка релевантности по заголовку и аннотации. На втором этапе проводился полнотекстовый анализ статей, прошедших первичный фильтр, для окончательной проверки соответствия критериям включения. В итоговую подборку вошли 55 публикаций, наиболее полно отражающие современные представления о роли B-клеток в поствакцинальном иммунитете против ВПЧ. Вирус папилломы человека (ВПЧ) является основной причиной рака шейки матки. Существуют три вакцины: «Церварикс» (бивалентная), «Гардасил-4» (квадривалентная) и «Гардасил-9» (новалентная), которые эффективны более чем на 90%. Вакцинация снижает риск развития рака шейки матки и других раков, связанных с ВПЧ. В 2020 году ВОЗ запустила глобальную стратегию по ликвидации рака шейки матки как важной проблемы здоровья населения. Эффективность вакцин против ВПЧ подтверждена клиническими и популяционными исследованиями. Вакцина 4vHPV снижает частоту остроконечных кондилом на 76%, а профилактика рака шейки матки у молодых женщин достигает 53-57%. В Финляндии вакцинация показала 100%-ную защиту от ВПЧ-ассоциированного рака у вакцинированных по сравнению с невакцинированными. Схемы с двумя и тремя дозами обеспечивают сопоставимую защиту, а однодозовый режим в ряде исследований демонстрирует эффективность 89-100%. Оптимальный иммунный ответ достигается при вакцинации детей 9-13 лет с двумя дозами. Адъюванты усиливают антительный и B-клеточный ответ, что важно для иммунологической памяти. Такая эффективность создает предпосылки для расширения применения однодозового режима, что поможет повысить охват вакцинацией и снизить затраты на программы профилактики рака шейки матки. Несмотря на признаки того, что одна доза вакцины против ВПЧ обеспечивает хорошую защиту от предраковых поражений, уровень антител при одной дозе ниже, чем после двух или трех. Защита после одной дозы, возможно, больше зависит от ответа B-клеток памяти при повторном контакте с антигеном. Однако данных о B-клеточном ответе после одной дозы вакцины нет, равно как и достаточных исследований локальных анамнестических ответов при повторном воздействии. Было бы большим достижением в вакцинологии, если бы одна доза вакцины против ВПЧ доказала способность вызывать защитный B-клеточный память при повторном контакте с антигенами ВПЧ.

The aim of the present review was to analyze the features of B cell immune response and development of immunological memory in humans after vaccination against human papillomavirus (HPV) and during natural infection, as well as to evaluate the efficiency of various types of vaccines, vaccination regimens and factors affecting the duration of protection against human papillomavirus. The literature review includes an analysis of research papers from the databases PubMed, Embase, eLibrary, CyberLeninka and Web of Science, CNKI and MEDLINE. The search period covered publications from 2000 to 2023, with a focus on the last decade. The following keywords and their combinations were used: "HPV vaccine", "B cell memory", "memory B cells", "humoral immunity", "long-term immunity", "immunological memory", "plasma cells", "Gardasil", "Cervarix". Inclusion and exclusion criteria: The analysis included original studies (randomized controlled, cohort studies) and systematic reviews devoted to the study of the humoral immune response, dynamics of specific antibodies and populations of memory B lymphocytes after HPV vaccination in humans. The exclusion criteria were as follows: publications not in English or Russian; research focused exclusively on T cell immunity; work performed only on animal models; conference abstracts and uncensored articles. Selection procedure: The selection was carried out in two stages: (1) Relevance was assessed based on the title and annotation; (2) A full-text analysis of the articles that passed the primary filter was carried out for final verification of compliance with the inclusion criteria. The final selection included 55 publications that most fully reflect the current understanding of the role of B cells in post-vaccination immunity against HPV. Human papillomavirus is the leading cause of cervical cancer. There are three vaccines: Cervarix (bivalent), Gardasil-4 (quadrivalent) and Gardasil-9 (nonavalent), which show efficiency of >90%. Vaccination reduces the risk of developing cervical cancer and other HPV-related disorders. In 2020, WHO launched a global strategy to eliminate cervical cancer as an important public health problem. The effectiveness of HPV vaccines has been confirmed by clinical and population-based studies. The 4vHPV vaccine reduces the incidence of genital warts by 76%, and prevention of cervical cancer in young women reaches 53-57%. In Finland, vaccination showed 100% protection against HPV-associated cancer in vaccinated people compared to those who were not vaccinated. Twoand three-dose regimens provide comparable protection, and a single-dose regimen has demonstrated 89-100% efficacy in a number of studies. The optimal immune response is achieved by vaccinating children aged 9-13 years with two doses. Despite some observations showing that a single dose of HPV vaccine provides good protection against precancerous lesions, the level of antibodies after one dose is lower than after two or three vaccinations. Protection after a single dose may depend more on the response of memory B cells upon repeated contact with the antigen. However, there are no data concrning B cell response after a single dose of HPV vaccine, as well as sufficient studies of local anamnestic responses upon repeated exposure. It would be a great advance in vaccinology if a single dose of HPV vaccine proved its ability to induce protective B cell memory upon repeated contact with HPV antigens.

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The authors declare that there are no conflicts of interest present.