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How Enhancing Immunity to Low‐Risk HPV Could Cure Recurrent Respiratory Papillomatosis
Author(s) -
Bai Ke,
Allen Clint
Publication year - 2021
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.29153
Subject(s) - recurrent respiratory papillomatosis , adjuvant , immune system , medicine , immunotherapy , immunology , immunity , disease , immune checkpoint , cancer immunotherapy , acquired immune system
Recurrent respiratory papillomatosis (RRP) is currently treated with repeat surgical resection of papillomatous disease that does not address the fundamental underlying issue of chronic infection with low‐risk human papillomavirus. Here, we review the biology and immunology of low‐risk human papillomavirus (HPV) infections. Antiviral or antiangiogenic adjuvant treatments similarly address the papillomatous disease itself but do not activate HPV immunity. It is likely that only through immune‐mediated clearance of low‐risk HPV infection can patients with RRP be cured. In some patients, this occurs spontaneously. In others with more aggressive disease, adjuvant immunotherapy to activate immunity may be needed. Based on current understanding of antiviral immune responses, the only rational strategy to clear HPV‐infected epithelial cells is through activation of the T‐lymphocyte arm of the adaptive immune response. Translation of immunotherapies that are Food and Drug Administration‐approved or under clinical study for cancer, such as immune checkpoint blockade or engineered therapeutic vaccines, may provide a path toward tolerable and efficacious adjuvant immunotherapy for RRP. Level of Evidence NA Laryngoscope , 131:2041–2047, 2021