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Publicatie

Control of HPV by first-void urine sampling

Boek - Dissertatie

Ondertitel:innovative, non-invasive follow-up of preventive and therapeutic interventions
Incidence and mortality of cervical cancer has reduced in countries with well-organized screening and treatment programs, and the use of prophylactic HPV vaccines will further accelerate this decrease. Nonetheless, challenges remain, like non-invasive options for monitoring interventions to control HPV. To date, HPV DNA testing of clinician-obtained cervical cells is the reference for identifying cervical HPV infection(s), while the evaluation of immunogenicity in HPV vaccine trials relies on serology. The use of first-void urine (FVU) could have several advantages over the current more invasive sampling. Moreover, the assessment of both, HPV infection and antibody presence, on such a readily obtained and non-invasive sample, is particularly attractive and could be of great value for the international HPV research community. With a view towards the use of FVU for the follow-up of preventive and therapeutic interventions, this thesis aimed to investigate and further improve the detection of HPV and HPV-specific antibodies in FVU. Besides, the use of FVU to follow-up HPV vaccination and cervical precancer treatment was examined. We demonstrated that there is no advantage in HPV detection in FVU collected in the morning vs. later during the day and showed the potential effect of an FVU collection device to detect HPV. Besides, we provided knowledge on the standardized and optimized protocol which has significantly enhanced the sensitivity of urinary HPV detection and make urine a potentially efficacious and accurate alternative to cervical samples. Also, based on a review of the literature, the presence of HPV antibodies at the cervix, using cervicovaginal secretions as a proxy, has been investigated and found feasible. Furthermore, with respect to method optimization, we compared the measurement of HPV antibodies in FV urine using a multiplex VLP-based ELISA (M4ELISA) with previously reported data. Correlations with HPV vaccination status and serum samples were found using those two different HPV immunoassays not yet specifically designed for urine. However, expected better sensitivity for M4ELISA was not observed. At last, preliminary data of two studies are reported that investigated the use of FVU for the follow-up of HPV vaccination and in a test-of-cure setting. In summary, though further studies are warranted, this dissertation provided information and data indicating that FVU may be a viable non-invasive option for monitoring interventions to control HPV and may therefore become an important tool in cervical cancer elimination plans.
Aantal pagina's: 201
Jaar van publicatie:2020
Trefwoorden:Doctoral thesis
Toegankelijkheid:Open