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Ways to Escape
A healthy cervix cell changing into a cancer cell can be seen as an evolutionary process. Just like the origin of many animal species, this process is based on mutations and selection. These mutations - changes in the DNA of the cell - are partly caused by HPV. Selection takes place by attempts of the immune system to destroy the malignantly changing cells. If the body succeeds in clearing away every malignant cell in time, there will be no cancer. In those patients who do get cancer, the tumor cells have found a way to escape the watchfulness of the immune system.
Research that was partly conducted in Leiden, shows that cervical cancer cells have found a number of ways to mislead the immune system. One of those ways undermines the lymphocytes inspecting the cell contents. Cytotoxic lymphocytes can detect deviant proteins (from viruses for example) in the cell nucleus because the surface of each cell shows parts of the content. This is done by specialized proteins; the HLA molecules. The genetic code for HLA proteins can be found on chromosome 6. Cancer cells can partly or completely eliminate the production of HLA molecules. Sometimes this process is reversible. By giving specific signaling substances from (from should be to?!) the immune system (cytokines), the production of HLA proteins can be encouraged again. This is not easy, because the part of chromosome 6 that holds the genetic code for HLA proteins has often been damaged. Usually, only one of the two copes of this chromosome is damaged, so the genetic code for these proteins has not been completely lost. Detailed analysis of cervical tumors is necessary to develop strategies that can stimulate the immune system. It would be ideal to give a peptide vaccine against cervical cancer that makes use of HLA before the cells have made themselves unrecognizable. The further the tumor has evolved, the harder it becomes to tackle the cancer in this way. Additional measures are necessary when vaccination is used as treatment in the later stages of cervical cancer.