Differences in HPV-specific antibody Fc-effector functions following Gardasil® and Cervarix® vaccination

Gardasil (R) (Merck) and Cervarix (R) (GlaxoSmithKline) both provide protection against infection with Human Papillomavirus 16 (HPV16) and Human Papillomavirus 18 (HPV18), that account for around 70% of cervical cancers. Both vaccines have been shown to induce high levels of neutralizing antibodies and are known to protect against progression beyond cervical intraepithelial neoplasia grade 2 (CIN2+), although Cervarix (R) has been linked to enhanced protection from progression. However, beyond the transmission-blocking activity of neutralizing antibodies against HPV, no clear correlate of protection has been defined that may explain persistent control and clearance elicited by HPV vaccines. Beyond blocking, antibodies contribute to antiviral activity via the recruitment of the cytotoxic and opsonophagocytic power of the immune system. Thus, here, we used systems serology to comprehensively profile Gardasil (R)- and Cervarix (R)- induced antibody subclass, isotype, Fc-receptor binding, and Fc-effector functions against the HPV16 and HPV18 major capsid protein (L1). Overall, both vaccines induced robust functional humoral immune responses against both HPV16 and HPV18. However, Cervarix (R) elicited higher IgG3 and antibody-dependent complement activating responses, and an overall more coordinated response between HPV16 and 18 compared to Gardasil (R), potentially related to the distinct adjuvants delivered with the vaccines. Thus, these data point to robust Fc-effector functions induced by both Gardasil (R) and Cervarix (R), albeit with enhanced coordination observed with Cervarix (R), potentially underlying immunological correlates of post-infection control of HPV.

Automated summary

Gardasil(R) and Cervarix(R) both protect against HPV16 and HPV18, which cause 70% of cervical cancers. Both vaccines induce high levels of neutralizing antibodies and protect against progression beyond CIN2+. Cervarix(R) provides enhanced protection. The study shows that both vaccines induce robust Fc-effector functions, but Cervarix(R) elicits higher levels of IgG3 and complement activation, suggesting potential immunological correlates of post-infection control of HPV.