Vaccines for control of fertility and hormone-dependent cancers

This article traces and reviews the development of vaccines against two reproductive hormones, luteinizing hormone release hormone (LHRH) and human chorionic gonadotrophin (hCG). The heterospecies dimer (HSD)-dehydrogenase hCG vaccine is the first to have completed phase II clinical trials providing evidence for the prevention of pregnancy in humans by immunization with this vaccine. The vaccine acts without blocking ovulation or disturbance of menstrual bleeding. Its effect is fully reversible and fertility is regained with decline of the antibodies. The antibody response in humans is directed against immunodominant epitopes located in the core part of beta hCG, distinct from the C-terminal region. However, problems arising from carrier-conjugated vaccines against 'self' hormones such as carrier-induced immuno-suppression on repeated immunization are evoked and solutions discussed. The LHRH vaccine, a model semi-synthetic vaccine, can be used in both sexes and has applications in regulation of fertility of animals. It has therapeutic applications as a cost-effective approach in clinical conditions where LHRH agonists and antagonists have therapeutic action. The vaccine has undergone phase I and II clinical trials in advanced-stage carcinoma of prostate patients with encouraging results.