Unlabelled forms of the biotinylated peptides were used as reference peptides to assess the validity of each experiment. Their sequences and inhibitory concentration (IC50) values were as follows: HA 306–318 (PKYVKQNTLKLAT) for DRB1*0101 (6 nM); DRB1*0401 (30 nM), DRB1*1101 (17 nM) and DRB5*0101 (8 nM), YKL (AAYAAAKAAALAA) for DRB1*0701 (42 nM); A3152–166 (EAEQLRAYLDGTGVE) for DRB1*1501 (28 nM); MT 2–16 (AKTIAYDEEARRGLE) for DRB1*0301 (660 nM); B1 21–36 (TERVRLVTRHIYNREE) for DRB1*1301 (268 nM); LOL 191–210 (ESWGAVWRIDTPDKLTGPFT) for DRB3*0101 (9 nM); and E2/E168 (AGDLLAIETDKATI)

for DRB4*0101 (3 nM). The peptide concentration that prevented binding of 50% of the labelled peptide (IC50) was evaluated. Data were expressed as relative affinity: ratios of the IC50 of the peptide by the IC50 of the reference peptide, which Ku-0059436 order binds the HLA II molecule strongly. Proliferation assays using E6 and E7 large peptides covering both whole proteins performed at entry into the study showed that blood T lymphocytes from 10 patients (nos 1, 2, 3, 4, 6, 8, 9, 11, 13, 14) proliferated in the presence of one to 10 peptides (Fig. 1). The strongest responses PD0332991 in vitro in eight patients (nos 3, 4, 6, 8, 9, 11, 13, 14) were directed against both peptides E6/2 (aa 14–34) and E6/4 (aa 45–68), whereas T cells in patient 1 proliferated against peptide E6/4 and in patient 2 against

E6/2 only, respectively (Fig. 1). SI of these strongest proliferative responses ranged from 3·1–22. Peptide E6/7 (aa 91–110) stimulated blood T lymphocytes from two patients (nos 2 and 6, SI = 3·8 and 4·3, respectively). One patient each displayed responses against peptide E6/5 (aa 61–80) (patient no. 6), peptide E6/8 (aa 105–126) (patient no. 6) and peptide E6/9 (aa 121–140) (patient no. 11). Finally, no response could be detected against peptides OSBPL9 E6/1, E6/3, E6/6 and E6/10. Only two patients (nos 2 and 6) had proliferative responses against E7 peptides. E7/7 (aa 65–87) was the better immunogenic peptide, recognized by two patients (with SI of 4 and 6), peptides E7/2 (7–27), E7/3 (21–40), E7/4 (35–55) and E7/8 (78–98) being recognized by only one patient. Peptides E7/1, E7/5 and E7/6 yielded no detectable response.

This assay was performed with E6 and E7 large peptides at entry into the study (Fig. 2). Numerous blood cells from patient 1 recognized three HPV-16 long peptides: E6/4, E7/2 and E7/3 with mean 270, 65 and 430 SFC/106 PBMCs. In patient 13 the recognized peptides were E6/7, E6/8, E7/1, E7/2, E7/3 and E7/8, with a mean of 43, 50, 38, 34, 33 and 30 SFC/106 PBMCs. These two patients both had large lesions (10 and 20 cm2, respectively). Nevertheless, their clinical outcome was different. The first patient experienced a complete and durable disappearance of the lesions 2 months after entry into the study following the electrocoagulation of less than 50% of the classic VIN lesion, whereas chronic and extensive lesions persisted in the second patient despite laser surgery.