Cervical cancer arises from lesions caused by infection with high-risk types of human papillomavirus (HPV).Therefore, vaccination against HPV could prevent carcinogenesis by preventing HPV infection or inducing lesion regression. HPV E2 protein is an attractive candidate for vaccine development because it is required for papilloma formation, is involved in all stages of the virus life cycle, and is expressed in all premalignant lesions as well as some cancers. This study reports vaccination against E2 protein using a rabbit model of papillomavirus infection. A recombinant adenovirus (Ad) vector expressing the E2 protein of cottontail rabbit papillomavirus (CRPV) was tested for therapeutic efficacy in CRPV-infected rabbits. Primary immunization with the Ad-E2 vaccine, compared to immunization with a control Ad vector, reduced the number of papillomaforming sites from 17 of 45 to 4 of 45. After booster immunization, vaccinated rabbits formed no new papillomas versus an additional 23 papillomas in rabbits that received the control vector. Papillomas in the Ad-E2 vaccinees were significantly smaller than those in the control rabbits, and all four papillomas in the Ad-E2 vaccinated rabbits regressed. No CRPV DNA was detected either in the regression sites or in sites that did not form papillomas, indicating that the vaccination led to clearance of CRPV from all infected sites.Human papillomaviruses (HPVs) cause cervical cancer, which affects about one-half million women worldwide annually (37, 51, 56). HPV-associated disease includes anal, vulvar (56), oral and other respiratory tract cancers (20), and nearly all skin cancers in patients with epidermodysplasia verruciformis (13). HPV infection is also implicated in nonmelanoma skin cancers in immunocompetent as well as immunodeficient patients (4-6, 13, 26, 29, 40). It has been estimated that 10% of the world's tumor burden is attributable to HPV infection (57).Cervical carcinogenesis begins with benign epithelial lesions induced by HPV. Because genital HPV infection is highly prevalent, many women are at risk (41). Progression to cervical cancer typically takes more than a decade, so cytological screening can detect high-grade lesions in time for treatment. However, present treatments do not cure all lesions in all patients, and recurrence is a common sequela. Furthermore, cervical cancer has a mortality rate of 33%, clearly indicating the need for better therapy.Because premalignant lesions caused by HPV can be detected early, vaccination against HPV antigens could provide an effective therapy to induce lesion regression and prevent cancer (9-12, 45). A therapeutic vaccine could also eliminate residual HPV infection after surgical removal of a lesion (9)(10)(11)(12)45). The viral E6 and E7 oncoproteins are presently popular targets for a therapeutic HPV vaccine. These proteins stimulate cellular proliferation, promote genetic instability, and transform cells, in large part by perturbing the p53 and retinoblastoma tumor suppressor pathways (reviewed in reference 38)...