中东呼吸综合征冠状病毒重组疫苗研究进展

中东呼吸综合征冠状病毒(Middle East respiratory syndrome corona virus,MERS-CoV)自发现以来就引起了人们的广泛关注,研制针对该病毒的有效疫苗成为近期的研究热点。本文主要介绍该病毒重组疫苗方面的研究新进展,包括动物模型的选择以及重组亚单位疫苗、重组活载体疫苗、假病毒疫苗的构建与优化。在对该病毒重组疫苗的研究新进展做出相关总结的基础上,对进一步验证疫苗安全性和有效性等的发展方向提出展望。     

SARS-CoV-2抗原表位分析及相关疫苗研发的进展与挑战

疫苗的接种被认为是阻止时下2019冠状病毒病(Corona Virus Disease 2019,COVID-19)疫情进一步蔓延的最有效手段。目前,国内外多个研究团队采用了不同的技术路线开展严重急性呼吸综合征冠状病毒2 (Severe Acute Respiratory Syndrome Coronavirus 2,SARS-CoV-2)相关疫苗的研发。本文就SARS-CoV-2抗原表位分析、相关疫苗的研究进展以及疫苗接种潜在的风险等多个方面的研究进行综述。评价各研发路线疫苗安全性和有效性的同时,对疫苗发展应用所面临的困难进行讨论。     

丙型肝炎病毒疫苗的研究进展

丙型肝炎是由丙型肝炎病毒(HCV)感染引起的重要传染病,有效的治疗性和预防性疫苗目前均尚未研制成功.HCV的高变异性及多种免疫逃避途径是疫苗研制的主要障碍.目前,已有多种类型的HCV候选疫苗进入临床试验或临床前期试验阶段,但其有效性、安全性等还不能令人满意.随着对HCV相关免疫应答机制的深入了解,有望研制出相应的治疗性和预防性疫苗.     

免疫抑制剂治疗对儿童疫苗诱导的免疫保护性的影响及其相关机制

疫苗是目前公认的预防传染病的有效手段,接种疫苗可极大降低人群传染病的发病率和病死率。随着现代医学的进展,接受免疫抑制剂治疗肿瘤、器官移植、造血干细胞移植及慢性病的患儿生存率有了很大提高,但免疫抑制剂的使用会影响疫苗诱导的免疫保护效果及儿童时期疫苗接种的安全性,使这部分免疫低下的特殊儿童成为疫苗可预防疾病的高危易感人群。本文综述了免疫抑制剂对儿童疫苗免疫保护性的影响及其相关机制。     

本体OAE对我国上市疫苗相关不良反应表征研究的可行性分析

从广义上来说,疫苗也是一种药物。由于疫苗是接种到成千上万的健康人群用来预防各类传染性疾病,因此对其安全性的要求要比传统药物更高。保证上市疫苗的安全性可以增强广大民众对疫苗的信心,提高疫苗接种的接受度和普及度,进而实现巨大的社会医疗经济效益。当前,我国疫苗年使用量超过世界任何一个国家或地区,但是受制于数据来源匮乏、研究方法缺失等客观因素,我国关于上市疫苗安全性及其相关不良反应的分析研究明显滞后与不足。本文,我们系统地介绍了时下不良反应研究领域热门的数据标准化与整合工具不良反应本体OAE及其在疫苗不良反应研究中的进展情况,并探讨将其引入到我国疫苗相关不良反应报告体系中的可行性,这将为未来我国上市疫苗安全监督体制的完善及后续科研分析带来极大的促进作用。     

水痘减毒活疫苗的研究进展

水痘是由水痘-带状疱疹病毒( VZV) 引起的一种高传染性疾病。接种疫苗是预防和控制VZV 流行的最有效手段。美国从1995 年开始实施儿童接种水痘疫苗的政策, 显著降低了水痘相关疾病的发病率和病死率。近年来, 水痘疫苗在我国应用越来越广泛。本文就水痘减毒活疫苗Oka 株的研发, 疫苗的有效性、安全性, 病毒减毒的分子生物学特征和免疫策略等方面进行综述, 以期能更全面地认识水痘减毒疫苗在预防和控制VZV 传播方面所起的作用。     

发展中国家接种人乳头瘤病毒疫苗的影响因素

当前,宫颈癌仅次于乳腺癌成为威胁全世界女性健康的第二大恶性肿瘤。宫颈癌的产生和发展与人乳头瘤病毒(HPV)感染密切相关,在宫颈癌患者中几乎100%能检测到HPV感染。接种人乳头瘤病毒疫苗是预防宫颈癌前病变及宫颈癌的主要方法。欧美等发达国家宫颈癌死亡率相对较低,主要是因为他们建立了完善的宫颈癌筛查项目和HPV疫苗接种项目。而发展中国家的宫颈癌死亡率较高,发展中国家缺乏自主研发的HPV疫苗,人们对HPV和宫颈癌认知水平偏低,直接影响HPV疫苗的接受度。本文综述了影响发展中国家接种HPV疫苗的因素,主要包括人们的宫颈癌和HPV感染相关知识水平、文化背景、HPV疫苗安全性与局限性、接种费用等方面。通过加大宣传HPV感染和HPV疫苗的相关知识,由政府和正规医疗机构提供疫苗渠道,同时国家承担全部或部分接种费用,将会大大提高发展中国家人群接种HPV疫苗,有效降低宫颈癌的死亡率。     

埃博拉病毒疫苗rVSV-ZEBOV的研究进展

埃博拉病毒被列为A类病原体,感染后可引起埃博拉出血热,具有高传染率和高致死率。研发安全有效的抗病毒疫苗迫在眉睫。目前正在研发的埃博拉病毒疫苗包括病毒载体疫苗、蛋白疫苗、DNA疫苗等,其中最有希望的是重组水疱性口炎病毒载体疫苗rVSV-ZEBOV。该疫苗在预防和治疗埃博拉出血热方面具有较高的安全性和有效性,有望在2018年上市。为了深入了解rVSV-ZEBOV疫苗,现主要从制备方法、药理学研究和作用机制等方面对该疫苗进行介绍。     

水痘-带状疱疹病毒疫苗的评价与研究进展

水痘-带状疱疹病毒(VZV)属疱疹病毒α亚科,即人类疱疹病毒3型,为双链DNA病毒。原发感染可引起具有高度传染性的全球流行性疾病——水痘;潜伏病毒的再激活感染可引发典型的疼痛性皮肤病——带状疱疹及不典型的内脏器官感染。日本和美国分别自1987年和1995年开始实行给全体儿童预防接种水痘减毒活疫苗(vOka)后,两国儿童的水痘发病率和病死率显著降低。但VZV疫苗的不良反应,包括二次传播和突破感染等时有发生,因此有必要研发更为有效、安全的新型疫苗。本文就VZV相关疫苗的有效性、安全性及其新型疫苗的研究进展进行综述。     

对近20年未接种相关疫苗的40岁以上成人接种单剂Tdap-IPV后再接种2剂Td-IPV的免疫原性与安全性的评估

<正>简介:本文通过对过去二十年内没有接种过白喉和破伤风相关疫苗的成人给予单剂量Tdap-IPV(破伤风、白喉、百日咳和灭活脊髓灰质炎疫苗)和两剂Td-IPV(破伤风、白喉和灭活脊髓灰质炎疫苗),来评价这两种疫苗的免疫原性与安全性。方法:开放性标记试验和多中心试验均在年龄     

Monitoring vaccine safety during an influenza pandemic

In the event that a vaccine is available during an influenza pandemic, vaccine safety monitoring will occur as part of comprehensive public health surveillance of the vaccination campaign. Though inactivated influenza vaccines have been widely used in the United States and much is known about their safety profile, attention will need to be paid to both common self-limited adverse reactions and rarer, more serious events that may or may not be causally related to vaccination. The primary surveillance systems used to generate and test hypotheses about vaccine safety concerns are the Vaccine Adverse Event Reporting System (VAERS) and the Vaccine Safety Datalink (VSD), respectively. Examples of recent use of these systems to investigate influenza vaccine safety and enhancements planned for use during a pandemic are presented. Ethical issues that will need to be addressed as part of an overall vaccine safety response include risk communication and injury compensation. Advance planning and the use of available technologic solutions are needed to respond to the scientific and logistic challenges involved in safely implementing mass vaccination during a pandemic.     

Risk perception,risk management and safety assessment: What can governments do to increase public confidence in their vaccine system?

For decades vaccine program managers and governments have devoted many resources to addressing public vaccine concerns, vaccine risk perception, risk management and safety assessment. Despite ever growing evidence that vaccines are safe and effective, public concerns continue. Education and evidence based scientific messages have not ended concerns. How can governments and programs more effectively address the public’s vaccine concerns and increase confidence in the vaccine safety system? Vaccination hesitation has been attributed to concerns about vaccine safety, perceptions of high vaccine risks and low disease risk and consequences. Even when the public believes vaccines are important for protection many still have concerns about vaccine safety. This overview explores how heuristics affect public perception of vaccines and vaccine safety, how the public finds and uses vaccine information, and then proposes strategies for changes in the approach to vaccine safety communications. Facts and evidence confirming the safety of vaccines are not enough. Vaccine beliefs and behaviours must be shaped. This will require a shift in the what, when, how and why of vaccine risk and benefit communication content and practice. A change to a behavioural change strategy such as the WHO COMBI program that has been applied to disease eradication efforts is suggested.     

An improved abnormal toxicity test by using reference vaccine-specific body weight curves and histopathological data for monitoring vaccine quality and safety in Japan

Vaccines differ from other pharmaceutical products. The quality and safety of batches are regulated to high standards by national regulatory authorities. Various quality control and safety tests have been developed, including the abnormal toxicity test (ATT), which is described in the World Health Organization (WHO) guidelines and in each country's pharmacopoeia. However, the criteria for abnormal results are not well defined in these guidelines. In addition, the animal grade to be used in ATT, classified on the basis of microbial colonization, was not designated in either guideline.In this study, we report a new and improved method of performing ATT, including statistical, histopathological analysis and hematological findings. It is based on the observation that there are body weight changes characteristic to each vaccine, and such standardized changes can be used as references for evaluating test vaccines. In addition, histopathological data are useful for determining vaccine quality and safety. Combined with histopathological examination, the improved ATT will be of great use for evaluating the consistency, quality and safety of different batches of vaccine. The results of these analyses were similar using either ‘clean’ or specific pathogen-free guinea pigs.     

Mode of action of adjuvants: Implications for vaccine safety and design

For decades, the search for new vaccine adjuvants has been largely empirical. A series of new adjuvants and related formulations are now emerging that are acting through identified immunological mechanisms. Understanding adjuvant mechanism of action is crucial for vaccine design, since this allows for directing immune responses towards efficacious disease-specific effector mechanisms and appropriate memory. It is also of great importance to build new paradigms for assessing adjuvant safety at development stages and at regulatory level. This report reflects the conclusions of a group of scientists from academia, regulatory agencies and industry who attended a conference, organized by the International Association for Biologicals (IABS), on the mode of action of adjuvants on 29–30 April 2010 in Bethesda, Maryland, USA, particularly focusing on how understanding adjuvants mode of action can impact on the assessment of vaccine safety and help to develop target-specific vaccines. More information on the conference output can be found on the IABS website, http://www.iabs.org/.     

Avian embryos and related cell lines: A convenient platform for recombinant proteins and vaccine production

Chick embryos are a significant historical research model in basic and applied sciences. The embryonated eggs have been used for virus inoculation in order to vaccine production for nearly a century. Recently, avian eggs and cell lines derived from embryonated eggs have found wide application in biotechnology. This review will discuss about the unique characteristics of avian eggs in terms of safety, large scale and economical production of recombinant proteins. This system also provides the human‐like glycosylation on target proteins and therefore can be considered as a suitable host for biomanufacturing of humanized monoclonal antibodies and therapeutic proteins. Avian derived cell lines are an alternative for rapid vaccine manufacturing during a pandemic. Based on the latest knowledge in cell and animal transgenesis, the currently available germ cell‐mediated gene transfer system provides a more efficient strategy in gene targeting and creation of transgenic birds that lead to advancements in industrial, biotechnology, and biological research applications. This review covers the recent development of avian fertilized eggs and related cell lines in a variety of human biopharmaceuticals and viral vaccine manufacturing.     

Vaccine and adjuvant design for emerging viruses: mutations, deletions, segments and signaling

Vaccination is currently the most effective strategy to medically control viral diseases. However, developing vaccines is a long and expensive process, and traditional methods, such as attenuating wild-type viruses by serial passage, may not be suitable for all viruses and may lead to vaccine safety considerations, particularly in the case of the vaccination of particular patient groups, such as the immunocompromised and the elderly. In particular, developing vaccines against emerging viral pathogens adds a further level of complexity, as they may only be administered to small groups of people or only in response to a specific event or threat, limiting our ability to study and evaluate responses. In this commentary, we discuss how novel techniques may be used to engineer a new generation of vaccine candidates as we move toward a more targeted vaccine design strategy, driven by our understanding of the mechanisms of viral pathogenesis, attenuation and the signaling events which are required to develop a lasting, protective immunity. We will also briefly discuss the potential future role of vaccine adjuvants, which could be used to bridge the gap between vaccine safety, and lasting immunity from a single vaccination.     

Preventing papillomavirus infectious and herpes zoster: new vaccines

Two new vaccines have been recently licensed : a quadrivalent vaccine against Human papillomavirus infections (HPV) 6, 11, 16 and 18, recommended to children from 9 years old and to young adults under the age of 26 years, and a vaccine against herpes zoster for adults from 60 years old onwards. A bivalent vaccine against HPV 16 and 18 will be shortly available. HPV vaccines are composed of the L1 structural proteins of 2 or 4 HPV genotypes, produced by genetic engineering and self-assembled. These inert vaccines are devoid of genetic materials and mimic the viral particle (virus-like particle, VLP). They allow, as suggested by the 4.5 to 5 years follow-up, to prevent HPV infections and the onset of pre-cancerous lesions associated with genotypes contained within the vaccine. They represent a major overhang in the vaccinology field, and, as anti-hepatitis B vaccine, will probably be effective in cancer prevention. Their use must be associated with the continued detection of cervix cancer by smears and also with the prevention of other sexually transmitted diseases. The herpes zoster vaccine is a living attenuated vaccine produced from the OKA/Merck strain already used in the vaccine against varicella. Its safety is good among persons 50 years old and over and its efficiency on lowering herpes zoster incidence, on the burden of illness and on post-herpetic neuralgia has been demonstrated in persons over 60 years old.     

Live recombinant vectors for AIDS vaccine development

Live recombinant vectors entered the AIDS vaccine field with the realization that live attenuated HIV vaccines posed too great a safety risk, and that subunit vaccines elicited antibodies which lacked the breadth or potency needed to induce sterilizing immunity. Vectored vaccines provided a means to bring the cellular arm of the immune system into play by mimicking natural viral infection. By delivering antigens within host cells, processing and presentation could occur for induction of cellular immune responses. This recombinant vector approach, either alone or combined with other strategies, has produced impressive results. Recombinants have been generated from DNA and RNA viruses and bacteria. With few exceptions, each vector poses some risk, yet each possesses unique features that make it attractive. In addition to safety, key considerations in vector selection have included previous success as a vaccine against the wild-type agent or other pathogens; ability to induce potent, persistent immune responses; ability to target mucosal inductive sites and antigen presenting cells; lack of integration into the host genome; presence of pre-existing immunity in people; ease of mucosal administration; cloning capacity; ease of engineering and production; and stability of the final product. Here we up-date the status of several live recombinant vectors that have shown good potential in pre-clinical studies. Some have progressed to human clinical trials, and others will shortly. The abundance of vectors, coupled with the complexity arising from use of combination regimens with other vaccine types and heterologous vectors, will necessitate selection of the most promising candidates for large-scale efficacy trials in people. The sooner comparative studies can be designed and implemented in which live recombinant vectors containing the same inserted genes are evaluated head-to-head, the closer we will be to an eventual vaccine.     

候选结核疫苗的评价模型

卡介苗作为目前唯一批准使用的预防结核疫苗,由于无法提供充足的保护力,目前结核病依然是严重危害人类健康的传染病,因此筛选优质候选疫苗迫在眉睫。所有候选疫苗进入临床试验前必须评价其安全性、免疫原性以及有效性。评价结果在一定程度上也预示候选疫苗在人体的免疫作用,也是目前评价候选疫苗是否优于传统卡介苗的依据。论述候选结核疫苗临床试验前所使用的体内和体外评价模型。对评价模型的充分认识将提高候选疫苗评价数据对人体临床试验的预测意义,也可更具体地执行实验动物的替代、减少和优化原则。     

冻干口服霍乱rBS—WC菌苗安全及保护效果评价的小鼠模型探讨

本文仿照人口服免疫程序用小鼠为模型对冻干口服霍乱ｒＢＳ－ＷＣ菌苗制品进行了安全及保护率评价。给ＫＭ小鼠口服三种不同剂量的ｒＢＳ－ＷＣ菌苗后,无发病,无体重减轻,无死亡现象,表明该菌苗安全,无毒副作用。免疫组与安慰剂组小鼠用肠结扎攻毒试验评价保护效果,两组小鼠用吴江－２及滨－４３活菌攻击后,免疫组显示良好保护作用（Ｐ＜０．０５）。此法可以用于口服型ｒＢＳ－ＷＣ菌苗的评价,但也存在需要动物数较多,个体间差异较大,手术较麻烦的问题。