Fournier J M
Unité du choléra et des vibrions, Institut Pasteur, Paris.
Bull Soc Pathol Exot. 1998;91(5 Pt 1-2):412-5.
Cholera remains today a major health problem in most developing countries. The long-term control of cholera depends on the improvement of hygiene but this is a distant goal for many countries. The availability of an effective cholera vaccine is thus important for the prevention of cholera in such countries. More than a century after the first attempt to vaccinate against cholera by Ferran in Spain, there is still no truly effective cholera vaccine. A bacterial fraction vaccine, referred to as CH1 +2 was prepared by Professor A. Dodin. A field trial of this vaccine was carried out in Zaire in 1983. Significant protection was observed but this vaccine was not evaluated in additional trials. Two other oral cholera vaccines, developed in Sweden and in the USA, were widely experimented on human beings: a combination of cholera toxin B-subunit and inactivated bacterial cells, and a live attenuated vaccine containing the genetically manipulated Vibrio cholerae O1 strain CVD 103-HgR. Despite their efficiency as evaluated in field trials (inactivated vaccine) or on volunteers (live vaccine), these vaccines have drawbacks that may limit their usefulness as practical vaccines. Protection induced by the inactivated vaccine was transient in young children, lasting only approximately for six months. One of the safety concerns associated with live vaccines is a possible reversion to virulence. Efforts should be continued to find a better cholera vaccine. A new vaccine development program based upon the hypothesis that immunoglobulin G directed to the O-specific polysaccharide of Vibrio cholerae O1 could confer protective immunity to cholera. This program may lead to the development of a cholera conjugate vaccine to elicit protection in infants.
如今，霍乱在大多数发展中国家仍是一个重大的健康问题。霍乱的长期控制取决于卫生条件的改善，但这对许多国家来说是一个遥远的目标。因此，有效的霍乱疫苗对于这些国家预防霍乱至关重要。在西班牙费兰首次尝试接种霍乱疫苗一个多世纪后，仍然没有真正有效的霍乱疫苗。A. 多丹教授制备了一种名为CH1 +2的细菌组分疫苗。1983年在扎伊尔对该疫苗进行了现场试验。观察到了显著的保护作用，但该疫苗未在其他试验中进行评估。另外两种在瑞典和美国研制的口服霍乱疫苗在人体上进行了广泛试验：一种是霍乱毒素B亚单位与灭活细菌细胞的组合，另一种是含有基因改造的霍乱弧菌O1菌株CVD 103-HgR的减毒活疫苗。尽管这些疫苗在现场试验（灭活疫苗）或志愿者试验（活疫苗）中显示出有效性，但它们存在一些缺点，可能会限制其作为实用疫苗的用途。灭活疫苗在幼儿中诱导的保护作用是短暂的，仅持续约六个月。与活疫苗相关的一个安全问题是可能恢复毒力。应继续努力寻找更好的霍乱疫苗。一个新的疫苗研发项目基于这样的假设，即针对霍乱弧菌O1的O-特异性多糖的免疫球蛋白G可以赋予对霍乱的保护性免疫。该项目可能会导致开发一种霍乱结合疫苗，以在婴儿中引发保护作用。
