Morrison Lynda A
Department of Molecular Microbiology and Immunology, Saint Louis University School of Medicine, Missouri 63104, USA.
Drugs. 2002;62(8):1119-29. doi: 10.2165/00003495-200262080-00001.
Herpes simplex viruses (HSV) cause lifelong persistent infections with numerous disease manifestations. Genital herpes infections are widespread in populations throughout the world and a vaccine to protect against or subdue established genital herpes infections has been under development for decades. Vaccine-mediated protection against persistent viral infections can be extremely difficult to achieve. The more rapidly a virus reaches its target tissue for persistence, the more vigorously a vaccine-induced immune response must defend the vaccinated individual. After exposure to HSV through sexual contact, only a few days are required for the virus to establish latent infection of its host. Despite numerous improvements, traditional vaccine approaches of whole virus or protein subunits have met with only marginal success. The many disappointments have heightened interest in determining correlates of immune protection, studies pursued both in animal models and in humans. They have also led to reassessment of the goals of vaccination. Necessity has sparked several creative new vaccine approaches involving nucleic acid or live attenuated viruses and vectors. With improved concepts of protective immune responses has come fervent discussion of the means to stimulate and maintain cell-mediated immunity. The result of this work is likely to be a more thorough understanding of antiviral immunity in the genital mucosa and the nervous system, and of HSV pathogenesis and immune evasion strategies, as additional strides are taken toward the goal of a successful vaccine with which to confront HSV.
单纯疱疹病毒（HSV）可引发终身持续性感染，并伴有多种疾病表现。生殖器疱疹感染在全球人群中广泛存在，数十年来，人们一直在研发一种预防或控制已确诊的生殖器疱疹感染的疫苗。通过疫苗介导预防持续性病毒感染极其困难。病毒越快到达其持久性感染的靶组织，疫苗诱导的免疫反应就必须越有力地保护接种疫苗的个体。通过性接触感染HSV后，病毒只需几天时间就能在宿主体内建立潜伏感染。尽管有诸多改进，但传统的全病毒或蛋白质亚单位疫苗方法仅取得了有限的成功。这些诸多失望促使人们更加关注确定免疫保护的相关因素，相关研究在动物模型和人类中都有开展。它们还导致了对疫苗接种目标的重新评估。需求催生了几种创新的新疫苗方法，涉及核酸、减毒活病毒和载体。随着对保护性免疫反应概念的改进，人们热烈讨论了刺激和维持细胞介导免疫的方法。这项工作的结果可能是更全面地了解生殖器黏膜和神经系统中的抗病毒免疫，以及HSV的发病机制和免疫逃逸策略，因为在朝着成功研发对抗HSV疫苗的目标迈进方面又取得了新的进展。
