Mauël J
Institute of Biochemistry, Ch. des Boveresses 155, CH-1066 Epalinges, Switzerland.
Curr Drug Targets Immune Endocr Metabol Disord. 2002 Oct;2(3):201-26. doi: 10.2174/1568008023340631.
Leishmaniasis, that affects millions of people worldwide, is an infectious disease caused by the protozoan parasite Leishmania. Incidence of the condition appears to be increasing in several parts of the world. Of the three main presentations of the disease, i.e. cutaneous, mucocutaneous and visceral, only the first one tends to heal spontaneously, while the other two are considered fatal if left to run their natural course. Recovery from leishmaniasis, whether spontaneous or drug-induced, is usually accompanied by solid immunity against reinfection, which provides a rationale for attempting to design vaccines against the disease. This review presents an outline of the main immunological features of Leishmania infections and of the mechanisms thought to operate in recovery from the disease. It describes various experimental approaches to vaccination in man and animal models, including the use of virulent and avirulent organisms, of dead parasites and extracts thereof, and of purified parasite proteins. Assays using novel technologies, such as the direct injection of DNAs encoding parasite proteins, or the inoculation of viral or bacterial vectors expressing such molecules, as well as recent experiments aimed at inducing an immune response against saliva of the insect vector, are also reviewed. Observations made during the course of these studies have reinforced the notion that vaccination against leishmaniasis is indeed feasible. However, in spite of intensive efforts by many groups and many reports of success in man and in animal models, a consensus is yet to emerge as to what constitutes the best approach to vaccination against leishmaniasis.
利什曼病是一种由原生动物寄生虫利什曼原虫引起的传染病，全球数百万人受其影响。在世界上的几个地区，这种疾病的发病率似乎正在上升。在该疾病的三种主要表现形式中，即皮肤型、黏膜皮肤型和内脏型，只有第一种往往会自发愈合，而另外两种如果任其自然发展则被认为是致命的。无论是自发康复还是药物诱导康复，从利什曼病中康复通常都伴随着对再次感染的稳固免疫力，这为尝试设计针对该疾病的疫苗提供了理论依据。本综述概述了利什曼原虫感染的主要免疫学特征以及被认为在疾病康复过程中起作用的机制。它描述了在人类和动物模型中进行疫苗接种的各种实验方法，包括使用有毒和无毒生物体、死寄生虫及其提取物以及纯化的寄生虫蛋白。还综述了使用新技术的检测方法，例如直接注射编码寄生虫蛋白的DNA，或接种表达此类分子的病毒或细菌载体，以及最近旨在诱导针对昆虫载体唾液的免疫反应的实验。在这些研究过程中所做的观察强化了这样一种观念，即针对利什曼病进行疫苗接种确实是可行的。然而，尽管许多研究小组付出了巨大努力，并且在人类和动物模型中有许多成功的报道，但对于什么是针对利什曼病的最佳疫苗接种方法尚未达成共识。
