Kaslow David C
Vical Incorporated, 10390 Pacific Center Court, San Diego, CA 92121-4340, USA.
Trans R Soc Trop Med Hyg. 2004 Oct;98(10):593-601. doi: 10.1016/j.trstmh.2004.03.007.
Vaccine development requires an amalgamation of disparate disciplines and has unique economic and regulatory drivers. Non-viral gene-based delivery systems, such as formulated plasmid DNA, are new and potentially disruptive technologies capable of providing 'cheaper, simpler, and more convenient-to-use' vaccines. Typically and somewhat ironically, disruptive technologies have poorer product performance, at least in the near-term, compared with the existing conventional technologies. Because successful product development requires that the product's performance must meet or exceed the efficacy threshold for a desired application, the appropriate selection of the initial product applications for a disruptive technology is critical for its successful evolution. In this regard, the near-term successes of gene-based vaccines will likely be for protection against bacterial toxins and acute viral and bacterial infections. Recent breakthroughs, however, herald increasing rather than languishing performance improvements in the efficacy of gene-based vaccines. Whether gene-based vaccines ultimately succeed in eliciting protective immunity in humans to persistent intracellular pathogens, such as HIV, malaria and tuberculosis, for which the conventional vaccine technologies have failed, remains to be determined. A success against any one of the persistent intracellular pathogens would be sufficient proof that gene-based vaccines represent a disruptive technology against which future vaccine technologies will be measured.
疫苗研发需要融合不同学科,并有其独特的经济和监管驱动因素。基于非病毒基因的递送系统,如配制好的质粒DNA,是新型且可能具有颠覆性的技术,能够提供“更便宜、更简单且更易于使用”的疫苗。通常且颇具讽刺意味的是,颠覆性技术的产品性能,至少在短期内,相较于现有的传统技术要更差。由于成功的产品开发要求产品性能必须达到或超过预期应用的疗效阈值,因此为颠覆性技术恰当选择初始产品应用对其成功发展至关重要。在这方面,基于基因的疫苗近期可能会在预防细菌毒素以及急性病毒和细菌感染方面取得成功。然而,近期的突破预示着基于基因的疫苗效力的提升在不断增加而非逐渐衰退。基于基因的疫苗最终能否成功在人体中引发针对传统疫苗技术未能攻克的持续性细胞内病原体(如艾滋病毒、疟疾和结核病)的保护性免疫,仍有待确定。若能成功应对任何一种持续性细胞内病原体,将足以证明基于基因的疫苗是一种颠覆性技术,未来的疫苗技术将以此为参照进行衡量。