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[抗病毒疫苗接种与呼吸道黏膜免疫:诱人设想仍带来令人失望的结果]

[Antiviral vaccination and respiratory mucosal immunity: still disappointing results from a seductive idea].

作者信息

Denis F, Alain S, Hantz S, Lagrange P

机构信息

Laboratoire de bactériologie-virologie-hygiène, CHU Dupuytren, Limoges.

出版信息

Presse Med. 2005 Oct 8;34(17):1245-53. doi: 10.1016/s0755-4982(05)84165-x.

Abstract

Mucosal surfaces of the respiratory tract represent a major portal of entry for most human viruses and a critical component of the mammalian immunologic repertoire. The major antibody isotype in external secretions is secretory immunoglobin A (S-IgA). The major effector cells in mucosal surfaces, however, are not IgA B cells, but T lymphocytes, which may account for up to 80% of the mucosal lymphoid cell population. Mucosal immunoprophylaxis is theoretically an important approach to control infections acquired through these portals. Passive antibodies can protect against mucosal viral infections, as shown for respiratory syncytial virus, but very high quantities of passive antibodies are needed to restrict virus replication on mucosal surface. Factors likely to induce mucosal antibody and cell-mediated immune responses include oral or respiratory routes of immunization and active (effectively replicating) vaccine agents. Very few antiviral vaccines have been developed to protect the mucosal surface of the respiratory tract, and only an attenuated influenza virus vaccine uses the nasal route. Other vaccines, approved for parenteral use, have been administered experimentally by the nasal route; these include active (replicating) and inactive (nonreplicating) vaccines. By this route they induce only a moderate local mucosal response. Neither the development of mucosal immunity nor the administration of vaccines via the mucosal route is essential for control or prevention of most respiratory viral infections and diseases acquired through the respiratory tract. Nonetheless, the example of the live attenuated intranasal influenza vaccine, which induces both systemic and local immune response, is promising for the future of mucosal immunization against respiratory viral infections.

摘要

呼吸道的黏膜表面是大多数人类病毒的主要侵入门户,也是哺乳动物免疫体系的关键组成部分。外分泌液中的主要抗体类型是分泌型免疫球蛋白A(S-IgA)。然而,黏膜表面的主要效应细胞并非IgA B细胞,而是T淋巴细胞,其数量可能占黏膜淋巴细胞群体的80%。理论上,黏膜免疫预防是控制通过这些门户获得感染的重要方法。被动抗体可预防黏膜病毒感染,如呼吸道合胞病毒,但需要大量的被动抗体才能限制病毒在黏膜表面的复制。可能诱导黏膜抗体和细胞介导免疫反应的因素包括口服或呼吸道免疫途径以及活性(能有效复制)疫苗制剂。目前开发用于保护呼吸道黏膜表面的抗病毒疫苗极少,只有减毒流感病毒疫苗采用鼻内接种途径。其他已获批用于注射的疫苗也已通过鼻内途径进行实验性接种;这些包括活性(可复制)疫苗和非活性(不可复制)疫苗。通过这种途径,它们仅诱导适度的局部黏膜反应。对于大多数通过呼吸道获得的呼吸道病毒感染和疾病的控制或预防而言,黏膜免疫的发展以及通过黏膜途径接种疫苗都并非必不可少。尽管如此,减毒活鼻内流感疫苗既能诱导全身免疫反应又能诱导局部免疫反应,这一例子对未来针对呼吸道病毒感染的黏膜免疫接种而言很有前景。

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