Loukas Alex, Bethony Jeffrey, Brooker Simon, Hotez Peter
Division of Infectious Diseases and Immunology, Queensland Institute of Medical Research, Brisbane, Australia.
Lancet Infect Dis. 2006 Nov;6(11):733-41. doi: 10.1016/S1473-3099(06)70630-2.
Hookworms are gastrointestinal nematodes that infect almost 1 billion people in developing countries. The main clinical symptom of human hookworm infections is iron-deficiency anaemia, a direct consequence of the intestinal blood loss resulting from the parasite's feeding behaviour. Although treatment is available and currently used for the periodic removal of adult hookworms from patients, this approach has not effectively controlled hookworm in areas of rural poverty. Furthermore, treated individuals remain susceptible to reinfection following exposure to third-stage infective hookworm larvae in the soil as early as 4-12 months after drug treatment. Therefore, a prophylactic vaccine against hookworm infection would provide an attractive additional tool for the public-health control of this disease. The feasibility of developing a vaccine is based on the previous success of an attenuated larval vaccine against canine hookworm. Several laboratory and field studies have explored the development of a human anti-hookworm vaccine, describing potential protective mechanisms and identifying candidate antigens, one of which is now in clinical trials. The current roadmap that investigators have conceived has been influenced by vaccine development for blood-feeding nematodes of livestock and companion animals; however, recombinant vaccines have yet to be developed for nematodes that parasitise animals or human beings. The roadmap also addresses the obstacles facing development of a vaccine for developing countries, where there is no commercial market.
钩虫是一种胃肠道线虫，在发展中国家感染了近10亿人。人类钩虫感染的主要临床症状是缺铁性贫血，这是寄生虫进食行为导致肠道失血的直接后果。尽管有治疗方法且目前用于定期清除患者体内的成虫，但这种方法在农村贫困地区并未有效控制钩虫感染。此外，接受治疗的个体在药物治疗后早至4 - 12个月接触土壤中的第三期感染性钩虫幼虫后仍易再次感染。因此，一种预防钩虫感染的疫苗将为这种疾病的公共卫生控制提供一种有吸引力的额外工具。开发疫苗的可行性基于之前一种减毒幼虫疫苗对犬钩虫的成功应用。多项实验室和现场研究探索了人类抗钩虫疫苗的开发，描述了潜在的保护机制并确定了候选抗原，其中一种目前正在进行临床试验。研究人员构想的当前路线图受到了家畜和伴侣动物吸血线虫疫苗开发的影响；然而，针对寄生动物或人类的线虫，重组疫苗尚未开发出来。该路线图还解决了在没有商业市场的发展中国家开发疫苗所面临的障碍。
