Polack Fernando P
Department of Pediatrics, Johns Hopkins University School of Medicine Baltimore, MD 21205, USA.
Pediatr Res. 2007 Jul;62(1):111-5. doi: 10.1203/PDR.0b013e3180686ce0.
Atypical measles and enhanced respiratory syncytial virus disease (ERD) were serious diseases that resulted from exposure of children immunized with inactivated vaccines against measles virus (MV) and respiratory syncytial virus (RSV) to the respective wild-type agents in the 1960s. Although the clinical manifestations of both illnesses were different, the immune responses elicited and primed for by the vaccines shared important similarities. Both vaccines failed to elicit long-lived protective antibody and to promote cytotoxic T lymphocyte responses. In both cases, postvaccination exposure to wild type virus during community outbreaks was associated with immune complex deposition in affected tissues, vigorous CD4 T lymphocyte proliferative responses, and a Th2 bias of the immune response. No relapses of atypical measles or ERD were ever reported. In this manuscript, the pathogeneses of both enhanced diseases and the requirements for the generation of protective antibodies against MV and RSV are discussed, to contribute to the development of newer safe and effective vaccines against these important pathogens.
非典型麻疹和强化呼吸道合胞病毒病（ERD）是20世纪60年代接种麻疹病毒（MV）和呼吸道合胞病毒（RSV）灭活疫苗的儿童接触相应野生型病原体后引发的严重疾病。尽管这两种疾病的临床表现不同，但疫苗引发和启动的免疫反应有重要的相似之处。两种疫苗均未能引发持久的保护性抗体，也未能促进细胞毒性T淋巴细胞反应。在这两种情况下，社区暴发期间接种疫苗后接触野生型病毒都与免疫复合物在受影响组织中的沉积、强烈的CD4 T淋巴细胞增殖反应以及免疫反应的Th2偏向有关。从未有非典型麻疹或ERD复发的报道。在本手稿中，讨论了这两种强化疾病的发病机制以及产生针对MV和RSV的保护性抗体的要求，以促进开发针对这些重要病原体的更新、安全有效的疫苗。
