Parez Nathalie
Urgences Pédiatriques, Hôpital Trousseau, AP-HP, Université Pierre et Marie Curie, EA3500, 26 rue du Dr A Netter, 75571 Paris cedex 12, France.
Comp Immunol Microbiol Infect Dis. 2008 Mar;31(2-3):253-69. doi: 10.1016/j.cimid.2007.07.005. Epub 2007 Aug 14.
Rotaviruses (RVs) are the main aetiologic agent of severe acute diarrhoea in children under the age of 5, worldwide. Given that the currently available preventive measures to fight against the transmission of RV disease are not sufficiently effective, vaccination likely represents the only efficacious adapted response to the massive impact of this infection. Although the two current RV vaccines have shown good tolerance and significant efficacy to protect infant against severe RV disease, their development have raised key questions that are still unanswered regarding their cost, efficacy and safety. These two vaccines have in common the disadvantages related to the use of oral attenuated live viruses which limit their implementation in both developed and developing countries. In order to overcome these hurdles, it is important to support the development of new, non-replicating vaccines which will not suffer the potential disadvantages of the present vaccines. New approaches and other routes of administration are being tested in animal models and soon will be evaluated in humans. Among those are viral-like particle-based vaccines which have provided the most promising results. Finally, the epidemiology of the disease which differs in developed and developing countries can affect decisions about vaccine composition and delivery. The answer brought by the development of new RV vaccines could reside in developing several types of RV vaccines specifically designed to be used in different settings.
轮状病毒（RVs）是全球5岁以下儿童严重急性腹泻的主要病因。鉴于目前可用的预防RV疾病传播的措施不够有效，疫苗接种可能是应对这种感染巨大影响的唯一有效适应性措施。尽管目前的两种RV疫苗已显示出良好的耐受性和显著的功效，可保护婴儿免受严重RV疾病的侵害，但它们的研发引发了一些关键问题，在成本、功效和安全性方面仍未得到解答。这两种疫苗都存在与使用口服减毒活病毒相关的缺点，这限制了它们在发达国家和发展中国家的应用。为了克服这些障碍，支持开发新的非复制型疫苗很重要，这种疫苗不会有目前疫苗的潜在缺点。新方法和其他给药途径正在动物模型中进行测试，很快将在人体中进行评估。其中基于病毒样颗粒的疫苗取得了最有希望的结果。最后，发达国家和发展中国家不同的疾病流行病学情况可能会影响疫苗成分和接种方式的决策。新型RV疫苗研发带来的答案可能在于开发几种专门设计用于不同环境的RV疫苗。
