Kweon Mi-Na
Mucosal Immunology Section, Laboratory Science Division, International Vaccine Institute, Kwanak-Gu, Seoul, Korea.
Curr Opin Infect Dis. 2008 Jun;21(3):313-8. doi: 10.1097/QCO.0b013e3282f88b92.
Shigellosis, a major form of bacillary dysentery, is caused by infection with Shigella organisms. In poor countries, Shigella-caused dysentery is endemic and causes an estimated 163 million illness episodes annually and more than one million deaths. Although several strategies have been used to develop vaccines targeting shigellosis, none has been licensed for use outside China. Owing to the wide range of Shigella serotypes and subtypes, there is a need for a multivalent vaccine representing prevalent species and serotypes.
Vaccine development has been limited by the lack of a suitable animal model for vaccine testing. This review discusses the most advanced strategies for Shigella vaccine development including live attenuated, conjugate, broad spectrum, and proteosome-based vaccines and describes current animal models under study.
The greatest barrier to the use of vaccine against shigellosis in developing areas is poor immune responses to oral vaccines in children who have minimal maternal antibodies. Clinical studies of promising shigellosis vaccine candidates are urgently needed after confirmation of safety, immunogenicity, and protection in volunteer challenge models.
志贺氏菌病是细菌性痢疾的主要形式，由感染志贺氏菌属微生物引起。在贫穷国家，志贺氏菌引起的痢疾呈地方性流行，估计每年导致1.63亿例发病，死亡人数超过100万。尽管已采用多种策略来研发针对志贺氏菌病的疫苗，但在中国以外地区尚无获批使用的疫苗。由于志贺氏菌血清型和亚型种类繁多，需要一种代表流行菌种和血清型的多价疫苗。
疫苗研发受到缺乏合适疫苗测试动物模型的限制。本综述讨论了志贺氏菌疫苗研发的最先进策略，包括减毒活疫苗、结合疫苗、广谱疫苗和基于蛋白酶体的疫苗，并描述了目前正在研究的动物模型。
在发展中地区，使用疫苗预防志贺氏菌病的最大障碍是母体抗体极少的儿童对口服疫苗的免疫反应较差。在志愿者激发模型中确认安全性、免疫原性和保护作用后，迫切需要对有前景的志贺氏菌病候选疫苗进行临床研究。
