Webster Daniel P, Farrar Jeremy, Rowland-Jones Sarah
Department of Infectious Diseases and Microbiology, John Radcliffe Hospital, Oxford, UK.
Lancet Infect Dis. 2009 Nov;9(11):678-87. doi: 10.1016/S1473-3099(09)70254-3.
The spread of dengue virus throughout the tropics represents a major, rapidly growing public health problem with an estimated 2.5 billion people at risk of dengue fever and the life-threatening disease, severe dengue. A safe and effective vaccine for dengue is urgently needed. The pathogenesis of severe dengue results from a complex interaction between the virus, the host, and, at least in part, immune-mediated mechanisms. Vaccine development has been slowed by fears that immunisation might predispose individuals to the severe form of dengue infection. A pipeline of candidate vaccines now exists, including live attenuated, inactivated, chimeric, DNA, and viral-vector vaccines, some of which are at the stage of clinical testing. In this Review, we present what is understood about dengue pathogenesis and its implications for vaccine design, the progress that is being made in the development of a vaccine, and the future challenges.
登革热病毒在整个热带地区的传播是一个重大且迅速发展的公共卫生问题，估计有25亿人面临登革热以及危及生命的重症登革热的风险。迫切需要一种安全有效的登革热疫苗。重症登革热的发病机制源于病毒、宿主之间复杂的相互作用，且至少部分是由免疫介导机制引起的。由于担心免疫接种可能使个体易患重症登革热感染，疫苗研发进程一直较为缓慢。目前已有一系列候选疫苗，包括减毒活疫苗、灭活疫苗、嵌合疫苗、DNA疫苗和病毒载体疫苗，其中一些正处于临床试验阶段。在本综述中，我们阐述了对登革热发病机制及其对疫苗设计的影响的理解、疫苗研发所取得的进展以及未来面临的挑战。
