Pace David
Mater Dei Hospital, Department of Paediatrics, Tal-Qroqq, Msida, MSD 2090, Malta.
Curr Opin Mol Ther. 2009 Dec;11(6):692-706.
Invasive meningococcal disease remains a major public health concern, with infants, children younger than 4 years and adolescents bearing the majority of the global disease burden. Protecting the vulnerable individuals in these age groups through vaccination remains the most rational strategy for the prevention of meningococcal disease. The formulation of polysaccharide-protein conjugate vaccines has been a major breakthrough in vaccinology, and has extended protection against pathogenic encapsulated bacteria to younger age groups. The dramatic decline in the incidence of Neisseria meningitidis serogroup C disease, observed following the introduction of glycoconjugate meningococcal C vaccines, demonstrates that vaccination can control disease at a population level. The development of quadrivalent glycoconjugate meningococcal ACWY vaccines has broadened protection against meningococcal disease. A novel meningococcal MenACWY-CRM (Menveo) glycoconjugate vaccine, formulated by selective conjugation chemistry of intermediate-chain-length meningococcal saccharides, was immunogenic in individuals aged 2 months to 65 years. The reactogenicity of MenACWY-CRM was similar to that of other licensed meningococcal glycoconjugates, yet the vaccine has the potential to extend protection against meningococcal serogroups A, Y and W-135 to children younger than 2 years of age - a need that remains unmet.
侵袭性脑膜炎球菌病仍然是一个主要的公共卫生问题，婴儿、4岁以下儿童和青少年承担着全球大部分疾病负担。通过接种疫苗保护这些年龄组中的弱势群体仍然是预防脑膜炎球菌病最合理的策略。多糖-蛋白质结合疫苗的研制是疫苗学的一项重大突破，已将针对致病性包膜细菌的保护扩展到更年轻的年龄组。在引入糖结合脑膜炎球菌C疫苗后，观察到脑膜炎奈瑟菌C群疾病发病率大幅下降，这表明接种疫苗可以在人群层面控制疾病。四价糖结合脑膜炎球菌ACWY疫苗的研制扩大了对脑膜炎球菌病的保护范围。一种新型的脑膜炎球菌MenACWY-CRM（Menveo）糖结合疫苗，通过中链长度脑膜炎球菌糖类的选择性结合化学方法研制而成，在2个月至65岁的个体中具有免疫原性。MenACWY-CRM的反应原性与其他已获许可的脑膜炎球菌糖结合疫苗相似，但该疫苗有可能将针对脑膜炎球菌A、Y和W-135群的保护扩展到2岁以下儿童——这一需求仍未得到满足。
