Center for Immunobiology and Vaccine Development, Children's Hospital Oakland Research Institute, Oakland, California, USA.
Clin Infect Dis. 2010 Mar 1;50 Suppl 2(S2):S54-65. doi: 10.1086/648966.
No broadly effective vaccines are available for prevention of group B meningococcal disease, which accounts for >50% of all cases. The group B capsule is an autoantigen and is not a suitable vaccine target. Outer-membrane vesicle vaccines appear to be safe and effective, but serum bactericidal responses in infants are specific for a porin protein, PorA, which is antigenically variable. To broaden protection, outer-membrane vesicle vaccines have been prepared from >1 strain, from mutants with >1 PorA, or from mutants with genetically detoxified endotoxin and overexpressed desirable antigens, such as factor H binding protein. Also, recombinant protein vaccines such as factor H binding protein, given alone or in combination with other antigens, are in late-stage clinical development and may be effective against the majority of group B strains. Thus, the prospects have never been better for developing vaccines for prevention of meningococcal disease, including that caused by group B strains.
目前尚无广泛有效的疫苗可用于预防 B 群脑膜炎球菌病，该病占所有病例的>50%。B 群荚膜是自身抗原，不是合适的疫苗靶标。外膜囊泡疫苗似乎安全有效，但婴儿的血清杀菌反应特异性针对一种孔蛋白 PorA，其抗原性具有变异性。为了扩大保护范围，已从>1 株制备了外膜囊泡疫苗，从具有>1 种 PorA 的突变体或从遗传解毒内毒素和过表达理想抗原（如因子 H 结合蛋白）的突变体中制备了外膜囊泡疫苗。此外，单独或与其他抗原联合使用的重组蛋白疫苗，如因子 H 结合蛋白，目前处于临床开发后期，可能对大多数 B 群菌株有效。因此，开发预防脑膜炎球菌病疫苗的前景从未如此之好，包括由 B 群菌株引起的脑膜炎球菌病。
