US Military Malaria Vaccine Program, Naval Medical Research Center/Walter Reed Army Institute of Research, Silver Spring, MD, USA.
Vaccine. 2010 Jul 12;28(31):4880-94. doi: 10.1016/j.vaccine.2010.05.033. Epub 2010 May 27.
RTS,S is the most advanced candidate vaccine against human malaria. During its remarkable journey from conception and design in the early 1980s to the multicenter Phase 3 trial currently underway across sub-Saharan Africa, RTS,S has overcome tremendous challenges and disproved established vaccine paradigms. In the last several years, Phase 2 studies conducted in infants and children in endemic areas have established the efficacy of RTS,S for reducing morbidity due to clinical malaria. If the results are realized in the Phase 3 trial, the chances for licensure in the near future appear high. Such progress is all the more remarkable given our lack of clear understanding regarding how the vaccine activates the human immune system, the immune correlates of protection or the mechanism whereby a vaccine targeting sporozoites and liver stage parasites can reduce the clinical disease associated with parasitemia. These unanswered questions pose important challenges to be addressed in the quest to understand the protection afforded by RTS,S and to build a more efficacious second generation vaccine against malaria. This review will focus on current knowledge about the protective efficacy of RTS,S and what we have learned regarding its impact on the human immune system.
RTS,S 是最先进的疟疾候选疫苗。从 20 世纪 80 年代初的构思和设计，到目前在撒哈拉以南非洲进行的多中心 3 期试验，RTS,S 克服了巨大的挑战，打破了传统的疫苗模式。在过去几年中，在流行地区的婴儿和儿童中进行的 2 期研究已经证实了 RTS,S 对降低临床疟疾发病率的疗效。如果 3 期试验的结果得到证实，那么在不久的将来获得许可的机会似乎很高。鉴于我们对疫苗如何激活人体免疫系统、保护的免疫相关性或针对疟原虫和肝脏阶段寄生虫的疫苗如何减少与寄生虫血症相关的临床疾病的机制缺乏清晰的认识，这一进展更加引人注目。这些未解决的问题对理解 RTS,S 提供的保护以及构建更有效的疟疾第二代疫苗构成了重要挑战。这篇综述将重点介绍关于 RTS,S 的保护效力的现有知识，以及我们对其对人体免疫系统影响的了解。
