CNR-IGV, Institute of Plant Genetics, Portici, Naples, Italy.
Expert Rev Vaccines. 2010 Aug;9(8):925-36. doi: 10.1586/erv.10.79.
The introduction of highly active antiretroviral therapy has drastically changed HIV infection from an acute, very deadly, to a chronic, long-lasting, mild disease. However, this requires continuous care management, which is difficult to implement worldwide, especially in developing countries. Sky-rocketing costs of HIV-positive subjects and the limited success of preventive recommendations mean that a vaccine is urgently needed, which could be the only effective strategy for the real control of the AIDS pandemic. To be effective, vaccination will need to be accessible, affordable and directed against multiple antigens. Plant-based vaccines, which are easy to produce and administer, and require no cold chain for their heat stability are, in principle, suited to such a strategy. More recently, it has been shown that even highly immunogenic, enveloped plant-based vaccines can be produced at a competitive and more efficient rate than conventional strategies. The high variability of HIV epitopes and the need to stimulate both humoral neutralizing antibodies and cellular immunity suggest the importance of using the plant system: it offers a wide range of possible strategies, from single-epitope to multicomponent vaccines, modulators of the immune response (adjuvants) and preventive molecules (microbicides), either alone or in association with plant-derived monoclonal antibodies, besides the potential use of the latter as therapeutic agents. Furthermore, plant-based anti-HIV strategies can be administered not only parenterally but also by the more convenient and safer oral route, which is a more suitable approach for possible mass vaccination.
高效抗逆转录病毒疗法的引入,使 HIV 感染从急性、高度致命转变为慢性、长期、轻度疾病。然而,这需要持续的护理管理,这在全球范围内都很难实施,尤其是在发展中国家。HIV 阳性患者的成本不断飙升,预防建议的效果有限,这意味着迫切需要一种疫苗,而疫苗可能是真正控制艾滋病大流行的唯一有效策略。为了有效,疫苗必须易于获得、价格合理,并针对多种抗原。基于植物的疫苗易于生产和管理,并且其热稳定性不需要冷链,原则上适合这种策略。最近的研究表明,即使是高度免疫原性的基于植物的疫苗,也可以以比传统策略更具竞争力和更有效的速度生产。HIV 表位的高度变异性以及需要刺激体液中和抗体和细胞免疫的需求,表明使用植物系统的重要性:它提供了广泛的可能策略,从单一表位到多组分疫苗、免疫反应调节剂(佐剂)和预防分子(杀微生物剂),无论是单独使用还是与植物来源的单克隆抗体联合使用,此外,后者还有可能作为治疗剂使用。此外,基于植物的抗 HIV 策略不仅可以通过更方便和更安全的口服途径给药,这对于可能的大规模疫苗接种来说是一种更合适的方法。