Respiratory Infection Group, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK.
Trends Microbiol. 2011 Sep;19(9):464-70. doi: 10.1016/j.tim.2011.06.003. Epub 2011 Jul 23.
Pneumococcal conjugate vaccines have had unprecedented success in controlling vaccine-type invasive pneumococcal disease. As serotype replacement and the complexity of designing vaccines to multiple capsular polysaccharides ultimately pose a threat to these vaccines, the development of alternative protein vaccines is important. Protein vaccines offer the promise of extended serotype coverage, reduced cost, and improved protection against otitis media and pneumococcal pneumonia. As placebo-controlled trials are not currently ethically justifiable, human pneumococcal challenge models using prevention of carriage as a test endpoint offer an attractive link between preclinical studies and clinical efficacy trials. Experimental human pneumococcal carriage studies offer a means of describing mechanisms of protection against carriage and a clinical tool to choose between vaccine candidates.
肺炎球菌结合疫苗在控制疫苗型侵袭性肺炎球菌病方面取得了前所未有的成功。由于血清型替代以及为多种荚膜多糖设计疫苗的复杂性最终对这些疫苗构成威胁，因此开发替代蛋白疫苗很重要。蛋白疫苗有望扩大血清型覆盖范围、降低成本，并改善对中耳炎和肺炎球菌肺炎的保护。由于目前进行安慰剂对照试验在伦理上是不合理的，因此使用预防携带作为试验终点的人体肺炎球菌挑战模型为临床疗效试验提供了一种有吸引力的联系。实验性人体肺炎球菌携带研究提供了一种描述针对携带的保护机制的方法，以及一种在候选疫苗之间进行选择的临床工具。
