Yogev Ram, Tan Tina
Children's Memorial Hospital, Special Infectious Diseases, Chicago, IL, USA.
Hum Vaccin. 2011 Aug;7(8):828-37. doi: 10.4161/hv.7.8.16270. Epub 2011 Aug 1.
Vaccination as a means to prevent meningococcal disease caused by Neisseria meningitidis is critical given the abrupt onset and rapid progression of this disease. Five serogroups--A, B, C, W-135, and Y--are responsible for the majority of cases. In developed countries, infants have the greatest risk of disease, with a smaller secondary peak observed in late adolescence. Vaccines utilizing the polysaccharide capsule are poorly immunogenic in young children but can reduce the incidence of meningococcal carriage in high risk groups. In contrast, protein conjugate vaccines to polysaccharide capsules A, C, W-135, and Y have broadened the population protection from disease but their effect on meningococcal carriage and transmission is yet unknown except for monovalent meningococcal C conjugate that has been shown to reduce carriage. Challenges remain in providing direct protection to infants and protection against meningococcal B disease. To date, outer membrane vesicle vaccines have been used to control meningococcal B disease in epidemic settings and vaccine candidates against subcapsular antigens are in development, but a vaccine that confers long-lasting protection is unavailable.
鉴于脑膜炎球菌病发病突然且进展迅速，接种疫苗作为预防由脑膜炎奈瑟菌引起的脑膜炎球菌病的手段至关重要。五个血清群——A、B、C、W - 135和Y——导致了大多数病例。在发达国家，婴儿患该病的风险最高，在青春期后期观察到一个较小的二次发病高峰。使用多糖荚膜的疫苗在幼儿中免疫原性较差，但可降低高危人群中脑膜炎球菌携带率。相比之下，针对多糖荚膜A、C、W - 135和Y的蛋白结合疫苗扩大了对疾病的人群保护范围，但它们对脑膜炎球菌携带和传播的影响尚不清楚，除了已显示可减少携带的单价脑膜炎球菌C结合疫苗。在为婴儿提供直接保护以及预防脑膜炎球菌B病方面仍存在挑战。迄今为止，外膜囊泡疫苗已用于在流行环境中控制脑膜炎球菌B病，针对荚膜下抗原的候选疫苗正在研发中，但尚无能够提供长期保护的疫苗。
