The Jenner Institute, University of Oxford, Old Road Campus Research Building, Oxford OX37DQ, UK.
Philos Trans R Soc Lond B Biol Sci. 2011 Oct 12;366(1579):2806-14. doi: 10.1098/rstb.2011.0091.
There is no licenced vaccine against any human parasitic disease and Plasmodium falciparum malaria, a major cause of infectious mortality, presents a great challenge to vaccine developers. This has led to the assessment of a wide variety of approaches to malaria vaccine design and development, assisted by the availability of a safe challenge model for small-scale efficacy testing of vaccine candidates. Malaria vaccine development has been at the forefront of assessing many new vaccine technologies including novel adjuvants, vectored prime-boost regimes and the concept of community vaccination to block malaria transmission. Most current vaccine candidates target a single stage of the parasite's life cycle and vaccines against the early pre-erythrocytic stages have shown most success. A protein in adjuvant vaccine, working through antibodies against sporozoites, and viral vector vaccines targeting the intracellular liver-stage parasite with cellular immunity show partial efficacy in humans, and the anti-sporozoite vaccine is currently in phase III trials. However, a more effective malaria vaccine suitable for widespread cost-effective deployment is likely to require a multi-component vaccine targeting more than one life cycle stage. The most attractive near-term approach to develop such a product is to combine existing partially effective pre-erythrocytic vaccine candidates.
目前没有针对任何人体寄生虫病的许可疫苗,而疟原虫疟疾是传染性死亡的主要原因,这给疫苗开发者带来了巨大的挑战。这促使人们评估了多种疟疾疫苗设计和开发方法,而小型候选疫苗功效测试的安全挑战模型的出现也为此提供了帮助。疟疾疫苗的开发一直处于评估许多新疫苗技术的前沿,包括新型佐剂、载体引发增强方案以及阻断疟疾传播的社区免疫接种概念。大多数当前的疫苗候选物针对寄生虫生命周期的单一阶段,针对早期红细胞前阶段的疫苗已显示出最大的成功。一种佐剂疫苗中的蛋白质通过针对孢子虫的抗体发挥作用,而针对细胞内肝期寄生虫的病毒载体疫苗则通过细胞免疫显示出一定的功效,抗孢子虫疫苗目前正在进行 III 期临床试验。然而,一种更有效的、适合广泛成本效益部署的疟疾疫苗可能需要针对多个生命周期阶段的多组分疫苗。开发此类产品最具吸引力的近期方法是将现有部分有效的红细胞前期疫苗候选物结合起来。