Licciardi Paul V, Tang Mimi L K
Pneumococcal Laboratory, Murdoch Childrens Research Institute, Melbourne, Australia.
Discov Med. 2011 Dec;12(67):525-33.
Vaccine-preventable diseases are still responsible for the deaths of more than 1 million children under the age of 5 years annually, mostly in developing countries. A substantial number of these deaths are due to pneumococcal bacteria and infections with rotavirus. Important issues faced by the WHO, governments, vaccine manufacturers, and international organizations such as UNICEF and the Global Alliance for Vaccines and Immunization (GAVI) are the cost-effective introduction of these life-saving vaccines in resource-poor countries where there is a considerable disease burden, and achieving high rates of completion of vaccination schedules remains elusive. Problems with vaccine coverage and vaccine delivery in these regions are significant, as in some cases large proportions of the target population do not receive adequate vaccination. Consequently, there is a need to develop more effective vaccination strategies that can provide adequate protection with reduced schedules. To date, emphasis has been placed on identifying novel vaccine antigens and adjuvants that induce stronger protective immune responses, as well as developing mucosally-administered vaccines. These approaches would have enormous benefits in allowing safe administration of vaccines in remote areas and may overcome the necessity for multiple doses. In this regard, the use of probiotic bacteria as novel mucosal adjuvants to enhance existing vaccine specific-immune responses offers an exciting new approach. In this review, we discuss the evidence for the role of probiotics in enhancing vaccine responses and provide justification for further investigation into their clinical effects and mechanisms of action.
疫苗可预防疾病每年仍导致100多万5岁以下儿童死亡，其中大部分发生在发展中国家。这些死亡中有很大一部分是由肺炎球菌和轮状病毒感染所致。世界卫生组织、各国政府、疫苗生产商以及联合国儿童基金会和全球疫苗免疫联盟（GAVI）等国际组织面临的重要问题是，在疾病负担相当重的资源匮乏国家以具有成本效益的方式引入这些挽救生命的疫苗，而实现高疫苗接种率仍然难以实现。这些地区的疫苗接种覆盖率和疫苗供应存在重大问题，因为在某些情况下，很大比例的目标人群没有得到充分的疫苗接种。因此，需要制定更有效的疫苗接种策略，以减少接种次数并提供充分的保护。迄今为止，重点一直放在识别能诱导更强保护性免疫反应的新型疫苗抗原和佐剂，以及开发黏膜给药疫苗上。这些方法在偏远地区安全接种疫苗方面将带来巨大益处，并且可能克服多剂接种的必要性。在这方面，使用益生菌作为新型黏膜佐剂来增强现有疫苗的特异性免疫反应提供了一种令人兴奋的新方法。在这篇综述中，我们讨论了益生菌在增强疫苗反应中作用的证据，并为进一步研究其临床效果和作用机制提供了依据。
