Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, MD 21201, USA.
Vaccine. 2011 Dec 30;29 Suppl 4:D116-25. doi: 10.1016/j.vaccine.2011.11.090.
In developing countries, immunization delivery would be more efficient, safer and economical if all vaccines could elicit long-term protection following needle-free administration of just a single dose and without need for a cold chain, and if immunization left an indelible (e.g., serologic) marker that would identify immunized persons. A few existing vaccines (e.g., yellow fever, measles) confer long-term protection following a single dose. To accomplish the same with less immunogenic live vaccines and with non-living antigens, potent (parenteral and mucosal) adjuvants are required. Emerging knowledge of how the innate immune system modulates adaptive immune responses is guiding development of modern adjuvants that can markedly enhance immune responses to vaccines by selective stimulation of components of the innate immune system. Needle-free immunization can be accomplished by administering vaccines via mucosal (oral or nasal) or transcutaneous routes or by parenteral injection using needle-free injection devices. Technologies such as vitrification (treatment with trehalose followed by drying) render vaccines resistant to temperature extremes. Ideally, immunization would lead to a biomarker such as a specific vaccine-derived antibody that allows differentiation of successfully immunized persons from susceptibles.
在发展中国家，如果所有疫苗都能在无需冷链的情况下通过无针接种仅单剂就产生长期保护，并且免疫接种后留下不可磨灭的（例如血清学）标记来识别免疫接种者，那么疫苗接种的提供将更加高效、安全和经济。一些现有的疫苗（例如黄热病、麻疹）在接种一剂后就会产生长期保护。为了用不太具有免疫原性的活疫苗和非活抗原达到同样的效果，需要使用有效的（肠内和粘膜）佐剂。关于固有免疫系统如何调节适应性免疫反应的新知识正在指导现代佐剂的开发，这些佐剂可以通过选择性刺激固有免疫系统的成分，显著增强对疫苗的免疫反应。无针免疫接种可以通过粘膜（口服或鼻内）或经皮途径给予疫苗，或者通过使用无针注射装置的肠外注射来完成。玻璃化（用海藻糖处理后干燥）等技术使疫苗能够抵抗极端温度。理想情况下，免疫接种会产生一种生物标志物，如特定的疫苗衍生抗体，从而将成功免疫接种者与易感者区分开来。
