Mater Dei Hospital, Department of Paediatrics, Msida, Malta.
Expert Opin Biol Ther. 2013 Jan;13(1):11-33. doi: 10.1517/14712598.2012.725718. Epub 2012 Sep 20.
The global disease burden of serious bacterial infections is caused mainly by Haemophilus influenzae type b (Hib), Streptococcus pneumoniae and Neisseria meningitidis. Death or disability may be the potential aftermath of invasive infections with these pathogens. Active immunisation is the only rational approach in preventing such infections.
This review discusses the immunology of vaccination and describes the immunogenicity, safety and impact of glycoconjugate vaccines that have been developed against Hib, the most prevalent serotypes of S. pneumoniae and N. meningitidis serogroups A, C, W-135 and Y in all ages. The immune response to the plain polysaccharide vaccines that target the same pathogens is compared to that induced by the respective glycoconjugate vaccine formulations.
Continued surveillance is necessary to recognise any epidemiological changes influenced by the impact of glycoconjugate vaccines and is crucial in guiding future vaccination strategies. Although, in general, the immunogenicity of glycoconjugate vaccines results in robust immune responses in all ages, subsequent booster doses may be necessary to sustain protection. Challenges in addressing inequities in vaccine availability between industrialised and developing countries are still there. The limitations of plain polysaccharide vaccines make immunisation with glycoconjugates a more sustainable long term option.
全球严重细菌感染的疾病负担主要由乙型流感嗜血杆菌(Hib)、肺炎链球菌和脑膜炎奈瑟菌引起。这些病原体的侵袭性感染可能导致死亡或残疾。主动免疫是预防此类感染的唯一合理方法。
本文综述了疫苗接种的免疫学,并描述了针对 Hib、肺炎链球菌最常见血清型以及脑膜炎奈瑟菌血清组 A、C、W-135 和 Y 的糖缀合物疫苗的免疫原性、安全性和影响。针对同一病原体的普通多糖疫苗所引起的免疫反应与相应糖缀合物疫苗制剂所诱导的免疫反应进行了比较。
需要持续监测以识别受糖缀合物疫苗影响的任何流行病学变化,这对于指导未来的疫苗接种策略至关重要。尽管一般来说,糖缀合物疫苗的免疫原性可在所有年龄段产生强大的免疫反应,但可能需要后续加强剂量以维持保护。在解决工业化国家和发展中国家之间疫苗供应不平等问题方面仍然存在挑战。普通多糖疫苗的局限性使得接种糖缀合物疫苗成为更可持续的长期选择。