University of Tennessee Health Science Center, Department of Medicine and Veterans Affairs Medical Center Research Service, Memphis, TN, USA.
Vaccine. 2013 Mar 15;31(12):1576-81. doi: 10.1016/j.vaccine.2013.01.019. Epub 2013 Jan 31.
The greatest burden of group A streptococcal (GAS) disease worldwide is due to acute rheumatic fever (ARF) and rheumatic heart disease (RHD). Safe, effective and affordable vaccines designed to prevent GAS infections that trigger ARF could reduce the overall global morbidity and mortality from RHD. The current study evaluated the potential coverage of a new 30-valent M protein-based vaccine using GAS isolates from school children in Bamako, Mali, a population at high risk for the development of RHD.
The bactericidal activity of rabbit antisera against the 30-valent vaccine was assessed using a collection of GAS isolates recovered during a study of the epidemiology of pharyngitis in Bamako.
Single isolates representing 42 of 67 emm-types, accounting for 85% of the GAS infections during the study, were evaluated. All (14/14) of the vaccine emm-types in the collection were opsonized (bactericidal killing >50%) and 26/28 non-vaccine types were opsonized. Bactericidal activity was observed against 60% of the total emm-types recovered in Bamako, which accounted for 81% of all infections.
Multivalent vaccines comprised of N-terminal M peptides elicit bactericidal antibodies against a broad range of GAS serotypes, indicating that their efficacy may extend beyond the emm-types included in the vaccine.
全球 A 组链球菌（GAS）疾病的最大负担是由急性风湿热（ARF）和风湿性心脏病（RHD）引起的。旨在预防引发 ARF 的 GAS 感染的安全、有效和负担得起的疫苗，可以降低 RHD 的全球总发病率和死亡率。本研究评估了一种新的 30 价 M 蛋白疫苗在马里巴马科学龄儿童中的潜在覆盖面，该人群发生 RHD 的风险较高。
使用在巴马科咽炎流行病学研究中回收的 GAS 分离株评估兔抗血清对 30 价疫苗的杀菌活性。
评估了代表 67 种 emm 型中的 42 种的单一分离株，占研究期间 GAS 感染的 85%。该系列中的所有（14/14）疫苗 emm 型均被调理（杀菌杀伤> 50%），28 种非疫苗型中有 26 种被调理。观察到针对在巴马科回收的总 emm 型的 60%具有杀菌活性，占所有感染的 81%。
由 N 端 M 肽组成的多价疫苗可引发针对广泛 GAS 血清型的杀菌抗体，表明其疗效可能超出疫苗中包含的 emm 型。
