Ausiello Clara Maria, Cassone Antonio
Anti-Infectious Immunity Unit, Department of Infectious, Parasitic and Immune-Mediated Diseases, Istituto Superiore di Sanità, Rome, Italy.
Department of Experimental Medicine and Biochemical Sciences, Medical School, University of Perugia, Perugia, Italy
mBio. 2014 Jun 10;5(3):e01339-14. doi: 10.1128/mBio.01339-14.
The resurgence of pertussis (whooping cough) in countries with high vaccination coverage is alarming and invites reconsideration of the use of current acellular pertussis (aP) vaccines, which have largely replaced the old, reactogenic, whole-cell pertussis (wP) vaccine. Some drawbacks of these vaccines in terms of limited antigenic composition and early waning of antibody levels could be anticipated by the results of in-trial or postlicensure human investigations of B- and T-cell responses in aP versus wP vaccine recipients or unvaccinated, infected children. Recent data in experimental models, including primates, suggest that generation of vaccines capable of a potent, though regulated, stimulation of innate immunity driving effective, persistent adaptive immune responses against Bordetella pertussis infection should be privileged. Adjuvants that skew Th1/Th17 responses or new wP (detoxified or attenuated) vaccines should be explored. Nonetheless, the high merits of the current aP vaccines in persuading people to resume vaccination against pertussis should not be forgotten.
在疫苗接种覆盖率高的国家中百日咳（百日咳）的再度流行令人担忧，这促使人们重新考虑使用目前的无细胞百日咳（aP）疫苗，这种疫苗已在很大程度上取代了旧的、有反应原性的全细胞百日咳（wP）疫苗。通过对aP疫苗与wP疫苗接种者或未接种疫苗的感染儿童进行的B细胞和T细胞反应的试验内或上市后人体研究结果，可以预见这些疫苗在抗原组成有限和抗体水平早期下降方面的一些缺点。包括灵长类动物在内的实验模型中的最新数据表明，应优先研发能够有效刺激先天免疫（尽管受到调控）从而驱动针对百日咳博德特氏菌感染产生有效、持久适应性免疫反应的疫苗。应探索能够偏向Th1/Th17反应的佐剂或新型wP（解毒或减毒）疫苗。尽管如此，目前aP疫苗在说服人们重新接种百日咳疫苗方面的高度优点不应被遗忘。
