Centre for Respiratory Infection, National Heart and Lung Institute, Imperial College London, London, W2 1PG, UK.
Curr Top Microbiol Immunol. 2015;386:381-98. doi: 10.1007/82_2014_425.
Although vaccines against influenza are widely available, control of the disease remains elusive. In part, this is due to the inability of current vaccines to induce durable, broadly protective immune responses. Prevention of influenza depends primarily on effective antibody responses that block virus entry. Following infection, high-affinity IgA antibodies are generated in the respiratory tract that lead to immune exclusion, while IgG prevents systemic spread. These are effective and long-lasting but also exert immune pressure. Mutation of the antigenic determinants of influenza therefore rapidly leads to emergence of novel variants that evade previously generated protective responses. Not only do vaccines suffer from this strain-specific limitation, but also they are suboptimal in their ability to induce durable immunity. However, recent evidence has demonstrated the possibility of inducing broadly cross-reactive antibody responses. Further understanding of the ways in which high-titer, long-lived antibody responses directed against such cross-reactive epitopes can be induced would lead to the development of novel vaccines that may remove the requirement for recurrent vaccination.
尽管流感疫苗已经广泛应用,但该病的防控仍然难以实现。部分原因是,目前的疫苗无法诱导持久、广泛的保护性免疫反应。流感的预防主要依赖于能阻断病毒进入的有效抗体反应。感染后,呼吸道中会产生高亲和力的 IgA 抗体,从而导致免疫排斥,而 IgG 则可防止病毒全身扩散。这些抗体有效且持久,但也会产生免疫压力。因此,流感抗原决定簇的突变会迅速导致新的变异体出现,从而逃避之前产生的保护性反应。不仅疫苗存在这种针对特定菌株的局限性,而且它们在诱导持久免疫方面的效果也不佳。然而,最近的证据表明,诱导广泛交叉反应性抗体反应是可能的。进一步了解针对这些交叉反应性表位产生高滴度、长寿命抗体反应的方法,将有助于开发新型疫苗,可能不再需要反复接种疫苗。