Clarke E, Desselberger U
MRC Unit, The Gambia, Banjul, The Gambia.
Department of Medicine, University of Cambridge, Cambridge, UK.
Mucosal Immunol. 2015 Jan;8(1):1-17. doi: 10.1038/mi.2014.114. Epub 2014 Dec 3.
Rotaviruses (RV) are the leading cause of gastroenteritis in infants and children worldwide and are associated with high mortality predominately in low-income settings. The virus is classified into G and P serotypes and further into P genotypes based on differences in the surface-exposed proteins VP7 and VP4, respectively. Infection results in a variable level of protection from subsequent reinfection and disease. This protection is predominantly homotypic in some settings, whereas broader heterotypic protection is reported in other cohorts. Two antigenically distinct oral RV vaccines are licensed and are being rolled out widely, including in resource-poor setting, with funding provided by the GAVI alliance. First is a monovalent vaccine derived from a live-attenuated human RV strain, whereas the second is a pentavalent bovine-human reassortment vaccine. Both vaccines are highly efficacious in high-income settings, but greatly reduced levels of protection are reported in low-income countries. Here, the current challenges facing mucosal immunologists and vaccinologists aiming to define immunological correlates and to understand the variable levels of protection conferred by these vaccines in humans is considered. Such understanding is critical to maximize the public health impact of the current vaccines and also to the development of the next generation of RV vaccines, which are needed.
轮状病毒（RV）是全球婴幼儿肠胃炎的主要病因，在低收入地区主要导致高死亡率。该病毒根据表面暴露蛋白VP7和VP4的差异分别分为G和P血清型，并进一步分为P基因型。感染会产生不同程度的保护，防止后续再次感染和发病。在某些情况下，这种保护主要是同型的，而在其他队列中则报道有更广泛的异型保护。两种抗原性不同的口服RV疫苗已获许可并正在广泛推广，包括在资源匮乏地区，由全球疫苗免疫联盟（GAVI）提供资金。第一种是源自减毒活人类RV毒株的单价疫苗，第二种是五价牛-人重组疫苗。两种疫苗在高收入地区都非常有效，但在低收入国家报道的保护水平大幅降低。在此，探讨了黏膜免疫学家和疫苗学家目前面临的挑战，他们旨在确定免疫相关性，并了解这些疫苗在人类中所提供的不同程度的保护。这种理解对于最大限度地提高现有疫苗的公共卫生影响以及开发下一代所需的RV疫苗至关重要。
