Wu Stephan J, Villarreal Daniel O, Shedlock Devon J, Weiner David B
Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, 505A Stellar-Chance Laboratories Curie Blvd, Philadelphia, 19104, PA, USA.
Adv Exp Med Biol. 2015;848:131-48. doi: 10.1007/978-1-4939-2432-5_7.
There is no licensed vaccine or cure for human cytomegalovirus (CMV), a ubiquitous β-herpes virus that infects 60-95 % of adults worldwide. Infection is a major cause of congenital abnormalities in newborns, contributes to development of childhood cerebral palsy and medulloblastoma, can result in severe disease in immunocompromised patients, and is a major impediment during successful organ transplantation. While CMV has been increasingly associated with numerous inflammatory diseases and cancers, only recently has it been correlated with increased risk of heart disease in adults, the number-one killer in the USA. These data, among others, suggest that subclinical CMV infection, or microinfection, in healthy individuals may play more of a causative role than an epiphenomenon in development of CMV-associated pathologies. Due to the myriad of diseases and complications associated with CMV, an efficacious vaccine would be highly valuable in reducing human morbidity and mortality as well as saving billions of dollars in annual health-care costs and disability adjusted life years (DALY) in the developing world. Therefore, the development of a safe efficacious CMV vaccine or immune therapy is paramount to the public health. This review aims to provide a brief overview on aspects of CMV infection and disease and focuses on current vaccine strategies. The use of new synthetic DNA vaccines might offer one such approach to this difficult problem.
人类巨细胞病毒(CMV)是一种普遍存在的β疱疹病毒,全球60%-95%的成年人都曾感染过该病毒,但目前尚无获得许可的疫苗或治疗方法。感染是新生儿先天性异常的主要原因,与儿童脑瘫和髓母细胞瘤的发展有关,可导致免疫功能低下患者出现严重疾病,并且是成功进行器官移植的主要障碍。虽然CMV越来越多地与多种炎症性疾病和癌症相关,但直到最近才发现它与美国头号杀手——成人心脏病风险增加有关。这些数据以及其他一些数据表明,健康个体中的亚临床CMV感染或微感染,在CMV相关病理发展中可能更多地起到病因作用,而非附带现象。由于CMV会引发众多疾病和并发症,一种有效的疫苗对于降低人类发病率和死亡率、在发展中国家节省数十亿美元的年度医疗保健成本以及伤残调整生命年(DALY)具有极高价值。因此,开发安全有效的CMV疫苗或免疫疗法对公众健康至关重要。本综述旨在简要概述CMV感染和疾病的各个方面,并重点关注当前的疫苗策略。使用新型合成DNA疫苗可能为解决这一难题提供一种方法。