Murphy Timothy F
Division of Infectious Diseases, Department of Medicine, Clinical and Translational Research Center, Department of Microbiology and Immunology, University at Buffalo, State University of New York, Buffalo, New York, USA
Clin Vaccine Immunol. 2015 May;22(5):459-66. doi: 10.1128/CVI.00089-15. Epub 2015 Mar 18.
Infections due to nontypeable Haemophilus influenzae result in enormous global morbidity in two clinical settings: otitis media in children and respiratory tract infections in adults with chronic obstructive pulmonary disease (COPD). Recurrent otitis media affects up to 20% of children and results in hearing loss, delays in speech and language development and, in developing countries, chronic suppurative otitis media. Infections in people with COPD result in clinic and emergency room visits, hospital admissions, and respiratory failure. An effective vaccine would prevent morbidity, help control health care costs, and reduce antibiotic use, a major contributor to the global crisis in bacterial antibiotic resistance. The widespread use of the pneumococcal conjugate vaccines is causing a relative increase in H. influenzae otitis media. The partial protection against H. influenzae otitis media induced by the pneumococcal H. influenzae protein D conjugate vaccine represents a proof of principle of the feasibility of a vaccine for nontypeable H. influenzae. An ideal vaccine antigen should be conserved among strains, have abundant epitopes on the bacterial surface, be immunogenic, and induce protective immune responses. Several surface proteins of H. influenzae have been identified as potential vaccine candidates and are in various stages of development. With continued research, progress toward a broadly effective vaccine to prevent infections caused by nontypeable H. influenzae is expected over the next several years.
儿童中耳炎和慢性阻塞性肺疾病（COPD）成人的呼吸道感染。复发性中耳炎影响高达20%的儿童，并导致听力丧失、言语和语言发育延迟，在发展中国家还会导致慢性化脓性中耳炎。COPD患者的感染会导致门诊和急诊就诊、住院以及呼吸衰竭。一种有效的疫苗将预防发病，有助于控制医疗成本，并减少抗生素使用，而抗生素使用是全球细菌抗生素耐药性危机的主要促成因素。肺炎球菌结合疫苗的广泛使用导致流感嗜血杆菌中耳炎相对增加。肺炎球菌流感嗜血杆菌蛋白D结合疫苗对流感嗜血杆菌中耳炎的部分保护代表了不可分型流感嗜血杆菌疫苗可行性的原理证明。理想的疫苗抗原应在菌株间保守，在细菌表面有丰富的表位，具有免疫原性，并诱导保护性免疫反应。流感嗜血杆菌的几种表面蛋白已被确定为潜在的疫苗候选物，正处于不同的开发阶段。随着持续研究，预计在未来几年内会朝着预防不可分型流感嗜血杆菌引起的感染的广泛有效疫苗取得进展。
