Rezza Giovanni
Pathog Glob Health. 2015 Jun;109(4):170-3. doi: 10.1179/2047773215Y.0000000017. Epub 2015 May 14.
During the last decade, the chikungunya (CHIKV) virus has expanded its range of activity, conquering new territories and becoming an important global health threat. In particular, the challenge represented by the recent emergence of CHIKV in the Americas has strengthened the need of a safe and effective vaccine. Although research on vaccines against CHIKV has been slow, a few vaccine candidates have been tested over the years. Inactivated and attenuated vaccine candidates have shown promising results in phase I/II trials, and engineered vaccines have proven to be safe and immunogenic in mouse and/or non-human primate models. Recently, a vaccine based on virus-like particles (VLP) has been successfully tested in a phase I trial. However, large phase I/II controlled trials, which are needed in order to provide evidence of vaccine efficacy, may be planned only under certain conditions. First, they should be conducted during epidemic periods, when a large number of cases occur, in order to ensure an adequate study power. Second, they are expensive and investments returns are not always guaranteed. To overcome this problem, public/private partnership and government support, the identification of target population groups for vaccination and the commitment of donor agencies are key factors for supporting both the development and the availability of vaccines against neglected tropical diseases like chikungunya.
在过去十年中,基孔肯雅病毒(CHIKV)扩大了其活动范围,占领了新的地区,成为全球健康的重大威胁。特别是,最近基孔肯雅病毒在美洲出现所带来的挑战,强化了对安全有效疫苗的需求。尽管针对基孔肯雅病毒的疫苗研究进展缓慢,但多年来已有几种候选疫苗经过了测试。灭活和减毒候选疫苗在I/II期试验中显示出了有前景的结果,而工程疫苗在小鼠和/或非人类灵长类动物模型中已证明是安全且具有免疫原性的。最近,一种基于病毒样颗粒(VLP)的疫苗已在I期试验中成功测试。然而,为了提供疫苗效力的证据而必需的大型I/II期对照试验,可能仅在某些条件下才会计划开展。首先,试验应在大量病例出现的流行期间进行,以确保有足够的研究效力。其次,试验成本高昂,投资回报并不总是有保障。为克服这一问题,公私伙伴关系和政府支持、确定疫苗接种的目标人群以及捐助机构的投入,是支持针对基孔肯雅热等被忽视热带病的疫苗研发和供应的关键因素。