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非伤寒沙门氏菌病:疫苗研发的现状

Nontyphoidal salmonella disease: Current status of vaccine research and development.

作者信息

Tennant Sharon M, MacLennan Calman A, Simon Raphael, Martin Laura B, Khan M Imran

机构信息

Center for Vaccine Development and Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA.

Jenner Institute, Nuffield Department of Medicine, University of Oxford, Roosevelt Drive, Oxford OX3 7DQ, United Kingdom; Wellcome Trust Sanger Institute, Wellcome Trust Genomes Campus, Hinxton, Cambridge CB10 1SA, United Kingdom.

出版信息

Vaccine. 2016 Jun 3;34(26):2907-2910. doi: 10.1016/j.vaccine.2016.03.072. Epub 2016 Mar 29.

Abstract

Among more than 2500 nontyphoidal Salmonella enterica (NTS) serovars, S. enterica serovar Typhimurium and S. enterica serovar Enteritidis account for approximately fifty percent of all human isolates of NTS reported globally. The global incidence of NTS gastroenteritis in 2010 was estimated to be 93 million cases, approximately 80 million of which were contracted via food-borne transmission. It is estimated that 155,000 deaths resulted from NTS in 2010. NTS also causes severe, extra-intestinal, invasive bacteremia, referred to as invasive nontyphoidal Salmonella (iNTS) disease. iNTS disease usually presents as a febrile illness, frequently without gastrointestinal symptoms, in both adults and children. Symptoms of iNTS are similar to malaria, often including fever (>90%) and splenomegaly (>40%). The underlying reasons for the high rates of iNTS disease in Africa are still being elucidated. Evidence from animal and human studies supports the feasibility of developing a safe and effective vaccine against iNTS. Both antibodies and complement can kill Salmonella species in vitro. Proof-of-principle studies in animal models have demonstrated efficacy for live attenuated and subunit vaccines that target the O-antigens, flagellin proteins, and other outer membrane proteins of serovars Typhimurium and Enteritidis. More recently, a novel delivery strategy for NTS vaccines has been developed: the Generalized Modules for Membrane Antigens (GMMA) technology which presents surface polysaccharides and outer membrane proteins in their native conformation. GMMA technology is self-adjuvanting, as it delivers multiple pathogen-associated molecular pattern molecules. GMMA may be particularly relevant for low- and middle-income countries as it has the potential for high immunologic potency at a low cost and involves a relatively simple production process without the need for complex conjugation. Several vaccines for the predominant NTS serovars Typhimurium and Enteritidis, are currently under development.

摘要

在2500多种非伤寒性肠炎沙门氏菌(NTS)血清型中,肠炎沙门氏菌鼠伤寒血清型和肠炎沙门氏菌肠炎血清型约占全球报告的所有人类NTS分离株的50%。2010年全球NTS肠胃炎的发病率估计为9300万例,其中约8000万例是通过食源性传播感染的。据估计,2010年有15.5万人死于NTS。NTS还会引发严重的肠外侵袭性菌血症,即侵袭性非伤寒性沙门氏菌(iNTS)病。iNTS病通常表现为发热性疾病,成人和儿童中常常没有胃肠道症状。iNTS的症状与疟疾相似,通常包括发热(>90%)和脾肿大(>40%)。非洲iNTS病高发的根本原因仍在研究中。动物和人体研究的证据支持开发一种安全有效的抗iNTS疫苗的可行性。抗体和补体在体外都能杀死沙门氏菌属。动物模型的原理验证研究表明,针对鼠伤寒血清型和肠炎血清型的O抗原、鞭毛蛋白和其他外膜蛋白的减毒活疫苗和亚单位疫苗具有疗效。最近,一种新型的NTS疫苗递送策略已经开发出来:膜抗原通用模块(GMMA)技术,该技术以天然构象呈现表面多糖和外膜蛋白。GMMA技术具有自我佐剂作用,因为它能递送多种病原体相关分子模式分子。GMMA对于低收入和中等收入国家可能特别重要,因为它有可能以低成本产生高免疫效力,并且生产过程相对简单,无需复杂的偶联。目前正在研发针对主要NTS血清型鼠伤寒血清型和肠炎血清型的几种疫苗。

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