Human Vaccine Institute, Duke University Medical Center, Durham, NC, USA.
Human Vaccine Institute, Duke University Medical Center, Durham, NC, USA; Department of Pediatrics, Duke University Medical Center, Durham, NC, USA.
Placenta. 2017 Dec;60 Suppl 1(Suppl 1):S73-S79. doi: 10.1016/j.placenta.2017.04.011. Epub 2017 Apr 20.
Human cytomegalovirus (HCMV) is the most common congenitally transmitted pathogen worldwide, impacting an estimated 1 million newborns annually. In a subset of infected infants, congenital HCMV causes severe, long-lasting sequelae, including deafness, microcephaly, neurodevelopmental delay, and even death. Accordingly, a maternal vaccine to prevent congenital HCMV infection continues to be a top public health priority. Nevertheless, all vaccines tested to date have failed to meet clinical trial endpoints. Maternal immunity provides partial protection against congenital HCMV transmission, as vertical transmission from seropositive mothers is relatively rare. Therefore, an understanding of the maternal immune correlates of protection against HCMV congenital infection will be critical to inform design of an efficacious maternal vaccine. This review summarizes our understanding of the innate and adaptive immune correlates of protection against congenital transmission of HCMV, and discusses the advantages and applications of a novel nonhuman primate model of congenital CMV transmission to aid in rational vaccine design and evaluation.
人类巨细胞病毒（HCMV）是全球最常见的先天性传播病原体，估计每年影响 100 万新生儿。在一部分受感染的婴儿中，先天性 HCMV 会导致严重的、持久的后遗症，包括耳聋、小头畸形、神经发育迟缓，甚至死亡。因此，预防先天性 HCMV 感染的母体疫苗仍然是公共卫生的首要任务。然而，迄今为止所有测试的疫苗都未能达到临床试验终点。母体免疫为先天性 HCMV 传播提供了部分保护，因为来自血清阳性母亲的垂直传播相对较少。因此，了解针对 HCMV 先天性感染的母体免疫保护相关因素对于告知有效的母体疫苗设计至关重要。这篇综述总结了我们对先天和适应性免疫相关因素的理解，这些因素可预防先天性 HCMV 传播，并讨论了一种新型非人类灵长类动物先天性 CMV 传播模型的优势和应用，以帮助合理的疫苗设计和评估。
