原始抗原性失误:全面回顾。

Original antigenic sin: A comprehensive review.

机构信息

University of California at Davis, Division of Rheumatology, Allergy and Clinical Immunology, Suite 6501, 451 Health Sciences Drive, Davis, CA, 95616, USA.

Center for Autoimmune Diseases Research (CREA), School of Medicine and Health Sciences, Universidad del Rosario, Carrera 24 No. 63-C-69, Bogotá, Colombia.

出版信息

J Autoimmun. 2017 Sep;83:12-21. doi: 10.1016/j.jaut.2017.04.008. Epub 2017 May 5.

Abstract

The concept of "original antigenic sin" was first proposed by Thomas Francis, Jr. in 1960. This phenomenon has the potential to rewrite what we understand about how the immune system responds to infections and its mechanistic implications on how vaccines should be designed. Antigenic sin has been demonstrated to occur in several infectious diseases in both animals and humans, including human influenza infection and dengue fever. The basis of "original antigenic sin" requires immunological memory, and our immune system ability to autocorrect. In the context of viral infections, it is expected that if we are exposed to a native strain of a pathogen, we should be able to mount a secondary immune response on subsequent exposure to the same pathogen. "Original antigenic sin" will not contradict this well-established immunological process, as long as the subsequent infectious antigen is identical to the original one. But "original antigenic sin" implies that when the epitope varies slightly, then the immune system relies on memory of the earlier infection, rather than mount another primary or secondary response to the new epitope which would allow faster and stronger responses. The result is that the immunological response may be inadequate against the new strain, because the immune system does not adapt and instead relies on its memory to mount a response. In the case of vaccines, if we only immunize to a single strain or epitope, and if that strain/epitope changes over time, then the immune system is unable to mount an accurate secondary response. In addition, depending of the first viral exposure the secondary immune response can result in an antibody-dependent enhancement of the disease or at the opposite, it could induce anergy. Both of them triggering loss of pathogen control and inducing aberrant clinical consequences.

摘要

“原始抗原性失误”的概念最初由小托马斯·弗朗西斯(Thomas Francis, Jr.)于 1960 年提出。这一现象有可能改写我们对免疫系统如何对感染作出反应的理解,以及对疫苗设计应如何进行的机制性启示。在动物和人类的几种传染病中,包括人类流感感染和登革热,已经证明存在抗原性失误现象。“原始抗原性失误”的基础是免疫记忆和我们的免疫系统自我纠错能力。在病毒感染的背景下,如果我们接触到病原体的本地株,我们应该能够在随后接触到同一病原体时产生二次免疫反应,这是可以预期的。“原始抗原性失误”不会与这一既定的免疫学过程相矛盾,只要随后的传染性抗原与原始抗原相同。但是,“原始抗原性失误”意味着,如果表位略有变化,那么免疫系统将依赖于对早期感染的记忆,而不是对新表位产生另一次原发性或继发性反应,从而更快、更强地作出反应。其结果是,针对新株的免疫反应可能不足,因为免疫系统无法适应,而是依赖其记忆来作出反应。就疫苗而言,如果我们只针对单一株或表位进行免疫,如果该株/表位随时间发生变化,那么免疫系统将无法产生准确的二次反应。此外,根据首次病毒暴露,二次免疫反应可能导致疾病的抗体依赖性增强,或者相反,它可能导致无反应。这两者都会导致病原体失去控制,并引发异常的临床后果。

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