Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, UK.
NIHR Oxford Biomedical Research Centre, Oxford, UK.
Arch Dis Child. 2017 Nov;102(11):1077-1081. doi: 10.1136/archdischild-2015-310282. Epub 2017 May 13.
Non-specific effects (NSE) or heterologous effects of vaccines are proposed to explain observations in some studies that certain vaccines have an impact beyond the direct protection against infection with the specific pathogen for which the vaccines were designed. The importance and implications of such effects remain controversial. There are several known immunological mechanisms which could lead to NSE, since it is widely recognised that the generation of specific immunity is initiated by non-specific innate immune mechanisms that may also have wider effects on adaptive immune function. However, there are no published studies that demonstrate a mechanistic link between such immunological phenomena and clinically relevant NSE in humans. While it is highly plausible that some vaccines do have NSE, their magnitude and duration, and thus importance, remain uncertain. Although the WHO recently concluded that current evidence does not justify changes to immunisation policy, further studies of sufficient size and quality are needed to assess the importance of NSE for all-cause mortality. This could provide insights into vaccine immunobiology with important implications for infant health and survival.
非特异性效应（NSE）或疫苗的异源效应被认为可以解释某些研究中的观察结果，即某些疫苗对特定病原体的直接感染具有保护作用之外，还具有影响。这种效应的重要性和意义仍然存在争议。有几种已知的免疫机制可能导致 NSE，因为人们普遍认识到，特异性免疫的产生是由非特异性先天免疫机制引发的，这些机制也可能对适应性免疫功能产生更广泛的影响。然而，目前还没有发表的研究表明这些免疫现象与人类临床相关的 NSE 之间存在机制联系。虽然一些疫苗确实可能具有 NSE，但它们的幅度和持续时间，以及因此的重要性，仍然不确定。尽管世卫组织最近得出结论，目前的证据不足以改变免疫政策，但仍需要进行足够规模和质量的进一步研究，以评估 NSE 对全因死亡率的重要性。这可以深入了解疫苗免疫生物学，对婴儿健康和生存具有重要意义。
