Pediatric Infectious Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Department of Health Sciences Education Development, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Microb Pathog. 2018 Sep;122:122-129. doi: 10.1016/j.micpath.2018.06.026. Epub 2018 Jun 14.
Despite the fact that pneumococcal conjugate vaccines (PCVs) have significantly reduced the rate of invasive pneumococcal diseases through the use of vaccine serotypes, infection with Streptococcus pneumoniae remains a major public health hazard. Serotype-independent vaccines that are economically viable species of common protein antigens such as whole-cell vaccines (WCVs) are needed. Considering the ongoing debate about the effectiveness of WCVs, a systematic literature review and meta-analysis was carried out to determine the efficacy of WCVs against colonization in mice.
A systematic review was undertaken of published studies on the protection (colonized/uncolonized) of whole cell pneumococcal vaccine in mice. The search terms used were "whole cell vaccine" and "Streptococcus pneumoniae" in PubMed, Google Scholar, Embase, Web of Science and Scopus engines. Data was extracted from original publications and a meta-analysis was performed on studies divided into sub-groups by the number of inoculations, type of sample, type of adjuvant, time of sampling, design of study and quality of study.
Ten eligible articles published from 2000 to 2016 were included in this review. The meta-analysis was performed on eight out of 10 studies and demonstrated that the estimated pooled risk ratios (RRs) for comparison of colonization between the vaccinated and unvaccinated mice for outcomes 1 and 2 were 0.18 and 0.24, respectively. Lower RRs were observed in sub-groups that were inoculated with vaccines three times, those using cholera toxin (CT) adjuvants and those obtained as tracheal specimens from the mice.
The best protocol for use of a WCV is its application with CT adjuvant administered intranasally in three inoculations at doses of 10⁸ CFU. Further studies performed under similar conditions to obtain accurate results on the effectiveness of this vaccine are recommended.
尽管肺炎球菌结合疫苗（PCV）通过使用疫苗血清型显著降低了侵袭性肺炎球菌病的发病率，但肺炎链球菌感染仍然是一个主要的公共卫生危害。需要具有经济可行性的、针对常见蛋白抗原的非血清型依赖性疫苗，例如全细胞疫苗（WCV）。考虑到目前关于 WCV 有效性的争论，我们进行了系统的文献综述和荟萃分析，以确定 WCV 对小鼠定植的效果。
我们对已发表的关于全细胞肺炎球菌疫苗在小鼠中保护（定植/未定植）作用的研究进行了系统综述。我们在 PubMed、Google Scholar、Embase、Web of Science 和 Scopus 引擎中使用了“全细胞疫苗”和“肺炎链球菌”这两个检索词。从原始出版物中提取数据，并对按接种次数、样本类型、佐剂类型、采样时间、研究设计和研究质量分组的研究进行了荟萃分析。
本综述纳入了 2000 年至 2016 年发表的 10 篇合格文章。对 10 项研究中的 8 项进行了荟萃分析，结果表明，接种疫苗和未接种疫苗的小鼠在结果 1 和 2 中比较定植的估计合并风险比（RR）分别为 0.18 和 0.24。在接种疫苗 3 次、使用霍乱毒素（CT）佐剂和从小鼠气管获得标本的亚组中观察到较低的 RR。
使用 WCV 的最佳方案是使用 CT 佐剂经鼻内接种 3 次，剂量为 10⁸ CFU。建议在类似条件下进行进一步研究，以获得关于该疫苗有效性的准确结果。
