F. Edward Hébert School of Medicine, Uniformed Services University, Bethesda, MD, USA.
Center for Vaccine Development, University of Maryland, Baltimore, MD, USA.
Clin Microbiol Infect. 2018 Oct;24(10):1039-1045. doi: 10.1016/j.cmi.2018.06.023. Epub 2018 Jun 28.
Acute diarrhoeal disease caused by viral, bacterial and parasitic infections is a major global health problem; in low- and middle-income countries (LMICs) it is associated with substantial mortality and morbidity in children under 5. Some of these infections also impact large segments of populations in high-income countries (HICs), as well as individuals who travel overseas for work, business or pleasure.
The aim of this review is to describe the current landscape of licensed enteric vaccines, potential new vaccines on the horizon, and the challenges of development and utilization of vaccines against enteric pathogens.
Relevant data from the literature, as well as clinical trials described in European and US registries, were examined in the conduct of this review.
The review involves discussion of current licensed vaccines against rotavirus, cholera and typhoid, as well as potential second- and third-generation vaccines against these pathogens currently in the development pipeline. In addition, novel vaccines against enterotoxigenic Escherichia coli, shigellosis and norovirus in advanced development are described. Challenges to the development and utilization of global vaccines are discussed.
Despite advances in population health, food security, improved sanitation and water quality, and the reduction in poverty, acute enteric infections continue to plague global populations. Advancing utilization of current enteric vaccines is of critical public health importance, as is the development of new vaccines, particularly for enteric pathogens where none currently exist.
由病毒、细菌和寄生虫感染引起的急性腹泻病是一个重大的全球卫生问题；在低收入和中等收入国家（LMICs），它与 5 岁以下儿童的大量死亡和发病有关。其中一些感染也影响到高收入国家（HICs）的大部分人群，以及因工作、商务或娱乐目的前往海外的个人。
本综述的目的是描述已获得许可的肠道疫苗的现状、即将出现的潜在新疫苗，以及开发和利用肠道病原体疫苗所面临的挑战。
在进行本综述时，检查了文献中的相关数据，以及欧洲和美国登记册中描述的临床试验。
本综述涉及目前针对轮状病毒、霍乱和伤寒的许可疫苗的讨论，以及针对这些病原体目前在开发管道中的第二代和第三代潜在疫苗。此外，还描述了针对肠产毒性大肠杆菌、志贺氏菌病和诺如病毒的新型疫苗，这些疫苗正在开发中。还讨论了全球疫苗开发和利用所面临的挑战。
尽管在人口健康、食品安全、改善卫生和水质以及减少贫困方面取得了进展，但急性肠道感染仍困扰着全球人口。推进现有肠道疫苗的利用具有至关重要的公共卫生意义，开发新疫苗也同样重要，特别是对于目前尚无疫苗的肠道病原体。
