Warner Bryce M, Safronetz David, Stein Derek R
Department of Medical Microbiology, University of Manitoba, Winnipeg, MB, Canada.
Zoonotic Diseases and Special Pathogens Program, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada,
Drug Des Devel Ther. 2018 Aug 14;12:2519-2527. doi: 10.2147/DDDT.S147276. eCollection 2018.
Lassa virus (LASV) is a rodent-borne arenavirus endemic to several West African countries that causes Lassa fever (LF). LF is typically mild but it can cause severe disease characterized by hemorrhagic fever and multi-organ failure. A current outbreak of LASV in Nigeria has seen greater than 300 cases with a case fatality rate of 22%. Currently, there are limited treatment options and no vaccine candidates are approved to prevent LASV infection. The Coalition for Epidemic Preparedness Innovations has identified LASV as an emerging pathogen of high consequence and this has resulted in a push for several preclinical vaccine candidates to be advanced toward clinical trials. Here, we discuss several important aspects of LASV infection including immunobiology, immune evasion, and correlates of protection against LF, which have been identified through animal models and human infections. In addition, we discuss several vaccine candidates that have shown efficacy in animal models that could be advanced toward clinical trials. The increased fatality rate seen in the recent LASV outbreak in Nigeria highlights the importance of developing effective treatment and prevention strategies against LF. The spike in LASV cases seen in West Africa has the potential for increased mortality and human-to-human transmission, making the development and testing of effective vaccines for LASV critical.
拉沙病毒(LASV)是一种由啮齿动物传播的沙粒病毒,在几个西非国家流行,可引发拉沙热(LF)。拉沙热通常症状较轻,但也可能导致以出血热和多器官衰竭为特征的严重疾病。尼日利亚目前爆发的拉沙病毒疫情已出现超过300例病例,病死率达22%。目前,治疗选择有限,且尚无获批的候选疫苗可预防拉沙病毒感染。流行病防范创新联盟已将拉沙病毒确定为具有高度影响的新兴病原体,这推动了几种临床前候选疫苗进入临床试验阶段。在此,我们讨论拉沙病毒感染的几个重要方面,包括免疫生物学、免疫逃逸以及通过动物模型和人类感染确定的针对拉沙热的保护相关因素。此外,我们还讨论了几种在动物模型中显示出疗效、可推进至临床试验的候选疫苗。尼日利亚近期拉沙病毒疫情中出现的病死率上升凸显了制定针对拉沙热的有效治疗和预防策略的重要性。西非拉沙病毒病例的激增有可能导致死亡率上升和人际传播,这使得开发和测试针对拉沙病毒的有效疫苗至关重要。