GlaxoSmithKline, Via Fiorentina 1, 53100 Siena, Italy.
Sci Transl Med. 2018 Aug 29;10(456). doi: 10.1126/scitranslmed.aat4615.
Bacterial conjugate vaccines are used in infants, adolescents, and the elderly, and they are among the safest and most successful vaccines developed during the last 40 years. Conjugation of polysaccharides to proteins provides T cell epitopes that are necessary in the germinal centers for the affinity maturation of polysaccharide-specific B cells. Collective analysis of data from animal experiments and clinical trials, reviewed with current knowledge of immunology, revealed possible mechanistic explanations that may improve our understanding of conjugate vaccines. Key conclusions are that naïve infants respond differently from adolescents and adults and that most of recommended schedules generate only 10 to 35% of the maximal antibody titer that the vaccine can induce, indicating that the full potential of glycoconjugate vaccines has not yet been reached.
细菌结合疫苗被用于婴儿、青少年和老年人，是过去 40 年来开发的最安全和最成功的疫苗之一。多糖与蛋白质的结合提供了 T 细胞表位，这些表位对于生发中心中多糖特异性 B 细胞的亲和力成熟是必需的。对动物实验和临床试验数据的综合分析，并结合当前的免疫学知识，揭示了可能的机制解释，这有助于我们更好地理解结合疫苗。主要结论是，婴儿的反应与青少年和成年人不同，而且大多数推荐的方案只能产生疫苗能诱导的最大抗体滴度的 10%至 35%，这表明糖缀合物疫苗的全部潜力尚未得到充分发挥。
