a Mayo Clinic Vaccine Research Group , Mayo Clinic , Rochester , MN , USA.
b Department of Health Sciences Research , Mayo Clinic , Rochester , MN , USA.
Expert Rev Vaccines. 2019 Jan;18(1):75-87. doi: 10.1080/14760584.2019.1559063. Epub 2018 Dec 26.
Repeated measles outbreaks in countries with relatively high vaccine coverage are mainly due to failure to vaccinate and importation; however, cases in immunized individuals exist raising questions about suboptimal measles vaccine-induced humoral immunity and/or waning immunity in a low measles-exposure environment.
The plaque reduction neutralization measurement of functional measles-specific antibodies correlates with protection is the gold standard in measles serology, but it does not assess cellular-immune or other parameters that may be associated with durable and/or protective immunity after vaccination. Additional correlates of protection and long-term immunity and new determinants/signatures of vaccine responsiveness such as specific CD46 and IFI44L genetic variants associated with neutralizing antibody titers after measles vaccination are under investigation. Current and future systems biology studies, coupled with new technology/assays and analytical approaches, will lead to an increasingly sophisticated understanding of measles vaccine-induced humoral immunity and will identify 'signatures' of protective and durable immune responses.
This will translate into the development of highly predictive assays of measles vaccine efficacy, effectiveness, and durability for prospective identification of potential low/non-responders and susceptible individuals who require additional vaccine doses. Such new advances may drive insights into the development of new/improved vaccine formulations and delivery systems.
在疫苗覆盖率相对较高的国家,麻疹反复爆发主要是由于疫苗接种失败和输入性病例;然而,在免疫个体中也存在麻疹病例,这引发了人们对麻疹疫苗诱导的体液免疫不理想和/或在低麻疹暴露环境中免疫衰减的质疑。
功能性麻疹特异性抗体的蚀斑减少中和测量与保护相关,是麻疹血清学的金标准,但它不能评估细胞免疫或其他可能与接种疫苗后持久和/或保护性免疫相关的参数。其他保护相关性和长期免疫以及新的疫苗反应决定因素/特征,如与麻疹接种后中和抗体滴度相关的特定 CD46 和 IFI44L 遗传变异体,正在研究中。当前和未来的系统生物学研究,加上新技术/检测方法和分析方法,将使人们对麻疹疫苗诱导的体液免疫有更深入的了解,并确定保护性和持久免疫反应的“特征”。
这将转化为麻疹疫苗功效、效果和持久性的高度预测性检测方法的开发,以便前瞻性地识别潜在的低/无反应者和需要额外疫苗剂量的易感个体。这些新进展可能会深入了解新的/改进的疫苗配方和输送系统的开发。