伤寒疫苗的研发现状及伤寒疫苗的临床试验。

The current status of typhoid vaccine development and clinical trials with typhoid vaccines.

作者信息

Levine M M, Tacket C O, Herrington D, Losonsky G, Murphy J, Ferreccio C

机构信息

Department of Medicine, University of Maryland School of Medicine, Baltimore 21201.

出版信息

Southeast Asian J Trop Med Public Health. 1988 Sep;19(3):459-69.

PMID:3064323

Abstract

The killed whole cell typhoid vaccines, although protective, have limited usefulness because of the adverse reactions they evoke. In contrast, new typhoid vaccines protect without reactogenicity. Attenuated oral vaccine Ty2la has been evaluated in field trials of efficacy in Santiago, Chile. Three doses of Ty2la in an enteric-coated formulation given within one week provided 69% efficacy for at least four years. Ty2la has reached the stage of being a practical public health tool. Two double auxotrophic (Aro-, Pur-) mutant strains of S. typhi (541Ty and 543Ty) were well-tolerated and stimulated cell-mediated immune responses but evoked little serological response. Parenteral purified Vi polysaccharide of S. typhi (single 25 mcg dose) was safe and immunogenic and provided 64-72% protection (for at least 17-21 months) in controlled field trials in Nepal and South Africa.

摘要

灭活全细胞伤寒疫苗虽然具有保护作用，但由于会引发不良反应，其用途有限。相比之下，新型伤寒疫苗在不产生反应原性的情况下提供保护。减毒口服疫苗Ty2la已在智利圣地亚哥进行了疗效现场试验评估。在一周内给予三剂肠溶包衣制剂的Ty2la，至少四年内的效力为69%。Ty2la已达到成为一种实用公共卫生工具的阶段。伤寒杆菌的两种双营养缺陷型（Aro-、Pur-）突变菌株（541Ty和543Ty）耐受性良好，可刺激细胞介导的免疫反应，但引发的血清学反应很少。伤寒杆菌的肠胃外纯化Vi多糖（单次25微克剂量）安全且具有免疫原性，在尼泊尔和南非的对照现场试验中提供了64-72% 的保护（至少17-21个月）。