Institute of Biomedical Engineering, University of Oxford, Oxford, UK.
Defence Science and Technology Laboratory, Porton Down, UK.
Clin Exp Immunol. 2019 May;196(2):189-204. doi: 10.1111/cei.13287. Epub 2019 Apr 8.
It is easy to argue that vaccine development represents humankind's most important and successful endeavour, such is the impact that vaccination has had on human morbidity and mortality over the last 200 years. During this time the original method of Jenner and Pasteur, i.e. that of injecting live-attenuated or inactivated pathogens, has been developed and supplemented with a wide range of alternative approaches which are now in clinical use or under development. These next-generation technologies have been designed to produce a vaccine that has the effectiveness of the original live-attenuated and inactivated vaccines, but without the associated risks and limitations. Indeed, the method of development has undoubtedly moved away from Pasteur's three Is paradigm (isolate, inactivate, inject) towards an approach of rational design, made possible by improved knowledge of the pathogen-host interaction and the mechanisms of the immune system. These novel vaccines have explored methods for targeted delivery of antigenic material, as well as for the control of release profiles, so that dosing regimens can be matched to the time-lines of immune system stimulation and the realities of health-care delivery in dispersed populations. The methods by which vaccines are administered are also the subject of intense research in the hope that needle and syringe dosing, with all its associated issues regarding risk of injury, cross-infection and patient compliance, can be replaced. This review provides a detailed overview of new vaccine vectors as well as information pertaining to the novel delivery platforms under development.
很容易论证疫苗的开发代表了人类最重要和最成功的努力，因为在过去的 200 年中，疫苗对人类发病率和死亡率的影响是巨大的。在这段时间里，詹纳和巴斯德最初的方法，即注射减活或灭活的病原体的方法，已经得到了发展，并补充了一系列广泛的替代方法，这些方法现在正在临床使用或正在开发中。这些下一代技术旨在生产一种疫苗，其有效性与最初的减活和灭活疫苗相当，但没有相关的风险和局限性。事实上，开发方法无疑已经偏离了巴斯德的三个原则（分离、灭活、注射），朝着基于理性设计的方法发展，这得益于对病原体-宿主相互作用和免疫系统机制的深入了解。这些新型疫苗探索了靶向递送抗原物质的方法，以及控制释放特性的方法，以便可以根据免疫系统刺激的时间框架和分散人群中医疗保健提供的实际情况来匹配剂量方案。疫苗接种的方法也是激烈研究的主题，希望能够替代针和注射器接种，因为它存在与损伤、交叉感染和患者依从性相关的所有问题。这篇综述详细概述了新的疫苗载体以及正在开发的新型输送平台的相关信息。
