Department of General Practice and Primary Health Care, University of Auckland, Auckland, New Zealand.
Department of Molecular Medicine and Pathology, University of Auckland, Auckland, New Zealand.
Front Immunol. 2019 Apr 9;10:683. doi: 10.3389/fimmu.2019.00683. eCollection 2019.
Have potential clues to an effective gonorrhea vaccine been lurking in international disease surveillance data for decades? While no clinically effective vaccines against gonorrhea have been developed we present direct and indirect evidence that a vaccine is not only possible, but may already exist. Experience from Cuba, New Zealand, and Canada suggest that vaccines containing Group B outer membrane vesicles (OMV) developed to control type-specific meningococcal disease may also prevent a significant proportion of gonorrhea. The mechanisms for this phenomenon have not yet been elucidated but we present some strategies for unraveling potential cross protective antigens and effector immune responses by exploiting stored sera from clinical trials and individuals primed with a meningococcal group B OMV vaccine (MeNZB). Elucidating these will contribute to the ongoing development of high efficacy vaccine options for gonorrhea. While the vaccine used in New Zealand, where the strongest empirical evidence has been gathered, is no longer available, the OMV has been included in the multi component recombinant meningococcal vaccine 4CMenB (Bexsero) which is now licensed and used in numerous countries. Several lines of evidence suggest it has the potential to affect gonorrhea prevalence. A vaccine to control gonorrhea does not need to be perfect and modeling supports that even a moderately efficacious vaccine could make a significant impact in disease prevalence. How might we use an off the shelf vaccine to reduce the burden of gonorrhea? What are some of the potential societal barriers in a world where vaccine hesitancy is growing? We summarize the evidence and consider some of the remaining questions.
是否有潜在的线索表明，一种有效的淋病疫苗已经在国际疾病监测数据中潜伏了几十年？虽然尚未开发出针对淋病的临床有效疫苗，但我们提供了直接和间接的证据，证明疫苗不仅是可能的，而且可能已经存在。古巴、新西兰和加拿大的经验表明，为控制特定类型脑膜炎球菌疾病而开发的含有 B 群外膜囊泡（OMV）的疫苗也可能预防很大一部分淋病。这种现象的机制尚未阐明，但我们提出了一些策略，通过利用临床试验和用脑膜炎球菌 B 群 OMV 疫苗（MeNZB）接种的个体中储存的血清来揭示潜在的交叉保护抗原和效应免疫反应。阐明这些问题将有助于为淋病开发高疗效的疫苗选择。虽然在收集到最强的经验证据的新西兰使用的疫苗已经不再可用，但 OMV 已被包含在多组分重组脑膜炎球菌疫苗 4CMenB（Bexsero）中，该疫苗现已在许多国家获得许可并使用。有几条证据表明它有可能影响淋病的流行率。控制淋病的疫苗不需要完美无缺，建模支持即使是一种中等有效的疫苗也可以显著影响疾病的流行率。我们如何利用现成的疫苗来减轻淋病的负担？在疫苗犹豫情绪日益增长的世界中，存在哪些潜在的社会障碍？我们总结了证据并考虑了一些尚存的问题。
