Middlesex University, Hendon, London, UK.
Vaxcine (UK) Limited, London Bioscience Innovation Centre, London, UK.
Clin Exp Immunol. 2019 Nov;198(2):153-169. doi: 10.1111/cei.13352. Epub 2019 Aug 8.
Many options now exist for constructing oral vaccines which, in experimental systems, have shown themselves to be able to generate highly effective immunity against infectious diseases. Their suitability for implementation in clinical practice, however, for prevention of outbreaks, particularly in low- and middle-income countries (LMIC), is not always guaranteed, because of factors such as cost, logistics and cultural and environmental conditions. This brief overview provides a summary of the various approaches which can be adopted, and evaluates them from a pharmaceutical point, taking into account potential regulatory issues, expense, manufacturing complexity, etc., all of which can determine whether a vaccine approach will be successful in the late stages of development. Attention is also drawn to problems arising from inadequate diet, which impacts upon success in stimulating effective immunity, and identifies the use of lipid-based carriers as a way to counteract the problem of nutritional deficiencies in vaccination campaigns.
现在有许多选择可以用来构建口服疫苗，在实验系统中，这些疫苗已经证明能够针对传染病产生高度有效的免疫。然而，它们在临床实践中的适用性，特别是在低收入和中等收入国家（LMIC），并不总是得到保证，这是由于成本、物流以及文化和环境条件等因素。本简要概述提供了可采用的各种方法的摘要，并从制药的角度对它们进行了评估，同时考虑了潜在的监管问题、费用、制造复杂性等，所有这些都可以决定疫苗方法在后期开发阶段是否会成功。此外，还注意到了饮食不足所带来的问题，这会影响刺激有效免疫的效果，并确定了使用基于脂质的载体作为对抗疫苗接种运动中营养缺乏问题的一种方法。
