为什么针对许多人类病毒性疾病的疫苗仍然无法获得?历史视角?
Why are vaccines against many human viral diseases still unavailable; an historic perspective?
机构信息
Burnet Institute, Melbourne, Victoria, Australia.
Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, Tennessee.
出版信息
J Med Virol. 2020 Feb;92(2):129-138. doi: 10.1002/jmv.25593. Epub 2019 Oct 3.
The number of new and improved human viral vaccines licensed in recent years contrasts sharply with what could be termed the golden era (1955-1990) when vaccines against polio-, measles, mumps, rubella, and hepatitis B viruses first became available. Here, we attempt to explain why vaccines, mainly against viruses other than human immunodeficiency virus and hepatitis C virus, are still unavailable. They include human herpesviruses other than varicella-zoster virus, respiratory syncytial and most other respiratory, enteric and arthropod-borne viruses. Improved oral poliovirus vaccines are also urgently required. Their unavailability is attributable to regulatory/economic factors and the properties of individual viruses, but also to an absence of relevant animal models and ethical problems for the conduct of clinical of trials in pediatric and other critical populations. All are portents of likely difficulties for the licensing of effective vaccines against emerging pathogens, such as avian influenza, Ebola, and Zika viruses.
近年来,新的和改进的人类病毒疫苗的数量与所谓的黄金时代(1955-1990 年)形成鲜明对比,当时针对脊髓灰质炎、麻疹、腮腺炎、风疹和乙型肝炎病毒的疫苗首次问世。在这里,我们试图解释为什么仍然没有针对除人类免疫缺陷病毒和丙型肝炎病毒以外的病毒的疫苗,包括除水痘带状疱疹病毒以外的人类疱疹病毒、呼吸道合胞病毒和大多数其他呼吸道、肠道和虫媒病毒。也迫切需要改进的口服脊髓灰质炎疫苗。它们的不可用性归因于监管/经济因素和单个病毒的特性,但也归因于缺乏相关的动物模型以及在儿科和其他关键人群中进行临床试验的伦理问题。所有这些都预示着,针对禽流感、埃博拉和寨卡病毒等新出现病原体的有效疫苗的许可可能会遇到困难。
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