Center for Tropical Medicine and Infectious Diseases, Texas Tech University Health Sciences Center, 3601 4th Street, Lubbock, TX, 79430, USA.
Department of Internal Medicine, School of Medicine, Texas Tech University Health Sciences Center, 3601 4th Street, Lubbock, TX, 79430, USA.
J Biomed Sci. 2020 Jan 22;27(1):28. doi: 10.1186/s12929-020-0621-y.
Schistosomiasis causes significant levels of morbidity and mortality in many geographical regions of the world. The disease is caused by infections with parasitic blood flukes known as schistosomes. The control of schistosomiasis over the last several decades has been centered on the mass drug administration (MDA) of praziquantel (PZQ), which is the only drug currently available for treatment. Despite the concerted efforts of MDA programs, the prevalence and transmission of schistosomiasis has remained largely unchecked due to the fact that PZQ is ineffective against juvenile schistosomes, does not prevent re-infection and the emergence of PZQ-resistant parasites. In addition, other measures such as the water, sanitation and hygiene programs and snail intermediate hosts control have had little to no impact. These drawbacks indicate that the current control strategies are severely inadequate at interrupting transmission and therefore, implementation of other control strategies are required. Ideally, an efficient vaccine is what is needed for long term protection thereby eliminating the current efforts of repeated mass drug administration. However, the general consensus in the field is that the integration of a viable vaccine with MDA and other control measures offer the best chance of achieving the goal of schistosomiasis elimination. This review focuses on the present status of schistosomiasis vaccine candidates in different phases of human clinical trials and provide some insight into future vaccine discovery and design.
血吸虫病在世界许多地理区域造成了相当程度的发病率和死亡率。这种疾病是由寄生虫性血吸病虫（即血吸虫）感染引起的。过去几十年，血吸虫病的控制工作主要集中在大规模药物治疗（MDA）方面，使用的药物是目前唯一可用的吡喹酮（PZQ）。尽管 MDA 项目进行了协调努力，但由于 PZQ 对幼年血吸虫无效，不能预防再感染和出现对 PZQ 有抗性的寄生虫，因此血吸虫病的流行和传播在很大程度上仍未得到控制。此外，水、环境卫生和个人卫生方案以及钉螺中间宿主控制等其他措施收效甚微。这些缺点表明，目前的控制策略严重不足以阻断传播，因此需要实施其他控制策略。理想情况下，需要一种有效的疫苗来提供长期保护，从而消除目前反复进行大规模药物治疗的努力。然而，该领域的普遍共识是，将可行的疫苗与 MDA 和其他控制措施相结合，是实现消除血吸虫病目标的最佳机会。本综述重点介绍了人类临床试验不同阶段的血吸虫病候选疫苗的现状，并为未来的疫苗发现和设计提供了一些见解。
