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疫苗和自然感染诱导的可调节疫苗安全性的机制。

Vaccine- and natural infection-induced mechanisms that could modulate vaccine safety.

作者信息

Kostoff Ronald N, Kanduc Darja, Porter Alan L, Shoenfeld Yehuda, Calina Daniela, Briggs Michael B, Spandidos Demetrios A, Tsatsakis Aristidis

机构信息

Research Affiliate, School of Public Policy, Georgia Institute of Technology, Gainesville, VA, 20155, USA.

Department of Biosciences, Biotechnologies, and Biopharmaceutics, University of Bari, 70125 Bari, Italy.

出版信息

Toxicol Rep. 2020;7:1448-1458. doi: 10.1016/j.toxrep.2020.10.016. Epub 2020 Oct 22.

Abstract

A degraded/dysfunctional immune system appears to be the main determinant of serious/fatal reaction to viral infection (for COVID-19, SARS, and influenza alike). There are four major approaches being employed or considered presently to augment or strengthen the immune system, in order to reduce adverse effects of viral exposure. The three approaches that are focused mainly on augmenting the immune system are based on the concept that pandemics/outbreaks can be controlled/prevented while maintaining the immune-degrading lifestyles followed by much of the global population. The fourth approach is based on identifying and introducing measures aimed at strengthening the immune system intrinsically in order to minimize future pandemics/outbreaks. Specifically, the four measures are: 1) restricting exposure to virus; 2) providing reactive/tactical treatments to reduce viral load; 3) developing vaccines to prevent, or at least attenuate, the infection; 4) strengthening the immune system intrinsically, by a) identifying those factors that contribute to degrading the immune system, then eliminating/reducing them as comprehensively, thoroughly, and rapidly as possible, and b) replacing the eliminated factors with immune-strengthening factors. This paper focuses on vaccine safety. A future COVID-19 vaccine appears to be the treatment of choice at the national/international level. Vaccine development has been accelerated to achieve this goal in the relatively near-term, and questions have arisen whether vaccine safety has been/is being/will be compromised in pursuit of a shortened vaccine development time. There are myriad mechanisms related to vaccine-induced, and natural infection-induced, infections that could adversely impact vaccine effectiveness and safety. This paper summarizes many of those mechanisms.

摘要

免疫系统功能退化或失调似乎是对病毒感染(如新冠病毒、非典病毒和流感病毒)产生严重/致命反应的主要决定因素。目前正在采用或考虑四种主要方法来增强或强化免疫系统,以减少接触病毒的不良影响。主要侧重于增强免疫系统的三种方法基于这样一种理念,即可以在维持全球大部分人口所遵循的有损免疫系统的生活方式的同时,控制/预防大流行/疫情爆发。第四种方法则基于识别并引入旨在从本质上强化免疫系统的措施,以尽量减少未来的大流行/疫情爆发。具体而言,这四种措施是:1)限制接触病毒;2)提供反应性/战术性治疗以降低病毒载量;3)研发疫苗以预防或至少减轻感染;4)从本质上强化免疫系统,具体做法是:a)识别那些导致免疫系统退化的因素,然后尽快全面、彻底且迅速地消除/减少这些因素,b)用增强免疫的因素替代被消除的因素。本文聚焦于疫苗安全性。未来的新冠疫苗似乎是国家/国际层面的首选治疗方法。为了在相对短期内实现这一目标,疫苗研发已加速进行,并且人们提出了这样的疑问,即在追求缩短疫苗研发时间的过程中,疫苗安全性是否已经/正在/将会受到损害。与疫苗诱导的感染以及自然感染诱导的感染相关的机制众多,这些机制可能会对疫苗的有效性和安全性产生不利影响。本文总结了其中的许多机制。

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