Department of Pharmaceutical Sciences, University of California, Irvine, CA 92697, United States of America.
Department of Pharmaceutical Sciences, University of California, Irvine, CA 92697, United States of America; Department of Chemical and Biomolecular Engineering, University of California, Irvine, CA 92697, United States of America; Department of Molecular Biology and Biochemistry, University of California, Irvine, CA 92697, United States of America; Department of Biomedical Engineering, University of California, Irvine, CA 92697, United States of America.
Adv Drug Deliv Rev. 2021 Mar;170:1-25. doi: 10.1016/j.addr.2020.12.011. Epub 2020 Dec 24.
Due to the high prevalence and long incubation periods often without symptoms, the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has infected millions of individuals globally, causing the coronavirus disease 2019 (COVID-19) pandemic. Even with the recent approval of the anti-viral drug, remdesivir, and Emergency Use Authorization of monoclonal antibodies against S protein, bamlanivimab and casirimab/imdevimab, efficient and safe COVID-19 vaccines are still desperately demanded not only to prevent its spread but also to restore social and economic activities via generating mass immunization. Recent Emergency Use Authorization of Pfizer and BioNTech's mRNA vaccine may provide a pathway forward, but monitoring of long-term immunity is still required, and diverse candidates are still under development. As the knowledge of SARS-CoV-2 pathogenesis and interactions with the immune system continues to evolve, a variety of drug candidates are under investigation and in clinical trials. Potential vaccines and therapeutics against COVID-19 include repurposed drugs, monoclonal antibodies, antiviral and antigenic proteins, peptides, and genetically engineered viruses. This paper reviews the virology and immunology of SARS-CoV-2, alternative therapies for COVID-19 to vaccination, principles and design considerations in COVID-19 vaccine development, and the promises and roles of vaccine carriers in addressing the unique immunopathological challenges presented by the disease.
由于高发病率和长潜伏期，且通常无症状，严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）已在全球范围内感染了数百万人，导致 2019 年冠状病毒病（COVID-19）大流行。即使最近批准了抗病毒药物瑞德西韦，以及针对 S 蛋白的单克隆抗体 bamlanivimab 和 casirimab/imdevimab 的紧急使用授权，人们仍然迫切需要高效和安全的 COVID-19 疫苗，不仅要预防其传播，还要通过大规模免疫来恢复社会和经济活动。最近辉瑞和 BioNTech 的 mRNA 疫苗的紧急使用授权可能提供了一个前进的途径，但仍需要监测长期免疫情况，并且仍在开发各种候选疫苗。随着对 SARS-CoV-2 发病机制及其与免疫系统相互作用的认识不断发展，各种候选药物正在接受研究并处于临床试验阶段。针对 COVID-19 的潜在疫苗和疗法包括重新利用的药物、单克隆抗体、抗病毒和抗原蛋白、肽和基因工程病毒。本文综述了 SARS-CoV-2 的病毒学和免疫学、COVID-19 疫苗接种以外的替代疗法、COVID-19 疫苗开发的原则和设计考虑因素，以及疫苗载体在应对该疾病所带来的独特免疫病理挑战方面的前景和作用。
