Singh Tulika, Otero Claire E, Li Katherine, Valencia Sarah M, Nelson Ashley N, Permar Sallie R
Duke University Medical Center, Duke Human Vaccine Institute, Durham, NC, United States.
Department of Molecular Genetics and Microbiology, Duke University, Durham, NC, United States.
Front Pediatr. 2020 Dec 15;8:569. doi: 10.3389/fped.2020.00569. eCollection 2020.
Congenital and perinatal infections are transmitted from mother to infant during pregnancy across the placenta or during delivery. These infections not only cause pregnancy complications and still birth, but also result in an array of pediatric morbidities caused by physical deformities, neurodevelopmental delays, and impaired vision, mobility and hearing. Due to the burden of these conditions, congenital and perinatal infections may result in lifelong disability and profoundly impact an individual's ability to live to their fullest capacity. While there are vaccines to prevent congenital and perinatal rubella, varicella, and hepatitis B infections, many more are currently in development at various stages of progress. The spectrum of our efforts to understand and address these infections includes observational studies of natural history of disease, epidemiological evaluation of risk factors, immunogen design, preclinical research of protective immunity in animal models, and evaluation of promising candidates in vaccine trials. In this review we summarize this progress in vaccine development research for Cytomegalovirus, Group B Streptococcus, Herpes simplex virus, Human Immunodeficiency Virus, Toxoplasma, Syphilis, and Zika virus congenital and perinatal infections. We then synthesize this evidence to examine how close we are to developing a vaccine for these infections, and highlight areas where research is still needed.
先天性和围产期感染是在孕期经胎盘或分娩期间由母亲传播给婴儿的。这些感染不仅会导致妊娠并发症和死产，还会引发一系列小儿疾病，包括身体畸形、神经发育迟缓以及视力、行动能力和听力受损。由于这些疾病的负担，先天性和围产期感染可能导致终身残疾，并严重影响个人充分发挥其生活能力。虽然有疫苗可预防先天性和围产期风疹、水痘和乙型肝炎感染，但目前还有更多疫苗正处于不同的研发阶段。我们为了解和应对这些感染所做的努力包括对疾病自然史的观察性研究、危险因素的流行病学评估、免疫原设计、动物模型中保护性免疫的临床前研究以及疫苗试验中对有前景候选疫苗的评估。在本综述中，我们总结了针对巨细胞病毒、B族链球菌、单纯疱疹病毒、人类免疫缺陷病毒、弓形虫、梅毒和寨卡病毒先天性和围产期感染的疫苗研发研究进展。然后，我们综合这些证据来审视我们距离研发出针对这些感染的疫苗还有多近，并突出仍需开展研究的领域。
