Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, USA.
Department of Pharmacology and Chemical Biology, Baylor College of Medicine, Houston, USA.
Expert Rev Vaccines. 2021 Apr;20(4):351-364. doi: 10.1080/14760584.2021.1903877. Epub 2021 May 2.
Respiratory Syncytial Virus (RSV) is a leading cause of acute lower respiratory infections worldwide. The RSV fusion (F) glycoprotein is a major focus of vaccine development. Despite over 60 years of research, there is no licensed vaccine for RSV.
The primary focus of this review is a novel RSV-F recombinant nanoparticle vaccine from Novavax utilizing the F protein, a conserved and immunodominant surface glycoprotein. This RSV F recombinant nanoparticle vaccine adsorbed to 0.4 mg of aluminum phosphate was ultimately administered by a single intramuscular injection during the third trimester of pregnancy in an effort to induce passive immunity in newborns. Its mechanism, performance in clinical trials, and place in RSV vaccine history are discussed.
The vaccine was safe and well tolerated in pregnant women and the results suggest potential benefits with respect to other medically relevant end-point events involving RSV-associated respiratory and all-cause disease in infants. However, the RSV-F recombinant nanoparticle vaccine did not meet the pre-specified primary success criteria for efficacy against RSV-associated, medically significant lower respiratory tract infection in infants up to 90 days of life. The potential benefits to infants from maternal immunization and excellent safety profile warrant further confirmatory studies.
呼吸道合胞病毒(RSV)是全球急性下呼吸道感染的主要原因。RSV 融合(F)糖蛋白是疫苗开发的主要重点。尽管已经进行了 60 多年的研究,但目前仍没有针对 RSV 的许可疫苗。
本综述的主要重点是 Novavax 公司利用 F 蛋白(一种保守且免疫显性的表面糖蛋白)开发的新型 RSV-F 重组纳米颗粒疫苗。这种 RSV F 重组纳米颗粒疫苗吸附到 0.4 毫克的磷酸铝中,最终在妊娠晚期通过单次肌肉注射给药,以在新生儿中诱导被动免疫。讨论了其机制、临床试验表现及其在 RSV 疫苗历史中的地位。
该疫苗在孕妇中安全且耐受良好,结果表明,在涉及 RSV 相关呼吸道和所有原因疾病的其他与医学相关的终点事件方面,该疫苗对婴儿具有潜在益处。然而,该 RSV-F 重组纳米颗粒疫苗未能达到针对婴儿 90 天内与 RSV 相关的具有医学意义的下呼吸道感染的预先指定的主要疗效标准。从母亲免疫接种中获得的潜在益处和极好的安全性概况需要进一步的确认性研究。