Walker Richard, Kaminski Robert W, Porter Chad, Choy Robert K M, White Jessica A, Fleckenstein James M, Cassels Fred, Bourgeois Louis
Center for Vaccine Innovation and Access, PATH, Washington, DC 20001, USA.
Department of Diarrheal Disease Research, Walter Reed Institute of Research, Silver Spring, MD 20910, USA.
Microorganisms. 2021 Jun 25;9(7):1382. doi: 10.3390/microorganisms9071382.
The global diarrheal disease burden for , enterotoxigenic (ETEC), and is estimated to be 88M, 75M, and 75M cases annually, respectively. A vaccine against this target trio of enteric pathogens could address about one-third of diarrhea cases in children. All three of these pathogens contribute to growth stunting and have demonstrated increasing resistance to antimicrobial agents. Several combinations of antigens are now recognized that could be effective for inducing protective immunity against each of the three target pathogens in a single vaccine for oral administration or parenteral injection. The vaccine combinations proposed here would result in a final product consistent with the World Health Organization's (WHO) preferred product characteristics for ETEC and vaccines, and improve the vaccine prospects for support from Gavi, the Vaccine Alliance, and widespread uptake by low- and middle-income countries' (LMIC) public health stakeholders. Broadly protective antigens will enable multi-pathogen vaccines to be efficiently developed and cost-effective. This review describes how emerging discoveries for each pathogen component of the target trio could be used to make vaccines, which could help reduce a major cause of poor health, reduced cognitive development, lost economic productivity, and poverty in many parts of the world.
据估计，全球范围内，产肠毒素性大肠杆菌（ETEC）和霍乱弧菌导致的腹泻病负担分别为每年8800万例、7500万例和7500万例。针对这三种肠道病原体的三联疫苗可解决约三分之一的儿童腹泻病例。这三种病原体都会导致发育迟缓，且对抗菌药物的耐药性不断增强。目前已确认了几种抗原组合，它们可有效诱导针对这三种目标病原体的保护性免疫，制成单一的口服或注射疫苗。本文提出的疫苗组合将产生一种最终产品，符合世界卫生组织（WHO）对ETEC和霍乱弧菌疫苗的首选产品特性，并改善疫苗获得疫苗免疫全球联盟（Gavi）支持的前景，以及提高低收入和中等收入国家（LMIC）公共卫生利益相关者的广泛接受度。具有广泛保护作用的抗原将使多病原体疫苗得以高效开发且具有成本效益。本综述描述了如何利用针对目标三联体中每种病原体成分的新发现来制备疫苗，这有助于减少世界许多地区健康状况不佳、认知发育受损、经济生产力损失和贫困的一个主要原因。
