Fundación INFANT, Buenos Aires, Argentina.
Vanderbilt University, Nashville, TN, USA.
Sci Transl Med. 2021 Oct 20;13(616):eabj7843. doi: 10.1126/scitranslmed.abj7843.
In 1967, two toddlers immunized with a formalin-inactivated vaccine against respiratory syncytial virus (FIRSV) in the United States died from enhanced RSV disease (ERD), a severe form of illness resulting from aberrant priming of the antiviral immune response during vaccination. Up to 80% of immunized children subsequently exposed to wild-type virus were hospitalized. These events hampered RSV vaccine development for decades. Here, we provide a characterization of the clinical, immunopathological, and transcriptional signature of fatal human ERD, outlining evidence for safety evaluation of RSV vaccines and a framework for understanding disease enhancement for pathogens in general.
1967 年，美国的两名幼儿在接种了针对呼吸道合胞病毒（RSV）的福尔马林灭活疫苗（FIRSV）后死于增强型 RSV 疾病（ERD），这是一种由疫苗接种期间抗病毒免疫反应异常引发的严重疾病。多达 80%的接种儿童随后因暴露于野生型病毒而住院。这些事件阻碍了 RSV 疫苗的开发数十年。在这里，我们对致命性人类 ERD 的临床、免疫病理学和转录特征进行了描述，为 RSV 疫苗的安全性评估提供了证据，并为一般病原体疾病增强的理解提供了框架。
