Oliveira Giuliana S, Oliveira Maria Leonor S, Miyaji Eliane N, Rodrigues Tasson C
Laboratório de Bacteriologia, Instituto Butantan, São Paulo 05503-900, SP, Brazil.
Vaccines (Basel). 2021 Nov 17;9(11):1338. doi: 10.3390/vaccines9111338.
The importance of has been well established. These bacteria can colonize infants and adults without symptoms, but in some cases can spread, invade other tissues and cause disease with high morbidity and mortality. The development of pneumococcal conjugate vaccines (PCV) caused an enormous impact in invasive pneumococcal disease and protected unvaccinated people by herd effect. However, serotype replacement is a well-known phenomenon that has occurred after the introduction of the 7-valent pneumococcal conjugate vaccine (PCV7) and has also been reported for other PCVs. Therefore, it is possible that serotype replacement will continue to occur even with higher valence formulations, but the development of serotype-independent vaccines might overcome this problem. Alternative vaccines are under development in order to improve cost effectiveness, either using proteins or the pneumococcal whole cell. These approaches can be used as a stand-alone strategy or together with polysaccharide vaccines. Looking ahead, the next generation of pneumococcal vaccines can be impacted by the new technologies recently approved for human use, such as mRNA vaccines and viral vectors. In this paper, we will review the advantages and disadvantages of the addition of new polysaccharides in the current PCVs, mainly for low- and middle-income countries, and we will also address future perspectives.
[此处原文中“The importance of ”后缺少具体内容]这些细菌可在无症状情况下定植于婴儿和成人，但在某些情况下会传播、侵袭其他组织并导致发病率和死亡率很高的疾病。肺炎球菌结合疫苗（PCV）的研发对侵袭性肺炎球菌疾病产生了巨大影响，并通过群体效应保护了未接种疫苗的人群。然而，血清型替换是一种众所周知的现象，在引入7价肺炎球菌结合疫苗（PCV7）后就已出现，其他PCV也有相关报道。因此，即使使用更高价的疫苗配方，血清型替换仍有可能继续发生，但研发不依赖血清型的疫苗或许可以克服这一问题。为提高成本效益，正在研发替代疫苗，要么使用蛋白质，要么使用肺炎球菌全细胞。这些方法既可以作为独立策略使用，也可以与多糖疫苗联合使用。展望未来，新一代肺炎球菌疫苗可能会受到最近批准用于人类的新技术的影响，如mRNA疫苗和病毒载体。在本文中，我们将主要针对低收入和中等收入国家，综述在当前PCV中添加新多糖的利弊，我们还将探讨未来前景。
