Bigay Julie, Le Grand Roger, Martinon Frédéric, Maisonnasse Pauline
Immunology of Viral Infections and Autoimmune Diseases (IMVA), IDMIT Department, Institut de Biologie François-Jacob (IBJF), University Paris-Sud-INSERM U1184, CEA, Fontenay-Aux-Roses, France.
Front Microbiol. 2022 Aug 10;13:932408. doi: 10.3389/fmicb.2022.932408. eCollection 2022.
The fight against infectious diseases calls for the development of safe and effective vaccines that generate long-lasting protective immunity. In a few situations, vaccine-mediated immune responses may have led to exacerbated pathology upon subsequent infection with the pathogen targeted by the vaccine. Such vaccine-associated enhanced disease (VAED) has been reported, or at least suspected, in animal models, and in a few instances in humans, for vaccine candidates against the respiratory syncytial virus (RSV), measles virus (MV), dengue virus (DENV), HIV-1, simian immunodeficiency virus (SIV), feline immunodeficiency virus (FIV), severe acute respiratory syndrome coronavirus 1 (SARS-CoV-1), and the Middle East respiratory syndrome coronavirus (MERS-CoV). Although alleviated by clinical and epidemiological evidence, a number of concerns were also initially raised concerning the short- and long-term safety of vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which is causing the ongoing COVID-19 pandemic. Although the mechanisms leading to this phenomenon are not yet completely understood, the individual and/or collective role of antibody-dependent enhancement (ADE), complement-dependent enhancement, and cell-dependent enhancement have been highlighted. Here, we review mechanisms that may be associated with the risk of VAED, which are important to take into consideration, both in the assessment of vaccine safety and in finding ways to define models and immunization strategies that can alleviate such concerns.
抗击传染病需要研发能产生持久保护性免疫的安全有效疫苗。在少数情况下，疫苗介导的免疫反应可能会在随后感染疫苗所针对的病原体时导致病情加重。对于针对呼吸道合胞病毒（RSV）、麻疹病毒（MV）、登革病毒（DENV）、HIV-1、猴免疫缺陷病毒（SIV）、猫免疫缺陷病毒（FIV）、严重急性呼吸综合征冠状病毒1（SARS-CoV-1）和中东呼吸综合征冠状病毒（MERS-CoV）的候选疫苗，在动物模型以及少数人类病例中已报告或至少怀疑存在这种疫苗相关增强疾病（VAED）。尽管临床和流行病学证据缓解了一些担忧，但最初也有人对针对严重急性呼吸综合征冠状病毒2（SARS-CoV-2）的疫苗的短期和长期安全性提出了一些担忧，该病毒正在引发当前的COVID-19大流行。尽管导致这种现象的机制尚未完全了解，但抗体依赖性增强（ADE）、补体依赖性增强和细胞依赖性增强的个体和/或集体作用已受到关注。在此，我们综述可能与VAED风险相关的机制，这些机制在评估疫苗安全性以及寻找确定可缓解此类担忧的模型和免疫策略的方法时都很重要，需要加以考虑。
