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SARS-CoV-2 与全球疫苗接种和加强针:在抗击 COVID-19 的战斗中,疫苗接种的未来如何?

SARS-CoV-2 in relation to global vaccination and booster doses: what is the future of vaccination in the battle against COVID-19?

出版信息

Bratisl Lek Listy. 2022;123(9):631-633. doi: 10.4149/BLL_2022_101.

Abstract

Many of the deletions and large mutations found in the Omicron version of COVID-19 are identical to those seen in the α, π, β, and δ based VOCs. Such deletions and alterations have long been known to increase the viral risk of transmission and binding ability. Additionally, these changes are anticipated to increase the chances of immunological evasion and antibody secretion. T478K, G339D, Y505H, S373P, S371L, S375F, N440K, K417N, S477N, G446S, Q493R, E484A, G496S, N501Y, Q498R, and D614G are all mutations that potentially affect the virus's behavior. The N terminal region of the spike is typically targeted by NABs or neutralizing antibodies, immunologic polypeptides that prevent viruses from infecting cells. If the target region of the NABs significantly alters, the viruses may be able to avoid the autoimmune response generated by initial infection and vaccination. A possible "receptor shift" wherein ACE2 is not exclusively an Omicron receptor is worrying, given the huge number of mutations within the RBD region. D614G is the most prevalent mutation discovered among the three major pandemic variants. The Omicron variant is the most divergent variation seen in large numbers thus far in the pandemic, raising concerns that it could be linked to a faster transmission rate, lower vaccine effectiveness, and a greater risk of re-infection. Since identifying the Omicron variant, various countries have made significant modifications to their vaccination programs, including the recommendation of a third injection of boosting vaccination dosages in large populations to reduce the risk of adverse effects. However, all three vaccine producers (Johnson et Johnson, BioNTech, Pfizer, and Moderna) have published statements claiming vaccines would protect against severe sickness and that variant-specific vaccinations and boosters are in the works. This review sheds insight on several genetic mutations and their evolution in distinct variations. However, further study is needed to improve our understanding of illness transmissibility, immune escape capacity, patient features and severity, and the use of further diagnostic and therapeutic techniques (Fig. 1, Ref. 20). Keywords: SARS-CoV-2, global vaccination, booster doses, COVID-19.

摘要

新冠病毒奥密克戎变异株中的许多缺失和大片段突变与α、π、β和δ 型变异株中的突变相同。这种缺失和改变早已被证实会增加病毒的传播风险和结合能力。此外,这些变化预计会增加免疫逃逸和抗体分泌的可能性。T478K、G339D、Y505H、S373P、S371L、S375F、N440K、K417N、S477N、G446S、Q493R、E484A、G496S、N501Y、Q498R 和 D614G 都是可能影响病毒行为的突变。刺突蛋白的 N 端区域通常是中和抗体或中和免疫球蛋白的靶标,这些免疫球蛋白可阻止病毒感染细胞。如果中和抗体的靶标区域发生显著改变,病毒可能能够逃避初次感染和接种疫苗产生的自身免疫反应。由于 RBD 区域存在大量突变,奥密克戎变体可能存在一种“受体漂移”现象,即 ACE2 不再是奥密克戎变体的唯一受体,这令人担忧。D614G 是三种主要大流行变体中发现的最常见突变。奥密克戎变体是大流行中迄今为止发现的数量最多的变异体,这引发了人们的担忧,即它可能与更高的传播率、更低的疫苗有效性和更高的再感染风险有关。自发现奥密克戎变体以来,各国已对其疫苗接种计划进行了重大修改,包括建议在大量人群中进行第三次加强针接种,以降低不良反应风险。然而,所有三家疫苗生产商(强生公司、BioNTech、辉瑞公司和 Moderna)都发表声明称,疫苗将预防重症,并正在开发针对特定变体的疫苗和加强针。本文综述了不同变异株中的几种基因突变及其进化情况。然而,需要进一步研究以提高我们对疾病传染性、免疫逃逸能力、患者特征和严重程度以及进一步诊断和治疗技术的理解(图 1,参考文献 20)。关键词:SARS-CoV-2,全球疫苗接种,加强针,COVID-19。

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