Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany.
Curr Opin Infect Dis. 2022 Oct 1;35(5):390-396. doi: 10.1097/QCO.0000000000000871.
Dengue vaccine development is a high public health priority. To date, no dengue vaccine is in widespread use. Here we review the challenges in dengue development and the latest results for the second-generation dengue vaccines.
The biggest hurdle is the immunological interaction between the four antigenically distinct dengue serotypes. The advantages of second-generation dengue vaccines are the inclusion of nonstructural proteins of the dengue backbone and a more convenient dosing with reduced numbers of doses needed.
Although dengue-primed individuals can already benefit from vaccination with the first licensed dengue vaccine CYD-TDV, the public health need for the dengue-naive population has not yet been met. The urgent need remains to identify correlates of both protection and enhancement; until such correlates have been identified, all second-generation dengue vaccines still need to go through full phase 3 trials. The 5-year efficacy and safety data for both second-generation dengue vaccines are imminent.
登革热疫苗的研发是一项高度优先的公共卫生事项。迄今为止,尚无广泛使用的登革热疫苗。本文综述了登革热疫苗研发所面临的挑战,以及第二代登革热疫苗的最新研究结果。
最大的障碍是四种抗原上不同的登革热血清型之间的免疫相互作用。第二代登革热疫苗的优势在于包含了登革热骨干的非结构蛋白,以及更方便的剂量方案,减少了所需的剂量数。
虽然已接种 CYD-TDV 的首支上市登革热疫苗的个体已能受益,但登革热无免疫力人群的公共卫生需求尚未得到满足。目前仍迫切需要确定保护和增强的相关因素;在这些相关因素确定之前,所有第二代登革热疫苗仍需要进行全面的 3 期临床试验。两种第二代登革热疫苗的 5 年疗效和安全性数据即将公布。