Research & Development, Sanofi, Marcy l'Etoile, France.
Department of Research and Evaluation, United Kingdom (UK) Health Security Agency, Salisbury, UK.
Expert Rev Vaccines. 2022 Dec;21(12):1727-1738. doi: 10.1080/14760584.2022.2137145. Epub 2022 Nov 11.
Pertussis vaccines have drastically reduced the disease burden in humans since their implementation. Despite their success, pertussis remains an important global public health challenge. resurgence could be a result of greater surveillance combined with improved diagnosis methods, changes in biology, vaccine schedules, and/or coverage. Additionally, mechanisms of protection conferred by acellular pertussis (aP) and whole-cell pertussis (wP) vaccines differ qualitatively. There are no clear immune correlates of protection for pertussis vaccines. Pertussis antigens can induce toxin neutralizing antibodies, block adherence or engage complement mediated phagocytic/bactericidal killing.
We reviewed the existing evidence on antibody-mediated serum bactericidal and opsonophagocytic activity and discussed the relevance of these functional antibodies in the development of next-generation pertussis vaccines.
Current paradigm proposes that wP vaccines may confer greater herd protection than aP vaccines due to their enhanced clearance of bacteria from the nasopharynx in animal models. Functional antibodies may contribute to the reduction of nasal colonization, which differentiates aP and wP vaccines. Understanding the intrinsic differences in protective immune responses elicited by each class of vaccines will help to identify biomarkers that can be used as immunological end points in clinical trials.
自从百白破疫苗问世以来，它在很大程度上降低了人类的疾病负担。尽管它们取得了成功，但百日咳仍然是一个重要的全球公共卫生挑战。这种疾病的死灰复燃可能是由于更广泛的监测以及诊断方法的改进、生物学变化、疫苗接种计划和/或覆盖率的变化所致。此外，无细胞百日咳（aP）和全细胞百日咳（wP）疫苗所提供的保护机制在性质上有所不同。目前还没有百日咳疫苗保护的明确免疫相关因素。百日咳抗原可以诱导毒素中和抗体，阻止附着或结合补体介导的吞噬/杀菌作用。
我们回顾了关于抗体介导的血清杀菌和调理吞噬活性的现有证据，并讨论了这些功能性抗体在下一代百日咳疫苗开发中的相关性。
目前的模式提出，全细胞百白破疫苗在动物模型中比无细胞百白破疫苗更能增强细菌从鼻咽部的清除，因此可能提供更大的群体保护。功能性抗体可能有助于减少鼻腔定植，这是无细胞百白破疫苗和全细胞百白破疫苗的区别。了解每类疫苗引起的保护性免疫反应的内在差异，将有助于确定可作为临床试验免疫终点的生物标志物。
