Wong Matthew Tze Jian, Anuar Nor Suhada, Noordin Rahmah, Tye Gee Jun
Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia, 11800 USM Pulau Pinang, Malaysia.
Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia, 11800 USM Pulau Pinang, Malaysia.
Acta Trop. 2023 Mar;239:106796. doi: 10.1016/j.actatropica.2022.106796. Epub 2022 Dec 29.
It has been tested and proven that vaccination is still the best strategy to combat infectious diseases. However, to date, there are still no vaccines against human soil-transmitted helminthic diseases, despite their high prevalence globally, particularly in developing countries and rural areas with tropical climates and poor sanitation. The development of vaccines against helminths is riddled with obstacles. Helminths have a complex life cycle, multiple stages within the same host with stage-specific antigen expression, and the ability to regulate host immune reactions to evade the immune response. These elements contribute to the main challenge of helminthic vaccines: the identification of effective vaccine candidates. Therefore, this article reviews the current progress and potential future direction of soil-transmitted helminthic vaccines, particularly against Trichuris trichiura, Ascaris lumbricoides, Strongyloides stercoralis, Necator americanus and Ancylostoma duodenale. The study design employed was a systematic review, using qualitative meta-summary synthesis. Preclinical studies and clinical trials on the development of protein subunit vaccines against the five soil-transmitted helminths were searched on PubMed and Scopus. Effectiveness was indicated by a reduction in worm burden or larval output, an increase in specific IgG levels, or an increase in cytokine production. Our findings show that only the hookworm vaccine against N. americanus is in the clinical trial phase, while the rest is still in exploratory research and pre-clinical development phase.
已经经过测试和证实，接种疫苗仍然是对抗传染病的最佳策略。然而，迄今为止，尽管全球范围内人体土源性蠕虫病的患病率很高，特别是在热带气候和卫生条件差的发展中国家和农村地区，但仍然没有针对这些疾病的疫苗。抗蠕虫疫苗的研发充满了障碍。蠕虫具有复杂的生命周期，在同一宿主体内有多个阶段，且各阶段有特定的抗原表达，同时它们还具有调节宿主免疫反应以逃避免疫应答的能力。这些因素构成了蠕虫疫苗的主要挑战：识别有效的候选疫苗。因此，本文综述了土源性蠕虫疫苗，特别是针对毛首鞭形线虫、蛔虫、粪类圆线虫、美洲板口线虫和十二指肠钩口线虫的疫苗的当前进展和未来潜在方向。所采用的研究设计是系统综述，使用定性元总结综合法。在PubMed和Scopus上搜索了针对这五种土源性蠕虫开发蛋白质亚单位疫苗的临床前研究和临床试验。有效性通过蠕虫负荷或幼虫产量的降低、特异性IgG水平的升高或细胞因子产生的增加来表明。我们的研究结果表明，只有针对美洲板口线虫的钩虫疫苗处于临床试验阶段，而其他疫苗仍处于探索性研究和临床前开发阶段。
