Frost Hannah, Excler Jean-Louis, Sriskandan Shiranee, Fulurija Alma
Murdoch Children's Research Institute, Melbourne, VIC, Australia.
International Vaccine Institute, Seoul, Republic of Korea.
NPJ Vaccines. 2023 Jan 17;8(1):1. doi: 10.1038/s41541-022-00593-8.
Understanding immunity in humans to Group A Streptococcus (Strep A) is critical for the development of successful vaccines to prevent the morbidity and mortality attributed to Strep A infections. Despite decades of effort, no licensed vaccine against Strep A exists and immune correlates of protection are lacking; a major impediment to vaccine development. In the absence of a vaccine, we can take cues from the development of natural immunity to Strep A in humans to identify immune correlates of protection. The age stratification of incidence of acute Strep A infections, peaking in young children and waning in early adulthood, coincides with the development of specific immune responses. Therefore, understanding the immune mechanisms involved in natural protection from acute Strep A infection is critical to identifying immune correlates to inform vaccine development. This perspective summarises the findings from natural infection studies, existing assays of immunity to Strep A, and highlights the gaps in knowledge to guide the development of Strep A vaccines and associated correlates of protection.
了解人类对A组链球菌（A群链球菌）的免疫力对于开发成功的疫苗以预防由A群链球菌感染导致的发病和死亡至关重要。尽管经过了数十年的努力，但目前尚无针对A群链球菌的许可疫苗，并且缺乏保护性免疫相关指标；这是疫苗开发的一个主要障碍。在没有疫苗的情况下，我们可以从人类对A群链球菌自然免疫的发展中获取线索，以确定保护性免疫相关指标。急性A群链球菌感染发病率的年龄分层在幼儿期达到峰值，在成年早期下降，这与特异性免疫反应的发展相吻合。因此，了解自然保护免受急性A群链球菌感染所涉及的免疫机制对于确定免疫相关指标以指导疫苗开发至关重要。本观点总结了自然感染研究、现有A群链球菌免疫检测的结果，并突出了知识空白，以指导A群链球菌疫苗及相关保护性免疫指标的开发。
