Department of Microbiology and Immunology, University of Melbourne, at The Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, 3000, Australia.
Department of Microbiology and Immunology, University of Melbourne, at The Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, 3000, Australia.
EBioMedicine. 2023 Jun;92:104585. doi: 10.1016/j.ebiom.2023.104585. Epub 2023 May 3.
Currently approved COVID-19 vaccines administered parenterally induce robust systemic humoral and cellular responses. While highly effective against severe disease, there is reduced effectiveness of these vaccines in preventing breakthrough infection and/or onward transmission, likely due to poor immunity elicited at the respiratory mucosa. As such, there has been considerable interest in developing novel mucosal vaccines that engenders more localised immune responses to provide better protection and recall responses at the site of virus entry, in contrast to traditional vaccine approaches that focus on systemic immunity. In this review, we explore the adaptive components of mucosal immunity, evaluate epidemiological studies to dissect if mucosal immunity conferred by parenteral vaccination or respiratory infection drives differential efficacy against virus acquisition or transmission, discuss mucosal vaccines undergoing clinical trials and assess key challenges and prospects for mucosal vaccine development.
目前批准的经肠胃外给药的 COVID-19 疫苗可诱导强大的全身体液和细胞反应。虽然这些疫苗对严重疾病非常有效，但它们在预防突破性感染和/或传播方面的效果降低，这可能是由于呼吸道黏膜引起的免疫反应不佳。因此，人们对开发新型黏膜疫苗产生了浓厚的兴趣，这种疫苗可引起更局部的免疫反应，从而在病毒进入部位提供更好的保护和回忆反应，与传统疫苗方法专注于全身免疫形成对比。在这篇综述中，我们探讨了黏膜免疫的适应性成分，评估了流行病学研究以剖析经肠胃外疫苗接种或呼吸道感染引起的黏膜免疫是否对病毒获得或传播产生不同的疗效，讨论了正在进行临床试验的黏膜疫苗，并评估了黏膜疫苗开发的关键挑战和前景。
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