Leiden Institute of Chemistry, Leiden University, Leiden, The Netherlands.
GSK, Via Fiorentina 1, Siena, Italy.
Expert Rev Vaccines. 2023 Jan-Dec;22(1):1055-1078. doi: 10.1080/14760584.2023.2274955. Epub 2023 Nov 8.
Antimicrobial resistance (AMR) is responsible for the death of millions worldwide and stands as a major threat to our healthcare systems, which are heavily reliant on antibiotics to fight bacterial infections. The development of vaccines against the main pathogens involved is urgently required as prevention remains essential against the rise of AMR.
A systematic research review was conducted on MEDLINE database focusing on the six AMR pathogens defined as ESKAPE (, , , , , and ), which are considered critical or high priority pathogens by the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC). The analysis was intersecated with the terms carbohydrate, glycoconjugate, bioconjugate, glyconanoparticle, and multiple presenting antigen system vaccines.
Glycoconjugate vaccines have been successful in preventing meningitis and pneumoniae, and there are high expectations that they will play a key role in fighting AMR. We herein discuss the recent technological, preclinical, and clinical advances, as well as the challenges associated with the development of carbohydrate-based vaccines against leading AMR bacteria, with focus on the ESKAPE pathogens. The need of innovative clinical and regulatory approaches to tackle these targets is also highlighted.
抗菌药物耐药性（AMR）在全球范围内导致数百万人死亡，对我们的医疗保健系统构成重大威胁，而这些系统严重依赖抗生素来对抗细菌感染。由于预防仍然是对抗 AMR 上升的关键，因此迫切需要开发针对主要病原体的疫苗。
在 MEDLINE 数据库中进行了系统的研究综述，重点关注被世界卫生组织（WHO）和疾病控制与预防中心（CDC）定义为 ESKAPE（耐甲氧西林金黄色葡萄球菌、万古霉素肠球菌、肺炎克雷伯菌、鲍曼不动杆菌、铜绿假单胞菌和肠杆菌属）的六种 AMR 病原体。分析与碳水化合物、糖缀合物、生物缀合物、糖纳米颗粒和多种呈现抗原系统疫苗的术语相交。
糖缀合物疫苗已成功预防脑膜炎和肺炎，人们高度期望它们将在对抗 AMR 方面发挥关键作用。本文讨论了针对主要 AMR 细菌开发基于碳水化合物的疫苗的最新技术、临床前和临床进展，以及相关挑战，重点是 ESKAPE 病原体。还强调了需要创新的临床和监管方法来解决这些目标。
