J Clin Invest. 2024 May 1;134(9):e179483. doi: 10.1172/JCI179483.
Herpesviruses establish latent infections, and most reactivate frequently, resulting in symptoms and virus shedding in healthy individuals. In immunocompromised patients, reactivating virus can cause severe disease. Persistent EBV has been associated with several malignancies in both immunocompromised and nonimmunocompromised persons. Reactivation and shedding occur with most herpesviruses, despite potent virus-specific antibodies and T cell immunity as measured in the blood. The licensure of therapeutic vaccines to reduce zoster indicates that effective therapeutic vaccines for other herpesviruses should be feasible. However, varicella-zoster virus is different from other human herpesviruses in that it is generally only shed during varicella and zoster. Unlike prophylactic vaccines, in which the correlate of immunity is antibody function, T cell immunity is the correlate of immunity for the only effective therapeutic herpesvirus vaccine-zoster vaccine. While most studies of therapeutic vaccines have measured immunity in the blood, cellular immunity at the site of reactivation is likely critical for an effective therapeutic vaccine for certain viruses. This Review summarizes the status of therapeutic vaccines for herpes simplex virus, cytomegalovirus, and Epstein-Barr virus and proposes approaches for future development.
疱疹病毒会引发潜伏感染，且大多数会频繁复发，导致健康个体出现症状和病毒脱落。在免疫功能低下的患者中，复发的病毒可导致严重疾病。在免疫功能低下和非免疫功能低下的个体中，持续存在的 EBV 与几种恶性肿瘤有关。尽管在血液中可检测到针对疱疹病毒的强效特异性抗体和 T 细胞免疫，但大多数疱疹病毒仍会发生再激活和脱落。带状疱疹治疗性疫苗的获批表明，针对其他疱疹病毒的有效治疗性疫苗应该是可行的。然而，水痘-带状疱疹病毒与其他人类疱疹病毒不同，它通常仅在水痘和带状疱疹期间脱落。与预防性疫苗不同，预防性疫苗中免疫的相关性是抗体功能，而 T 细胞免疫是唯一有效的治疗性疱疹病毒疫苗——带状疱疹疫苗的免疫相关性。虽然大多数治疗性疫苗的研究都在血液中测量了免疫功能，但在再激活部位的细胞免疫可能对某些病毒的有效治疗性疫苗至关重要。这篇综述总结了针对单纯疱疹病毒、巨细胞病毒和 EBV 的治疗性疫苗的现状，并提出了未来的发展方向。
