Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, United States.
Pathog Dis. 2024 Feb 7;82. doi: 10.1093/femspd/ftae017.
Chlamydia trachomatis is the most prevalent bacterial sexually transmitted infection globally. Antibiotic treatment is highly effective, but infection is often asymptomatic resulting in most individuals going undetected and untreated. This untreated infection can ascend to the upper female genital tract to cause pelvic inflammatory disease, tubal factor infertility, and ectopic pregnancy. Chlamydia screening and treatment programs have failed to control this epidemic and demonstrate the need for an efficacious vaccine to prevent transmission and disease. Animal models and human epidemiological data reveal that natural immunity can provide partial or short-lived sterilizing immunity. These data further demonstrate the importance of eliciting interferon gamma (IFNγ)-producing cluster of differentiation 4 (CD4) T cells (Th1 and Th1/17 cells) that can likely synergize with antibody-mediated opsonophagocytosis to provide optimal protection. These studies have guided preclinical rational vaccine design for decades and the first Phase 1 clinical trials have recently been completed. Recent advances have led to improvements in vaccine platforms and clinically safe adjuvants that help provide a path forward. This review describes vaccine models, correlates of immunity, antigen and adjuvant selection, and future clinical testing for Chlamydia vaccine development.
沙眼衣原体是全球最普遍的细菌性性传播感染。抗生素治疗非常有效，但感染通常无症状，导致大多数人未被发现和未得到治疗。这种未经治疗的感染会向上蔓延到女性生殖道的上部，导致盆腔炎、输卵管因素不孕和宫外孕。沙眼衣原体筛查和治疗计划未能控制这一流行，表明需要一种有效的疫苗来预防传播和疾病。动物模型和人类流行病学数据表明，自然免疫可以提供部分或短暂的绝育免疫。这些数据进一步表明，诱导产生干扰素γ（IFNγ）的簇分化 4（CD4）T 细胞（Th1 和 Th1/17 细胞）的重要性，这些细胞可能与抗体介导的调理吞噬作用协同作用，提供最佳保护。这些研究为临床前合理疫苗设计提供了指导，并且最近已经完成了第一个 1 期临床试验。最近的进展导致了疫苗平台和临床安全佐剂的改进，这有助于提供前进的道路。这篇综述描述了疫苗模型、免疫相关性、抗原和佐剂选择以及未来的临床测试，以促进沙眼衣原体疫苗的开发。
