Levine M M, Noriega F
Dept of Pediatrics, University of Maryland School of Medicine, Baltimore 21201.
Pediatr Ann. 1993 Dec;22(12):719-25. doi: 10.3928/0090-4481-19931201-07.
Considerable progress has been made in the last decade in developing vaccines against the most important bacterial enteric infections. Two new vaccines against typhoid fever (oral Ty21a and parenteral Vi polysaccharide) have been licensed in many countries. Newer generations of more sophisticated typhoid vaccines are undergoing clinical testing including recombinant attenuated S typhi strains and Vi polysaccharide-carrier protein conjugate vaccines. Two inactivated oral cholera vaccines, consisting of inactivated V cholerae 01 bacteria alone or in combination with the B subunit of cholera toxin, each conferred 50% to 53% protection over 3 years in a field trial in Bangladesh where subjects were immunized with a three-dose regimen. An engineered live oral cholera vaccine, strain CVD 103-HgR, has been shown in extensive clinical trials to be well tolerated by children and adults in developing countries and highly immunogenic following administration of just a single oral dose; a large-scale field trial of the efficacy of this vaccine is underway. Several candidate vaccines against Shigella and enterotoxigenic E coli are in clinical trials.
在过去十年中，针对最重要的细菌性肠道感染研发疫苗方面取得了相当大的进展。两种新型伤寒疫苗（口服Ty21a和注射用Vi多糖疫苗）已在许多国家获得许可。新一代更先进的伤寒疫苗正在进行临床试验，包括重组减毒伤寒杆菌菌株和Vi多糖-载体蛋白结合疫苗。两种灭活口服霍乱疫苗，一种仅由灭活的霍乱弧菌01组成，另一种与霍乱毒素B亚单位联合使用，在孟加拉国的一项现场试验中，采用三剂免疫方案，每种疫苗在3年内均提供了50%至53%的保护。一种经基因工程改造的口服活霍乱疫苗CVD 103-HgR，在广泛的临床试验中表明，发展中国家的儿童和成人对其耐受性良好，仅口服一剂后就具有高度免疫原性；该疫苗疗效的大规模现场试验正在进行。几种针对志贺氏菌和产肠毒素大肠杆菌的候选疫苗正在进行临床试验。
