Sansonetti P J
Unité de Pathogénie Microbienne Moléculaire, INSERM U 199, Institut Pasteur, Paris.
Ann Gastroenterol Hepatol (Paris). 1994 Mar-Apr;30(2):60-3.
Development of vaccines against enterobacterial species responsible for enteric infections sounds like an unrealistic project. On the other hand, based on our growing understanding of the pathogenesis of infections caused by the major species (i.e. Salmonella typhi, Shigella flexneri and Shigella dysenteriae 1, Enterotoxigenic Escherichia coli) and on our better characterization of the immunological parameters of mucosal protection, it is likely that a limited number of vaccines controlling diseases such as typhoid fever, bacillary dysentery and cholera-like E. coli infections will become available. There are three major problems that still need to be solved: the variety of antigens and antigenic specificities, the nature of protective antigens and, provided that these prerequisites are fulfilled, the presentation of the vaccine and the immunization route. With the exception of typhoid fever, which has a systemic phase that probably makes immunization attempts by purified Vi antigen successful, experimental strategies rely very much on induction of a mucosal immunity. Either subunit vaccines, or genetically manipulated strains which attenuated virulence are currently considered.
研发针对引起肠道感染的肠杆菌属细菌的疫苗,听起来像是一个不切实际的项目。另一方面,基于我们对主要菌种(即伤寒沙门氏菌、福氏志贺氏菌和痢疾志贺氏菌1型、产肠毒素大肠杆菌)所致感染发病机制的深入了解,以及对黏膜保护免疫参数的更好表征,控制伤寒热、细菌性痢疾和霍乱样大肠杆菌感染等疾病的有限数量疫苗很可能会问世。仍有三个主要问题有待解决:抗原和抗原特异性的多样性、保护性抗原的性质,以及在满足这些前提条件的情况下,疫苗的呈现方式和免疫途径。除了伤寒热有一个可能使通过纯化Vi抗原进行免疫接种尝试成功的全身阶段外,实验策略非常依赖于诱导黏膜免疫。目前考虑的要么是亚单位疫苗,要么是毒力减弱的基因工程菌株。