Levine M M, Kaper J B
Center for Vaccine Development, University of Maryland School of Medicine, Baltimore 21201.
Vaccine. 1993;11(2):207-12. doi: 10.1016/0264-410x(93)90019-t.
One hundred years elapsed between the first (live, parenteral) cholera vaccine that entered clinical trials in 1885 and the field trials of two oral inactivated cholera vaccines undertaken in Bangladesh in the mid-1980s. The oral inactivated vaccines advanced the art by establishing, convincingly, that oral vaccines could protect (although multiple doses were required) and that (at least in adults) protection could last 3 years. Attenuated Vibrio cholerae O1 strain CVD 103-HgR (deleted of the cholera toxin A subunit gene and harbouring a gene encoding resistance to Hg++) constitutes another significant advance. This live oral vaccine is well tolerated and highly immunogenic in adults and children and highly protective (in adult volunteer challenge studies) following ingestion of of a single dose.
1885年进入临床试验的第一种（活的、肠胃外注射的）霍乱疫苗与20世纪80年代中期在孟加拉国进行的两种口服灭活霍乱疫苗的现场试验之间相隔了100年。口服灭活疫苗取得了进展，令人信服地证明口服疫苗可以提供保护（尽管需要多剂），并且（至少在成年人中）保护作用可以持续3年。减毒霍乱弧菌O1菌株CVD 103-HgR（霍乱毒素A亚基基因缺失并携带编码对Hg++耐药性的基因）是另一项重大进展。这种活口服疫苗在成人和儿童中耐受性良好且免疫原性高，单次摄入后（在成人志愿者激发试验中）具有高度保护作用。
