Vaginal delivery of vaccines.
Vaginal delivery of vaccines.
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DOI：
10.1016/j.addr.2021.113956
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发表时间：
2021-11
影响因子：
16.1
通讯作者：
Woodrow KA
中科院分区：
文献类型：
--
作者：
VanBenschoten HM;Woodrow KA
最近的估计表明，每两个性活跃的人中就有一个会在25岁之前获得性传播感染，这是一个令人震惊的统计数字，相当于全球每天有100多万新感染病例。对于性传播感染的疫苗接种是非常可取的，以减轻这一全球疾病负担。阴道免疫是一种很有前途的对抗通过阴道粘膜传播的策略。对于常见的获得性免疫相关因素来说，阴道通常被认为是一个很差的诱导部位。然而，新出现的证据表明，免疫耐受性可以通过精心设计的疫苗接种计划来克服，这种计划协调细胞介导的免疫并建立组织常驻记忆免疫细胞。在这篇综述中，我们将讨论阴道粘膜独特的免疫学环境，以及我们对几种常见性病的发病机制和预防的当前了解。然后，我们总结了最近的阴道疫苗研究，并根据免疫的必要特征，探讨了粘膜佐剂和递送系统在增强保护方面的作用。最后，我们对阴道疫苗接种的挑战和未来方向提出了看法，讨论了剩余的生理障碍和可能克服这些障碍的创新疫苗配方。
Recent estimates suggest that one in two sexually active individuals will acquire a sexually transmitted infection by age 25, an alarming statistic that amounts to over 1 million new infections per day worldwide. Vaccination against STIs is highly desirable for alleviating this global burden of disease. Vaginal immunization is a promising strategy to combat transmission via the vaginal mucosa. The vagina is typically considered a poor inductive site for common correlates of adaptive immunity. However, emerging evidence suggests that immune tolerance may be overcome by precisely engineered vaccination schemes that orchestrate cell-mediated immunity and establish tissue resident memory immune cells. In this review, we will discuss the unique immunological milieu of the vaginal mucosa and our current understanding of correlates of pathogenesis and protection for several common STIs. We then present a summary of recent vaginal vaccine studies and explore the role that mucosal adjuvants and delivery systems play in enhancing protection according to requisite features of immunity. Finally, we offer perspectives on the challenges and future directions of vaginal vaccine delivery, discussing remaining physiological barriers and innovative vaccine formulations that may overcome them.
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