Malaria Vaccines: Moving Forward After Encouraging First Steps.
Malaria Vaccines: Moving Forward After Encouraging First Steps.
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DOI：
10.1007/s40475-015-0041-3
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发表时间：
2015-03
影响因子：
5.4
通讯作者：
中科院分区：
文献类型：
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减少发病率和死亡率并有助于消除疟疾的有效疟疾疫苗是一种急需的工具，特别是在难以持续提供保健和控制病媒的流行地区。S/AS01RTS很可能是第一个获得许可的疟疾疫苗，代表着朝着控制和消除疟疾迈出的重要一步。然而，部分有效的疫苗，如RTS，S/AS01号，对评估第二代疟疾疫苗的效力提出了挑战。全子孢子免疫方法已经显示出很有希望的结果，在幼稚疟疾成人的小规模试验中诱导了不育免疫，但在流行人群中可能无法实现持久的不育保护。针对红细胞前和侵入红细胞的寄生虫(裂殖子)的疫苗可以通过中和从受感染的肝细胞中涌出的裂殖子来消除突破性感染，而针对有性阶段的疫苗则试图打破传播循环。展望未来，多阶段疫苗可能是消除和根除疟疾的下一步。
An effective malaria vaccine that reduces morbidity and mortality and contributes to malaria elimination is a much-needed tool, particularly in endemic areas where health-care delivery and vector control efforts are difficult to sustain. RTS,S/AS01 is likely to be the first licensed malaria vaccine and represents an important step toward malaria control and elimination. However, a partially effective vaccine such as RTS,S/AS01 poses challenges for evaluating the efficacy of second-generation malaria vaccines. Whole-sporozoite immunization approaches have shown promising results, inducing sterile immunity in small-scale trials of malaria-naïve adults, but may not achieve durable sterile protection in endemic populations. Vaccines targeting both the pre-erythrocytic and the erythrocyte-invasive form of the parasite (merozoites) may abrogate breakthrough infections by neutralizing merozoites emerging from infected hepatocytes, whereas vaccines targeting the sexual stages seek to break the transmission cycle. Moving forward, a multi-stage vaccine could be the next step toward malaria elimination and eradication.