Rubella.
Rubella.
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DOI：
10.1016/s0140-6736(14)60539-0
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发表时间：
2015-06-06
期刊：
影响因子：
--
通讯作者：
Poland GA
中科院分区：
文献类型：
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作者：
Lambert N;Strebel P;Orenstein W;Icenogle J;Poland GA
风疹仍然是全球一种重要的病原体，据估计，每年约有10万例先天性风疹综合征发生。风疹疫苗在人群中使用时非常有效和安全，因此，自2009年以来，风疹在美洲的地方性传播已经中断。不完全的风疹疫苗接种计划导致疾病继续传播，最近在日本和其他地方爆发的大规模疫情就是明证。在此，我们提供了有关风疹控制、消除和根除政策的最新结果，并简要回顾了新的实验室诊断方法。此外，我们提供了有关风疹疫苗免疫遗传学的新信息，并回顾了风疹疫苗体液和细胞介导的先天性和获得性免疫反应的个体间差异及其与人类基因组中的HLA等位基因、单倍型和单核苷酸多态的关系的新证据。最后，我们呼吁进一步研究风疹疫苗的免疫遗传学及其为开发新的候选疫苗提供疫苗组学水平的方法的能力，以及需要一种负担得起、易于管理且不需要冷链来获得最佳免疫原性的下一代疫苗。
Rubella remains an important pathogen globally with approximately 100,000 cases of congenital rubella syndrome estimated to occur each year. Rubella vaccine is highly effective and safe when used across a population and, as a result, endemic rubella transmission has been interrupted in the Americas since 2009. Incomplete rubella vaccination programs result in continued disease transmission as evidenced by recent large outbreaks in Japan and elsewhere. Herein, we provide current results regarding rubella control, elimination and eradication policies, and a brief review of new laboratory diagnostics. In addition, we provide novel information regarding rubella vaccine immunogenetics and review the emerging evidence of inter-individual variability in humoral and cell-mediated innate and adaptive immune responses to rubella vaccine and their association with HLA alleles, haplotypes, and single nucleotide polymorphisms across the human genome. Finally, we conclude with a call for further research in rubella vaccine immunogenetics and its ability to inform a vaccinomics-level approach to novel vaccine candidate development and the need for a next generation vaccine that is affordable, easy to administer, and does not require a cold chain for optimal immunogenicity.