A critical review on a globally-licensed, live, orally-administrable, monovalent human rotavirus vaccine: Rotarix
A critical review on a globally-licensed, live, orally-administrable, monovalent human rotavirus vaccine: Rotarix
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DOI：
10.1517/14712590903103787
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发表时间：
2009-07
影响因子：
4.6
通讯作者：
T. Nakagomi;O. Nakagomi
中科院分区：
文献类型：
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作者：
T. Nakagomi;O. Nakagomi
轮状病毒是全世界儿童严重胃肠炎的主要原因，两种口服活疫苗在全球获得许可。它们是Rotarix，一种单价的基于人轮状病毒的疫苗（葛兰素史克），和RotaTeq，一种五价的牛-人重组疫苗（默克）。RIX 4414株是一种G1 P病毒[8]，包含在Rotarix疫苗中。它在人体肠道中有效生长，疫苗病毒脱落到粪便中就是证明。RIX 4414在肠道中的有效增殖可能在刺激中和抗体以外的免疫效应物中发挥作用，这可能解释了针对完全异型G2 P菌株的保护性免疫[4]。由Rotarix提供的针对严重轮状病毒胃肠炎的保护功效对于与RIX 4414共享G和P血清型的菌株（即，G1 P [8]），或仅P血清型（即，G3 P [8]、G4 P [8]和G9 P [8]）。如果Rotarix疫苗在6 - 12周龄之间接种第一剂，在24周龄时接种最后一剂，两剂之间的最小间隔为4周，则Rotarix疫苗对肠套叠是安全的。美国免疫实践咨询委员会将第一次接种的年龄限制扩大到15周龄，最后一次接种的年龄限制扩大到8个月，这需要密切监测。
Rotavirus is the major cause of severe gastroenteritis in children worldwide, and two, live, orally-administrable vaccines are licensed globally. They are Rotarix, a monovalent, human rotavirus-based vaccine (GlaxoSmithKline), and RotaTeq, a pentavalent, bovine–human reassortant vaccine (Merck). The RIX4414 strain, a G1P[8] virus, is contained in the Rotarix vaccine. It grows efficiently in the human intestine, as evidenced by vaccine virus shedding into faeces. Efficient multiplication of RIX4414 in the intestines may play a role in stimulating immune effectors other than neutralizing antibodies that may explain the protective immunity against fully heterotypic G2P[4] strains. The protective efficacy against severe rotavirus gastroenteritis afforded by Rotarix is consistently better against strains that share with RIX4414 both G and P serotypes (i.e., G1P[8]), or only P serotype (i.e., G3P[8], G4P[8] and G9P[8]). The Rotarix vaccine is safe regarding intussusception if its first dose is administered between 6 and 12 weeks of age and the last dose by 24 weeks of age with a minimum interval of 4 weeks between the two doses. The expansion by Advisory Committee on Immunization Practices, USA, of the age limit for the first dose to age <15 weeks, and the last dose by 8 months requires close monitoring.