Vaccination against the major infectious diseases
Vaccination against the major infectious diseases
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DOI：
10.1016/s0764-4469(00)87191-7
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发表时间：
1999-11-01
期刊：
影响因子：
--
通讯作者：
Plotkin, SA
中科院分区：
文献类型：
--
作者：
Plotkin, SA
疫苗接种的声誉建立在200年来成功对抗主要传染病的历史上。这一成功导致了“每种疾病，一种疫苗”的学说。虽然有些疾病已被证明令人沮丧，但这一学说具有相当大的真理。然而，当我们回顾现有的疫苗时，很明显，大多数成功的疫苗都是在微生物处于菌血症或病毒血症阶段时获得的，在此期间，微生物对中和抗体的作用敏感，并且在它所嗜的特定器官中复制之前。脊髓灰质炎和被包囊的细菌感染是疫苗接种有效的例子。然而，针对在呼吸道或胃肠道粘膜上复制的药剂也取得了一些成功。流感疫苗、百日咳疫苗和轮状病毒疫苗是此类试剂的实例，针对这些试剂，已经可以诱导局部以及全身作用的免疫应答。此外，当细菌通过外毒素产生疾病时，这些毒素的纯化和化学或遗传失活已经产生了非常有效的疫苗。细胞内病原体的控制尚未实现，除了部分使用针对结核病的BCG疫苗之外，现代努力针对细胞免疫应答至关重要的病原体。总的来说，两项成就对疫苗的成功至关重要：在个体中诱导持久的免疫记忆，以及刺激群体免疫，加强对人群中传染病的控制。(C)1999年科学院/科学和医学版Elsevier SAS。
The reputation of vaccination rests on a 200-year-old history of success against major infectious diseases. That success has led to the doctrine of 'for each disease, a vaccine'. Although some diseases have proved frustrating, this doctrine carries considerable truth. However, when one reviews the vaccines now available it is apparent that most successes have been obtained when the microbe has a bacteremic or viremic phase during which it is susceptible to the action of neutralizing antibodies, and before replication in the particular organ to which it is tropic. Poliomyelitis and infections by capsulated bacteria are examples where vaccination has worked efficiently. However, some success has also been achieved against agents replicating on respiratory or gastrointestinal mucosae. Influenza, pertussis and rotavirus vaccines are examples of such agents, against which it has been possible to induce immune responses acting locally as well as systemically. In addition, when bacteria produce disease through exotoxins, purification and chemical or genetic inactivation of those toxins has yielded highly efficacious vaccines. Control of intracellular pathogens has not been achieved, except partly with the BCG vaccine against tuberculosis, and modern efforts are directed towards pathogens against which cellular immune responses are critical. In general, two achievements have been crucial to the success of vaccines: the induction of long-lasting immunological memory in individuals and the stimulation of a herd immunity that enhances control of infectious diseases in populations. (C) 1999 Academie des sciences/Editions scientifiques et medicales Elsevier SAS.