H5N1 vaccines in humans.
H5N1 vaccines in humans.
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DOI：
10.1016/j.virusres.2013.05.006
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发表时间：
2013-12-05
期刊：
影响因子：
5
通讯作者：
Subbarao K
中科院分区：
文献类型：
--
作者：
Baz M;Luke CJ;Cheng X;Jin H;Subbarao K
自1997年以来高致病性H5N1禽流感病毒的传播及其对家禽和人类的毒力引起了人们对其可能引起流感大流行的关注。疫苗是对抗大流行威胁的最可行手段。然而，如果大流行迅速蔓延，生产、分发和实施新疫苗将是一项挑战。因此，正在努力开发使用较少抗原并引起交叉保护和持久反应的大流行病疫苗，这种疫苗可以在宣布大流行病时立即或甚至可能在此之前施用，以便使人口做好准备，并允许快速和保护性的抗体反应。在过去几年中，几家疫苗制造商开发了基于反向遗传学的候选大流行和大流行前疫苗，并通过使用不同的佐剂配制这些疫苗来提高免疫原性。从对H5N1疫苗的临床研究中得出的一些重要和一致的观察结果如下：通常需要两剂灭活疫苗才能达到达到许可标准所需的免疫水平；如果包括水浸油佐剂，则可以使用较少的抗原；一般而言，抗体滴度迅速下降，但可以通过额外剂量的疫苗来提高；如果引起高滴度的抗体，则观察到针对其他进化支的交叉反应。启动-增强策略会引发更强大的免疫反应。在这篇综述中，我们讨论了各种H5N1流感疫苗的临床试验数据。我们还描述了在动物模型中进行的研究，以探索大流行减毒活疫苗候选疫苗与季节性流感病毒之间重新组合的可能性，因为这是在大流行环境中使用活疫苗的重要考虑因素。
The spread of highly pathogenic avian H5N1 influenza viruses since 1997 and their virulence for poultry and humans has raised concerns about their potential to cause an influenza pandemic. Vaccines offer the most viable means to combat a pandemic threat. However, it will be a challenge to produce, distribute and implement a new vaccine if a pandemic spreads rapidly. Therefore, efforts are being undertaken to develop pandemic vaccines that use less antigen and induce cross-protective and long-lasting responses, that can be administered as soon as a pandemic is declared or possibly even before, in order to prime the population and allow for a rapid and protective antibody response. In the last few years, several vaccine manufacturers have developed candidate pandemic and pre-pandemic vaccines, based on reverse genetics and have improved the immunogenicity by formulating these vaccines with different adjuvants. Some of the important and consistent observations from clinical studies with H5N1 vaccines are as follows: two doses of inactivated vaccine are generally necessary to elicit the level of immunity required to meet licensure criteria, less antigen can be used if an oil-in-water adjuvant is included, in general antibody titers decline rapidly but can be boosted with additional doses of vaccine and if high titers of antibody are elicited, cross-reactivity against other clades is observed. Prime-boost strategies elicit a more robust immune response. In this review, we discuss data from clinical trials with a variety of H5N1 influenza vaccines. We also describe studies conducted in animal models to explore the possibility of reassortment between pandemic live attenuated vaccine candidates and seasonal influenza viruses, since this is an important consideration for the use of live vaccines in a pandemic setting.
DOI：
10.1007/978-3-0346-0279-2_10
发表时间：
2010-06-18
期刊：
Influenza Vaccines for the Future
影响因子：
--
作者：
Luke CJ;Subbarao K
通讯作者：
Subbarao K