Progress on norovirus vaccine research: public health considerations and future directions.

Progress on norovirus vaccine research: public health considerations and future directions.
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DOI:
10.1080/14760584.2018.1510327
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发表时间:
2018-09
影响因子:
6.2
通讯作者:
Hall AJ
Hall AJ
中科院分区:
医学2区
文献类型:
--
作者:
Mattison CP;Cardemil CV;Hall AJ

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诺如病毒是全球食源性疾病的主要原因,约占全球急性胃肠炎(AGE)病例的五分之一,并造成巨大的经济负担。候选诺沃克病毒疫苗正在开发中,但目前还没有获得许可的疫苗。诺如病毒每年在所有年龄段造成约6.84亿例病例和21.2万人死亡,尽管负担估计因研究和地区而异。疫苗研究面临的挑战包括大量和快速演变的遗传多样性、对感染的短期和同型免疫,以及缺乏单一的、成熟的保护相关性。尽管如此,几种诺沃克病毒候选疫苗目前正在开发中,利用病毒样颗粒(VLP)、P颗粒和重组腺病毒。其中,以GI.1/GII.4 VLP为基础的双价肌肉注射疫苗(IIb期)和GI.1口服疫苗(I期)正在进行临床试验。诺沃克病毒疫苗应该针对高危人群,包括年轻人和老年人,并保护他们免受最常见的流行诺沃克病毒株的影响。诺沃克病毒疫苗将是预防和控制诺沃克病毒的有力工具,同时减轻全世界的老龄化负担。然而,需要更有力的负担和成本估计,以证明对诺沃克病毒疫苗开发的投资是合理的,并指导开发。
Noroviruses are the leading cause of foodborne illness worldwide, account for approximately one-fifth of acute gastroenteritis (AGE) cases globally, and cause a substantial economic burden. Candidate norovirus vaccines are in development, but there is currently no licensed vaccine. Noroviruses cause approximately 684 million cases and 212,000 deaths per year across all age groups, though burden estimates vary by study and region. Challenges to vaccine research include substantial and rapidly evolving genetic diversity, short-term and homotypic immunity to infection, and the absence of a single, well-established correlate of protection. Nonetheless, several norovirus vaccine candidates are currently in development, utilizing virus-like particles (VLPs), P particles, and recombinant adenoviruses. Of these, a bivalent GI.1/GII.4 VLP-based intramuscular vaccine (Phase IIb) and GI.1 oral vaccine (Phase I) are in clinical trials. A norovirus vaccine should target high-risk populations, including the young and the elderly, and protect them against the most common circulating norovirus strains. A norovirus vaccine would be a powerful tool in the prevention and control of norovirus while lessening the burden of AGE worldwide. However, more robust burden and cost estimates are needed to justify investments in and guide norovirus vaccine development.
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