Malaria vaccines and their potential role in the elimination of malaria.
Malaria vaccines and their potential role in the elimination of malaria.
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DOI：
10.1186/1475-2875-7-s1-s10
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发表时间：
2008-12-11
期刊：
影响因子：
3
通讯作者：
Greenwood BM
中科院分区：
文献类型：
--
作者：
Targett GA;Greenwood BM
疟疾疫苗的研究目前主要是为了研制预防临床疟疾的疫苗。在某些流行病情况下，目前正在认真考虑消灭疟疾，这需要一种不同的疫苗战略，因为成功与否将取决于能否杀死社区中的所有寄生虫，以便完全阻止传播。对消灭方案构成最大挑战的人类疟疾生命周期的特点是寄生虫作为无症状感染持续存在。这些是传播给蚊子的重要来源。因此，消灭疟疾战略需要采取以社区为基础的办法，涵盖所有个人，而不仅仅是那些易患临床疟疾的人。综述了疟疾候选疫苗的研究进展。其中许多药物不太可能具有完全消灭寄生虫所需的效力，尽管它们可能作为未来综合防治方案的一部分发挥重要作用。消除疫苗必须具有高水平的效力，以阻止传播给蚊子。这可以通过一些红细胞前期候选疫苗或通过直接针对性阶段的传播阻断疫苗来实现。具有此类目标的扩大疟疾疫苗计划现在是一个优先事项。
Research on malaria vaccines is currently directed primarily towards the development of vaccines that prevent clinical malaria. Malaria elimination, now being considered seriously in some epidemiological situations, requires a different vaccine strategy, since success will depend on killing all parasites in the community in order to stop transmission completely. The feature of the life-cycles of human malarias that presents the greatest challenge to an elimination programme is the persistence of parasites as asymptomatic infections. These are an important source from which transmission to mosquitoes can occur. Consequently, an elimination strategy requires a community-based approach covering all individuals and not just those who are susceptible to clinical malaria. The progress that has been made in development of candidate malaria vaccines is reviewed. It is unlikely that many of these will have the efficacy required for complete elimination of parasites, though they may have an important role to play as part of future integrated control programmes. Vaccines for elimination must have a high level of efficacy in order to stop transmission to mosquitoes. This might be achieved with some pre-erythrocytic stage candidate vaccines or by targeting the sexual stages directly with transmission-blocking vaccines. An expanded malaria vaccine programme with such objectives is now a priority.