Why does drug resistance readily evolve but vaccine resistance does not?
Why does drug resistance readily evolve but vaccine resistance does not?
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DOI：
10.1098/rspb.2016.2562
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发表时间：
2017-03-29
期刊：
影响因子：
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通讯作者：
Read AF
中科院分区：
文献类型：
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作者：
Kennedy DA;Read AF
为什么耐药性常见而疫苗耐药性罕见？药物和疫苗都对病原体群体施加了巨大的压力，使其产生耐药性，事实上，耐药性通常在药物引入后不久就出现了。但疫苗耐药性很少出现。利用群体遗传学和进化生态学的公认原则，我们认为疫苗和药物之间的两个关键差异解释了为什么迄今为止疫苗被证明比药物更能对抗进化。首先，疫苗往往起预防作用，而药物往往起治疗作用。其次，疫苗往往会诱导针对病原体上多个靶标的免疫应答，而药物往往只针对很少的靶标。因此，病原体群体产生的疫苗抗性变异比药物抗性变异少，选择作用于这种变异的机会也更少。当疫苗耐药性出现时，这些普遍性就被打破了。通过仔细的预先考虑，甚至在引入疫苗之前就有可能识别出有失败风险的疫苗。
Why is drug resistance common and vaccine resistance rare? Drugs and vaccines both impose substantial pressure on pathogen populations to evolve resistance and indeed, drug resistance typically emerges soon after the introduction of a drug. But vaccine resistance has only rarely emerged. Using well-established principles of population genetics and evolutionary ecology, we argue that two key differences between vaccines and drugs explain why vaccines have so far proved more robust against evolution than drugs. First, vaccines tend to work prophylactically while drugs tend to work therapeutically. Second, vaccines tend to induce immune responses against multiple targets on a pathogen while drugs tend to target very few. Consequently, pathogen populations generate less variation for vaccine resistance than they do for drug resistance, and selection has fewer opportunities to act on that variation. When vaccine resistance has evolved, these generalities have been violated. With careful forethought, it may be possible to identify vaccines at risk of failure even before they are introduced.