Malaria and Early Life Immunity: Competence in Context.

Malaria and Early Life Immunity: Competence in Context.
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DOI:
10.3389/fimmu.2021.634749
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发表时间:
2021
影响因子:
7.3
通讯作者:
Feeney ME
Feeney ME
中科院分区:
医学2区
文献类型:
--
作者:
Callaway PC;Farrington LA;Feeney ME

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在过去的世纪里,儿童疫苗一直是公共卫生的基石工具。新生儿接种疫苗的主要障碍是婴儿免疫系统的“不成熟”和常规疫苗方法在出生时诱导免疫的效率低下。虽然许多关于胎儿和新生儿免疫的文献都集中在生命早期的免疫耐受倾向上,但最近的研究表明,胎儿的免疫能力比以前认为的更强,并且在某些情况下,可以在子宫内对围产期病原体产生适应性B和T细胞应答。尽管在这些发现转化为疫苗和其他保护性策略之前仍存在重大障碍,但它们应该对新生儿甚至胎儿接种疫苗的前景持乐观态度。实现这一目标的下一步应该包括努力定义婴儿免疫应答的最佳刺激条件,包括抗原时机,剂量和递送途径,以及抗原呈递途径和共刺激要求。更好地了解这些因素将有助于最佳地部署疟疾和其他病原体疫苗,以保护处于最脆弱时期的婴儿。
Childhood vaccines have been the cornerstone tool of public health over the past century. A major barrier to neonatal vaccination is the “immaturity” of the infant immune system and the inefficiency of conventional vaccine approaches at inducing immunity at birth. While much of the literature on fetal and neonatal immunity has focused on the early life propensity toward immune tolerance, recent studies indicate that the fetus is more immunologically capable than previously thought, and can, in some circumstances, mount adaptive B and T cell responses to perinatal pathogens in utero. Although significant hurdles remain before these findings can be translated into vaccines and other protective strategies, they should lend optimism to the prospect that neonatal and even fetal vaccination is achievable. Next steps toward this goal should include efforts to define the conditions for optimal stimulation of infant immune responses, including antigen timing, dose, and route of delivery, as well as antigen presentation pathways and co-stimulatory requirements. A better understanding of these factors will enable optimal deployment of vaccines against malaria and other pathogens to protect infants during their period of greatest vulnerability.
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