Leishmaniasis Vaccine: Where are We Today?
Leishmaniasis Vaccine: Where are We Today?
复制标题
DOI：
10.4103/0974-777x.62881
复制
发表时间：
2010-05-01
影响因子：
1.6
通讯作者：
Kedzierski, Lukasz
中科院分区：
文献类型：
--
作者：
Kedzierski, Lukasz
利什曼病是一种严重程度从皮肤损害到严重毁容和致命的全身感染的疾病。世卫组织已将这种疾病归类为新出现和不受控制的疾病，并估计这种感染每年导致200万新病例。目前全世界有1 200万人受到感染，利什曼病威胁着88个国家的3.5亿人。目前的治疗以化疗为基础，化疗依赖于少数几种药物，这些药物具有严重的局限性，如成本高、毒性大、给药途径困难以及在流行地区缺乏疗效。接种疫苗仍然是控制各种形式的疾病的最大希望，开发安全、有效和负担得起的抗利什曼病疫苗是全球公共卫生的一个重要优先事项。来自动物模型研究的大量证据表明，通过使用确定的亚单位疫苗或利什曼原虫减毒活菌株进行免疫接种，可以实现牢固的保护。然而，迄今为止，尽管许多实验室作出了巨大努力，但仍没有这种疫苗。疫苗设计的主要障碍是将动物模型的数据转化为人类疾病，以及从实验室到现场的过渡。此外，保护性免疫反应和免疫记忆的产生和维持，抗寄生虫疫苗开发的最重要和最少研究的方面，在利什曼原虫感染的透彻理解是必要的。本文综述了抗利什曼原虫疫苗领域的最新研究成果，并强调了当前疫苗开发和实施所面临的困难。
Leishmaniasis is a disease that ranges in severity from skin lesions to serious disfigurement and fatal systemic infection. WHO has classified the disease as emerging and uncontrolled and estimates that the infection results in two million new cases a year. There are 12 million people currently infected worldwide, and leishmaniasis threatens 350 million people in 88 countries. Current treatment is based on chemotherapy, which relies on a handful of drugs with serious limitations such as high cost, toxicity, difficult route of administration and lack of efficacy in endemic areas. Vaccination remains the best hope for control of all forms of the disease, and the development of a safe, effective and affordable antileishmanial vaccine is a critical global public-health priority. Extensive evidence from studies in animal models indicates that solid protection can be achieved by immunization with defined subunit vaccines or live-attenuated strains of Leishmania. However, to date, no such vaccine is available despite substantial efforts by many laboratories. The major impediment in vaccine design is the translation of data from animal models to human disease, and the transition from the laboratory to the field. Furthermore, a thorough understanding of protective immune responses and generation and maintenance of the immunological memory, the most important and least-studied aspect of antiparasitic vaccine development, during Leishmania infection is needed. This review focuses on recent findings in antileishmania vaccine field and highlights current difficulties facing vaccine development and implementation.