The herpes zoster subunit vaccine
The herpes zoster subunit vaccine
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DOI：
10.1517/14712598.2016.1134481
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发表时间：
2016-02-01
影响因子：
4.6
通讯作者：
Cunningham, Anthony L.
中科院分区：
文献类型：
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作者：
Cunningham, Anthony L.
简介：带状疱疹（HZ）可引起老年人的剧烈疼痛和皮疹，并可能伴有长期疼痛（带状疱疹后神经痛; PHN）。涉及的领域：HZ是由潜伏的水痘带状疱疹病毒（VZV）感染重新激活引起的，通常与年龄相关或其他原因导致的T细胞免疫力下降有关。浓缩的减毒活疫苗可增强这种免疫力，并提供针对HZ的部分保护，但这种免疫力随着年龄的增长而下降，并在5-8岁后下降。新的HZ亚单位（HZ/su或Shingrix）疫苗将关键的表面VZV糖蛋白（E）与T细胞加强佐剂（AS 01（B））组合。它对免疫功能正常的受试者的HZ保护非常有效（97%），并且随着年龄的增长不会下降，并且保护作用可维持3年以上。I-II期试验显示，在严重免疫功能低下患者中安全性和相似的免疫原性。少数患者（9.5%）局部注射部位疼痛和肿胀可能很严重，但为一过性（2天）。专家意见：在ZoE-50对照试验中，HZ/su疫苗在免疫功能正常的患者中非常有前景。目前ZoE-50试验的揭盲和伴随的ZoE-70试验结果的发表将更多地揭示其作用机制及其对PHN的疗效，特别是在>70岁的受试者中。免疫功能低下患者的III期试验结果正在等待。
Introduction: Herpes zoster (HZ) causes severe pain and rash in older people and may be complicated by prolonged pain (postherpetic neuralgia; PHN).Areas covered: HZ results from reactivation of latent varicella-zoster virus (VZV) infection, often associated with age related or other causes of decreased T cell immunity. A concentrated live attenuated vaccine boosts this immunity and provides partial protection against HZ, but this decreases with age and declines over 5-8 years. The new HZ subunit (HZ/su or Shingrix) vaccine combines a key surface VZV glycoprotein (E) with T cell boosting adjuvant (AS01(B)). It is highly efficacious in protection (97%) against HZ in immunocompetent subjects, with no decline in advancing age and protection maintained for >3 years. Phase I-II trials showed safety and similar immunogenicity in severely immunocompromised patients. Local injection site pain and swelling can be severe in a minority (9.5%) but is transient (2 days).Expert Opinion: The HZ/su vaccine appears very promising in immunocompetent patients in the ZoE-50 controlled trial. The unblinding of the current ZoE-50 trial and publication of results from the accompanying ZoE-70 trial will reveal more about its mechanism of action and its efficacy against PHN, particularly in subjects >70 years. Phase III trial results in immunocompromised patients are eagerly awaited.