狂犬病"早死"现象及其相关因素分析

Biancou等[1]认为疫苗接种与发生狂犬病"早死"现象有关.狂犬病病毒的免疫应答具有两重性:其特异性抗体既具有保护机体抵抗病毒感染的作用;也有促进机体发生免疫病理的一面.为了解狂犬病"早死"现象与其相关因素的关系,本文对2例狂犬病病例分析如下:     

人用狂犬病疫苗肌肉注射免疫程序研究进展

狂犬病尚无有效治疗方法,其预防措施主要为暴露前或暴露后接种人用狂犬病疫苗。随着狂犬病疫苗生产工艺的发展,疫苗质量不断提高,其免疫程序也在不断改进。目前,国内普遍采用肌肉注射方法进行狂犬病疫苗接种,暴露前免疫程序为在第0、7、21或28天(0、7、21或28 d)各注射1剂疫苗;暴露后免疫程序为5针法和2-1-1法,再暴露免疫程序则根据第1次暴露后免疫后间隔时间的不同,接种不同剂次的疫苗。2018年《狂犬病疫苗:WHO立场文件》根据狂犬病研究的最新进展,对狂犬病暴露预防免疫程序进行了简化。本文将在新立场文件的基础上,对国内外狂犬病暴露预防处置程序研究进展进行总结,并就我国狂犬病疫苗免疫程序与新立场文件倡导的免疫程序间存在的差异及改进方案加以讨论。     

狂犬病疫苗研究进展

<正> 狂犬病在医学上有其独特之处。一方面其临床经过凶险,发病后几乎100％死亡,个别治愈的报告尚难重复。另一方面,病毒感染后,一般潜伏期较长,可用自动免疫获得良好的保护作用。狂犬病既可在暴露前进行预防,又可以在暴露后接种疫苗防止发病。由此可见,狂犬疫苗在控制狂犬病中起着重要作用。 一、狂犬病毒抗原的研究 用去污剂裂解病毒可以知道至少有5种大的蛋白多肽成份;1.糖蛋白(G);2.膜蛋白1(M_1);3.膜蛋白2(M_2);4.核蛋白(N);5.多聚酶(L)。最近发现核蛋白虽然不能诱生抗体,但有保护作用,1988年WHO已承认,N蛋白的亚单位疫苗也可以用     

模式识别受体在HBV感染过程中的作用研究进展

乙型肝炎病毒感染后常可导致慢性乙型肝炎。机体模式识别受体（PRRs）作为一类重要的识别分子,在病毒感染早期可识别病原体并诱导抗病毒免疫应答。本文阐述了PRRs的定义、种类和信号通路,将其分为Toll样受体家族和Toll非依赖性模式识别受体家族,介绍了其与乙型肝炎病毒感染之间的关系。     

HBV感染免疫应答和免疫治疗新进展

病毒、病毒感染的靶细胞和机体的抗病毒免疫是推动疾病进展的“三架马车”,抗HBV治疗的“爬坡假说”根据宿主免疫应答的特点,提出调节宿主免疫应答的治疗策略可用以弥补单一抗病毒治疗慢性HBV感染的不足.笔者对病毒感染的免疫应答和免疫治疗研究的新进展进行综述.     

狂犬病动物抗体水平检测和监测

检测人和动物体内狂犬病抗体的主要目的有三个方面,第一,对暴露前预防免疫的人或动物进行抗体监测,确定人的预防免疫效果和动物的免疫水平及免疫覆盖率;第二,对暴露后免疫治疗的人体内的中和抗体进行检测,以确定暴露后治疗效果;第三,对狂犬病疑似患者或患畜,通过测定患病早期和     

呼吸道感染性疾患的巨细胞病毒感染状态

对５８例呼吸道感染性疾病患者应用分子生物学及血清学方法，检测巨细胞病毒的感染状态，并对巨细胞病毒感染后的免疫应答及病毒血症进行初探。实验结果表明，呼吸道感染性疾患存在巨细胞病毒感染状态，但不产生病毒血症，呼吸道感染疾病患者巨细胞病毒感染后免疫应答较明显。     

乙型肝炎的细胞免疫功能研究的进展

机体免疫对决定急性乙型肝炎的临床表现及结局有重要意义。带抗原者常有免疫应答的低下,但对其引起免疫应答低下的具体环节及组织损害的确切机理仍然不够了解。最近对急性乙型肝炎病毒感染进行系统的细胞及体液免疫应答测定,发现以T细胞对前S抗原的应答出现最早,常于肝损害症象出现之前30日即已显现,此时血清HBeAg刚出现阳性。继而出现对核心抗原(HBcAg)的细胞及体液免疫应答。常于肝损害前10日出现对乙型肝炎表面抗原(HBsAg)的明显T细胞应答。临床症状出现后,上述细胞     

诺如病毒感染宿主免疫应答的研究进展

诺如病毒是引起非细菌性急性感染性胃肠炎的主要病原体,常常引起严重的公共卫生与食品安全问题。诺如病毒疫苗的研发被越来越多的国家提上日程,疫苗的研制和应用依赖于对宿主和病毒相互关系的深入了解,依赖于宿主对病毒的免疫应答机制的了解。本文综述了诺如病毒国内外流行现状、诺如病毒感染与HBGAs受体关系和诺如病毒感染人或动物后机体的免疫应答研究现状。     

减毒狂犬病病毒CTN181-3株免疫学特性研究

目的 对本室研发的1株狂犬病减毒株CTN181-3的免疫学特性进行研究。方法 以小鼠和金黄地鼠为模型,口腔或肌肉免疫1次后考查暴露前免疫;以金黄地鼠为模型,肌肉免疫考查暴露后免疫。结果 CTN181-3株经小鼠和金黄地鼠分别口腔或肌肉免疫1次均能产生高滴度的中和抗体和良好的攻击保护效果;经小鼠口腔和肌肉免疫早期即开始产生细胞因子IFN-γ和IL-2,诱发有效的细胞免疫。以金黄地鼠为模型的暴露后免疫结-果显示:肌肉免疫1次的保护率为50%,而免疫2次的保护率可达100%。结论 CTN181-3株具有良好的体液免疫和细胞免疫保护效果,而且暴露后2次免疫不必接种免疫球蛋白即可达到100%有效保护,其免疫性强、保护效果好,是一种很有应用前景的狂犬病动物用候选疫苗株。     

Evasion of Influenza A Viruses from Innate and Adaptive Immune Responses

The influenza A virus is one of the leading causes of respiratory tract infections in humans. Upon infection with an influenza A virus, both innate and adaptive immune responses are induced. Here we discuss various strategies used by influenza A viruses to evade innate immune responses and recognition by components of the humoral and cellular immune response, which consequently may result in reduced clearing of the virus and virus-infected cells. Finally, we discuss how the current knowledge about immune evasion can be used to improve influenza A vaccination strategies.     

乙型病毒性肝炎的免疫动力学

乙型肝炎的发病机制主要是机体清除乙型肝炎病毒(hepatitis B virus,HBV)而引发的细胞免疫病理改变,机体对病毒的免疫应答有赖于一系列免疫活性细胞的相互作用.目前国内外主要就HBV感染控制者和感染持续者间的免疫差异原因进行研究.本文就乙型肝炎病毒感染状态下机体控制HBV感染下各相关免疫细胞间的作用机制以及...     

COVID-19 disease and immune dysregulation

The SARS-CoV-2 virus has complex and divergent immune alterations in differing hosts and over disease evolution. Much of the nuanced COVID-19 disease immune dysregulation was originally dominated by innate cytokine changes, which has since been replaced with a more complex picture of innate and adaptive changes characterized by simultaneous hyperinflammatory and immunosuppressive phenomena in effector cells. These intricacies are summarized in this review as well as potential relevance from acute infection to a multisystem inflammatory syndrome commonly seen in children. Additional consideration is made for the influence of variant to variant host cellular changes and the impact of potential vaccination upon these phenotypes. Finally, therapeutic benefit for immune alterations are discussed.     

Hepatitis C virus strategies to evade the specific-T cell response: a possible mission favoring its persistence

Hepatitis C virus (HCV) is a small, enveloped RNA virus. The number of HCV-infected individuals worldwide is estimated to be approximately 200 million. The vast majority of HCV infections persist, with up to 80% of all cases leading to chronic hepatitis associated with liver fibrosis, cirrhosis, and hepatocellular carcinoma. The interaction between HCV and the host have a pivotal role in viral fitness, persistence, pathogenicity, and disease progression. The control of HCV infection requires both effective innate and adaptive immune responses. The HCV clearance during acute infection is associated with an early induction of the innate and a delayed initiation of the adaptive immune responses. However, in the vast majority of acute HCV infections, these responses are overcome and the virus persistence almost inexorably occurs. Recently, several host- and virus-related mechanisms responsible for the failure of both the innate and the adaptive immune responses have been recognized. Among the latter, the wide range of escape mutations to evade the specific-T-and B-cell responses as well as the T cell anergy and the CD8+ T cell exhaustion together with the interference with its function after prolonged virus exposure hold a pivotal role. Other HCV strategies include the modification or manipulation of molecules playing key roles in the induction of the interferon response and its induced effector proteins. In this review, we attempt to gain insights on the main T cell immune evasion strategies used by the virus in order to favor its persistence.     

Induced immunity against hepatitis B virus

Prevention of hepatitis B virus (HBV) infection with its consequent development of HBV chronic liver disease and hepatocellular carcinoma is a global mandatory goal. Fortunately, safe and effective HBV vaccines are currently available. Universal hepatitis B surface antigen HBV vaccination coverage is almost done. Growing knowledge based upon monitoring and surveillance of HBV vaccination programs has accumulated and the policy of booster vaccination has been evaluated. This review article provides an overview of the natural history of HBV infection, immune responses and the future of HBV infection. It also summarizes the updated sources, types and uses of HBV vaccines, whether in the preclinical phase or in the post-field vaccination.     

Natural history of hepatitis B virus infection: pediatric perspective

Hepatitis B virus (HBV) infection is an important disease globally. Chronic HBV infection may result in serious complications. Its transmission may be either perinatal or horizontal. Perinatal transmission is particularly important after the implementation of a universal vaccination program. Through either route, chronic carrier status is usually established in early childhood. The course of the disease course is determined by the host–virus interaction. The host’s immune system initially tolerates the virus, and then gradually attempts to clear it. The virus, on the other hand, tries to avoid host immune system attack by a strategy involving targeted epitope mutations. By generating mutants, the virus can survive attacks from the host’s immune system, enabling the infection to persist. Different individuals have different responses to HBV infection; genetic polymorphisms in cytokines, hormones, and other immune modulators may affect the final outcome of chronic HBV infection. Due to the implementation of a universal infant HBV vaccination program, HBV infection is now under control. Unfortunately, there still are some cases of vaccination failure. Very high maternal viremia, in utero infection, or escape mutants are possible reasons for vaccination failure. Immunocompromised hosts also risk vaccination failure. Blood or organ donors with occult HBV infection are possible sources for immunocompromised hosts. These victims of vaccination failure may exhibit a different disease course due to chronic HBV infection from those who acquired the infection before the universal vaccination era. The achievement of our ultimate goal of HBV elimination depends on a globally effective universal vaccination program, as well as the application of some novel successful medications to control those who are already infected.     

Fitness constraints on immune escape from HIV: Implications of envelope as a target for both HIV-specific T cells and antibody

Sterilising immunity against HIV-1 infection, whilst ideal, appears an unrealistic vaccination goal in the short term. More achievable is slowing the progression to disease and decreasing transmission by mounting strong T cell and neutralising antibody responses to maintain low viral loads. However, in both acute and chronic infection, mutant virus is selected to escape both arms of the adaptive immune system. Each mutation away from wildtype virus likely incurs at least some reduction in replicative capacity ("fitness") of the virus. Rapid reversion to wildtype of some immune escape mutations upon transmission, suggests fitness costs may be significant. HIV-1 Envelope is unique in that it is subject to both neutralising antibody and cell-mediated immune responses. Although Envelope is variable between strains, considerable serial pressure and mutational escape from both neutralising antibody and cytotoxic T lymphocyte attack may result in impaired structure and function. This could ultimately be exploited in HIV vaccine design.     

Impfungen im Alter

The aging immune system, so-called immunosenescence, is well documented as the cause of increased infection rates and severe, often complicated course of infections in the elderly with increased morbidity and mortality rates. Furthermore, it can lead to decreased efficacy of vaccination. The administration of more immunogenic vaccines can be beneficial in the elderly. Implementing vaccination recommendations for the elderly by STIKO can reduce burden of infectious diseases by prevention of infection or reduction of severity of infection. The following vaccinations are recommended by STIKO for all persons aged 60 and above: annual influenza vaccination (additionally all nursing home residents independently of age), once only pneumococcal polysaccharide vaccination, completion of tetanus and diphtheria (Td) vaccination as well as regular revaccination. All adults should be vaccinated against pertussis with Tdap vaccine once. Meanwhile, pneumococcal conjugate vaccine is allowed for administration in adults but is not recommended by STIKO yet. A lifelong course of vaccination may help to attenuate the effect of immunosenescence.     

SARS-CoV-2 vaccine-induced cerebral venous thrombosis

The nosological entity of the cerebral venous thrombosis caused by the SARS-CoV-2 vaccination differs from the common cerebral venous thrombosis in that it is due to immune thrombocytopenia triggered by vaccination. Cerebral venous thrombosis is one of several manifestations of this type of immune thrombocytopenia. Albeit many general aspects of management of cerebral venous thrombosis are similar, immune thrombocytopenia requires a specific therapeutic approach, which is not normally adopted for cerebral venous thrombosis due to other causes, therefore its early recognition is essential.     

Human immune repertoire in hepatitis B virus infection

Hepatitis B virus (HBV) infection is a public health threat that affects 257 million people worldwide and can progress to liver cirrhosis, liver failure, and hepatocellular carcinoma. The HBV antigen- induced adaptive immune response plays an important role in HBV clearance. Immune repertoire sequencing (IRS) has been used to investigate the molecular mechanisms behind the immune system, find novel ways to treat HBV infection, and evaluate the genetic responses and immune characteristics of individuals infected by HBV or immunized by HBV vaccine. This review summarizes the human immune repertoire analysis methodology, and the application of the IRS in the prediction of HBV infection progression, treatment, and vaccination.