国产麻腮风联合减毒活疫苗的稳定性观察

目的  观察国产麻腮风联合减毒活疫苗（麻腮风疫苗）的稳定性。方法  取24批上海生物制品研究所有限责任公司（上海公司）2008－2017年生产的麻腮风疫苗,按照国家食品药品监督管理局批准的麻腮风疫苗注册标准和中国药典的要求进行各项检定：在0个月进行热稳定性试验;在0和18个月进行鉴别试验,外观、水分、无菌、异常毒性检查,牛血清白蛋白残留量、抗生素残留量（2010年10月以后）、细菌内毒素（2013年12月以后）、pH值和渗透压摩尔浓度检测（2015年12月以后）;在0、6、12、18个月进行病毒滴定。同时对新、老车间生产的各3批疫苗进行加速稳定性与长期稳定性试验,重点考察水分和病毒滴度。结果  麻腮风疫苗在有效期内各项指标检定结果均符合注册标准和药典要求。质量可比性研究结果显示新老车间生产的疫苗质量相似。疫苗中水分都不高于3.0%,麻疹、腮腺炎、风疹病毒滴度分别为3.3～4.3 、4.6～5.6 、3.3～4.3 半数细胞培养感染量/ml。结论  上海公司10年间生产的麻腮风疫苗质量稳定、安全有效。     

麻疹、腮腺炎、风疹、水痘联合减毒活疫苗的生产工艺研究

目的  建立麻疹、腮腺炎、风疹、水痘联合减毒活疫苗（combined live attenuated measles，mumps，rubella and varicella vaccine，MMRV）的生产工艺。方法  根据现有疫苗病毒原液生产工艺，将麻疹病毒沪-191纯化株、腮腺炎病毒S79株、风疹病毒BRD-Ⅱ株和水痘-带状疱疹病毒Oka株在原代鸡胚成纤维细胞或人二倍体细胞MRC-5株中制备高滴度病毒原液，并超低温保存。筛选无明胶冻干稳定剂配方。按国外已上市同类产品的病毒配比，研究MMRV中4种病毒的原液配制滴度及成品配制比例，建立最佳冻干工艺。结果  用筛选出的适合于MMRV的无明胶冻干稳定剂配方进行试验，确定病毒原液的配制滴度为，麻疹4.6 lg半数细胞培养感染量（50% cell culture infective dose，CCID₅₀）/ml、腮腺炎5.8 lgCCID₅₀/ml、风疹4.3 lgCCID₅₀/ml、水痘4.8 lg噬斑形成单位（plaque forming unit，PFU）/ml。使成品中腮腺炎病毒滴度至少达到麻疹和风疹和水痘病毒的10倍，水痘病毒滴度高于现有单价水痘疫苗。连续制备3批MMRV，平均病毒滴度为，麻疹4.5 lgCCID₅₀/ml、腮腺炎5.1 lgCCID₅₀/ml、风疹4.3 lgCCID₅₀/ml、水痘4.6 lgPFU/ml；平均水分为1.2%。其他项目检定均合格。结论  建立了MMRV的生产工艺，可以稳定生产出达到国外同类产品质量标准并符合我国4种单价减毒活疫苗国家标准的产品。     

病毒性疫苗渗透压摩尔浓度的质量控制

目的  通过检测6种病毒性疫苗成品的渗透压摩尔浓度,比较不同疫苗检测均值的差异,并观察同种疫苗检测值的批间稳定性,为增加病毒性疫苗质量控制手段提供依据。方法  采用冰点下降法检测麻疹减毒活疫苗、风疹减毒活疫苗、麻疹腮腺炎联合减毒活疫苗、麻疹腮腺炎风疹联合减毒活疫苗、水痘减毒活疫苗、流感病毒裂解疫苗的渗透压摩尔浓度,对检测值进行统计学处理,计算变异系数。以麻疹腮腺炎风疹联合减毒活疫苗的渗透压摩尔浓度检测均值作为对照,进行方差齐性检验及假设检验,比较各疫苗检测均值的差异。结果  麻疹腮腺炎联合减毒活疫苗与对照相比,均值差异无统计学意义（t=1.66,P>0.05）;麻疹减毒活疫苗、风疹减毒活疫苗、水痘减毒活疫苗及流感病毒裂解疫苗与对照相比,均值差异均有统计学意义（Z>1.96,P<0.001）。同种疫苗批间渗透压摩尔浓度较为稳定,变异系数均<3%,变化幅度能控制在90%~110%均值范围内。结论  6种病毒性疫苗渗透压摩尔浓度存在一定差异,但同种疫苗检测值批间稳定性较好,因此,应根据不同疫苗的渗透压摩尔浓度,分别制定质量控制标准。     

麻疹减毒活疫苗生产工艺优化

目的 调整优化现行麻疹疫苗原液生产工艺,为提高麻疹疫苗及其联合疫苗质量提供参考。方法 应用10层细胞工厂(CF10)、三种不同感染复数(MOI)和两种换液次数制备麻疹单价疫苗及其联合疫苗,并取2020年北京生物制品研究所有限责任公司疫苗一室生产的麻腮风联合减毒活疫苗原液商业批的连续三批为对照组,通过比较活细胞数、细胞存活率来确认各组间基线一致性,通过比较麻疹病毒滴度与细胞病变程度、麻腮风成品中麻疹病毒滴度及其热稳后滴度来评估优化后的工艺效果。结果 各组细胞悬液所含活细胞数与存活率均符合国家规定,具有较好的基线一致性。其中E组滴度均数和标准差波动幅度较理想,一收滴度为(5.77±0.07)lgCCID₅₀/ml,二收滴度为(6.00±0.08)lgCCID₅₀/ml,原液滴度为(5.97±0.05)lgCCID₅₀/ml,E组病变程度更高、面积更大、分布更均匀,与滴度结果相匹配。热稳试验后各组滴度均有不同程度下降,E组方案制备的MMR中麻疹单基滴度和热稳下降幅度较理想,单基滴度为(4.23±0.07) lgCCID     

麻疹风疹联合减毒活疫苗的稳定性观察

目的  观察麻疹风疹联合减毒活疫苗（麻风二联）的稳定性。方法  将17批北京生物制品研究所有限责任公司（北京公司）2012—2017年生产的麻风二联存放于（5±3）℃,分别在0、9、12、18和24个月按照企业注册标准和中国药典2010或2015年版三部要求进行相关检测。同时对新、旧车间生产的各3批疫苗进行主要质量指标比对。结果  随着存放时间延长,疫苗的病毒滴度呈逐渐下降趋势,麻疹病毒滴度波动于3.9~4.8 lg半数细胞培养感染量（CCID₅₀)/ml,风疹病毒滴度波动于4.0~4.8 lgCCID₅₀/ml,热稳定病毒滴度下降均不超过1.0 lg,疫苗水分不高于3.0%,疫苗的其余各项指标均符合企业注册标准和中国药典要求。新、旧车间生产的疫苗质量没有差别。结论  北京公司生产的麻风二联的质量稳定。     

器官移植受者接种麻疹、腮腺炎、风疹系列疫苗的有效性和安全性研究

器官移植受者术后易于感染许多疫苗可预防疾病,存在预后不良的风险,甚至可因严重感染而威胁生命。接种麻疹、腮腺炎、风疹（麻腮风）系列疫苗能有效降低器官移植受者术后的麻疹、腮腺炎和风疹发病率。此文综述了器官移植受者接种麻腮风系列疫苗的有效性和安全性,以期为器官移植受者制定个性化麻腮风系列疫苗免疫接种程序提供参考。     

麻疹-腮腺炎-风疹联合减毒活疫苗无菌生产工艺风险评估

目的 评价国产麻疹-腮腺炎-风疹联合减毒活疫苗(麻腮风疫苗)的无菌生产工艺风险。方法 应用质量风险管理的原则,使用失效模式和效果分析的风险管理工具评估确定麻腮风疫苗生产工艺中所有可能存在的质量问题和潜在风险。采用定量方法,计算风险系数,对此进行风险评估。结果 风险评估后各工艺环节的风险系数均小于40。结论 麻腮风疫苗无菌生产工艺风险可控,可不采取措施。     

两种不同取样方式测定麻腮风类减毒活疫苗病毒滴度的评价

目的：比较麻腮风类减毒活疫苗的两种取样方式测定疫苗各组分滴度是否存在差异。方法：采用多支疫苗混合滴定和单支疫苗滴定两种方法对国内上市的麻腮风类疫苗进行检测，对两种方法测定的结果平行比对。结果：单支疫苗滴定后的均值与多支疫苗混合后的检测结果基本一致； 腮腺炎疫苗的支间滴度差异略高，麻疹、风疹疫苗的支间滴度差异较小。结论：目前使用的多支混合滴定的检测方法能够满足对麻腮风类疫苗质控的要求，但单支滴定法对工艺改进更有指导意义。     

Sabin株脊髓灰质炎病毒纯化的离子交换层析条件研究

目的  研究Sabin株脊髓灰质炎病毒（Sabin strain polio virus,sPV）纯化的离子交换层析（ion exchange chromatography,IEC）条件。 方法  在不同层析条件下对sPV凝胶层析粗纯液进行IEC,设定的层析参数分别为介质Q Sepharose FF或Eshmuno Q、上样量30%或40%柱体积、流速（150±5）或（240±8） cm/h。分别检测各型sPV纯化液的D抗原含量、蛋白浓度、病毒滴度、宿主细胞蛋白残留量和Vero细胞DNA残留量,计算D抗原回收率和比活。结果  Eshmuno Q IEC纯化的各型sPV纯化液的D抗原回收率均明显高于Q Sepharose FF IEC。在上样量40% 柱体积、流速（150±5） cm/h条件下,Eshmuno Q IEC纯化的各型sPV纯化液的D抗原比活均高于Q Sepharose FF IEC,差异均有统计学意义（Ⅰ型：t=4.23,Ⅱ型：t=5.73,Ⅲ型：t=4.18,P值均<0.05）,而且前者的宿主细胞蛋白残留量（Ⅰ型：t=8.29,Ⅱ型：t=7.89,Ⅲ型：t=8.18,P值均<0.05）和Vero细胞DNA残留量（Ⅰ型：t=4.23,Ⅱ型：t=4.56,Ⅲ型：t=4.78,P值均<0.05）均低于后者,差异均有统计学意义。结论  用IEC纯化sPV进行纯化时,以Eshmuno Q代替Q Sepharose FF可增加上样量和流速,从而缩短IEC时间,提高纯化效率。     

新的三价麻疹-腮腺炎-风疹疫苗在幼儿中的临床试验

本文报道1982年1月～6月在芬兰坦佩雷市用三价麻疹-腮腺炎-风疹疫苗对幼儿进行的一次临床试验.作者将174名14～24月龄无麻疹、腮腺炎和风疹病史的健康儿童,随机分成3组.在双盲情况下接种下述三种疫苗之一:(1)高滴度Pluserix疫苗:每瓶含麻疹病毒Schwarz株10~(3.9)TCID_(50)、腮腺炎病毒Urabe Am9株10~(4.92)TCID_(50)和风疹病毒RA27/3株10~(4.14)TCID_(50);(2)低滴度Pluserix疫苗:每瓶含麻疹病毒Schwarz株10~(3.25)TCID_(50)、腮腺炎病毒     

Measles,mumps, rubella vaccine (Priorix; GSK-MMR): a review of its use in the prevention of measles,mumps and rubella

GSK-MMR (Priorix) is a trivalent live attenuated measles, mumps and rubella (MMR) vaccine which contains the Schwarz measles, the RIT 4385 mumps (derived from the Jeryl Lynn mumps strain) and the Wistar RA 27/3 rubella strains. GSK-MMR as a primary vaccination demonstrated high immunogenicity in clinical trials in >7500 infants aged 9-27 months, and was as immunogenic as Merck-MMR (MMR II). However, antimumps seroconversion rates and geometric mean titres (GMTs) were significantly higher in infants receiving GSK-MMR compared with Berna-MMR (Triviraten trade mark ) recipients. Coadministration of GSK-MMR with a varicella vaccine (Varilrix; GSK-MMR/V) did not significantly affect the immunogenicity of GSK-MMR. A persistent immune response to GSK-MMR has been demonstrated in follow-up data from several randomised trials. GMTs for measles, mumps and rubella antibodies remained high in GSK-MMR recipients 1-2 years post-vaccination and were similar to those in Merck-MMR recipients. The immunogenicity of GSK-MMR was high, and similar to that of Merck-MMR, when used as a second dose in children aged 4-6 or 11-12 years who had received a primary vaccination with Merck-MMR in their second year of life. Although there are no protective efficacy data concerning the GSK-MMR vaccine to date, the rubella Wistar RA 27/3 rubella and Schwarz measles strains have well established protective efficacy; the new RIT 4385 mumps strain is expected to afford similar protection from mumps to that achieved with mumps vaccines that contain the Jeryl Lynn mumps strain (e.g. Merck-MMR). GSK-MMR was well tolerated as a primary or secondary vaccination, and in most clinical studies comparing GSK-MMR with Merck-MMR as a primary vaccination in infants, GSK-MMR was associated with significantly fewer local adverse events (e.g. pain, swelling and redness). The incidence of local adverse events with GSK-MMR, GSK-MMR/V or Berna-MMR was similar. GSK-MMR and Merck-MMR were associated with similar rates of fever, rash and parotid gland swelling, but Berna-MMR was associated with a lower incidence of fever. In conclusion, GSK-MMR is a highly immunogenic MMR vaccine with good tolerability. In clinical trials, the immunogenicity of GSK-MMR was similar to that of Merck-MMR, and the mumps component was more effective at eliciting seroprotection than that of Berna-MMR. Furthermore, GSK-MMR causes fewer injection-site adverse events than Merck-MMR. As such, GSK-MMR is an attractive alternative for immunisation against measles, mumps and rubella.     

配制麻疹-腮腺炎-风疹-水痘联合减毒活疫苗的各病毒原液最适滴度研究

目的 研究配制麻疹-腮腺炎-风疹-水痘联合减毒活疫苗(measles-mumps-rubella-varicellacombined attenuated live vaccine,MMRV)的各病毒原液最适滴度.方法 将麻疹、腮腺炎、风疹和水痘病毒原液分别冻干,检测各冻干单价疫苗的滴度和热稳定性,观察病毒滴度的下降幅度.将4种病毒原液按不同配比配制MMRV,检测配制前后的各病毒滴度,摸索配制MMRV的最佳配比.按确认的最佳配比配制MMRV并冻干,检测冻干MMRV的各病毒滴度和热稳定性,确定配制MMRV的各病毒原液最适滴度.结果 各病毒原液冻干后,麻疹、腮腺炎、风疹和水痘病毒滴度分别下降约0.6、0.6、0.4 lgCCID50/ml和0.5 lgPFU/ml;各冻干单价疫苗37℃放置1周后,麻疹、腮腺炎、风疹和水痘病毒的滴度分别下降约0.6、0.5、0.5 lgCCID50/ml和0.5 lgPFU/ml.在配制MMRV过程中,仅腮腺炎病毒可能在一定程度上受到其他病毒的干扰.按确认的最佳配比配制的MMRV冻干后,麻疹、腮腺炎、风疹和水痘病毒滴度分别下降约0.5、0.6、0.5 lgCCID50/ml和0.6 lgPFU/ml;冻干MMRV于37℃放置1周后,麻疹、腮腺炎、风疹和水痘病毒滴度分别下降约0.6、0.6、0.5 lgCCID50/ml和0.5 lgPFU/ml.结论 在按确认的最佳配比配制MMRV时,麻疹、腮腺炎、风疹和水痘病毒原液的滴度需分别≥6.0、≥6.5、≥6.0 lgCCID50/ml和≥5.3 lgPFU/ml.     

Swedish experience of two dose vaccination programme aiming at eliminating measles, mumps, and rubella.

In 1982 a two dose regimen was introduced in Sweden for the combined vaccination against measles, mumps, and rubella of children aged 18 months and 12 years. Since 1977 about half of the preschool children were vaccinated against measles annually, and since 1974 about 80% of 12 year old girls were vaccinated against rubella. During the period 1982 to 1985 90-93% of the eligible age cohorts of 18 month old children and 88-91% of the 12 year old children were immunised with the new combined vaccine. A study in 1982 of about 140 18 month old children who were nearly all seronegative before vaccination showed that 96%, 92%, and 99% seroconverted against measles, mumps, and rubella, respectively. A second study was carried out in 1983 of 247 12 year old children, of whom 11% lacked antibodies to measles, 27% to mumps, and 45% to rubella. This showed seroconversion in 82% and 80% against measles and mumps, respectively, and all children seroconverted against rubella. In the latest study in 1985 of 496 12 year olds 9% and 13% were seronegative against measles and mumps before vaccination, and 41% against rubella. Of these, 88% seroconverted to measles and 80% to mumps, and all converted to rubella when sera were tested by the haemolysis in gel method. After a neutralisation test against measles as well all children showed immunity to the disease. A low incidence of measles and declining figures for mumps and rubella were reported in 1984 to 1986. An outbreak of rubella during 1985 affected mainly boys in age cohorts in which only the girls had been vaccinated during the 1970s.     

Live attenuated measles, mumps, rubella, and varicella zoster virus vaccine (Priorix-Tetra)

The live attenuated tetravalent vaccine against measles, mumps, rubella, and varicella zoster viruses (MMRV) is a combination of the measles, mumps, and rubella (MMR) vaccine and the varicella zoster virus vaccine. The immunogenicity after each dose of a two-dose vaccination course of MMRV vaccine was generally similar to that of two doses of separately administered MMR plus varicella zoster vaccines, or a single dose of separately administered MMR plus varicella zoster vaccines followed by a dose of MMR vaccine, in infants aged 9-24 months. In infants aged 9-24 months administered a two-dose course of MMRV vaccine, geometric mean titers for antibodies against all vaccine antigens increased after the second dose relative to the first dose, with the increase being most pronounced for varicella zoster virus antibodies (10- to 21-fold). MMRV as the second vaccination was immunogenic in children aged 5-6 years who had previously received either MMRV or MMR as the first vaccination at 12-24 months of age. The immunogenicity for measles, mumps, rubella, and varicella zoster viruses, in terms of seropositivity and antibody titers, was not altered when MMRV was coadministered with a booster dose of diphtheria, tetanus, acellular pertussis, hepatitis B, inactivated poliovirus, and Haemophilus influenzae type b conjugate vaccine in infants aged 12-23 months. Nor was the immunogenicity of the latter vaccine altered by coadministration. The tolerability profile of MMRV vaccine was comparable to that of separately administered MMR plus varicella zoster vaccines or of MMR vaccine alone. Injection-site redness and fever (rectal temperature > or =38degreesC or axillary temperature > or =37.5degreesC) were the most frequent adverse events in both groups.     

麻疹、腮腺炎、风疹和水痘联合减毒活疫苗的研制

目的 建立麻疹、腮腺炎、风疹和水痘(measles,mumps,rubella and varicella,MMRV)联合减毒活疫苗的生产工艺和检定方法.方法 采用麻疹病毒沪-191株、腮腺炎病毒S79株、风疹病毒BRDⅡ株、水痘-带状疱疹病毒北京84-7株,在原代鸡胚细胞或人胚肺二倍体细胞2BS株中制备高滴度疫苗病毒原液.观察4种原液按不同比例稀释配制后病毒的滴度变化和相互干扰现象,确定MMRV疫苗中4种原液的配制比例,并筛选适宜保护剂,建立最佳冻干工艺.同时,建立MMRV联合减毒活疫苗的检定方法.采用t检验对结果进行比较.结果 选择最佳配制比例、保护剂和冻干工艺制备出连续多批MMRV疫苗,按国家药典要求检定全部合格.其中连续3批疫苗经国家检定机构检定合格:麻疹病毒基础滴度和37℃放置7d后的滴度分别≥3.9和≥3.5 lg半数细胞培养感染量(50％ cell culture infective dose,CCID50)/ml,腮腺炎病毒≥5.0和≥4.7 lgCCID50/ml,风疹病毒≥5.0和≥4.8 lgCCID50/ml,水痘病毒≥4.5和≥4.4 lg噬斑形成单位/ml.用建立的方法检测MMRV疫苗,结果4种病毒滴度实测值与理论值之间的差异无统计学意义(t值为0.149～1.838,P值均＞0.05).结论 建立了稳定、可行的MMRV疫苗生产工艺和检定方法.     

腮腺炎病毒在转瓶和细胞工厂中制备的比较

目的 比较15 L转瓶及40层细胞工厂工艺制备腮腺炎减毒活疫苗的病变情况、病毒滴度和原液各项质量指标。方法 分别采用15 L转瓶及40层细胞工厂培养原代鸡胚细胞1～3 d后感染S79株腮腺炎病毒,继续培养至5～7 d收获病毒液。两种培养方式收获的腮腺炎病毒单次收获液分别合并后获得疫苗原液,并进行相关检定。结果 转瓶收获的单次病毒液0和21 d检定的平均滴度分别为6.6、6.1 lg半数细胞培养感染量（50% cell culture infective dose,CCID₅₀）/ml。细胞工厂收获的单次病毒液0和21 d检定的平均滴度分别为6.8、6.2 lgCCID₅₀/ml。两种方式制备的腮腺炎减毒活疫苗原液各项质量指标均合格。结论 应用40层细胞工厂工艺制备腮腺炎减毒活疫苗的细胞病变情况及单次病毒收获液滴度均优于15 L转瓶培养工艺,此实验为40层细胞工厂制备腮腺炎减毒活疫苗的大规模生产及工艺改进奠定了基础。     

A combination vaccine against measles, mumps, rubella and varicella

A new combination vaccine against measles, mumps, rubella and varicella (MMRV) from GlaxoSmithKline Biologicals has recently been approved in Europe. It combines the components from two well-established, live, attenuated vaccines against measles, mumps and rubella. This review presents a summary of the development of this MMRV vaccine from published clinical studies. Seroconversion rates and antibody titers after the first and second dose are similar to those observed after concomitant administration of the MMR and varicella vaccines. Furthermore, the clinical profile of this combination vaccine, in terms of injection- site and general tolerability, is similar to that of the component vaccines. A higher incidence of low-grade fever has been noted following the first dose of MMRV vaccine, although it is no different from component vaccines following the second dose. MMRV vaccines were recommended in Germany in 2006 for administration in two doses to children aged 11-14 months and 15-23 months. They offer a convenient way to implement varicella vaccination and to achieve high vaccine coverage rates mirroring those of MMR vaccines. For other countries considering introducing these vaccines, the advantages for children, parents and healthcare providers of protecting against four diseases in a single vaccine should be noted.