评估新冠病毒疫苗临床效力的挑战

新型冠状病毒,即严重急性呼吸综合征冠状病毒2(SARS-CoV-2)所引起的新型冠状病毒肺炎(COVID-19)在疫情暴发后已导致全球超过264万人死亡,造成了巨大的经济损失和社会动荡.有效的疫苗对于阻止发病率和死亡率进一步攀升至关重要.尽管部分国家可能会仅凭安全性和免疫原性数据来部署使用COVID-19疫苗,但疫苗的...     

新型冠状病毒疫苗研发进展及其潜在不良反应

新型冠状病毒感染是目前危害全球的传染性疾病,造成约1亿人感染和200万人死亡.在缺乏有效抗病毒药物的情况下,疫苗成为全球防控新冠病毒的重要方法,在我国已经有超过1 000万人注射了灭活疫苗.从疫苗的研发机制、研发进展和潜在的不良反应3个方面,系统综述新型冠状病毒的灭活疫苗、减毒疫苗、亚单位疫苗、RNA疫苗、DNA疫苗和...     

实体器官移植受者的新型冠状病毒肺炎疫苗接种

实体器官移植（SOT）受者是新型冠状病毒肺炎（COVID-19）的高风险人群,该人群接种COVID-19疫苗的安全性和有效性倍受关注。目前有关SOT受者接种COVID-19疫苗的研究报道主要集中在接种信使核糖核酸疫苗,也有少数接种重组腺病毒载体疫苗的个案报道。这些研究结果显示,SOT受者接种COVID-19疫苗是安全的...     

新型冠状病毒肺炎疫苗的安全性

随着新型冠状病毒肺炎（COVID-19）疫苗研发的快速推进,数十种疫苗进入临床研究阶段,数种不同类型COVID-19疫苗在不同国家和地区获批使用。疫苗的安全性始终是专家和公众都密切关注的重点之一。此文系统总结并分析了目前已公开发表或官方发布的COVID-19疫苗上市前后安全性数据,为全面理解疫苗安全性,增强公众对疫苗的信心,同时更好地开展疫苗大规模应用后安全性监测和信号挖掘提供科学参考。     

特应性皮炎患者接种新型冠状病毒疫苗的建议及依据

新型冠状病毒为新型冠状病毒感染的病因,疫苗接种可起到有效的防控作用。然而,部分特定人群尤其是慢性疾病和免疫紊乱的患者,对新型冠状病毒疫苗的接种持观望态度,即疫苗犹豫。特应性皮炎(AD)是一类与免疫紊乱相关的慢性炎症性皮肤病,目前没有明确的指南说明AD患者是否应该接种新型冠状病毒疫苗。本文整理了新型冠状病毒疫苗与AD患者症状间的交集,结合国内外AD患者接种疫苗的相关建议,以及对AD患者接种新型冠状病毒疫苗的回顾性调研,针对AD患者是否应该接种新型冠状病毒疫苗提出建议,旨在为医务工作人员和相关研究人员提供参考。     

新型冠状病毒肺炎疫苗临床研究进展

至2021年2月,新型冠状病毒引起的新型冠状病毒肺炎疫情全球大流行已造成1亿以上的报告病例和超过200万的致死病例。随着临床治疗、病理学、流行病学和病毒分子生物学研究取得进展,疫苗研发也获得了重大突破。目前已有多款疫苗完成初步的临床安全性和效力评估,并获得紧急使用或有条件上市批准。此文对研究进展较快的多种类型新型冠状病...     

新型冠状病毒疫苗加强免疫效果研究进展

新型冠状病毒感染仍处于全球大流行阶段, 疫苗接种是阻断疫情传播的重要手段。全球多个平台研发的新型冠状病毒疫苗接种正在积极推进, 加强免疫策略在当前应对新型冠状病毒流行毒株不断变异的情况下尤为重要, 尤其是同源和异源加强接种的免疫原性和保护效果等方面备受关注。此文主要介绍了不同平台疫苗加强免疫的临床研究和真实世界研究的结果, 为免疫策略提供参考。     

自身免疫疾病患者的新型冠状病毒肺炎疫苗接种

病情稳定的自身免疫疾病（AID）患者接种新型冠状病毒肺炎（COVID-19）疫苗的获益大于风险。信使核糖核酸疫苗、灭活疫苗和重组蛋白亚单位疫苗对AID患者是安全的,而重组腺病毒载体疫苗的安全性尚不确定。部分AID治疗药物可能降低机体对COVID-19疫苗的免疫应答,影响疫苗的免疫效力,这种影响可能与疫苗接种时机有关。本...     

mRNA疫苗技术概述及新型冠状病毒肺炎mRNA疫苗的研究进展

mRNA疫苗技术的发展受到分子本身不稳定、自身免疫原性高以及体内递送效率低等因素的限制，经过30多年的研究，近年来随着其稳定性、高效传递系统方面的技术日趋成熟，肿瘤和传染病mRNA疫苗研究进展明显。与传统疫苗技术相比，该技术可诱导机体产生体液免疫和细胞免疫，疫苗生产工艺简单、研发周期短、成本低，便于标准化生产，适用于大流行疾病和传染病暴发流行期间的疫苗开发和生产，是一种应用前景广阔的疫苗。在当前新型冠状病毒肺炎全球大流行的背景下，本文从mRNA疫苗的特征、疫苗递送系统入手，结合新型冠状病毒肺炎mRNA疫苗的研究现状进行了分析和阐述，以期为后续的mRNA疫苗研究开发提供参考依据。     

现行新型冠状病毒疫苗的临床试验进展

为有效预防新型冠状病毒的感染及控制病毒的传播,疫苗的研制迫在眉睫.截至2020年9月28日,WHO公布现有40项新型冠状病毒疫苗临床试验正在进行,疫苗类型包括灭活疫苗、病毒载体疫苗、DNA疫苗和mRNA疫苗等,每类疫苗都有其优缺点.其中新型冠状病毒灭活疫苗、黑猩猩腺病毒载体疫苗和5型腺病毒载体疫苗等7款候选疫苗在Ⅰ/Ⅱ...     

我国新型冠状病毒疫苗研发进展及思考

新型冠状病毒(SARS-CoV-2)是继SARS冠状病毒(SARS-CoV)和中东呼吸综合征冠状病毒(MERS-CoV)之后又一严重危害人类的病毒。SARS-CoV-2引起的疾病被世界卫生组织命名为COVID-19,具有较高的传染性和病死率。为控制疫情蔓延,我国正应急开展多种技术路线的COVID-19疫苗研发,包括灭活疫苗、重组蛋白疫苗、病毒载体疫苗和核酸疫苗(DNA和mRNA)等,在加快疫苗研发进程的同时把握应急研发进度和科学性之间的平衡,并行解决相关科学问题,在满足安全性的前提下保证疫苗的有效性和质量可控。目前我国研发的腺病毒载体疫苗已率先进入Ⅰ期临床试验,多家企业进入注册检验和滚动提交审评资料阶段。本文对COVID-19疫苗研究进展进行综述,并提出现阶段对此种新疫苗研发的考虑。     

Highly pathogenic coronaviruses: thrusting vaccine development in the spotlight

Coronaviruses (CoVs) are a large family of viruses that cause illness ranging from the common cold to more severe diseases such as Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS). Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) disease (COVID-19) has caused major public health crises. There have been more than 4,400,000 reported cases of COVID-2019 and more than 300,000 reported deaths to date (16/05/2020). SARS-CoV, MERS-CoV and SARS-CoV-2 have attracted widespread global attention due to their high infectivity and pathogenicity. To date, there is no specific treatment proven effective against these viral infectious diseases. Vaccination is considered one of the most effective strategies to prevent viral infections. Therefore, the development of effective vaccines against highly pathogenic coronaviruses is essential. In this review, we will briefly describe coronavirus vaccine design targets, summarize recent advances in the development of coronavirus vaccines, and highlight current adjuvants for improving the efficacy of coronavirus vaccines.     

基于脂质载体的mRNA疫苗递送系统研究进展

转录信使RNA（mRNA）具有安全有效的蛋白质表达谱,在遗传病新疗法、表达功能性蛋白和抗体、疫苗或基因编辑的开发上具有良好的应用前景。随着病原生物学与免疫学的发展,mRNA疫苗凭借其高效性与稳定性而愈发被重视。目前,有效的体内递送手段是mRNA疫苗所面临的较大挑战,脂质载体的mRNA疫苗递送系统具有靶向性强、包封率高、细胞亲和性好的特点,部分脂质载体能够使mRNA疫苗在体内以非侵入性的方式进行靶向递送。从mRNA疫苗递送的主要难点、脂质载体在mRNA疫苗递送中的研究现状以及针对新型冠状病毒（SARS-CoV-2）的mRNA脂质载体疫苗开发进展,共3个方面总结了目前基于脂质载体的mRNA疫苗递送系统研究进展,并对未来的基因疫苗递送系统研究方向进行展望。     

抗体依赖性增强作用及对新型冠状病毒疫苗研发的思考

通常情况下病毒性疫苗诱导机体产生的中和抗体能与入侵病毒结合并使其失去感染宿主细胞和发生疾病的能力,但在某些情况下疫苗接种后诱导产生的抗体不但未产生保护作用,反而加重了疾病的临床表现,即通过抗体依赖性增强作用导致疫苗增强性疾病.本文对既往疫苗临床研究和冠状病毒动物试验研究中发生的抗体依赖性增强作用及其可能的作用机制等进行...     

Intranasal vaccines for SARS-CoV-2: From challenges to potential in COVID-19 management

Unlike conventional Coronavirus 2019 (COVID-19) vaccines, intranasal vaccines display a superior advantage because the nasal mucosa is often the initial site of infection. Preclinical and clinical studies concerning intranasal immunization elicit high neutralizing antibody generation and mucosal IgA and T cell responses that avoid severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in both; the upper and lower respiratory tract. A nasal formulation is non-invasive with high appeal to patients. Intranasal vaccines enable self-administration and can be designed to survive at ambient temperatures, thereby simplifying logistical aspects of transport and storage. In this review, we provide an overview of nasal vaccines with a focus on formulation development as well as ongoing preclinical and clinical studies for SARS-CoV-2 intranasal vaccine products.     

Multifactorial Traits of SARS-CoV-2 Cell Entry Related to Diverse Host Proteases and Proteins

The most effective way to control newly emerging infectious disease, such as the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, is to strengthen preventative or therapeutic public health strategies before the infection spreads worldwide. However, global health systems remain at the early stages in anticipating effective therapeutics or vaccines to combat the SARS-CoV-2 pandemic. While maintaining social distance is the most crucial metric to avoid spreading the virus, symptomatic therapy given to patients on the clinical manifestations helps save lives. The molecular properties of SARS-CoV-2 infection have been quickly elucidated, paving the way to therapeutics, vaccine development, and other medical interventions. Despite this progress, the detailed biomolecular mechanism of SARS-CoV-2 infection remains elusive. Given virus invasion of cells is a determining factor for virulence, understanding the viral entry process can be a mainstay in controlling newly emerged viruses. Since viral entry is mediated by selective cellular proteases or proteins associated with receptors, identification and functional analysis of these proteins could provide a way to disrupt virus propagation. This review comprehensively discusses cellular machinery necessary for SARS-CoV-2 infection. Understanding multifactorial traits of the virus entry will provide a substantial guide to facilitate antiviral drug development.     

Potential adjuvants for the development of a SARS-CoV-2 vaccine based on experimental results from similar coronaviruses

The extensive efforts around the globe are being made to develop a suitable vaccine against COVID-19 (Coronavirus Disease-19) caused by SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus-2). An effective vaccine should be able to induce high titers of neutralizing antibodies to prevent the virus from attaching to the host cell receptors. However, to elicit the protective levels of antibodies, a vaccine may require multiple doses or assistance from other immunostimulatory molecules. Further, the vaccine should be able to induce protective levels of antibodies rapidly with the least amount of antigen used. This decreases the cost of a vaccine and makes it affordable. As the pandemic has hit most countries across the globe, there will be an overwhelming demand for the vaccine in a quick time. Incorporating a suitable adjuvant in a SARS-CoV-2 vaccine may address these requirements. This review paper will discuss the experimental results of the adjuvanted vaccine studies with similar coronaviruses (CoVs) which might be useful to select an appropriate adjuvant for a vaccine against rapidly emerging SARS-CoV-2. We also discuss the current progress in the development of adjuvanted vaccines against the disease.     

Immune and bioinformatics identification of T cell and B cell epitopes in the protein structure of SARS-CoV-2: A systematic review

The beginning of 2020 was marked as the emergence of a COVID-19 outbreak caused by a new coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Currently, there is no vaccine or approved treatment for this infectious virus so the invention of an efficient vaccine is certainly a high priority. Some studies have employed several techniques to facilitate the combination of the immunoinformatics approach and comparative genomic approach in order to determine the potential peptides for designing the T-cell epitope-based peptide vaccine using the 2019-nCoV envelope protein as a target. Via screening the bioimmunoinformatic SARS-CoV2 derived B-cell and T-cell epitopes within the basic immunogenic of SARS-CoV2 proteins, we presented a set of inferred B-cell and T-cell epitopes from the spike (S) and nucleocapsid (N) proteins with high antigenicity and without allergenic property or toxic effects. Our findings provide a screened set of epitopes that can be introduced as potential targets for developing peptide vaccines against the SARS-CoV-2 virus.     

Current COVID-19 vaccine candidates: Implications in the Saudi population

AimThe purpose of this review is to discuss the current status of local and international efforts undergoing clinical trials aiming at developing a Coronavirus Disease-2019 (COVID-19) vaccine, and to highlight the anticipated challenges of this vaccine globally and in Saudi Arabia.Present FindingsCOVID-19 vaccine development efforts started in early January 2020 when Chinese scientists shared the Coronavirus genomic sequence in public domain. Approximately 321 research groups initiated the search for a vaccine, out of which 41 have reached phase I/II trails and 11 reached phase-III clinical trials, including approved vaccines for early to limited use. Out of these projects are two labs in the Kingdom of Saudi Arabia still in early stages of development of a COVID-19 vaccine. Several vaccine attempts are being tested from traditional, attenuated virus methods, to new nucleic acid-based designs. However, no vaccine has yet completed clinical trials and reached public domain.In spite of the challenges faced during previous vaccine trials, researchers have found that Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), the causative agent of COVID-19 is structurally similar to the (SARS-CoV-1) and the Middle Eastern Respiratory Syndrome Coronavirus (MERS-CoV), which caused epidemics in 2003 and 2012 respectively. Both SARS strains show identical affinity towards the type-II alveolar pneumocytes angiotensin converting enzyme-2 (ACE-2) receptor binding domains and therefore, similar pathogenicity. The race to develop the vaccine is predominantly for individuals at high risk of developing the infection, i.e. population groups who are most susceptible to experiencing fatal symptoms of the coronavirus. These include patients with comorbidities, above the age of 60 years and people at risk of contracting large viral loads, such as healthcare providers caring for critical admissions in in-patient wards, Intensive Care Units and Emergency Room settings.SummaryMany different vaccine strategies are under development throughout different stages of the research timeline; however, it is estimated that none will show favorable results before end of 2020. For any immunization or interventional prevention/therapy system to reach the public and patients at high risk, it needs to undergo multiple phase trials to ensure safety and effectiveness. In this scoping review we aim to map the literature on COVID-19 vaccines and provide recommendations related to gaps in research, applicability and expected challenges for implementation of nationwide vaccination in Saudi Arabia.     

Early clinical trial data and real-world assessment of COVID-19 vaccines: Insights from the Society of Infectious Diseases Pharmacists

As of August 2021, there were three COVID-19 vaccines available in the United States for the prevention of coronavirus 2019 (COVID-19). The purpose of this narrative review is to examine the early experience from the Emergency Use Authorization (EUA) of BNT162b2 (Pfizer, Inc./BioNTech), mRNA-1273 (Moderna, Inc.), and Ad26.COV2.S (Johnson and Johnson/Janssen Global Services, LLC) through July 2021. The EUA data from the clinical trials have largely been corroborated by real-world effectiveness investigations post-authorization. These studies indicate that immunity is obtained within 2 weeks post-vaccination and may endure for 6 months. The immunity conferred by the vaccines may also be effective against SARS-CoV-2 variants of concern. Additionally, populations not included in the emergency use authorization studies may also benefit from vaccination. This look back at the initial clinical experience can be used by the global community to inform and develop COVID-19 vaccine programs.