乙型肝炎病毒母婴阻断免疫预防策略综述

乙型肝炎（乙肝）病毒（Hepatitis B Virus,HBV）母婴传播是全球不容忽视的重要公共卫生问题,是现阶段婴幼儿感染HBV的主要方式。目前,接种乙肝疫苗和乙肝免疫球蛋白是阻断HBV母婴传播的主要措施。现就全球HBV母婴阻断免疫预防策略进行综述,为我国预防控制乙肝提供依据。     

Outcome of Displacement Bone Marrow Transplantation for Inborn Errors of Metabolism

The concept of displacement bone marrow transplantation arose from our work at Westminster 1970–1973, by which time we had extended the donors from matched siblings to other family and unrelated donors. DBMT is not a panacea, but can be applied to about 7% of understood inborn errors, where it is possible to devise in vitro tests to predict in vivo donor effects. Its use to install donor bone marrow as a component factory for the life of the recipient, and the importance of immunoprophylaxis are summarised. Worthwhile correction has been achieved for 48 previously fatal genetic diseases, partial correction for another five, but there has been failure for three diseases. Some 80% of our patients were not found in known families and could not have been prevented.     

乙型肝炎病毒携带者母乳喂养的研究

目的探讨乙型肝炎(乙肝)病毒(hepatitis B virus，HBV)携带者在其新生儿、婴儿接受被动及主动全程联合免疫的条件下，是否可以母乳喂养。方法对2001年9月至2003年10月间妊娠期无症状HBV携带者所娩婴儿进行前瞻性随访研究，新生儿出生时留取脐血检测HBV脱氧核糖核酸(HBV DNA)，出生后12h内及第14天注射乙肝免疫球蛋白，并按0、1、6的程序全程接种乙肝疫苗，由产妇自愿选择母乳喂养或人工喂养，55例母乳喂养，36例人工喂养。分别于婴儿7个月和12个月时随访检测HBV DNA及乙肝血清标志物，婴儿7个月时未感染乙肝但抗-HBs阴性者给予乙肝疫苗5μg加强注射。结果婴儿7个月和12月时，母乳喂养组HBV DNA阳性率分别为9．09％(5／55)及9．09％(5／55)，抗HBs阳性率分别为85．45％(47／55)及90．90％(50／55)；人工喂养组HBVDNA阳性率分别为8．33％(3／36)及8．33％(3／36)，抗HBs阳性率分别为86．11％(31／36)及91．67％(33／36)。母乳喂养与人工喂养相比，差异均无统计学意义。结论在新生儿、婴儿接受被动及主动全程联合免疫的条件下，无症状HBV携带者可以母乳喂养。     

病毒性乙型肝炎免疫预防

中国是病毒性乙型肝炎流行最高的国家之一,病毒性乙型肝炎作为一种传染病严重危害着中国人的身体健康和生命质量,因此,病毒性乙型肝炎的预防问题引起广泛关注,其预防措施包括:管理传染源、切断传播途径、保护易感人群。免疫预防是保护易感人群的重要手段,文章主要就病毒性乙型肝炎免疫制剂、免疫对象及程序、免疫效果、影响免疫效果的因素、接种疫苗的不良反应及禁忌等简要综述。     

肺炎球菌性疾病免疫预防专家共识（2020版）

肺炎球菌性疾病是全球严重的公共卫生问题之一,也是导致中国儿童及成年人发病和死亡的重要原因。肺炎球菌性疾病的临床治疗用药以抗生素为主,由于抗生素的广泛应用,肺炎球菌的耐药性问题日益严重。采用肺炎球菌疫苗预防肺炎球菌性疾病并减少细菌耐药性,尤为必要和迫切。本文在《肺炎球菌性疾病免疫预防专家共识（2017版）》基础上,结合WHO肺炎球菌疫苗立场文件（2019年）和国内外最新研究进展,对肺炎球菌性疾病的病原学、临床学、流行病学、疾病负担、疫苗学等方面进行系统综述,目的是为公共卫生和预防接种专业人员在科学使用疫苗与发挥疫苗最佳预防作用方面提供证据,提高肺炎球菌性疾病防控水平。     

全球麻疹消除的意义与发展现状

麻疹疫苗虽然已经使用了40余年,但麻疹仍是引起儿童死亡和其他严重疾病的主要原因。麻疹引起的并发症几乎存在于人体的每个器官。其中,肺炎、喉炎及脑炎是造成死亡的最常见原因。近年麻疹并发症的发生率有所升高,病死率虽在许多发达国家已经下降,但在发展中国家仍然很高。世界卫生组织美洲区以提高常规免疫接种率辅以初始强化免疫和后续免疫,使麻疹发病例数大幅减少,从而阻断了麻疹病毒的传播。欧洲区也确定了消除麻疹的目标。而在全球,即使已有麻疹疫苗的今天,全球每年仍有新发病例4300万,死亡人数100万。在发展中国家,麻疹是儿童的主要死因。     

应用单克隆抗体对小鼠绿脓杆菌感染保护作用的研究

本文报道用淋巴细胞杂交瘤技术制备抗绿脓杆菌单克隆抗体(McAb)保护小鼠抗绿脓杆菌感染,获得满意的效果。用约3个LD_(50)菌量攻击,实验组存活率为80％,而对照组全部死亡,两者有显著性差异。实验揭示抗绿脓杆菌Ⅰ群10115株杂交瘤单克隆抗体(A_4和D_4混合剂)具有明显抗小鼠该型绿脓杆菌感染的保护作用。     

儿童轮状病毒胃肠炎免疫预防专家共识(2020版)

A组轮状病毒(Group A rotavirus,RV)是引起中国<5岁儿童重度胃肠炎和死亡的主要病原之一。接种RV疫苗是预防控制儿童轮状病毒胃肠炎(Rotavirus gastroenteritis,RVGE)的最有效措施。本共识通过回顾RV相关文献,结合中国RV疾病监测数据、世界卫生组织(World Health Organization,WHO)RV疫苗立场文件和专家研讨意见编写而成,旨在为中国儿童RV疫苗使用提供相关科学信息,供专业技术人员在相关工作中参考使用,为制定中国儿童RVGE免疫预防策略提供循证依据。     

Protective response mediated by immunization with recombinant proteins in a murine model of toxocariasis and canine infection by Toxocara canis

Toxocariasis is a neglected parasitic zoonosis of global importance. The development of a formulation that can be used as a vaccine would help the definitive control of the infection. Preclinical studies selected two recombinant T. canis proteins (rTcVcan and rTcCad) which significantly protected mice against larval migration. In the present work, these proteins plus three adjuvants (Alhydrogel®, PAM3CSK4®, and Quil-A®) were used to immunize mice against toxocariasis; blood samples were collected three times to measure IgG (total, IgG1, IgG2a), IgA, and IgE via indirect ELISA. Cytokines (IL-5, TNF-α, and IL-10) were measured in splenocytes supernatant, and T. canis larvae were quantified in tissues. The best protein + adjuvant pair found (rTVcan + QuialA®) was then used to immunize T. canis-free puppies (n = 18) that were experimentally infected with T. canis and T. canis naturally-infected puppies (n = 6). Immunoglobulin (IgA, IgE, IgG, IgG1, and IgG2a), parasite load (eggs in feces), number of expelled adults and eggs extracted from the female uterus, and their fertility percentages were analyzed. In mice, it was observed a highly significant reduction (73%) of tissue larvae, a mixed cytokine profile (Th₁/Th₂), and anti-T. canis antibody titers (IgG, IgG1, IgG2a) using rTVcan + QuialA® mix. In canines, rTVcan + QuialA® promoted reduction in the parasite eggs in feces (95%) and eggs reduction obtained from the uteri of pharmacologically expelled adult females (58.38%). In our knowledge this is the first canine clinical trial of a vaccine with T. canis recombinant proteins. The formulation used has been shown to efficiently stimulate the production of antibodies against infection by T. canis. In the canine, a significant reduction in the number of eggs expelled by the experimental animals that received the formulation prophylactically was evidenced. Future tests should be developed to evaluate the duration of the protective effect and analyze other immune pathways that could be stimulated by the formulation used.