载体蛋白及多种疫苗同时接种对结合疫苗的免疫干扰

多种多糖-蛋白结合疫苗被开发成功,用于预防b型流感嗜血杆菌、脑膜炎球菌和肺炎链球菌感染,为婴幼儿健康提供了保障.常用的载体蛋白是破伤风类毒素、白喉类毒素和白喉类毒素突变体CRM197.在临床研究中观察到,相同载体或不同载体结合疫苗同时接种,或者与DTP/HBV/IPV等疫苗同时接种时,会干扰对某些抗原的免疫应答,其中可能有多种机制在起作用.随着更多的结合疫苗有望进入婴幼儿期基础免疫程序和无细胞百日咳疫苗(aP)逐渐代替全细胞百日咳疫苗(wP),如何选择合适的或者新的载体蛋白和佐剂、谨慎设计临床研究方案和接种程序等问题日益受到关注.

Immune interference on conjugate vaccines by carrier proteins or co-administrated vaccines

Polysaccharide-protein conjugate vaccines are developed successfully to prevent Haemophilus influenzae type b,Neisseria meningitidis and Streptococus pnuemoniae infections,especially for infants.The most commonly used carrier proteins are tetanus toxoid,diphtheria toxoid,and diphtheria toxin variant CRM197.In clinical trials,immune interference has been observed when conjugate vaccines with the same or different carrier proteins were co-administrated,or the conjugate vaccines were immunized concurrently with DTP/HBV/IPV.Several mechanisms may work together.As more conjugate vaccines are expected to be included into the childhood primary immunization schedule,and whole cell pertussis vaccine (wP) is replaced by acellular pertussis vaccine (aP) gradually,the problemns,including how to choose suitable carrier proteins and adjuvants,carefully designing the clinical trial and immunization schedule,attract more people's attention.