trachomavaccinetrialsinthegambia在冈比亚开展的沙眼疫苗试验.ppt

Progress towards a safe and effective chlamydial vaccine安全有效的衣原体疫苗研究进展 David Mabey London School of Hygiene Tropical Medicine Why do we need a chlamydial vaccine?为何需要衣原体疫苗？ Most infections cause no symptoms 大多数感染无症状 Screening programmes are expensive and have had little or no impact 筛查项目昂贵且效果不大 Reported number of cases continues to increase worldwide 世界范围内报告病例数持续增加 Why is there no chlamydial vaccine?为何尚无衣原体疫苗？ Chlamydia are difficult to study and could not be genetically manipulated until recently 衣原体研究困难，尚不能基因操作 Lack of good animal models: mice and guinea pigs are different from humans 缺少好的动物模型：小鼠和豚鼠不同于人类 Non-human primates (monkeys) are expensive 非人类灵长类（猴）模型昂贵 Concern that vaccines could cause immunopathology 对疫苗引起免疫病理损伤的担忧 Recent progress 新近进展 Good evidence that protective immunity follows natural infection in humans 人体自然感染后发生保护性免疫的证据 Review of evidence from trachoma vaccine trials: some evidence of efficacy, no evidence of harm 沙眼疫苗试验的证据：一些有效、无损伤的证据 Better understanding of the immunological correlates of protective immunity in humans 对人体保护性免疫相关性的认识 New adjuvants can elicit the required immune response 新的佐剂可引致所需要的免疫反应 Identification of new target antigens through genomic and proteomic approaches 基因组和蛋白质组研究发现新的靶抗原 Genetic transformation of Chlamydia trachomatis 沙眼衣原体基因转化 Encouraging results with a live attenuated vaccine in monkeys 在猴进行的活的减毒疫苗的令人鼓舞的结果 Trachoma Follicles (TF) 沙眼滤泡 Trachoma Scarring (TS)沙眼瘢痕形成 Trachoma Trichiasis (TT) 沙眼倒睫 Is there evidence of protective immunity following natural infection?是否有自然感染后保护性免疫的证据？ Reduced prevalence and intensity of ocular C. trachomatis infection with increasing age 随着年龄增长沙眼衣原体眼感染率及严重程度下降 Solomon AW et al. NEJM 2004; 351: 1962-71. Reduced duration and incidence of untreated ocular C. trachomatis infection with increasing age 随着年龄增长未经治疗的沙眼衣原体眼感染病程及发生率下降 Grassly NC PLoS Negl Trop Dis 2008; 2: e341 Evidence of protective immunity following natural ocular Ct infection from Tanzania 来自坦桑尼亚的沙眼衣原体眼自然感染后产生保护性免疫的证据 So