摘要：对西非婴儿的一项新的研究报告说，一种新的儿童结核病（或TB）疫苗在与针对其它疾病的疫苗同时接种时效果会变差。 这些发现可能会彻底改变发展中国家儿童疫苗接种的常规方法。 根据世界卫生组织的建议，目前的TB疫苗（或称卡介苗，或BCG）在发展中国家是在新生儿出生的时候接种的。 尽管在婴儿时接种BCG可保护儿童不感染严重的TB、改善其存活率并提升机体对乙型肝炎和口服灰髓炎疫苗的反应，但在成人中TB的日益流行表明这一功效并不持久。人们急需一种更好的TB疫苗。 但是，由于接种BCG可带来婴儿时期的裨益，因此发展一种包括BCG在内的TB疫苗接种策略是讲得通的。MVA85A就是临床上最先进的新型TB疫苗，它的设计目的就是为了增进BCG的功效。 Martina Ota及其同事决定观察MVA85A是否可与其它的儿童时期的疫苗同时接种。 研究人员对3组4个月大的婴儿进行了观察：第一组的婴儿所接受的是正常的儿童疫苗接种，第二组的儿童接受的是正常儿童疫苗接种加上BCG和MVA85A，第三组的儿童仅接受MVA85A的疫苗接种。 研究人员发现，当MVA85A与常规的儿童疫苗一同接种时，婴儿对MVA85A的免疫反应要明显低下，尽管研究人员对造成这种情况的原因仍然不清楚。 该结果表明，不同疫苗间的相互作用会对功效产生影响，这从而提示，标准的儿童疫苗接种时间表可能需要作修改以纳入新一代的TB疫苗。
生物探索推荐英文原文报道：
New childhood TB vaccine is better off alone
A new childhood tuberculosis or TB vaccine is less effective when given alongside shots for other diseases, reports a new study on infants in West Africa. The findings could overhaul the way routine childhood vaccines in developing countries are administered. The current vaccine for TB, Bacillus Calmette-Guerin or BCG is given at birth in developing countries, in accordance with World Health Organization recommendations. Although BCG protects against severe forms of TB in childhood, improves survival and boosts responses to hepatitis B and oral polio vaccines when given in infancy, the increasing prevalence of TB in adults indicates that this effect is not long lasting, and there is an urgent need for a better vaccine. However, because of the benefits of BCG in infancy, it makes sense to develop a vaccination strategy against TB that includes BCG. MVA85A is the most clinically advanced new TB vaccine that is designed to enhance BCG. Martina Ota and colleagues decided to see if MVA85A can be given at the same time as the other childhood vaccines. The researchers looked at three groups of 4-month-old infants: the first group received the normal regimen of childhood vaccines, the second group received the normal regimen of childhood vaccines plus the BCG and MVA85A, and the third group received the MVA85A vaccine alone. The infants’ immune response to MVA85A was significantly lower when given with routine childhood vaccines, the researchers found, though it remains unclear why this is case. The results show that interactions among different vaccines can impact efficacy, and hint that standard childhood vaccine schedules may need revision to incorporate a new generation of vaccines against TB.
生物探索推荐英文论文摘要
Sci Transl Med 22 June 2011:
DOI: 10.1126/scitranslmed.3002461
Immunogenicity of the Tuberculosis Vaccine MVA85A Is Reduced by Coadministration with EPI Vaccines in a Randomized Controlled Trial in Gambian Infants
ABSTRACT
New tuberculosis vaccines are urgently needed to curtail the current epidemic. MVA85A is a subunit vaccine that could enhance immunity from BCG vaccination. To determine MVA85A safety and immunogenicity as well as interactions with other routine vaccines administered in infancy, we randomized healthy 4-month-old infants who had received Bacille Calmette-Guérin at birth to receive Expanded Program on Immunization (EPI) vaccines alone, EPI and MVA85A simultaneously, or MVA85A alone. Adverse events were monitored throughout. Blood samples obtained before vaccination and at 1, 4, and 20 weeks after vaccination were used to assess safety and immunogenicity. The safety profile of both low and standard doses was comparable, but the standard dose was more immunogenic and therefore was selected for the second stage of the study. In total, 72 (first stage) and 142 (second stage) infants were enrolled. MVA85A was safe and well tolerated and induced a potent cellular immune response. Coadministration of MVA85A with EPI vaccines was associated with a significant reduction in MVA85A immunogenicity, but did not affect humoral responses to the EPI vaccines. These results provide important information regarding timing of immunizations, which is required for the design of infant efficacy trials with MVA85A, and suggest that modifications to the standard EPI schedule may be required to incorporate a new generation of T cell–inducing vaccines.
