Hookworm vaccines: current and future directions.

IF 5.5 3区 医学 Q1 IMMUNOLOGY
Eti R Sarkar, Suchandan Sikder, Paul Giacomin, Alex Loukas
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Abstract

Introduction: Hookworms infect about half a billion people worldwide and are responsible for the loss of more than two billion disability-adjusted life years. Mass drug administration (MDA) is the most popular preventive approach, but it does not prevent reinfection. An effective vaccine would be a major public health tool in hookworm-endemic areas.

Areas covered: We highlight recent human studies where vaccination with irradiated larvae and repeated rounds of infection-treatment have induced partial protection. These studies have emphasized the importance of targeting the infective larvae to generate immunity to prevent adult worms from maturing in the gut. We summarize the current status of human and animal model vaccine trials.

Expert opinion: Hookworm infection is endemic in resource-poor developing regions where polyparasitism is common, and vaccine cold chain logistics are complex. Humans do not develop sterile immunity to hookworms, and the elderly are frequently overlooked in MDA campaigns. For all these reasons, a vaccine is essential to create long-lasting protection. The lack of a robust animal model to mimic human hookworm infections is a barrier to the discovery and development of a vaccine, however, there have been major recent advances in human challenge studies which will accelerate the process.

钩虫疫苗:当前和未来的方向。
导言:全世界约有 5 亿人受到钩虫感染,造成的残疾调整寿命损失超过 20 亿年。大规模用药(MDA)是最常用的预防方法,但无法防止再次感染。有效的疫苗将成为钩虫流行地区的主要公共卫生工具:我们重点介绍了最近的一些人类研究,在这些研究中,用经过辐照的幼虫接种疫苗并反复进行感染治疗,可以产生部分保护作用。这些研究强调了针对感染性幼虫产生免疫力以防止成虫在肠道中成熟的重要性。我们总结了人类和动物模型疫苗试验的现状:钩虫感染是资源匮乏的发展中地区的地方病,这些地区常见多寄生虫,疫苗冷链物流非常复杂。人类不会对钩虫产生无菌免疫,而且在 MDA 运动中,老年人经常被忽视。鉴于上述原因,疫苗对于提供持久保护至关重要。缺乏可靠的动物模型来模拟人类钩虫感染是发现和开发疫苗的一个障碍,不过,最近在人类挑战研究方面取得了重大进展,这将加快这一进程。
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来源期刊
Expert Review of Vaccines
Expert Review of Vaccines 医学-免疫学
CiteScore
9.10
自引率
3.20%
发文量
136
审稿时长
4-8 weeks
期刊介绍: Expert Review of Vaccines (ISSN 1476-0584) provides expert commentary on the development, application, and clinical effectiveness of new vaccines. Coverage includes vaccine technology, vaccine adjuvants, prophylactic vaccines, therapeutic vaccines, AIDS vaccines and vaccines for defence against bioterrorism. All articles are subject to rigorous peer-review. The vaccine field has been transformed by recent technological advances, but there remain many challenges in the delivery of cost-effective, safe vaccines. Expert Review of Vaccines facilitates decision making to drive forward this exciting field.
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