Progress toward Development of a Vaccine against Congenital Cytomegalovirus Infection.

Q2 Biochemistry, Genetics and Molecular Biology
Clinical and Vaccine Immunology Pub Date : 2017-12-05 Print Date: 2017-12-01 DOI:10.1128/CVI.00268-17
Mark R Schleiss, Sallie R Permar, Stanley A Plotkin
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引用次数: 81

Abstract

A vaccine against congenital human cytomegalovirus (CMV) infection is a major public health priority. Congenital CMV causes substantial long-term morbidity, particularly sensorineural hearing loss (SNHL), in newborns, and the public health impact of this infection on maternal and child health is underrecognized. Although progress toward development of a vaccine has been limited by an incomplete understanding of the correlates of protective immunity for the fetus, knowledge about some of the key components of the maternal immune response necessary for preventing transplacental transmission is accumulating. Moreover, although there have been concerns raised about observations indicating that maternal seropositivity does not fully prevent recurrent maternal CMV infections during pregnancy, it is becoming increasing clear that preconception immunity does confer some measure of protection against both CMV transmission and CMV disease (if transmission occurs) in the newborn infant. Although the immunity to CMV conferred by both infection and vaccination is imperfect, there are encouraging data emerging from clinical trials demonstrating the immunogenicity and potential efficacy of candidate CMV vaccines. In the face of the knowledge that between 20,000 and 30,000 infants are born with congenital CMV in the United States every year, there is an urgent and compelling need to accelerate the pace of vaccine trials. In this minireview, we summarize the status of CMV vaccines in clinical trials and provide a perspective on what would be required for a CMV immunization program to become incorporated into clinical practice.

先天性巨细胞病毒感染疫苗的研究进展
针对先天性人类巨细胞病毒(CMV)感染的疫苗是一项重要的公共卫生重点。先天性巨细胞病毒在新生儿中引起大量的长期发病率,特别是感音神经性听力损失(SNHL),并且这种感染对孕产妇和儿童健康的公共卫生影响未得到充分认识。尽管由于对胎儿保护性免疫相关因素的不完全了解,疫苗开发的进展受到限制,但关于预防经胎盘传播所必需的母体免疫反应的一些关键成分的知识正在积累。此外,尽管有观察表明母体血清阳性并不能完全预防妊娠期间母体巨细胞病毒复发感染,但越来越清楚的是,孕前免疫确实能在一定程度上保护新生儿免受巨细胞病毒传播和巨细胞病毒疾病(如果发生传播)。尽管感染和疫苗接种对巨细胞病毒的免疫都是不完善的,但从临床试验中出现的令人鼓舞的数据表明,候选巨细胞病毒疫苗的免疫原性和潜在功效。鉴于美国每年有2万至3万名婴儿出生时患有先天性巨细胞病毒,迫切需要加快疫苗试验的步伐。在这篇小型综述中,我们总结了巨细胞病毒疫苗在临床试验中的现状,并提供了巨细胞病毒免疫规划纳入临床实践所需的观点。
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来源期刊
Clinical and Vaccine Immunology
Clinical and Vaccine Immunology 医学-传染病学
CiteScore
2.88
自引率
0.00%
发文量
0
审稿时长
1.5 months
期刊介绍: Cessation. First launched as Clinical and Diagnostic Laboratory Immunology (CDLI) in 1994, CVI published articles that enhanced the understanding of the immune response in health and disease and after vaccination by showcasing discoveries in clinical, laboratory, and vaccine immunology. CVI was committed to advancing all aspects of vaccine research and immunization, including discovery of new vaccine antigens and vaccine design, development and evaluation of vaccines in animal models and in humans, characterization of immune responses and mechanisms of vaccine action, controlled challenge studies to assess vaccine efficacy, study of vaccine vectors, adjuvants, and immunomodulators, immune correlates of protection, and clinical trials.
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