Promising pharmaceutical development of vaccines for the prevention of meningococcal infection

Meningococcal infection (MI) refers to anthroponoses; is an acute infectious disease with an aerosol transmission mechanism, characterized by various forms of the infectious process: from local (nasopharyngitis) and asymptomatic infections to generalized forms of invasive infection with the development of meningococcemia and meningitis. The causative agent of MI is meningococcus (Neisseria meningitidis) that belongs to the pathogen risk group 2. Preventive vaccination against MI is included in the calendar of preventive vaccinations according to epidemic indications. The problem of MI retains a great medical and social significance for Russian health care due to the continuing high rates of associated mortality, disability, high costs of treatment and rehabilitation. Vaccines against five of the six main N. meningitidis serogroups have been registered worldwide. Serogroup X vaccine is under development. Recently, there has been an increase in the heterogeneity of the meningococcal population due to serogroups W, Y, and X. The polysaccharide vaccines developed in Russia have restrictions on their use, and there is no full-cycle production of meningococcal conjugate vaccines in the Russian Federation. Given the above, the development and registration of new vaccines against MI is an urgent task. The purpose of this work is to analyze the current state of development of vaccines for MI prevention. Currently, depending on the production technology, the following types of meningococcal vaccines are available: polysaccharide, conjugated, based on outer membrane vesicles (OMV), protein and based on synthetic polysaccharides. Serogroup-targeted meningococcal vaccines are effective in reducing the public health burden of invasive MI. Polysaccharide conjugate and protein/OMV vaccines are among the most promising vaccines for most invasive meningococcal serogroups. In modern conditions, with the progress in technologies for future polysaccharide conjugate vaccines, new opportunities are opening up for the use of such approaches as chemical/enzymatic synthesis, improved characteristics of the carrier protein, and site-specific conjugation. The development of a single vaccine against the main invasive meningococcal serogroups, rather than its individual antigenic variants, does not lose its relevance. It is timely to develop in the near future a vaccine against N. meningitidis serogroup X, which was previously a rare cause of sporadic meningitis, but has caused outbreaks in various African countries in 20062010 and in recent years.