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全球脑膜炎球菌多糖结合疫苗研究进展

Research progress in global meningococcal polysaccharide conjugate vaccine

摘要流行性脑脊髓膜炎(流脑)是由脑膜炎球菌感染引起的急性中枢神经系统性疾病,具有发病不确定性、起病急、进展快、致死和致残率均较高等特点,疾病负担重。脑膜炎球菌常定植在人的鼻咽部,国际上通常将脑膜炎球菌引起的一系列疾病,如败血症、关节炎、脑膜炎、肺炎和心包炎等疾病统称为脑膜炎球菌病(meningococcal diseases)。至今接种疫苗是控制和预防该病最经济有效的措施之一。脑膜炎球菌分为12种血清群,目前全球均面临多菌群流行和变迁的威胁,为给人群提供更广更全的保护,多联多价脑膜炎球菌疫苗已成为研发和使用主力军。脑膜炎球菌疫苗的研发先后经历从单价到多价,从多糖到多糖结合疫苗的过程。脑膜炎球菌多糖结合疫苗在提升免疫原性、诱导免疫记忆和降低带菌率等方面具有明显优势。国际上首款四价和五价脑膜炎球菌多糖结合疫苗分别于2005年和2023年上市,我国首款四价脑膜炎球菌多糖结合疫苗于2021年底获批上市。本综述将系统梳理脑膜炎球菌多糖结合疫苗的研究进展,以期为我国脑膜炎球菌多糖结合疫苗的应用、脑膜炎球菌病的防控策略制定提供参考。

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abstractsEpidemic cerebrospinal meningitis (epidemic encephalitis) is an acute central nervous system infectious disease caused by Neisseria meningitidis ( Nm). It is characterized by uncertainty in onset, rapid onset, rapid progression, high mortality and disability rates, and a heavy disease burden. Nm commonly colonizes the human nasopharynx and can cause a series of diseases, such as sepsis, arthritis, meningitis, pneumonia and pericarditis, which are collectively called meningococcal diseases. Vaccination is regarded as the most cost-effective and efficacious measure for the prevention and control of meningococcal diseases now. Nm is divided into 12 serogroups. Currently, the spread and change of multiple serogroups pose a threat to the world. To provide wider and more comprehensive protection for the population, multivalent combined vaccines have become the main force in development and use. The global research and development of meningococcal vaccines has undergone a progression from monovalent to multivalent and from polysaccharide to conjugate vaccines. Meningococcal polysaccharide conjugate vaccines have greater advantages in enhancing immunogenicity, inducing immunological memory and reducing carrier rates. Internationally, the first quadrivalent and pentavalent meningococcal polysaccharide conjugate vaccines were licensed in 2005 and 2023, respectively, and the first quadrivalent meningococcal polysaccharide conjugate vaccine was licensed in 2021 in China. This review summarizes the research progress in meningococcal polysaccharide conjugate vaccines and hopes to provide fundamental data for guiding vaccine implementation and developing strategies to prevent and control meningococcal diseases in China.

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