Обзор мирового опыта применения зарегистрированных вакцин и разработки новых вакцин для профилактики пневмококковой инфекции

Инфекция, вызванная Streptococcus pneumoniae, является наиболее частой причиной высокой заболеваемости и смертности среди детей до 5 лет, людей с ослабленным иммунитетом и пожилых. Несмотря на значительный успех, одобренные пневмококковые конъюгированные и полисахаридные вакцины имеют ограниченную эффективность, обеспечивая защиту от небольшой части известных серотипов пневмококков. Быстрое распространение мультирезистентных штаммов усугубляет глобальную проблему лечения инфекционного заболевания, вызванного S. pneumoniae. При этом появление новых штаммов возбудителя диктует необходимость включения новых серотипов в состав вакцин. Ввиду этого дальнейшее совершенствование вакцин для профилактики пневмококковых инфекций является актуальной задачей. Цель работы — рассмотрение достижений в разработке пневмококковых вакцин (полисахаридных, конъюгированных, цельноклеточных), а также вакцин на основе белковых антигенов и вакцин, снабженных системой доставки антигена. В настоящее время на основе данных геномики и протеомики усовершенствованы подходы к созданию полисахаридных и белковых вакцин, а также созданию цельноклеточных вакцин, имеющих потенциал для профилактического охвата населения от различных серотипов пневмококков, не вошедших в состав зарегистрированных пневмококковых вакцин. Важное значение при разработке вакцин имеет способ доставки антигена в клетку. Наиболее перспективной стратегией усовершенствования пневмококковых вакцин является создание вакцин на основе бактериоподобных или синтетических частиц, несущих несколько антигенов, в том числе поверхностные белки пневмококка. В заключение необходимо отметить, что наиболее приоритетными пневмококковыми вакцинами являются те, которые обеспечивают широкий комплекс защиты в отношении спектра циркулирующих серотипов пневмококка и, помимо развития системного иммунного ответа, вызывают индукцию местного иммунитета.

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