人源产肠毒素大肠杆菌疫苗的研发进展

Advances in new vaccines against human enterotoxigenic Escherichia coli-A review

摘要:

腹泻是全球范围内引起5岁以下幼童死亡的第二大病因,而产肠毒素大肠杆菌(ETEC)是引起腹泻的最常见病原菌,其产生的细菌定植因子(CFs)和肠毒素是关键的毒力因子。CFs介导细菌黏附宿主小肠上皮细胞并完成定植,产生热敏肠毒素(LT)和热稳定肠毒素(ST)破坏宿主上皮细胞内的体液平衡,使体液和电介质过量分泌从而导致腹泻。预防ETEC腹泻的首选方法是使用能激发宿主产生抗黏附素免疫力和抗肠毒素免疫力的疫苗,阻断ETEC黏附和定植并中和肠毒素。目前一种名为Dukoral® 的霍乱疫苗因能刺激机体产生抗热敏毒素免疫,已经被一些国家批准用于短期保护和预防旅行者腹泻。新型试验性ETEC候选疫苗正在研发中,旨在提供保护期长、反应谱广的抗ETEC感染免疫保护力。本文针对疫苗研发的关键问题和研究现状作一综述,并对未来的研究作出展望。

Abstract:

Enterotoxigenic Escherichia coli (ETEC) is the most common cause of diarrhea, which is a second leading cause of death for the children under five years old from all over the world. The key factors of ETEC contain both colonization factors (CFs) and enterotoxins including heat-labile enterotoxin (LT) and heat-stable enterotoxin (ST). CFs mediated the binding of bacteria to the host intestinal epithelial cells, whereas LT and ST stimulated the over-secretion of body fluids and electrolytes, resulting in the destruction of the host fluid balance and leading diarrhea. The vaccine against CFs and enterotoxins could stimulate the host immune response, blocking ETEC adhesion and neutralizing enterotoxins, which is effective in the prevention of ETEC diarrhea. For the moment, depending on the stimulated immune response against LT, a cholera vaccine called Dukoral ® has been approved for use in some countries for the short-term protection and prevention of travelers' diarrhea. ETEC candidate vaccines are still in progress, which is designed to provide a long and wide-spectrum protection for ETEC infections. This paper briefly summarizes the advanced findings and key problems of vaccine development, and discusses prospects for future research.