Evaluation of a Live, Cold‐Passaged, Temperature‐Sensitive, Respiratory Syncytial Virus Vaccine Candidate in Infancy
作者:Peter F. Wright、Ruth A. Karron、Robert B. Belshe、Juliette Thompson、James E. Crowe, Jr.、Thomas G. Boyce、Lisa L. Halburnt、George W. Reed、Stephen S. Whitehead、Edwin L. Anderson、Alec E. Wittek、Roberta Casey、Maryna Eichelberger、Bhagvanji Thumar、Valerie B. Randolph、Stephen A. Udem、Robert M. Chanock、Brian R. Murphy
DOI:10.1086/315859
日期:2000.11
A live-attenuated, intranasal respiratory syncytial virus (RSV) candidate vaccine, cpts-248/404, was tested in phase 1 trials in 114 children, including 37 1–2-month-old infants—a target age for RSV vaccines. The cpts-248/404vaccine was infectious at 104 and 105 plaque-forming units in RSV-naive children and was broadly immunogenic in children >6 months old. Serum and nasal antibody responses in 1–2 month olds were restricted to IgA, had a dominant response to RSV G protein, and had no increase in neutralizing activity. Nevertheless, there was restricted virus shedding on challenge with a second vaccine dose and preliminary evidence for protection from symptomatic disease on natural reexposure. The cpts-248/404vaccine candidate did not cause fever or lower respiratory tract illness. In the youngest infants, however, cpts-248/404was unacceptable because of upper respiratory tract congestion associated with peak virus recovery. A live attenuated RSV vaccine for the youngest infant will use cpts-248/404 modified by additional attenuating mutations.
一种活减毒的鼻用呼吸道合胞病毒(RSV)候选疫苗cpts-248/404已在114名儿童中进行I期试验,包括37名1到2个月大的婴儿,这是RSV疫苗的目标年龄。cpts-248/404疫苗在RSV初感染的儿童中,在10^4和10^5斑块形成单位下具有感染性,并且在6个月以上儿童中具有广泛的免疫原性。1到2个月大的婴儿的血清和鼻腔抗体反应仅限于IgA,主要对RSV G蛋白产生反应,且未见中和活性的增加。尽管如此,在接种第二剂疫苗后挑战时,病毒的排出受到限制,并且在自然再暴露时有初步证据表明其对症状性疾病的保护作用。cpts-248/404候选疫苗并未引起发热或下呼吸道疾病。然而,在最年轻的婴儿中,由于与病毒恢复高峰相关的上呼吸道充血,cpts-248/404的使用被认为不可接受。针对最年轻婴儿的活减毒RSV疫苗将采用cpts-248/404进行额外减毒突变的修改。