Trained-immunity and cross-reactivity for protection: insights from the coronavirus disease 2019 and monkeypox emergencies for vaccine development

A. Portilho, E. De Gaspari
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Abstract

The emergence and re-emergence of pathogens is a public-health concern, which has become more evident after the coronavirus disease 2019 (COVID-19) pandemic and the monkeypox outbreaks in early 2022. Given that vaccines are the more effective and affordable tools to control infectious diseases, the authors reviewed two heterologous effects of vaccines: the trained immunity and the cross-reactivity. Trained immunity, provided by attenuated vaccines, was exemplified in this article by the decreased the burden of COVID-19 in populations with high Bacille Calmette-Guerin (BCG) coverage. Cross-reactive responses were exemplified here by the studies which suggested that vaccinia could help controlling the monkeypox outbreak, because of common epitopes shared by orthopoxviruses. Although modern vaccination is likely to use subunit vaccines, the authors discussed how adjuvants might be the key to induce trained immunity and improve cross-reactive responses, ensuring that heterologous effects would improve the vaccine’s response.
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经过训练的免疫力和交叉反应性保护:2019冠状病毒病和猴痘紧急情况对疫苗开发的见解
病原体的出现和再出现是一个公共卫生问题,在2019年冠状病毒病(COVID-19)大流行和2022年初猴痘疫情爆发后,这一问题变得更加明显。鉴于疫苗是控制传染病的更有效和负担得起的工具,作者综述了疫苗的两种异源效应:训练免疫和交叉反应性。本文通过降低卡介苗(BCG)高覆盖率人群的COVID-19负担来证明减毒疫苗提供的训练免疫。交叉反应反应在这里的研究中得到了例证,这些研究表明痘苗可以帮助控制猴痘暴发,因为正痘病毒具有共同的表位。虽然现代疫苗接种可能使用亚单位疫苗,但作者讨论了佐剂如何可能是诱导训练免疫和改善交叉反应反应的关键,确保异源效应将改善疫苗的反应。
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