非脊髓灰质炎肠道病毒能否被疫苗驯服以减少其引起的瘫痪?

O. Bharti
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引用次数: 1

摘要

背景:虽然我们正在朝着全球消灭脊髓灰质炎的目标缓慢前进,但由非脊髓灰质炎病毒(NPEV)引起的瘫痪构成了更大的挑战。本文对印度北方邦64个县3596例急性弛缓性麻痹(AFP)患者进行了致急性弛缓性麻痹(AFP)的相关因素研究,以观察AFP与野生脊髓灰质炎及NPEV的间接关系。最近的一项研究表明,有必要调查脊髓灰质炎病毒阴性但NPEV阳性的AFP病例。方法:对患儿粪便标本的实验室检测结果进行列示和分析,观察各因素与随访60天出现麻痹的关系。以零OPV剂量AFP病例为生物学基础,我们研究了在脊髓灰质炎病毒存在或不存在的情况下,60天随访时出现麻痹与粪便样本中出现NPEV的关系。结果:86例AFP病例中有70例(81%)在随访60天时出现麻痹,这些病例中OPV剂量为零,粪便样本中仅分离出NPEV。4.54%(162例)AFP病例未携带脊髓灰质炎病毒,但在粪便样本中分离出NPEV,随访60天瘫痪。79%(75/95)的零口服脊髓灰质炎疫苗剂量儿童,在60天随访时仍有残余虚弱,其粪便样本中同时携带脊髓灰质炎病毒和NPEV。总AFP病例,在60天的随访中有残余虚弱和粪便样本中有NPEV,随着口服脊髓灰质炎疫苗剂量的增加而减少;这种行为类似于野生脊髓灰质炎病毒(WPV)对脊髓灰质炎病毒的行为。结论:可能像NPEV这样的脊髓灰质炎是引起儿童严重瘫痪的活跃分子,并对脊髓灰质炎疫苗有反应。正如M. Margalith, B. Fattal等人的研究表明,肠道病毒有抗体反应,我们可以考虑研制出一种针对肠道病毒的疫苗。因此,肠道病毒疫苗可以按照与口服脊髓灰质炎疫苗类似的路线生产,因为现在我们有足够的NPEV分离株。有效的NPEV监测系统也需要到位。
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Can Non-Polio Enteroviruses Be Tamed with a Vaccine to Minimize Paralysis Caused by Them?
Background: While we are inching towards global eradication of polio, the paralysis due to non-polio viruses (NPEV) poses greater challenge. Factors responsible for causing Acute Flaccid Paralysis (AFP) were studied in 3596 AFP patients in 64 districts of Uttar-Pradesh, India, to observe indirect relationship of AFP with wild polio as well as NPEV. A recent study suggests the need to investigate polio virus negative but NPEV positive AFP cases. Methods: The lab results of the stool samples of these children were line listed and analysed to observe the association of various factors with respect to presence of paralysis on 60 follow-up days. Taking zero OPV dose AFP cases as a biological base, we studied the relationship of presence of paralysis at 60 follow-up days to that of presence of NPEV in stool samples while polio virus was present or absent. Results: 70 of the 86 AFP cases (81%) with zero OPV dose and having only NPEV isolated in stool samples were having paralysis at 60 follow-up days. There were 4.54% (162) AFP cases, which did not carry any polio virus but were having NPEV isolated in the stool samples and paralysis at 60 follow-up days. 79% (75/95) of zero OPV dose children, who were having residual weakness at 60 follow-up days, were carrying both polio virus as well as NPEV in their stool samples. Total AFP cases, having residual weakness at 60 follow-up days and having NPEV in stool samples, decreased with increase in OPV doses; a behavior similar to what wild polio viruses (WPV) have to OPV. Conclusions: Maybe polio like NPEV is active for causing severe paralysis in children and is responding to the OPV. As is evident in the studies by M. Margalith, B. Fattal et al. [1] that there is an antibody response to the enteroviruses, we can think of coming out with a vaccine against the enteroviruses. Therefore, enterovirus vaccine can be produced on similar lines to that of OPV, as now we have enough isolates of NPEV. Effective NPEV surveillance system also needs to be in place.
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