肺炎球菌和脑膜炎球菌病粘膜疫苗的评价

Ana Maria Pereira dos Santos, I. Pereira, M. Miguez, A. Argondizzo, M. Rocha-Leão
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摘要

肺炎是一种影响呼吸道和肺部的感染,是全球最大的传染性死亡原因,2015年有920,136名5岁以下儿童死亡,占该年龄儿童死亡总数的15%。肺炎的主要传染因子是肺炎链球菌,通常存在于鼻子或喉咙,可通过咳嗽或打喷嚏的飞沫传播[1]。肺炎链球菌能够引起严重的侵袭性疾病,但它可以定殖不出现症状的个体,这表明定殖是该细菌的主要选择力[2]。同样,脑膜炎球菌性脑膜炎是一种主要由脑膜炎奈瑟菌引起的细菌性威胁生命的疾病。在欧洲、美国和其他发达国家,脑膜炎球菌病的发病率通常在每10万人中1至10人之间,偶尔会出现由特定菌株引起的持续疾病的“高流行”期[3]。撒哈拉以南非洲从塞内加尔延伸到埃塞俄比亚的狭长地带被称为“非洲脑膜炎带”,在26个非洲国家中有4.3亿人处于危险之中,每年反复发生的疫情造成2万至20万例病例和2万至2万例死亡[4]。由于这些疾病主要通过呼吸道传播,包括无症状个体携带者,因此必须不断评估粘膜免疫机制。
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Evaluation of Mucosal Vaccines against Pneumococcal and Meningococcal Diseases
Pneumonia is an infection that affects respiratory tract and lungs and it ́s globally the largest infectious cause of death with 920,136 deaths in 2015 for children under five years old, representing 15% of all obits in this age. The main infectious agent of pneumonia, the bacterium Streptococcus pneumoniae, is normally found at nose or throat and can spread by droplets from a cough or sneeze [1]. S. pneumoniae is capable to cause serious severe invasive disease, but it can colonize individuals that will not to present symptoms, suggesting that colonization represents the primary selective force for this bacterium [2]. In the same way, meningococcal meningitis is a bacterial lifethreatening disease caused mainly by Neisseria meningitidis. In Europe, the US and other developed countries, meningococcal disease incidence is typically between 1 and 10 per 100,000 population, with occasional ‘hyper endemic’ periods of persistent disease caused by particular strains [3]. A strip of land of SubSaharan Africa, extending from Senegal to Ethiopia is referred as the “African Meningitis Belt”, represents 430 million people at risk in 26 African countries, with recurring epidemics causing 20,000 to 200,000 cases and 2,000 to 20,000 deaths annually [4]. As transmission of these diseases occurs mainly by respiratory tract, including from asymptomatic individuals carriers, mucosal immunization mechanisms must be constantly evaluated.
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