Vaccination against Group B streptococcus

被引:49
作者
Heath, PT [1 ]
Feldman, RG
机构
[1] Gen Hosp St Georg, Sch Med, Dept Child Hlth, London, England
[2] Gen Hosp St Georg, Sch Med, Vaccine Inst, London, England
[3] Univ London Imperial Coll Sci Technol & Med, Dept Paediat, London, England
关键词
conjugate vaccine; Group B streptococcus; mucosal vaccine; protein vaccine; Streptococcus agalactiae; vaccine;
D O I
10.1586/14760584.4.2.207
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Streptococcus agalactiae (Group B streptococcus) is an important cause of disease in infants, pregnant women, the elderly and in immunosuppressed adults. An effective vaccine is likely to prevent the majority of infant disease (both early and late onset), as well as Group B streptococcus-related stillbirths and prematurity, to avoid the current real and theoretical limitations of intrapartum antibiotic prophylaxis, and to be cost effective. The optimal time to administer such a vaccine would be in the third trimester of pregnancy. The main limitations on the production of a Group 8 streptococcus vaccine are not technical or scientific, but regulatory and legal. A number of candidates including capsular conjugate vaccines using traditional carrier proteins such as tetanus toxoid and mutant diphtheria toxin CRM 197, as well as Group B streptococcus-specific proteins such as C5a peptidase, protein vaccines using one or more Group B streptococcus surface proteins and mucosal vaccines, have the potential to be successful vaccines. The capsular conjugate vaccines using tetanus and CRM 197 carrier proteins are the most advanced candidates, having already completed Phase 11 human studies including use in the target population of pregnant women (tetanus toxoid conjugate), however, no definitive protein conjugates have yet been trialed. However, unless the regulatory environment is changed specifically to allow the development of a Group B streptococcus vaccine, it is unlikely that one will ever reach the market.
引用
收藏
页码:207 / 218
页数:12
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