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加一剂吸入疫苗加强也许更好!

已有 2081 次阅读 2022-12-16 20:37 |系统分类:科普集锦

目前大部分人打了二针或三针国产灭火疫苗,加一剂吸入疫苗混打也是不错的选择,道理何在?其实选择机会也许由不得自己,要看疫苗来源,有什么打什么!

1.疫苗的效果

流行病学证据表明,传播的主要驱动因素(年轻人)和毒性(对老年人造成的伤害程度)脱钩。这意味着那些传播最少的人的疾病严重程度更高。一般而言,在呼吸道病毒中,严重疾病与下唿吸道的入侵和复制有关。重要的是要区分病毒的内在毒力和具有不同程度免疫能力(以前的感染和疫苗接种)的人群中的有效毒力。目前 Omicron 的毒力在很大程度上反映了获得性免疫的保护作用,尽管一致认为 Omicron 也表现出降低的内在毒力(表),但疫苗的保护作用与其它变异株相比是大大降低的。

image.png

Cold Spring Harb Perspect Med2022 May 27;12(5):a041390. doi: 10.1101/cshperspect.a041390.


Clinical significance of variants of concern (VOCs)

VOC/variant being monitored (VBM)

Transmissibility

Disease    burden/virulence

Neutralization    by monoclonal antibodies

Vaccine    efficacy

Alpha

Increased 50%

Increased

Susceptible


Beta

Increased 25%

Increased

Susceptible

Reduced

Delta

Increased 100%

Increased

AY.1 and AY.2 lineages are not   susceptible to some clinically used monoclonal antibodies

Reduced

Epsilon


Unknown



Gamma

Increased 30%

Possibly increased

Not susceptible to some clinically   used monoclonal antibodies

Modest reduction

Kappa

Increased

Unknown

Susceptible

Reduced

Mu

Increased

Unknown

Susceptible

Reduced

Omicron

Increased >100%

Decreased for BA.1 and BA.2

Not susceptible to most, but not all   clinically used monoclonal antibodies

Greatly reduced

2. 有效疫苗的策略

 下图和表说明了 SARS-CoV-2感染的治疗策略。一种针对所有这些病毒株的有效疫苗将是防止这些有害病毒未来爆发的一个必要的里程碑.

image.png

J Virol Methods. 2022 Feb; 300: 114375.

image.png

Prophylactic approaches to treat SARS-CoV-2 and its potential targets.

Prophylactic approach

Potential target

References

Universal Vaccine

Viral analogue Spike and Accessory proteins

(Du et al., 2009Rockx et al., 2010)

ACE2 receptor blocking

Renin-angiotensin system (RAS),Type I Ang II receptor

(Glowacka et al., 2010Wu, 2020)

Monoclonal antibody

Spike proteins of virus

(Zhai et al., 2020)

Filibustering HR1 and HR2 receptor

S2 domain of Spike protein, HR1 and HR2 receptor

(Zhu et al., 2004;Xia et al., 2020a,2020b)

Use of Inhibitors

Various interactions sites of SARS-CoV-2

(Wang et al., 2020a2020b)

Antiviral drug therapies

RNA dependent polymerase (RdRp),Type II trans membrane   serine protease (TMPRSS2),Viral glycoproteins, Endoplasmic reticulum-Golgi   intermediate compartment (ERGIC)

(Savarino et al., 2003Sheahan et al., 2017Hoffmann et al., 2020),(Hu et al., 2020)

Blocking viral endocytic pathway

Protein kinases 1 (AAK1),cyclin G-associated kinase

(Richardson et al., 2020)

Anti-parasitic agents

Reticence of IMPα1/ β1 mediated nuclear import of viral   proteins

(Caly et al., 2020)

Targeted immunotherapy

Dendritic cells, B, T cells, release of cytokines and   chemokines

(Li et al., 2020a2020b)

Mesenchymal Stem Cells

Amplified number of peripheral lymphocytes, the decline   in the C-reactive protein, and waning of over-activated cytokine-secreting   immune cells (CXCR3+CD4+ T cells, CXCR3+CD8+ T cells, and CXCR3 + NK cells)   and CD14+CD11c + CD11bmid regulatory dendritic cell (DC)

(Leng et al., 2020Liang et al., 2020)

CRISPR-CAS based study

Application of Cas13a based assay to inhibit   replication of SARS-related coronaviruses

(Abbott et al., 2020)

3.疫苗的种类与用法

混打疫苗的道理所在

image.png

J Med Virol. 2022 Oct 6 : 10.1002/jmv.28172.

WHO Emergency Use Listing and Prequalification (EUL/PQ)‐approved vaccines and their antigens

Vaccine

Manufacturer

Antigen

Type of vaccine

Reference

CoronaVac/PiCoVacc

Sinovac, National Institute for Communicable Disease   Control and Prevention, China

Whole virus (CN2 strain)

Inactivated virus

[160]

BBIBP‐CorV

Beijing Institute of Biological Products, Sinopharm and   Institute of Viral Disease Control and Prevention, China

Whole virus (HB02 strain)

Inactivated virus

[161]

Covaxin/BBV152

Bharat Biotech and Indian Council of Medical Research

Whole virus (NIV‐2020‐770)

Inactivated virus

[90]

BNT16B2

BioNTech, Fosun Pharma, and Pfizer, Germany

S‐2P

LNP‐mRNA

[162]

mRNA‐1273

Moderna, National Institute of Allergy and Infectious   Diseases, USA

S‐2P

LNP‐mRNA

[163164]

ChAdOx1 nCoV‐19/AZD1222

The University of Oxford, and AstraZeneca, UK

Full‐length S

Nonreplicating viral vector

[165166]

Convidecia™ Ad5‐ CoV

CanSino Biological Inc. and Beijing Institute of   Biotechnology, China

Full‐length S

Nonreplicating viral vector

[167168]

Ad26. COV2‐S

Johnson & Johnson, USA

S‐2P

Nonreplicating viral vector

[169170]

NVX‐CoV2373

Novavax, USA

S‐2P

Protein‐ased

[171]






image.png

六种目前使用的预防冠状病毒疾病 -19大流行的疫苗

image.png

吸入法与肌肉注射法免疫反应的对应差异。肌肉免疫诱导抗原指导的先天性和适应性反应,激活 T 细胞和 B 细胞反应。产生、分化和成熟 IgG + 浆细胞以产生抗抗原中和抗体。除了这些免疫反应,吸入免疫还能诱导组织驻留 T 细胞和 IgA + B 细胞产生循环粘膜 IgA 抗体。



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