PDF(Pubmed)
Abstract：
Development of a vaccine against gonorrhoea is a global priority, driven by the rise in antibiotic resistance. Although Neisseria gonorrhoeae (Ng) infection does not induce substantial protective immunity, highly exposed individuals may develop immunity against re-infection with the same strain. Retrospective epidemiological studies have shown that vaccines containing Neisseria meningitidis (Nm) outer membrane vesicles (OMVs) provide a degree of cross-protection against Ng infection. We conducted a clinical trial (NCT04297436) of 4CMenB (Bexsero, GSK), a licensed Nm vaccine containing OMVs and recombinant antigens, comprising a single arm, open label study of two doses with 50 adults in coastal Kenya who have high exposure to Ng. Data from a Ng antigen microarray established that serum IgG and IgA reactivities against the gonococcal homologs of the recombinant antigens in the vaccine peaked at 10 but had declined by 24 weeks. For most reactive OMV-derived antigens, the reverse was the case. A cohort of similar individuals with laboratory-confirmed gonococcal infection were compared before, during, and after infection: their reactivities were weaker and differed from the vaccinated cohort. We conclude that the cross-protection of the 4CMenB vaccine against gonorrhoea could be explained by cross-reaction against a diverse selection of antigens derived from the OMV component.
摘要：
开发针对淋病的疫苗是全球优先事项，在抗生素耐药性上升的推动下。尽管淋病奈瑟菌（Ng）感染并不诱导实质性的保护性免疫，高度暴露的个体可能会对相同菌株的再次感染产生免疫力。回顾性流行病学研究表明，含有脑膜炎奈瑟氏球菌（Nm）外膜囊泡（OMV）的疫苗可提供一定程度的抗Ng感染的交叉保护。我们进行了4CMenB（Bexsero，GSK),含有OMV和重组抗原的许可的Nm疫苗，包括一只手臂，在肯尼亚沿海地区，对50名成年人进行了两次剂量的开放标签研究，这些成年人高度暴露于Ng。来自Ng抗原微阵列的数据确定，针对疫苗中重组抗原的淋球菌同源物的血清IgG和IgA反应性在10达到峰值，但下降了24周。对于大多数反应性OMV衍生抗原，情况正好相反。之前比较了一组经实验室证实的淋球菌感染的类似个体，during,和感染后：他们的反应性较弱，与接种疫苗的队列不同。我们得出的结论是，4CMenB疫苗对淋病的交叉保护作用可以通过对源自OMV成分的多种抗原的交叉反应来解释。
