Summary
The present situation and the future prospects for the use of oral vaccines against the major enteric diseases typhoid fever, shigellosis and cholera are discussed in this paper. No significant protection could be demonstrated for oral inactivated whole-cell vaccines. In contrast, an oral live vaccine based on the attenuatedSalmonella typhi strain Ty 21a was highly efficacious in volunteer challenge studies and in a controlled field trial. Two attenuated strains are presently being tested in volunteer studies as candidate vaccines against shigellosis; one usesS. typhi Ty 21a and the otherEscherichia coli K-12 as the carrier for shigella antigens. Experimental challenge studies in volunteers showed that recovery from clinical cholera confers solid and long-lasting protection. The goal of present research is to develop a vaccine that mimics the events of clinical cholera without causing disease.
Zusammenfassung
Es werden die gegenwärtigen Möglichkeiten und Aussichten für die Verwendung oraler Impfstoffe gegen die wichtigsten enteralen Bakterieninfektionen Typhus, Dysenterie und Cholera besprochen. Orale Impfstoffe gegen Typhus, bestehend aus inaktivierten Bakterien, sind unwirksam. Demgegenüber erwies sich ein oraler Lebendimpfstoff, basierend auf dem attenuiertenSalmonella typhi Stamm Ty 21a, in klinischen Belastungsversuchen und in Feldversuchen als sehr wirksam. Gegenwärtig werden in Freiwilligen zwei attenuierte Stämme als mögliche Kandidaten für einen Lebendimpfstoff gegen Shigellose getestet; der eine benütztS. typhi Ty 21a und der andereEscherichia coli K-12 als Träger für Shigella Schutzantigene. Belastungsversuche in Freiwilligen haben gezeigt, daß eine überstandene Cholera-Erkrnkung einen guten und langdauernden Schutz hinterläßt. Das Ziel gegenwärtiger Forschung ist, einen Impfstoff zu entwickeln, der möglichst nahe die Ereignisse einer Cholera-Infektion nachahmt, jedoch ohne deren Symptome auszulösen.
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Germanier, R. Oral vaccination against enteric bacterial infections: An overview. Infection 13 (Suppl 2), S206–S210 (1985). https://doi.org/10.1007/BF01644432
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DOI: https://doi.org/10.1007/BF01644432