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Chapter 24 : New Pneumococcal Vaccines: Basic Science Developments

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Abstract:

The first experimental vaccines, comprising killed whole cells, were tested in the early 1900s, albeit with inconclusive results. Polyvalent capsular polysaccharide (PS)-protein conjugates vaccines are aimed at preventing invasive diseases such as pneumonia, meningitis, and bacteremia, as well as less serious but highly prevalent infections such as otitis media. They are being targeted principally at specific groups at high risk of pneumococcal disease, particularly children under 2 years and adults over 65 years of age. The increasing prevalence of penicillin-resistant and multiply resistant pneumococci is complicating management of patients with suspected pneumococcal disease, particularly those with meningitis. Polyvalent PS-protein conjugate vaccines are very expensive to produce, and addition of further PS types or periodic reformulation to take account of altered serotype prevalence will add further to this cost. This may place the vaccine even further out of the reach of many developing countries, whose need for effective pneumococcal vaccines is greatest. Studies on the vaccine potential of pneumococcal surface protein A (PspA) have extended to human trials, and immune sera from volunteers immunized with a family 1 PspA fragment reacted with 37 different strains belonging to diverse capsular and PspA types. A further strategy under consideration for prevention of pneumococcal disease is the use of DNA vaccines. The ongoing high global morbidity and mortality associated with pneumococcal disease, and the complications caused by increasing rates of resistance to antimicrobials, have underpinned extensive efforts in recent years to develop more effective vaccination strategies against .

Citation: Paton J. 2004. New Pneumococcal Vaccines: Basic Science Developments, p 382-402. In Tuomanen E, Mitchell T, Morrison D, Spratt B (ed), The Pneumococcus. ASM Press, Washington, DC. doi: 10.1128/9781555816537.ch24
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FIGURE 1

Protection against pulmonary infection with elicited by immunization with PspA, PdB (genetically toxoided pneumolysin), PsaA, or combinations thereof. CBA/N mice were immunized with the indicated proteins on alum or with alum alone, challenged with 10 CFU of strain EF3030 (capsular group 19), and sacrificed 7 days later to determine numbers of CFU in their lungs. Significance of difference relative to control mice (alum only): ?, < 0.04; ??, < 0.001. (Reproduced with permission from the Journal of Infectious Diseases [ ].)

Citation: Paton J. 2004. New Pneumococcal Vaccines: Basic Science Developments, p 382-402. In Tuomanen E, Mitchell T, Morrison D, Spratt B (ed), The Pneumococcus. ASM Press, Washington, DC. doi: 10.1128/9781555816537.ch24
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