epidemiologyЭпидемиология и ВакцинопрофилактикаEpidemiology and Vaccinal Prevention2073-30462619-0494«Numicom» LLC10.31631/2073-3046-2021-20-4-103-113epidemiology-1324Research ArticleОБЗОРREVIEWМенингококковые вакцины новых поколений – первые 20 лет примененияMeningococcal Vaccines of New Generations – the First 20 Years of UseКостюковаН. Н.KostyukovaN. N.

Костюкова Наталья Николаевна, д. м. н., профессор, ведущий научный сотрудник

Москва

+7 (499)193-61-51, +7 (499) 249-69-24

Кostyukova Natalya, Dr. Sci. (Med.), Professor, Leading Researcher

Moscow

+7 (499) 193-61-51, +7 (499) 249-69-24

nathakos@mail.ruБехалоВ. А.BekhaloV. A.

Владимир Андреевич Бехало – к. б. н., ведущий научный сотрудник

Москва

+7(916)935 41 42

Vladimir A. Behalo – Cand. Sci. (Biol.), Leading Researcher

Moscow

+ 7(916)935 41 42

bekhalo@gamaleya.orgФГБУ «НИЦ эпидемиологии и микробиологии им. Н. Ф. Гамалеи» Минздрава РоссииРоссияThe National Research Center for Epidemiology and Microbiology named after Honorary Academician N. F. GamaleyaRussian Federation202104092021204103113Copyright © Костюкова Н.Н., Бехало В.А., 20212021Костюкова Н.Н., Бехало В.А.Kostyukova N.N., Bekhalo V.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.epidemvac.ru/jour/article/view/1324Актуальность

Актуальность. Менингококковой инфекции (МИ) присущ аэрозольный (воздушно-капельный) механизм передачи, поэтому наиболее рациональным и надежным противоэпидемическим мероприятием является создание невосприимчивости к ней у населения путем массовой иммунопрофилактики.

Цель обзора

Цель обзора. Представить анализ данных литературы об эффективности менингококковых вакцин новых поколений – конъюгированных полисахаридных серогрупп A, C, W и Y и белковых серогруппы В.

Выводы

Выводы. В отношении конъюгированных вакцин имеется большое количество достоверных наблюдений, подтверждающих высокую иммунологическую и эпидемиологическую эффективность этих препаратов, в том числе в предотвращении бактерионосительства и в формировании коллективного иммунитета. Они мало реактогенны, во многих странах введены в национальные программы иммунизации и применяются как обязательные (Великобритания) или по эпидемиологическим показаниям. «Пузырьковая» вакцина, состоящая из белков наружной мембраны менингококка серогруппы В, показала высокую эффективность только в тех случаях, когда белковый состав штамма, вызвавшего заболеваемость, соответствовал составу (преимущественно по субтиповому антигену PorA) вакцины. Вакцины, полученные генно-инженерным путем и содержащие только несколько белковых антигенов менингококка серогруппы В, с добавлением «пузырьков» или без них, пока трудно оценить из-за небольшого числа наблюдений, связанных с низким распространением этой серогруппы, однако Великобритания также ввела эту вакцину как обязательную для иммунизации младенцев. В то же время новые вакцины серогруппы В вызывают иммунную защиту против некоторых штаммов менингококка других серогрупп – C, W и Y и даже против других видов нейссерий, в частности – гонококка. Это обстоятельство вселяет надежду на создание белковых менингококковых вакцин более широкого спектра специфичности, чем групповой, и даже чем видовой.

Relevance

Relevance. Meningococcal vaccine refers to any of the vaccines used to prevent infection by Neisseria meningitidis. Therefore, there is a great scientific and practical interest in the existing and developed menicococcal vaccines.

Aims the review is to provide an analysis: literature data on the effectiveness of meningococcal vaccines of new generations - conjugated polysaccharide serogroups A, C, W and Y and protein serogroup B.

Conclusions

Conclusions. With regard to conjugated vaccines, there are a large number of reliable observations confirming the high immunological and epidemiological effectiveness of these vaccine preparations, including the prevention of bacterial carriage and the development of herd immunity. These vaccines are weakly reactogenic, and in many countries, they are introduced into national immunization programs and in some countries are used as mandatory (UK) or in connection with the existing epidemic indications. The protein «vesicle» vaccine based on serogroup B meningococcal outer membrane proteins, showed high efficacy only in those cases when the protein composition of the strain that caused the morbidity corresponded to the composition (mainly in terms of the PorA subtype antigen) of the vaccine. Genetic-engineered vaccines containing only a few serogroup B meningococcal protein antigens with or without the addition of «vesicle» proteins are difficult to evaluate due to the small number of observations associated with low serogroup В prevalence, but in Great Britain, such vaccine was also introduced as mandatory in the national immunization schedule for babies. At the same time, new vaccines of serogroup B induce immune protection against some strains of meningococcus of other serogroups C, W, and Y, and even against other species of Neisseria, in particular - gonococcus. This circumstance gives rise to hope for the development of protein meningococcal vaccines with a wider spectrum of specificity than the group, and even than the species.

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The authors declare that there are no conflicts of interest present.