epidemiologyЭпидемиология и ВакцинопрофилактикаEpidemiology and Vaccinal Prevention2073-30462619-0494«Numicom» LLC10.31631/2073-3046-2018-17-3-4-18epidemiology-514Research ArticleПРОБЛЕМНАЯ СТАТЬЯPROBLEM-SOLVING ARTICLEВакцины против полиомиелита: настоящее и будущееPolio Vaccines: Present and FutureЧумаковК. М.ChumakovK.

доктор наук, сотрудник

PDh

chumakov@cber.fda.govИшмухаметовА. А.IshmukhametovA. A.

чл.-корр. РАН, д. м. н., профессор Москва. генеральный директор ФГУП «Федеральный научный центр исследований и  разработки иммунологических препаратов им.  М.  П  Чумакова РАН» (2013 г.), заведующий кафедрой организации и  технологии производства иммунобиологических препаратов Института фармации и трансляционной медицины Сеченовского университета.

ID L-4482-2018

corresponding member of  the Russian Academy of Sciences, Dr. Sci. (Med.), professor, Director of the Bacterial and Viral Agents Enterprise of the M.P. Chumakov Institute of Poliomyelitis and Viral Encephalitis. Moscow

ID L-4482-2018

ishmukhametov@chumakovs.suЦентра по оценке и исследованию биологических продуктов, FDA, Silver SpringСоединённые Штаты АмерикиOffice of Vaccines Research and Review, Center for Biologics Evaluation and Research, FDA,United StatesФГБНУ «Федеральный научный центр исследований и разработки иммунобиологических препаратов им. М. П. Чумакова» РАН, Москва; ФГАОУ ВО Первый Московский государственный медицинский университет им. И. М. Сеченова МЗ РоссииРоссияFederal State Budget Institution of Science «Chumakov Federal Scientific Center for Research and Development of Immune-andBiological Products» of Russian Academy of Sciences, Moscow; Sechenov First Moscow State Medical University, of the Ministry of Health of the Russian FederationRussian Federation201820062018173418Copyright © Чумаков К.М., Ишмухаметов А.А., 20182018Чумаков К.М., Ишмухаметов А.А.Chumakov K., Ishmukhametov A.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/514

В статье представлена история разработки и применения вакцин против полиомиелита, которая представляет собой пример эволюции вакцин под воздействием меняющейся эпидемиологической обстановки и социально-экономических факторов. Создание двух вакцин против полиомиелита – инактивированной вакцины Солка (ИПВ) и живой оральной вакцины Сейбина (ОПВ), каждая со своими преимуществами и недостатками, – числится в списке наиболее значимых достижений профилактической медицины прошлого века. За последние 50 лет они применялись в различных условиях, по разным схемам и в различных комбинациях. Это позволило добиться полной ликвидации полиомиелита почти во всех странах мира. Продолжение инициативы по ликвидации, возглавляемой ВОЗ, может в скором времени привести к полному прекращению циркуляции диких штаммов вируса. В таком случае полиовирус – как и вирус натуральной оспы – останется лишь в лабораториях. Однако остановить вакцинацию после прекращения циркуляции патогена, как было в случае с уничтожением вируса оспы, не представляется возможным. Вакцины против полиомиелита не потеряют своей актуальности в ближайшем будущем ввиду наличия выраженных различий в свойствах и эпидемиологических характеристиках этих двух вирусов. В статье приведены доводы в пользу необходимости поддержания высокого коллективного иммунитета против полиовирусов и разработки нового поколения вакцин. Кроме того, рассмотрены желаемые характеристики и новые технологии производства вакцин, которые могут найти применение в условиях полной ликвидации вируса.

 

The history of polio vaccines and their use illustrates the concept of evolution of vaccines driven by changing epidemiological and socioeconomic conditions. The development of two vaccines against poliomyelitis – inactivated Salk vaccine (IPV) and live oral Sabin vaccine (OPV) – is among the most consequential achievements of prophylactic medicine of the past century. Each with their own strengths and weaknesses, they were used over the past 50 years in different settings and different regimens and combinations. This resulted in virtual elimination of the disease in almost the entire world with the exception of a few countries. Continuation of the eradication campaign coordinated by WHO may soon result in complete cessation of wild poliovirus transmission, and poliovirus may join smallpox virus in the club of extinct pathogens. However, unlike smallpox vaccination that was stopped after the interruption of virus circulation, vaccination against poliomyelitis will have to continue into the foreseeable future, due to significant differences in the nature and epidemiology of the viruses. This review provides the reasons for the need to maintain high population immunity against polioviruses, makes the case for developing a new generation of polio vaccines, and discusses their desirable properties as well as new vaccine technologies that could be used to create polio vaccines for the post-eradication environment.

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