New Pertussis Vaccines: A Need and a Challenge

HOZBOR, DANIELA

ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY.

SPRINGER-VERLAG BERLIN

Año: 2019

0065-2598

Effective diphtheria, tetanus toxoids, wholecellpertussis (wP) vaccines were used formassive immunization in the 1950s. Thebroad use of these vaccines significantlyreduced the morbidity and mortality associatedwith pertussis. Because of reports on theinduction of adverse reactions, lessreactogenicacellular vaccines (aP) were laterdeveloped and in many countries, especiallythe industrialized ones, the use of wP waschanged to aP. For many years, the situationof pertussis seemed to be controlled with theuse of these vaccines, however in the lastdecades the number of pertussis casesincreased in several countries. The loss of theimmunity conferred by the vaccines, which isfaster in the individuals vaccinated with theacellular vaccines, and the evolution of thepathogen towards geno/phenotypes thatescape more easily the immunity conferredby the vaccines were proposed as the maincauses of the disease resurgence. Accordingto their composition of few immunogens, theaP vaccines seem to be exerting a greaterselection pressure on the circulating bacterialpopulation causing the prevalence of bacterialisolates defective in the expression of vaccineantigens. Under this context, it is clear thatnew vaccines against pertussis should bedeveloped. Several vaccine candidates are inpreclinical development and few others haverecently completed phaseI/phaseII trials. Vaccinecandidate based on OMVs is a promisingcandidate since appeared overcoming themajor weaknesses of current aP-vaccines.The most advanced development is the liveattenuated-vaccine BPZE1 which has successfullycompleted a first-in-man clinical trial.