Principles Learned from the International Race to Develop a Safe and Effective COVID-19 Vaccine.,ACS Central Science

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Principles Learned from the International Race to Develop a Safe and Effective COVID-19 Vaccine.
ACS Central Science ( IF 12.7 ) Pub Date : 2020-07-21 , DOI: 10.1021/acscentsci.0c00644
Ariel H Thames _{1,

2,

3} , Kristy L Wolniak ₄ , Samuel I Stupp _{5,

6,

7,

8,

9} , Michael C Jewett _{1,

2,

3,

5,

10}

Affiliation

Medical Scientist Training Program, Northwestern University Feinberg School of Medicine, Chicago, Illinois 60611, United States.
Center for Synthetic Biology, Northwestern University, 2145 Sheridan Road, Tech B486, Evanston, Illinois 60208, United States.
Interdisciplinary Biological Sciences Program, Northwestern University, Evanston, Illinois 60208, United States.
Division of Hematopathology, Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, Illinois 60611, United States.
Simpson Querrey Institute, Northwestern University, Chicago, Illinois 60611, United States.
Department of Biomedical Engineering, Northwestern University, Evanston, Illinois 60208, United States.
Department of Chemistry, Northwestern University, Evanston, Illinois 60208, United States.
Department of Materials Science and Engineering, Northwestern University, Evanston, Illinois 60208, United States.
Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois 60611, United States.
Department of Chemical and Biological Engineering, Northwestern University, 2145 Sheridan Road, Evanston, Illinois 60208, United States.

Vaccines against COVID-19 have the potential to protect people before they are exposed to the infective form of the virus. However, because of the involvement of pathogenic immune processes in many severe presentations of COVID-19, eliciting an immune response with a vaccine must strike a delicate balance to achieve viral clearance without also inducing immune-mediated harm. This Outlook synthesizes current laboratory findings to define which parts of the immune system help with recovery from and protection against the virus and which can lead to adverse outcomes. To inform our understanding, we analyze research about the immune mechanisms implicated in SARS-CoV, from the 2003 outbreak, and SARS-CoV-2, the virus causing COVID-19. The impact of how innate immunity, humoral immunity, and cell-mediated immunity play a role in a harmful versus helpful response is discussed, establishing principles to guide the development and evaluation of a safe but effective COVID-19 vaccine. The principles derived include (i) targeting the appropriate specificity and effector function of the humoral response, (ii) eliciting a T cell response, especially a cytotoxic T cell response, to achieve safe, yet effective, immune protection from COVID-19, and (iii) monitoring for the possibility of acute lung injury during SARS-CoV-2 infection post-vaccination in preclinical and clinical studies. These principles can not only guide efforts toward a safe and effective COVID-19 vaccine, but also the development of effective vaccines for viral pandemics to come.

中文翻译：

从开发安全有效的 COVID-19 疫苗国际竞赛中学到的原则。

针对 COVID-19 的疫苗有可能在人们接触病毒传染性之前提供保护。然而，由于 COVID-19 的许多严重表现都涉及致病性免疫过程，因此用疫苗引发免疫反应必须达到微妙的平衡，以实现病毒清除，同时又不引起免疫介导的伤害。本展望综合了当前的实验室研究结果，以确定免疫系统的哪些部分有助于恢复和抵御病毒，哪些部分可能导致不良后果。为了加深我们的理解，我们分析了 2003 年爆发的 SARS-CoV 和引起 COVID-19 的病毒 SARS-CoV-2 所涉及的免疫机制的研究。讨论了先天免疫、体液免疫和细胞介导的免疫如何在有害反应和有益反应中发挥作用的影响，建立了指导安全但有效的 COVID-19 疫苗开发和评估的原则。得出的原则包括 (i) 针对体液反应的适当特异性和效应器功能，(ii) 引发 T 细胞反应，特别是细胞毒性 T 细胞反应，以实现安全而有效的针对 COVID-19 的免疫保护，以及(iii) 在临床前和临床研究中监测疫苗接种后 SARS-CoV-2 感染期间发生急性肺损伤的可能性。这些原则不仅可以指导开发安全有效的 COVID-19 疫苗，还可以指导开发针对即将到来的病毒大流行的有效疫苗。

更新日期：2020-08-26

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