ABSTRACT

Introduction: Dengue virus is a global health threat, with approximately 390 million dengue infections annually. Efficient vaccines for dengue prevention are currently lacking. This review aims to summarize the current progress in dengue vaccine development.

Area covered: This article discusses recent dengue vaccine developments based on the published literature and ClinicalTrials.gov website up to December 2020.

Expert opinion: The first live-attenuated chimeric yellow-fever/tetravalent dengue vaccine (CYD-TDV), Dengvaxia, has been licensed in several countries. However, the low efficacy of this vaccine was observed in children and dengue-naïve individuals. It also increased the risk of severe dengue in people who had not been exposed to dengue. The heterologous prime-boost regimen of sequential immunization with DENVax and Dengvaxia covers four serotypes of immunogenicity, eliminating the effect of ADE. Moreover, a heterologous prime-boost regimen that combines inactivated vaccines with alum and live attenuated vaccines might increase the immunogenic response. The lack of an ideal animal model is an obstacle to the development of dengue vaccines, and the macaque model may be considered for similar immunologic responses in humans.

摘要

简介：登革热病毒是一种全球性的健康威胁，每年约有 3.9 亿登革热感染。目前缺乏预防登革热的有效疫苗。本综述旨在总结登革热疫苗开发的当前进展。

涵盖范围：本文根据截至 2020 年 12 月的已发表文献和 ClinicalTrials.gov 网站讨论了近期登革热疫苗的发展。

专家意见：第一个减毒嵌合黄热病/四价登革热疫苗（CYD-TDV）登革夏已在多个国家获得许可。然而，在儿童和未感染登革热的个体中观察到这种疫苗的低效力。它还增加了未接触过登革热的人患严重登革热的风险。DENVax 和 Dengvaxia 序贯免疫的异源初免加强方案涵盖了四种免疫原性血清型，消除了 ADE 的影响。此外，将灭活疫苗与明矾和减毒活疫苗相结合的异源初免加强方案可能会增加免疫原性反应。缺乏理想的动物模型是开发登革热疫苗的障碍，猕猴模型可以考虑用于人类的类似免疫反应。