ABSTRACT

Introduction

Leishmaniasis is a major public health problem and the second most lethal parasitic disease in the world due to the lack of effective treatments and vaccines. Even when not lethal, leishmaniasis significantly affects individuals and communities through life-long disabilities, psycho-sociological trauma, poverty, and gender disparity in treatment.

Areas covered

This review discusses the most relevant and recent research available on Pubmed and GoogleScholar highlighting leishmaniasis’ global impact, pathogenesis, treatment options, and lack of effective control strategies. An effective vaccine is necessary to prevent morbidity and mortality, lower health care costs, and reduce the economic burden of leishmaniasis for endemic low- and middle-income countries. Since there are several forms of leishmaniasis, a pan-Leishmania vaccine without geographical restrictions is needed. This review also focuses on recent advances and common challenges in developing prophylactic strategies against leishmaniasis.

Expert opinion

Despite advances in pre-clinical vaccine research, approval of a human leishmaniasis vaccine still faces major challenges – including manufacturing of candidate vaccines under Good Manufacturing Practices, developing well-designed clinical trials suitable in endemic countries, and defined correlates of protection. In addition, there is a need to explore Challenge Human Infection Model to avoid large trials because of fluctuating incidence and prevalence of leishmanasis.

中文翻译：

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从感染到疫苗接种：回顾全球负担、疫苗开发历史和全球利什曼病保护中反复出现的挑战

摘要

介绍

由于缺乏有效的治疗方法和疫苗，利什曼病是一个主要的公共卫生问题，也是世界上第二大致命的寄生虫病。即使不是致命的，利什曼病也会通过终身残疾、心理社会创伤、贫困和治疗中的性别差异显着影响个人和社区。

涵盖的领域

这篇综述讨论了 Pubmed 和 GoogleScholar 上最相关和最近的研究，强调了利什曼病的全球影响、发病机制、治疗选择以及缺乏有效的控制策略。有效的疫苗对于预防发病率和死亡率、降低医疗保健成本和减轻利什曼病流行的低收入和中等收入国家的经济负担是必要的。由于利什曼病有多种形式，因此需要一种不受地域限制的泛利什曼病疫苗。本综述还重点介绍了制定针对利什曼病的预防策略的最新进展和共同挑战。

专家意见

尽管临床前疫苗研究取得了进展，但人类利什曼病疫苗的批准仍面临重大挑战——包括根据良好生产规范生产候选疫苗、开发适合流行国家的精心设计的临床试验以及确定的保护相关性。此外，有必要探索挑战人类感染模型以避免由于利什曼病的发病率和流行率波动而进行的大型试验。