[Cellular and acellular anti-pertussis vaccines]

Since 1940, vaccination with whole cell vaccines, composed of Bordetella pertussis extracts, has dramatically reduced the incidence of whooping cough. However, the occurrence of side effects has stimulated research that has resulted in the design of new, acellular vaccines. These vaccines are composed of adhesins, such as filamentous haemagglutinin and pertactin, and detoxified pertussis toxin. Detoxification can be achieved by genetic engineering resulting in alterations of specific amino acid residues that are involved in the enzymatic activity or in the target-cell receptor binding activity of the toxin. Assessment on laboratory animals and in clinical trials have indicated that these acellular vaccines are almost as protective as the whole cell vaccines, and that they are much less reactogenic. However, these vaccines are more expensive and still need multiple injections to achieve optimal protection. An interesting alternative would be the construction of attenuated strains able to protect after a single intranasal administration. In addition, the construction of recombinant attenuated strains would perhaps simultaneously protect against whooping cough and other infectious or parasitic diseases.