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Strategies for exploiting the immune system in the design of vaccines
1Department of Immunology and Infectious Diseases, Johns Hopkins School of Hygiene and Public Health, Baltimore, MD 21205.
There are three types of vaccines in medical use today--live, attenuated agents, mainly viruses; inactivated whole organisms; and subunit preparations. Though there are examples in each category of successful preparations, live attenuated viruses have almost invariably given long-lasting immunity after one or two administrations. Contributing reasons for this are gleaned, not from human vaccine studies, but from model systems and it is concluded that a vaccine needs to achieve four goals: activation of antigen-presenting cells; overcoming genetic variability in T cell responses; generation of high levels of T and B memory cells; and persistence of antigen for recruitment of B memory cells. Of the newer approaches to vaccine development, synthetic peptides have substantial limitations but should be successful in some cases. Subunit preparations may also be limited as a general method. Some live viral or bacterial vaccines, used as vectors of nucleic acid coding for other antigens, hold considerable promise as is illustrated by recent examples.
There are three types of vaccines in medical use today--live, attenuated agents, mainly viruses; inactivated whole organisms; and subunit preparations. Though there are examples in each category of successful preparations, live attenuated viruses have almost invariably given long-lasting immunity after one or two administrations. Contributing reasons for this are gleaned, not from human vaccine studies, but from model systems and it is concluded that a vaccine needs to achieve four goals: activation of antigen-presenting cells; overcoming genetic variability in T cell responses; generation of high levels of T and B memory cells; and persistence of antigen for recruitment of B memory cells. Of the newer approaches to vaccine development, synthetic peptides have substantial limitations but should be successful in some cases. Subunit preparations may also be limited as a general method. Some live viral or bacterial vaccines, used as vectors of nucleic acid coding for other antigens, hold considerable promise as is illustrated by recent examples.