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全球Streptococcus pyogenes菌株多样性,疾病关联以及对疫苗开发的影响:系统性审查

Pierre R Smeesters¹, Gabrielle de Crombrugghe², Shu Ki Tsoi³

¹Department of Paediatrics, Brussels University Hospital, Academic Children Hospital Queen Fabiola, Université libre de Bruxelles, Brussels, Belgium; Molecular Bacteriology Laboratory, European Plotkin Institute for Vaccinology, Université Libre de Bruxelles, Brussels, Belgium; Tropical Diseases Research Group, Murdoch Children's Research Institute, Melbourne, VIC, Australia; Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia.

The Lancet. Microbe

|December 9, 2023

概括

在Streptococcus pyogenes中高菌株多样性阻碍了疫苗开发. 较低的人类发展指数 (HDI) 与更大的多样性相关,这表明社会因素影响疾病和疫苗目标.

科学领域:

微生物学微生物学
流行病学流行病学
疫苗学疫苗学疫苗学

背景情况:

菌 pyogenes (S. pyogenes) 呈现出显著的菌株多样性,使疫苗设计复杂化.
由于病原体的全球流行和多样化的遗传构成,开发一种通用疫苗具有挑战性.

研究的目的:

系统地审查全球S. pyogenes emm型分布.
通过分析菌株多样性及其与社会经济因素的相关性来确定潜在的疫苗点.

主要方法:

进行了PubMed,MEDLINE和Embase数据库 (1990-2023) 的系统审查.
分析了来自55个国家的212个数据集,包括74,468个S. pyogenes分离物和211个emm类型.
采用人口加权分析来考虑研究偏差,并确定关键的疫苗目标.

主要成果:

在S. pyogenes菌株多样性和人类发展指数 (HDI; r=-0.72, p<0.0001) 之间发现了显著的逆相关性.
较低的HDI与增加的菌株多样性有关,这表明社会决定因素对S. pyogenes感染的影响.
确定了15个关键的代表性分离物体作为潜在的疫苗点.
观察到感染部位 (侵入性,皮肤,喉) 和特定的链球菌血统之间的强烈关联.

结论:

疫苗开发必须解决多维的病原体多样性,包括社会和环境环境,而不仅仅是地理分布.
全球疫苗战略需要了解社会经济因素与病原体演变之间的相互作用.

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