制定优化免疫和保护儿科移植接受者的策略
Dana Danino1,2, Monica I Ardura3,4
1Pediatric Infectious Diseases, Director Pediatric Department A, Saban Children's Hospital, Soroka University Medical Center, Beer-Sheva.
Current opinion in infectious diseases
|July 23, 2025
概括
在实体器官或造血细胞移植后接种免疫功能低下儿童的疫苗至关重要,但往往不理想. 新疫苗显示出希望,但需要更多的研究来改善对疫苗可预防疾病的保护.
科学领域:
- 儿科移植和免疫学
- 疫苗学和传染病预防
背景情况:
- 儿科固体器官 (SOT) 和血液细胞移植 (HCT) 种群正在增加,由于免疫抑制,感染风险增加.
- 免疫接种对于预防这些脆弱儿童的疫苗可预防疾病 (VPD) 至关重要,但疫苗接种率仍然低于最佳水平.
研究的目的:
- 审查有关SOT和HCT接种者的疫苗和免疫策略的新兴儿科数据.
- 突出疫苗配方的进步,更新的指导和优化疫苗介导保护的发展策略.
- 为了确定在儿科移植免疫中持续存在的知识差距.
主要方法:
- 对近期儿科数据和关于移植受体免疫接种的已发表建议进行全面审查.
- 对新兴疫苗配方的分析,包括重组,结合和活减弱疫苗.
- 评估当前的免疫策略及其在小儿SOT和HCT群体中的有效性.
主要成果:
- 尽管有建议,儿童移植候选人和接受者经常没有接种足够的疫苗,增加了他们患VPD的风险.
- 新的疫苗 (例如,复合性乙型肝炎,高价值肺炎球菌,脑膜炎球菌B) 显示出潜力,但需要在这个人群中进行更多的研究.
- 证据表明,在精选的SOT接种者中使用活体减弱疫苗 (MMR,水) 的安全性和免疫性,在HCT接种者中使用高剂量流感疫苗.
结论:
- 免疫技术的进步为儿童移植接受者加强对VPD的保护提供了机会,改善了结果.
- 在移植前和移植后优先进行疫苗接种是关键.
- 未来的研究必须包括儿科移植接受者在临床试验中,以更好地了解疫苗的安全性,疗效和有效性.
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