Vaccine Immunology

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Introduction
To generate vaccine-mediated protection is a complex challenge. Currently available vaccines have largely been developed empirically, with little or no understanding on how they activate the immune system. Their early protective effi cacy is primarily conferred by the induction of antigen-specifi c antibodies (Box 2–1). However, there is more to antibody-mediated pro-tection than the peak of vaccine-induced antibody titers. The quality of such antibody responses, e.g., their avidity, has been identifi ed as a determining factor of effi cacy. In addition, long-term protection requires the persistence of vaccine antibodies and/or the generation of immune memory cells capable of rapid and effective reactivation upon subsequent microbial exposure. The determinants of immune memory induction, as well as the relative contribution of persisting antibodies and of immune memory to protection against specifi c diseases, are thus essential parameters of long-term vaccine efficacy.
The predominant role of B cells in the effi cacy of current vaccines should not shadow the importance of T cell responses: T cells are essential to the induction of high-affi nity antibodies and immune memory, and novel vaccine targets have been identifi ed against which T cells are likely to be the prime effectors. New methods have emerged allowing us to assess a growing number of vaccine-associated immune parameters, including in humans. This development raises new questions relative to the optimal markers to assess and their correlation with vaccineinduced protection. The identifi cation of immune correlates— or at least surrogates—of vaccine effi cacy is a major asset for the development of new vaccines or the optimization of immunization strategies using available vaccines. Thus, their determination generates a considerable amount of interest at all levels, from the immunologist working at the bench to the physician wishing to optimize a vaccine schedule for a specific patient. The tailoring of vaccine strategies for specific vulnerable populations, being the very young, the elderly or the immunosuppressed, is also largely relying on a better understanding of what supports or limits vaccine effi cacy underspecial circumstances.

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