Impfstrategien bei Schwerem Akutem Respiratorischem Syndrom (SARS)

Zusammenfassung

Die Mehrzahl der Patienten mit schwerem akutem respiratorischem Syndrom (SARS) bildet Antikörper gegen das SARS Coronavirus und überlebt die Infektion. Daraus lässt sich ableiten, dass eine aktive oder passive Immunisierung eine wichtige Maßnahme der Prävention und/oder Therapie von SARS sein könnte. Die Entwicklung von Impfstoffen ist daher ein wichtiges Ziel der SARS Forschung. Durch eine Datenbankrecherche wurde der Stand zu möglichen Impfstrategien analysiert. Die passive Immunisierung mit Seren genesener Patienten zeigte teilweise Erfolge. Obwohl die passive Immunisierung eine viel versprechende Therapiestrategie zu sein scheint, ist die Entwicklung einer aktiven Vakzine zur Prävention einer erneuten SARS-Pandemie sehr wichtig. Weltweit arbeiten zahlreiche Gruppen an der Entwicklung von Impfstoffen mit inaktivierten SARS Coronaviren, rekombinanten Untereinheiten, rekombinanter DNA und viralen Vektoren. Alle neuen Impfstoffe müssen jedoch kritisch evaluiert werden, da die durch Impfung induzierten Antikörper auch eine Steigerung der Viruslast und Exazerbation der Erkrankung verursachen können.

Abstract

Most patients with severe acute respiratory syndrome (SARS) develop antibodies against the SARS coronavirus and survive the infection. This suggests that active or passive immunisation might be an effective option in preventing or treating SARS. Therefore, the development of SARS vaccination strategies belongs to the most important targets of SARS research. The present study analyses data-bases for the current knowledge on vaccination strategies. Both, passive and active immunisation protocols are presently being developed. Passive immunisation with sera from surviving patients leads to partial success. Whereas the passive immunisation exhibits a promising therapeutic tool, only active immunisation can successfully prevent infection. A number of approaches has been used on the basis of inactivated SARS coronaviruses, recombinant subunits, recombinant DNA, and viral vectors. However, all recently developed candidates need to be evaluated critically before clinical use. The so-called “antibody-dependent enhancement” can improve viral uptake into host cells resulting in increased viral load and exacerbation of disease.

Literatur

• 1 Groneberg D A, Zhang L, Welte T. et al . Severe acute respiratory syndrome: global initiatives for disease diagnosis.  QJ Med. 2003;  96 845-852
• 2 Poon L L, Guan Y, Nicholls Y M. et al . The aetiology, origins and diagnosis of severe acute respiratory syndrome.  Lancet Infect dis. 2004;  4 663-671
• 3 Reilley B, Herp M van, Sermand D. et al . SARS and Carlo Urbani.  N Engl J Med. 2003;  348 1951-1952
• 4 World Health Organization (WHO) .Summary of propable SARS cases with onset of illness from 1. November 2002 to 31. July 2003. http//www.who.int/csr/sars/country/table2004_04_21/en,2003 (accessed feb 3, 2005)
• 5 World Health Organization Multicentre Collaborative Network for Severe Acute Respiratory Syndrome Diagnosis . A multicentre collaboration to investigate the cause of severe acute respiratory syndrome.  Lancet. 2003;  361 1730-1733
• 6 Peiris J S, Lai S T, Poon L L. et al . Coronavirus as a possible cause of severe acute respiratory syndrome.  Lancet. 2003;  361 1319-1325
• 7 Drosten C, Gunter S, Preiser W. et al . Identification of a novel coronavirus in patients with severe acute respiratory syndrome.  N Engl J MED. 2003;  348 1967-1976
• 8 Ksiazek T G, Erdmann D, Goldsmith C S. et al . A novel coronavirus associated with severe acute respiratory syndrome.  N Engl J Med. 2003;  348 1953-1966
• 9 Zhang Q F, Cui J M, Huang X J. et al . Morpholigy and morphogenesis of severe acute respiratory syndrome (SARS)- associated virus.  Chin J Biochem Biophys. 2003;  35 587-691
• 10 Cavanagh D. Nidovirales: a new order comprising Coronaviridae and Arteriviridae.  Arch Virol. 1997;  142 629-633
• 11 Sidell S, Wege H, ter Meulen V. The structure and replication of coronaviruses.  Curr Top Microbiol Immunol. 1982;  99 131-163
• 12 Wege H, Sidell S, ter Meulen V. The biology and pathogenesis of Coronaviruses.  Curr Top Microbiol Immunol. 1982;  99 165-200
• 13 Guan Y, Zheng B J, He Y Q. et al . Isolation and characterization of viruses related to the SARS coronavirus from animals in southern China.  Science. 2003;  302 276-278
• 14 Bonn D. Wild animals could be source of SARS.  Lancet Infect Dis. 2003;  3 395
• 15 Chan P K, Tang J W, Hui D S. SARS: clinical presentation, transmission, pathogenesis and treatment options.  Clin Sci (Lond). 2006;  110 193-204
• 16 Hanf G, Suttop N. Häufige Virusinfektionen der Atemwege und schweres akutes respiratorisches Syndrom (SARS). In: Dietel M, Suttorp N, Zeitz M (Hrsg). Harrisons Innere Medizin, 16. Aufl. 1141-1147
• 17 Marra M A, Jones S J, Astell C R. et al . The genome sequence of the SARS-associated coronavirus.  Science. 2003;  300 1399-404
• 18 Rota P A, Oberste M S, Monroe S S. et al . Characterisation of a novel coronavirus associated with severe acute respiratory syndrome.  Science. 2003;  300 1394-1399
• 19 Lai M M, Cavanagh D. The molecular biology of coronaviruses.  Adv Virus Res. 1997;  48 1-100
• 20 Wentworth D E, Gillim-Ross L, Espina N. et al . Mice susceptible to SARS coronavirus.  Emerge Infect Dis. 2004;  10 1293-1296
• 21 Martina B E, Haagmans B L, Kuikan T. et al . Virology: SARS virus infection of cats and ferrets.  Nature. 2003;  425 915
• 22 Tsui P T, Kwok M L, Yuen H. et al . Sevre acute respiratory syndrome: clinical outcome and prognostic correlates.  Emerge Infect Dis. 2003;  9 1064-1069
• 23 Donnelly C A, Ghani A C, Leung G M. et al . Epidemiological determinants of spread of causal agent of severe acute respiratory syndrome in Hong Kong.  Lancet. 2003;  361 1761-1766
• 24 Bitnun A, Allen U, Heurter H. et al . Children hospitalized with severe acute respiratory syndrome- related illness in Toronto.  Pediatrics. 2003;  112 e261
• 25 De Groot A S. How the SARS vaccine effort can learn from HIV- speeding towards the future, learning from the past.  Vaccine. 2003;  21 4095-4104
• 26 Wong V W, Dai D, Wu A K. et al . Treatment of SARS with convalescent plasma.  Hong Kong Med J. 2003;  9 199-201
• 27 Subbarao K, McAuliffe J, Vogel L. et al . Prior infection and passive transfer of neutralizing antibody prevent replication of SARS coronavirus in the respiratory tract of mice.  J Virol. 2004;  78 3572-3577
• 28 Traggiai E, Becker S, Subbarao K. et al . An efficient method to make human monoclonal antibodies from memory B cells: potent neutralization of SARS coronavirus.  Nat Med. 2004;  10 871-875
• 29 ter Meulen J, Bakker A B, Brink E N van den. et al . Human monoclonal antibody as prophylaxis for SARS coronavirus infection in ferrets.  Lancet. 2004;  363 2139-2141
• 30 Marshall E, Enserink M. Medicine. Caution urged on SARS vaccines.  Science. 2004;  303 944-946
• 31 Olsen C W. A review of feline infectious peritonitis virus: molecular biology, immunopathogenesis, clinical aspects, and vaccination.  Vet Microbiol. 1993;  36 1-37
• 32 Gao W, Tamin A, Soloff A. et al . Effects of a SARS associated coronavirus vaccine in monkeys.  Lancet. 2003;  362 1895-1896
• 33 Bukreyev A, Lamirande E W, Buchholz U J. et al . Mucosal immunisation of African green monkeys with an attenuated parainfluenza virus expressing the SARS coronavirus spike protein for the prevention of SARS.  Lancet. 2004;  363 2122-2127
• 34 Bisht H, Roberts A, Vogel L. et al . SARS coronavirus spike protein expressed by attenuated vaccinia virus protectively immunizes mice.  Proc Natl Acad Sci USA. 2004;  101 6641-6646
• 35 Yang Z Y, Kong W P, Huang Y. et al . A DNA vaccine induces SARS coronavirus neutralization and protective immunity in mice.  Nature. 2004;  428 561-564
• 36 Kim T W, Lee J H, Hung C F. et al . Generation and characterization of DNA vaccines targeting the nucleocapsid protein of SARS coronavirus.  J Virol. 2004;  78 4638-4645
• 37 Zhu M S, Pan Y, Chen H Q. et al . Induction of SARS-nucleoprotein-specific immune response by use of DNA vaccine.  Immunol Lett. 2004;  92 237-243
• 38 Muller M P, McGeer A, Straus S E. et al . Clinical trials and novel pathogens: lessons learned from SARS.  Emerg Infect Dis. 2004;  10 389-394
• 39 Hagen L Von, Pletz M W, Dickgreber N. et al . Pharmakotherapie bei Schwerem Akutem Respiratorischem Syndrom (SARS).  Pneumologie. 2006;  60 694-700
• 40 Tuan P A, Horby P, Dinh P N. et al . SARS transmission in Vietnam outside of the health-care setting.  . 2006;  26 -10
• 41 Srikantiah P, Charles M D, Reagan S. et al . SARS clinical features, United States, 2003.  Emerg Infect Dis. 2005;  11(1) 135-138
• 42 Jiang S, He Y, Liu S. SARS vaccine development.  Emerg Infect Dis. 2007;  11 1016-1020
• 43 Peiris J S, Guan Y, Yuen K Y. Severe acute respiratory syndrome.  Nat Med. 2004;  10 S88-97
• 44 Shen S, Lin P S, Chao Y C. et al . The severe acute respiratory syndrome coronavirus 3a is a novel structural protein.  . 2005;  330 286-292
• 45 Ho Y, Lin P H, Liu C Y. et al . Assembly of human severe acute respiratory syndrome coronavirus-like particles.  . 2004 11;  318 833-838
• 46 Progrebnyak N, Golovkin M, Adrianov V. et al . Severe acute respiratory syndrome (SARS) S protein production in plants: development of recombinant Vaccine.  Proc Natl Acad Sci USA. 2005;  1002 9062-9067
• 47 Roberts A, Vogel L, Guarner J. et al . Severe acute respiratory syndrome coronavirus infection of goldon Syrian hamsters.  J Virol. 2005;  79 503-511