An oral B subunit: whole cell vaccine against cholera.
During the last decade there has been a rapid progress in the development of new, much improved vaccines against cholera. These vaccines, which are given orally to stimulate the gut mucosal immune system, are based on either a combination of purified cholera toxin B (binding) subunit and killed cholera vibrios of Inaba and Ogawa serotypes and El Tor and classical biotypes (B subunit-whole cell vaccine, B-WC) or on a live attenuated mutant strain of Vibrio cholerae producing the B subunit (CVD 103-HgR). The safety of the oral B-WC cholera vaccine and the immunogenicity and protective efficacy of this vaccine against both cholera and diarrhoea caused by enterotoxigenic Escherichia coli have been extensively documented, e.g. in a large randomized, placebo-controlled field trial in 90,000 persons living in a cholera endemic area. The potential for inexpensive large-scale manufacturing of the B-WC vaccine has recently been much facilitated by the introduction of recombinant DNA technology for production of the B subunit component. This now gives promise that this vaccine could become a useful, cost-effective tool in future strategies to control cholera both in endemic situations and in relation to acute epidemic outbreaks.
Holmgren
J
J
Department of Medical Microbiology and Immunology, University of Göteborg, Sweden.
Svennerholm
A M
AM
Jertborn
M
M
Clemens
J
J
Sack
D A
DA
Salenstedt
R
R
Wigzell
H
H
D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D001459:Bangladesh; D002648:Child; D002675:Child, Preschool; D002771:Cholera / Q000453:epidemiology / Q000517:prevention & control*; D002772:Cholera Toxin / Q000276:immunology*; D022121:Cholera Vaccines / Q000008:administration & dosage / Q000276:immunology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D014611:Vaccination; D014613:Vaccines, Attenuated / Q000276:immunology; D015164:Vaccines, Inactivated / Q000276:immunology; D014614:Vaccines, Synthetic / Q000276:immunology; D014734:Vibrio cholerae / Q000276:immunology
D022121:Cholera Vaccines; D014613:Vaccines, Attenuated; D015164:Vaccines, Inactivated; D014614:Vaccines, Synthetic; D002772:Cholera Toxin