Progress towards development of a cholera subunit vaccine.
Cholera, an enteric disease that can reach pandemic proportions, remains a world-wide problem that is positioned to increase in incidence as changes in global climate or armed conflict spawn the conditions that enhance transmission to humans and, thus, precipitate epidemic cholera. An effective subunit cholera vaccine that can provide protective immunity with one parenteral immunization would be a major advantage over the existing oral vaccines that can require two doses for optimal protection. The existing vaccines are clearly effective in some settings, but are less so in others, especially with respect to specific groups such as young (2-5 years) children. In our efforts to develop a cholera subunit vaccine, we focused on two Vibrio cholerae antigens, LPS (lipopolysaccharide) and TCP (toxin co-regulated pilus), that are known to induce protective antibodies in animal models and, in the case of anti-LPS antibodies, to be associated with clinical protection of V. cholerae exposed or vaccinated individuals. This review discusses the current cholera vaccines and compares the advantages of a cholera subunit vaccine to that of the whole cell vaccines. We discuss the possible subunit antigens and prospective targeted use of a subunit cholera vaccine.
Taylor
Ronald K
RK
Department of Microbiology and Immunology, Dartmouth Medical School, Lebanon, NH 03756, USA.
Kirn
Thomas J
TJ
Bose
Niranjan
N
Stonehouse
Emily
E
Tripathi
Shital A
SA
Kovác
Pavol
P
Wade
William F
WF
D000818:Animals; D002771:Cholera / Q000517:prevention & control* / Q000635:transmission; D022121:Cholera Vaccines / Q000737:chemistry* / Q000627:therapeutic use; D006801:Humans; D013678:Technology, Pharmaceutical / Q000639:trends; D014613:Vaccines, Attenuated / Q000737:chemistry / Q000627:therapeutic use; D015164:Vaccines, Inactivated / Q000737:chemistry / Q000627:therapeutic use; D022223:Vaccines, Subunit / Q000737:chemistry / Q000627:therapeutic use
D022121:Cholera Vaccines; D014613:Vaccines, Attenuated; D015164:Vaccines, Inactivated; D022223:Vaccines, Subunit