title: Serotype-independent pneumococcal vaccines.
abstract: Streptococcus pneumoniae remains an important cause of disease with high mortality and morbidity, especially in children and in the elderly. The widespread use of the polysaccharide conjugate vaccines in some countries has led to a significant decrease in invasive disease caused by vaccine serotypes, but an increase in disease caused by non-vaccine serotypes has impacted on the overall efficacy of these vaccines on pneumococcal disease. The obvious solution to overcome such shortcomings would be the development of new formulations that provide serotype-independent immunity. This review focuses on the most promising approaches, including protein antigens, whole cell pneumococcal vaccines, and recombinant bacteria expressing pneumococcal antigens. The protective capacity of these vaccine candidates against the different stages of pneumococcal infection, including colonization, mucosal disease, and invasive disease in animal models is reviewed. Some of the human trials that have already been performed or that are currently ongoing are presented. Finally, the feasibility and the possible shortcomings of these candidates in relation to an ideal vaccine against pneumococcal infections are discussed.
authors.affiliation: Centro de Biotecnologia, Instituto Butantan, Av Vital Brasil 1500, São Paulo, SP, 05503-900, Brazil. enmiyaji@butantan.gov.br
authors.forename: Eliane Namie
authors.initials: EN
authors.lastname: Miyaji
authors.forename: Maria Leonor Sarno
authors.initials: ML
authors.lastname: Oliveira
authors.forename: Eneas
authors.initials: E
authors.lastname: Carvalho
authors.forename: Paulo Lee
authors.initials: PL
authors.lastname: Ho
mesh_terms: D000818:Animals; D000941:Antigens / Q000276:immunology; D002986:Clinical Trials as Topic; D004195:Disease Models, Animal; D006801:Humans; D016920:Meningitis, Bacterial / Q000276:immunology* / Q000382:microbiology; D051379:Mice; D009092:Mucous Membrane / Q000276:immunology; D011008:Pneumococcal Infections / Q000276:immunology* / Q000382:microbiology / Q000517:prevention & control*; D022242:Pneumococcal Vaccines / Q000276:immunology* / Q000627:therapeutic use*; D011994:Recombinant Proteins / Q000276:immunology; D012703:Serotyping; D013296:Streptococcus pneumoniae; D018074:Vaccines, Conjugate / Q000276:immunology / Q000627:therapeutic use
chemical_list: D000941:Antigens; D022242:Pneumococcal Vaccines; D011994:Recombinant Proteins; D018074:Vaccines, Conjugate