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Publication
Vacinas para vírus sincicial respiratório : o estado da arte
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Abstract(s)
Introdução: As infeções respiratórias virais causaram quase 2,38 milhões de mortes em 2016, sendo a sexta principal causa de mortalidade em todas as idades e a principal causa de morte entre crianças com menos de 5 anos. O Vírus Sincicial Respiratório (RSV) é um dos principais vírus a causar estas infeções. Atualmente não existe vacina nem tratamento específico para as infeções causadas pelo RSV.
Objetivos: Esta revisão sistemática teve como principal objetivo caraterizar e descrever os ensaios clínicos em humanos de vacinas contra o RSV nos últimos 5 anos em adultos e crianças, de modo a perceber o porquê da não existência de uma vacina em uso clínico.
Materiais e métodos: Foi efetuada pesquisa na base de dados PubMed, com os termos: ((Respiratory syncycial virus) and (Human vaccines)). Na pesquisa foram colocados filtros ao nível temporal de artigos publicados apenas nos últimos 5 anos (2016 a setembro de 2021) e também a nível do tipo de artigo, sendo apenas selecionados os ensaios clínicos publicados em inglês.
Resultados: A pesquisa efetuada no PubMed, permitiu a obtenção de 33 resultados, mas apenas 19 cumpriam todos os critérios de inclusão e foram utilizados. Nestes ensaios clínicos foram utilizadas diversas estratégias para a produção da vacina contra o RSV, entre elas a utilização como imunogénio da proteína de fusão (F) do RSV. Os ensaios clínicos foram maioritariamente de fase 1, destacando-se as vacinas dos estudos de McFarland et al. (2020) e Beran et al. (2018). Verifica-se que apesar de haver eficácia das vacinas na diminuição de infeções mais graves, a prevenção já não é tão fácil de obter. Conclusão: O estudo de Auguste et al. (2017) tem a respetiva vacina a ser testada em mulheres grávidas do terceiro trimestre para avaliar a proteção do bebé nos primeiros meses de vida. Espera-se a continuação e desenvolvimento destas vacinas e outras vacinas.
Introduction: Viral respiratory infections occur when a virus infects respiratory mucosal cells. These infections are the sixth leading cause of mortality at all ages, with nearly 2.38 million deaths in 2016, and the leading cause of death among children under 5 years of age. The Respiratory Syncytial Virus (RSV) is one of the main viruses causing the aforementioned infections, and there are few treatments available to prevent and treat the consequential illness. Objectives: This systematic review characterizes and describes the clinical trials in humans of vaccines against the RSV in the last 5 years, both in adults and in children, in order to understand the reason behind the unexistence of a vaccine in clinical use for this virus. Materials and methods: The PubMed database was searched with the terms ((Respiratory syncycial virus) and (Human vaccines)). For this search, a temporal filter was applied, so to only return articles published in the last 5 years (2016 to September 2021), together with an article type filter, with only english clinical trials being considered. Results: The previously described search returned a total of 33 articles, but only 19 met all the inclusion criteria and were used. After an analysis of the relevant articles, several strategies were identified for producing a vaccine for the RSV, including the use of RSV F protein (Fusion). Clinical trials were mostly phase 1, highlighting the vaccines from the studies by McFarland et al. (2020) and Beran et al. (2018). The vaccines are effective in reducing more serious infections, but the effective prevention measures are harder to enforce. Conclusion: The study by Auguste et al. (2017) has the respective vaccine being tested in third trimester pregnant women to assess the baby's protection in the first months of life. Vaccines development is expected to continue, with the goal of significantly reducing infections and contagions.
Introduction: Viral respiratory infections occur when a virus infects respiratory mucosal cells. These infections are the sixth leading cause of mortality at all ages, with nearly 2.38 million deaths in 2016, and the leading cause of death among children under 5 years of age. The Respiratory Syncytial Virus (RSV) is one of the main viruses causing the aforementioned infections, and there are few treatments available to prevent and treat the consequential illness. Objectives: This systematic review characterizes and describes the clinical trials in humans of vaccines against the RSV in the last 5 years, both in adults and in children, in order to understand the reason behind the unexistence of a vaccine in clinical use for this virus. Materials and methods: The PubMed database was searched with the terms ((Respiratory syncycial virus) and (Human vaccines)). For this search, a temporal filter was applied, so to only return articles published in the last 5 years (2016 to September 2021), together with an article type filter, with only english clinical trials being considered. Results: The previously described search returned a total of 33 articles, but only 19 met all the inclusion criteria and were used. After an analysis of the relevant articles, several strategies were identified for producing a vaccine for the RSV, including the use of RSV F protein (Fusion). Clinical trials were mostly phase 1, highlighting the vaccines from the studies by McFarland et al. (2020) and Beran et al. (2018). The vaccines are effective in reducing more serious infections, but the effective prevention measures are harder to enforce. Conclusion: The study by Auguste et al. (2017) has the respective vaccine being tested in third trimester pregnant women to assess the baby's protection in the first months of life. Vaccines development is expected to continue, with the goal of significantly reducing infections and contagions.
Description
Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas Moniz
Keywords
Infeções respiratórias Vírus sincicial respiratório Vacinas humanas Vírus respiratórios