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MessagePublié: 19 Jan 2011 17:17 
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Enregistré le: 08 Fév 2007 01:55
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Correcting a public health fiasco: The need for a new vaccine against Lyme disease.
Plotkin SA.

University of Pennsylvania, Doylestown, 18902, USA. stanley.plotkin@vaxconsult.com
Abstract
A vaccine against Lyme disease was licensed in the United States in 1998 but was subsequently removed from the market because of lack of sales. I believe that the poor acceptance of the vaccine was based on tepid recommendations by the Centers for Disease Control and Prevention (CDC), undocumented and probably nonexistent safety issues, and insufficient education of physicians. A new vaccine is feasible but will not be developed unless there is a demand by infectious diseases specialists, epidemiologists, authorities in affected states and the public that is evident to manufacturers. The fact that there is no vaccine for an infection causing ∼20,000 annual cases is an egregious failure of public health.

PMID: 21217175 [PubMed - in process]


http://www.ncbi.nlm.nih.gov/pubmed/21217175

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A new approach to a lyme disease vaccine.
Livey I, O'Rourke M, Traweger A, Savidis-Dacho H, Crowe BA, Barrett PN, Yang X, Dunn JJ, Luft BJ.

Baxter Innovations GmbH, Biomedical Research Center, Orth an der Donau, Austria. ian.livey@baxter.com
Abstract
A single recombinant outer surface protein A (OspA) antigen designed to contain protective elements from 2 different OspA serotypes (1 and 2) is able to induce antibody responses that protect mice against infection with either Borrelia burgdorferi sensu stricto (OspA serotype-1) or Borrelia afzelii (OspA serotype-2). Protection against infection with B burgdorferi ss strain ZS7 was demonstrated in a needle-challenge model. Protection against B. afzelii species was shown in a tick-challenge model using feral ticks. In both models, as little as .03 μg of antigen, when administered in a 2-dose immunization schedule with aluminum hydroxide as adjuvant, was sufficient to provide complete protection against the species targeted. This proof of principle study proves that knowledge of protective epitopes can be used for the rational design of effective, genetically modified vaccines requiring fewer OspA antigens and suggests that this approach may facilitate the development of an OspA vaccine for global use.

PMID: 21217174 [PubMed - in process]


http://www.ncbi.nlm.nih.gov/pubmed/21217174

Citer:
Clin Infect Dis. 2011 Feb;52 Suppl 3:s253-8.
Vaccines against Lyme disease: What happened and what lessons can we learn?
Poland GA.

Department of Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota 55905, USA. poland.gregory@mayo.edu
Abstract
This article reviews events that led to the withdrawal of the only vaccine to prevent Lyme disease licensed in the United States. The primary issues that led to the vaccine's withdrawal appear to be a combination of vaccine safety concerns, sparked by a molecular mimicry hypothesis that suggested that the vaccine antigen, outer surface protein A, serves as an autoantigen and hence was arthritogenic; concerns raised by anti-vaccine groups regarding vaccine safety; vaccine cost; a difficult vaccination schedule and the potential need for boosters; class action lawsuits; uncertainty regarding risk of disease; and low public demand. This article reviews lessons learned from these events and proposes that future candidate Lyme disease vaccines are unlikely to be developed, tested, and used within the United States in the near future, thus leaving at-risk populations unprotected.

PMID: 21217172 [PubMed - in process]


http://www.ncbi.nlm.nih.gov/pubmed/21217172

Citer:
Clin Infect Dis. 2011 Feb;52 Suppl 3:s247-52.
The lyme disease vaccine--a public health perspective.
Shen AK, Mead PS, Beard CB.

Department of Health and Human Services, Washington, DC, USA.
Abstract
Lyme disease, which is caused by the spirochetal agent Borrelia burgdoferi, is the most common vector-borne illness in the United States. In 1998, the US Food and Drug Administration approved a recombinant Lyme disease vaccine that was later voluntarily withdrawn from the market by the manufacturer. Current Lyme disease prevention efforts focus on a combination of methods and approaches, including area acaricides, landscape management, host-targeted interventions, management of deer populations, and personal protective measures, such as the use of insect repellant and tick checks. Although these methods are generally safe and relatively inexpensive, the primary limitations of these methods are that their effectiveness has been difficult to demonstrate conclusively and that rates of compliance are generally poor. An effective human Lyme disease vaccine that has been adequately evaluated in the highest-risk population groups could be very beneficial in preventing Lyme disease; however, it would need to meet high standards regarding safety, efficacy, cost, and public acceptance.


http://www.ncbi.nlm.nih.gov/pubmed/21217171

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MessagePublié: 13 Fév 2013 22:55 
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Enregistré le: 14 Déc 2007 22:03
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Pour les courageux... (je n'en fait pas partie!) :wink:
http://www.frontiersin.org/Journal/Down ... -00006.pdf

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