Melioidosis vaccines: A systematic review and appraisal of the potential to exploit biodefense vaccines for public health purposes
Background: Burkholderia pseudomallei is a Category B select agent and the cause of melioidosis. Research funding for vaccine development has largely considered protection within the biothreat context, but the resulting vaccines could be applicable to populations who are at risk of naturally acquire...
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th-mahidol.151152018-06-11T12:24:48Z Melioidosis vaccines: A systematic review and appraisal of the potential to exploit biodefense vaccines for public health purposes Sharon J. Peacock Direk Limmathurotsakul Yoel Lubell Gavin C K W Koh Lisa J. White Nicholas P J Day Richard W. Titball Mahidol University University of Cambridge Nuffield Department of Clinical Medicine University of Exeter Medicine Pharmacology, Toxicology and Pharmaceutics Background: Burkholderia pseudomallei is a Category B select agent and the cause of melioidosis. Research funding for vaccine development has largely considered protection within the biothreat context, but the resulting vaccines could be applicable to populations who are at risk of naturally acquired melioidosis. Here, we discuss target populations for vaccination, consider the cost-benefit of different vaccination strategies and review potential vaccine candidates. Methods and Findings: Melioidosis is highly endemic in Thailand and northern Australia, where a biodefense vaccine might be adopted for public health purposes. A cost-effectiveness analysis model was developed, which showed that a vaccine could be a cost-effective intervention in Thailand, particularly if used in high-risk populations such as diabetics. Cost-effectiveness was observed in a model in which only partial immunity was assumed. The review systematically summarized all melioidosis vaccine candidates and studies in animal models that had evaluated their protectiveness. Possible candidates included live attenuated, whole cell killed, sub-unit, plasmid DNA and dendritic cell vaccines. Live attenuated vaccines were not considered favorably because of possible reversion to virulence and hypothetical risk of latent infection, while the other candidates need further development and evaluation. Melioidosis is acquired by skin inoculation, inhalation and ingestion, but routes of animal inoculation in most published studies to date do not reflect all of this. We found a lack of studies using diabetic models, which will be central to any evaluation of a melioidosis vaccine for natural infection since diabetes is the most important risk factor. Conclusion: Vaccines could represent one strand of a public health initiative to reduce the global incidence of melioidosis. © 2012 Peacock et al. 2018-06-11T05:20:30Z 2018-06-11T05:20:30Z 2012-01-01 Review PLoS Neglected Tropical Diseases. Vol.6, No.1 (2012) 10.1371/journal.pntd.0001488 19352735 19352727 2-s2.0-84856565602 https://repository.li.mahidol.ac.th/handle/123456789/15115 Mahidol University SCOPUS https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84856565602&origin=inward |
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Medicine Pharmacology, Toxicology and Pharmaceutics Sharon J. Peacock Direk Limmathurotsakul Yoel Lubell Gavin C K W Koh Lisa J. White Nicholas P J Day Richard W. Titball Melioidosis vaccines: A systematic review and appraisal of the potential to exploit biodefense vaccines for public health purposes |
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Background: Burkholderia pseudomallei is a Category B select agent and the cause of melioidosis. Research funding for vaccine development has largely considered protection within the biothreat context, but the resulting vaccines could be applicable to populations who are at risk of naturally acquired melioidosis. Here, we discuss target populations for vaccination, consider the cost-benefit of different vaccination strategies and review potential vaccine candidates. Methods and Findings: Melioidosis is highly endemic in Thailand and northern Australia, where a biodefense vaccine might be adopted for public health purposes. A cost-effectiveness analysis model was developed, which showed that a vaccine could be a cost-effective intervention in Thailand, particularly if used in high-risk populations such as diabetics. Cost-effectiveness was observed in a model in which only partial immunity was assumed. The review systematically summarized all melioidosis vaccine candidates and studies in animal models that had evaluated their protectiveness. Possible candidates included live attenuated, whole cell killed, sub-unit, plasmid DNA and dendritic cell vaccines. Live attenuated vaccines were not considered favorably because of possible reversion to virulence and hypothetical risk of latent infection, while the other candidates need further development and evaluation. Melioidosis is acquired by skin inoculation, inhalation and ingestion, but routes of animal inoculation in most published studies to date do not reflect all of this. We found a lack of studies using diabetic models, which will be central to any evaluation of a melioidosis vaccine for natural infection since diabetes is the most important risk factor. Conclusion: Vaccines could represent one strand of a public health initiative to reduce the global incidence of melioidosis. © 2012 Peacock et al. |
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Mahidol University |
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Mahidol University Sharon J. Peacock Direk Limmathurotsakul Yoel Lubell Gavin C K W Koh Lisa J. White Nicholas P J Day Richard W. Titball |
format |
Review |
author |
Sharon J. Peacock Direk Limmathurotsakul Yoel Lubell Gavin C K W Koh Lisa J. White Nicholas P J Day Richard W. Titball |
author_sort |
Sharon J. Peacock |
title |
Melioidosis vaccines: A systematic review and appraisal of the potential to exploit biodefense vaccines for public health purposes |
title_short |
Melioidosis vaccines: A systematic review and appraisal of the potential to exploit biodefense vaccines for public health purposes |
title_full |
Melioidosis vaccines: A systematic review and appraisal of the potential to exploit biodefense vaccines for public health purposes |
title_fullStr |
Melioidosis vaccines: A systematic review and appraisal of the potential to exploit biodefense vaccines for public health purposes |
title_full_unstemmed |
Melioidosis vaccines: A systematic review and appraisal of the potential to exploit biodefense vaccines for public health purposes |
title_sort |
melioidosis vaccines: a systematic review and appraisal of the potential to exploit biodefense vaccines for public health purposes |
publishDate |
2018 |
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https://repository.li.mahidol.ac.th/handle/123456789/15115 |
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1763488855417159680 |