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Estratégias no desenvolvimento de vacinas contra Helicobacter Pylori
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Resumo(s)
A presente monografia foi elaborada com o intuito de rever os conhecimentos sobre a bactéria Helicobacter pylori de uma forma geral, realçando as principais estratégias que têm sido aplicadas no desenvolvimento de uma vacina capaz de a erradicar.
O adenocarcinoma gástrico é a terceira principal causa de morte provocado por cancro a nível mundial, com maior incidência nos países em vias de desenvolvimento. A maioria destes cancros estão associados à infeção por H. pylori. Este microrganismo origina uma resposta imune muito intensa por parte do hospedeiro, recorrendo ao seu mecanismo fisiopatológico, desencadeando uma série de patologias gástricas, sendo a mais grave o cancro.
O tratamento recomendado atualmente compreende o uso de terapêutica combinada de vários antibióticos com inibidores da bomba de protões. Todavia, uma vez que inúmeros doentes submetidos à terapêutica, não demonstram sucesso no combate à doença, este é considerado um tratamento de difícil execução.
Assim, torna-se de extrema importância o desenvolvimento de uma vacina capaz de erradicar esta bactéria, constituindo assim uma ferramenta poderosa na prevenção do cancro gástrico. Com base nesta necessidade, várias iniciativas de desenvolvimento de vacinas vão surgindo, focando-se na descoberta de antigénios e adjuvantes capazes de induzir uma resposta imunitária mais potente, bem como da via de administração mais adequada. Estes estudos mostram que a vacina pode ser profilática, e usada como terapêutica após infeção. Apesar dos inúmeros ensaios clínicos que têm sido desenvolvidos, não existe no mercado nenhuma vacina aprovada. Contudo, uma vacina promissora chegou à fase III dos ensaios clínicos. No entanto, foi descontinuada posteriormente, tornando-se assim a abordagem mais próxima de chegar ao mercado.
Apesar de ser uma patologia de alcance global, o desenvolvimento de uma vacina contra H. pylori tem sido efetuado até agora por pequenos laboratórios, mostrando a necessidade de um grande investimento por parte das principais empresas farmacêuticas, com o objetivo de possibilitar a realização de ensaios clínicos mais satisfatórios e conclusivos.
The present monograph has been prepared to provide knowledge about the Helicobacter pylori bacteria in a general way, highlighting the main strategies that have been applied in the development of an efficacy vaccine. Gastric adenocarcinoma is the third leading cause of cancer death worldwide, with the highest incidence in developing countries. Most of these cancers are associated to the gastric infection by H. pylori. This microorganism triggers a very intense immune response by the host, using its pathophysiological mechanism, triggering a series of gastric pathologies, the most serious being cancer. The treatment currently recommended comprises the use of antibiotics simultaneously with proton pump inhibitors. However, since many patients submitted to therapy do not show success in combating the disease, this is considered a difficult treatment to perform. Therefore, the development of a vaccine capable of eradicating this bacterial infection becomes of extreme importance, thus constituting a powerful tool in the prevention of gastric cancer. Based on this need, several vaccine development initiatives are emerging, focusing mainly on the discovery of the best antigens and adjuvants capable of promoting a more potent immune response, as well as the most appropriate route of administration. These studies show that the vaccine can be prophylactic, as well as used as therapeutic after infection. Despite the numerous clinical trials that have been developed, no vaccine is currently on the market. However, one promising vaccine has reached phase III of clinical trials. However, it has been discontinued, making it the closest approach to reaching the market so far. Although it is a global pathology, the development of a vaccine against H. pylori vaccine has so far been carried out by small laboratories, showing the need for a large investment by major pharmaceutical companies to enable more satisfactory and conclusive clinical trials.
The present monograph has been prepared to provide knowledge about the Helicobacter pylori bacteria in a general way, highlighting the main strategies that have been applied in the development of an efficacy vaccine. Gastric adenocarcinoma is the third leading cause of cancer death worldwide, with the highest incidence in developing countries. Most of these cancers are associated to the gastric infection by H. pylori. This microorganism triggers a very intense immune response by the host, using its pathophysiological mechanism, triggering a series of gastric pathologies, the most serious being cancer. The treatment currently recommended comprises the use of antibiotics simultaneously with proton pump inhibitors. However, since many patients submitted to therapy do not show success in combating the disease, this is considered a difficult treatment to perform. Therefore, the development of a vaccine capable of eradicating this bacterial infection becomes of extreme importance, thus constituting a powerful tool in the prevention of gastric cancer. Based on this need, several vaccine development initiatives are emerging, focusing mainly on the discovery of the best antigens and adjuvants capable of promoting a more potent immune response, as well as the most appropriate route of administration. These studies show that the vaccine can be prophylactic, as well as used as therapeutic after infection. Despite the numerous clinical trials that have been developed, no vaccine is currently on the market. However, one promising vaccine has reached phase III of clinical trials. However, it has been discontinued, making it the closest approach to reaching the market so far. Although it is a global pathology, the development of a vaccine against H. pylori vaccine has so far been carried out by small laboratories, showing the need for a large investment by major pharmaceutical companies to enable more satisfactory and conclusive clinical trials.
Descrição
Trabalho Final de Mestrado Integrado, Ciências Farmacêuticas, 2021, Universidade de Lisboa, Faculdade de Farmácia.
Palavras-chave
Helicobacter pylori Vacina CagA VacA Urease Mestrado integrado - 2021