WordNet

immunogen consisting of a suspension of weakened or dead pathogenic cells injected in order to stimulate the production of antibodies (同)vaccinum
any of a class of carbohydrates whose molecules contain chains of monosaccharide molecules (同)polyose
of or derived from or caused by bacteria of the genus pneumococcus

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牛痘種,痘苗(牛痘を起こすビールスで,天然痘予防のために人体に接種される) / (伝染病の病原菌から作った)ワクチン

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2016/07/11 00:47:21」(JST)

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Pneumococcal polysaccharide vaccine (PPSV)—the latest version is known as Pneumovax 23 (PPV-23)—is the first pneumococcal vaccine, the first vaccine derived from a capsular polysaccharide, and an important landmark in medical history. The polysaccharide antigens were used to induce type-specific antibodies that enhanced opsonization, phagocytosis, and killing of Streptococcus pneumoniae (pneumococcal) bacteria by phagocytic immune cells. The pneumococcal polysaccharide vaccine is widely used in high-risk adults.^[1] As a result, there have been important reductions in the incidence, morbidity, and mortality from invasive pneumococcal disease.

First used in 1945, the tetravalent vaccine was not widely distributed, since its deployment coincided with the discovery of penicillin.^[2] In the 1970s, Robert Austrian championed the manufacture and distribution of a 14-valent PPSV.^[3]^[4] This evolved in 1983 to a 23-valent formulation (PPSV23). A significant breakthrough affecting the burden of pneumococcal disease was the licensing of a protein conjugate heptavalent vaccine (PCV7) beginning in February 2000.^[5]

Medical uses

In the United States, PPSV is recommended for adults 65 years of age or older, adults with serious long-term health problems, smokers, children older than two years with serious long-term health problems, giving the protection of 5 years or more.^[6] The World Health Organization recommendations are similar. The WHO does not recommend use of PPV in routine childhood immunization programs.^[7] Pneumococcal vaccine is beneficial to control exacerbations of chronic obstructive pulmonary disease (COPD) and asthma.

In March 2011, The Joint Committee on Vaccination and Immunisation (JCVI) of the United Kingdom advised to stop using PPSV, for those aged 65 years and older. However, as of 2013, the Green Book, which is the United Kingdom's official government recommendations on immunizations, still carried the recommendation to give PPSV to those aged 65 and over.^[8] PPSV should be offered to those in clinical risk groups.^[9]

PPSV is important for those with HIV/AIDS. In Canadian HIV patients, the vaccine has been reported to decrease the incidence of invasive pneumococcal disease from 768/100,000 person-years to 244/100,000 patient-years.^[1] Current WHO guidelines recommend immunization with PPV-23 for HIV patients in clinical stage 1, while the CDC recommends immunization in those with a CD4 cell count greater than 200/μL.

Adverse events

Approximately half of people who receive PPSV experience pain and soreness at the vaccination site. Fewer than one percent develop a fever and/or muscle aches.^[10]

Vaccination schedule

Adults and children over two years of age

The 23-valent vaccine (e.g., Pneumovax 23) is effective against 23 different pneumococcal capsular types (serotypes 1, 2, 3, 4, 5, 6B, 7F, 8, 9N, 9V, 10A, 11A, 12F, 14, 15B, 17F, 18C, 19F, 19A, 20, 22F, 23F and 33F) and so covers 90 percent of the types found in pneumococcal bacteremia.^[11]

Young children

Children under the age of two years fail to mount an adequate response to the 23-valent adult vaccine, and instead a 13-valent Pneumococcal Conjugated Vaccine (PCV) (e.g. Prevnar 13) must be used. Prevnar 13 is a new vaccine which has replaced Prevnar 7, adding six new serotypes to the vaccine. While this covers only thirteen strains out of more than ninety strains, these thirteen strains caused 80 percent to 90 percent of cases of severe pneumococcal disease in the US before introduction of the vaccine, and it is considered to be nearly 100 percent effective against these strains.^[12]

Special risk-group: Children at special risk (e.g. sickle cell disease and those without a functioning spleen) require additional protection using the 13-valent congugated vaccine, with the then more extensive 23-valent vaccine given after the second year of life:

**Vaccination schedule for children at special risk**^[13]
Age	2–6 months	7–11 months	12–23 months
Conjugated vaccine	3× monthly dose	2× monthly dose	2 doses, 2 months apart
	Further dose in second year of life
23-valent vaccine	Then after 2nd birthday single dose of 23-valent

References

^ ^a ^b Siemieniuk, Reed A.C.; Gregson, Dan B.; Gill, M. John (November 2011). "The persisting burden of invasive pneumococcal disease in HIV patients: an observational cohort study". BMC Infectious Diseases 11: 314. doi:10.1186/1471-2334-11-314. PMC 3226630. PMID 22078162. Cite uses deprecated parameter |coauthors= (help)
^ Macleod CM, Hodges RG, Heidelberger M, Bernhard WG (1945). "Prevention of pneumococcal pneumonia by immunization with specific capsular polysaccharides". J Exp Med 82 (6): 445–65. doi:10.1084/jem.82.6.445. PMC 2135567. PMID 19871511.
^ Austrian R, Douglas RM, Schiffman G, et al. (1976). "Prevention of pneumococcal pneumonia by vaccination". Trans Assoc Am Physicians 89: 184–94. PMID 14433.
^ Klein, JO, Plotkin, SA (2007). "Robert Austrian: 1917-2007". Clin Infect Dis 45: 2. doi:10.1086/520068.
^ Kim NH, Lee J, Lee SJ, Lee H, Kim KH, Park SE, et al. (2007). "Immunogenicity and safety of pneumococcal 7-valent conjugate vaccine (diphtheria CRM(197) protein conjugate; Prevenar ) in Korean infants: differences that are found in Asian children". Vaccine 25 (45): 7858–65. doi:10.1016/j.vaccine.2007.08.022. PMID 17931753.
^ "Pneumococcal Disease In-Short". US Centers for Disease Control and Prevention (CDC).
^ World Health Organization. Pneumococcal vaccines at the Wayback Machine (archived March 6, 2002)
^ (PDF) https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/263318/Green-Book-Chapter-25-v5_2.pdf. Missing or empty |title= (help)
^ "JCVI issues preliminary advice on pneumococcal polysaccharide vaccination programme". National electronic Library for Medicines, NHS. 2011-03-17.
^ Pneumococcal Polysaccharide Vaccine: What You Need to Know. US Centers for Disease Control and Prevention. 2009
^ Pneumovax package insert Merck
^ Childhood Pneumococcal Disease – information on the disease and the Prevnar vaccine, from the Victoria State (Australia) government. Includes possible side effects.
^ "Chapter 25: Pneumococcal" (PDF). Immunisation against infectious disease — 'The Green Book' (PDF). Department of Health (UK). 2006.

External links

Pneumococcal Vaccines World Health Organization (WHO)
Pneumovax 23 information Merck
Pneumovax package insert Merck
PATH's Vaccine Resource Library pneumococcus resources
Centers for Disease Control and Prevention (2012). "Ch. 16: Pneumococcal Disease". In Atkinson W, Wolfe S, Hamborsky J. Epidemiology and Prevention of Vaccine-Preventable Diseases (12th ed.). Washington DC: Public Health Foundation. pp. 233–248.

UpToDate Contents

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1. 成人における肺炎球菌ワクチン pneumococcal vaccination in adults
2. 小児における肺炎球菌（肺炎レンサ球菌）多糖類ワクチン pneumococcal streptococcus pneumoniae polysaccharide vaccines in children
3. HIV感染成人における肺炎球菌ワクチンの接種 pneumococcal immunization in hiv infected adults
4. 炎症性腸疾患の小児および青年における重要な健康維持の問題 important health maintenance issues for children and adolescents with inflammatory bowel disease
5. 無脾症患者における敗血症の予防 prevention of sepsis in the asplenic patient

English Journal

Adult zebrafish model for pneumococcal pathogenesis.

Saralahti A, Piippo H, Parikka M, Henriques-Normark B, Rämet M, Rounioja S.Author information Institute of Biomedical Technology, BioMediTech, University of Tampere, FI-33014 Tampere, Finland.AbstractStreptococcus pneumoniae (pneumococcus) is a leading cause of community acquired pneumonia, septicemia, and meningitis. Due to incomplete understanding of the host and bacterial factors contributing to these diseases optimal treatment and prevention methods are lacking. In the present study we examined whether the adult zebrafish (Danio rerio) can be used to investigate the pathophysiology of pneumococcal diseases. Here we show that both intraperitoneal and intramuscular injections of the pneumococcal strain TIGR4 cause a fulminant, dose-dependent infection in adult zebrafish, while isogenic mutant bacteria lacking the polysaccharide capsule, autolysin, or pneumolysin are attenuated in the model. Infection through the intraperitoneal route is characterized by rapid expansion of pneumococci in the bloodstream, followed by penetration of the blood-brain barrier and progression to meningitis. Using Rag1 mutant zebrafish, which are devoid of somatic recombination and thus lack adaptive immune responses, we show that clearance of pneumococci in adult zebrafish depends mainly on innate immune responses. In conclusion, this study provides evidence that the adult zebrafish can be used as a model for a pneumococcal infection, and that it can be used to study both host and bacterial factors involved in the pathogenesis. However, our results do not support the use of the zebrafish in studies on the role of adaptive immunity in pneumococcal disease or in the development of new pneumococcal vaccines.
Developmental and comparative immunology.Dev Comp Immunol.2014 Feb;42(2):345-53. doi: 10.1016/j.dci.2013.09.009. Epub 2013 Sep 25.
Streptococcus pneumoniae (pneumococcus) is a leading cause of community acquired pneumonia, septicemia, and meningitis. Due to incomplete understanding of the host and bacterial factors contributing to these diseases optimal treatment and prevention methods are lacking. In the present study we exami
PMID 24076065

Serotype distribution and antimicrobial susceptibilities of nasopharyngeal isolates of Streptococcus pneumoniae from healthy children in the 13-valent pneumococcal conjugate vaccine era.

Zuccotti G1, Mameli C2, Daprai L3, Garlaschi ML3, Dilillo D2, Bedogni G4, Faccini M5, Gramegna M6, Torresani E3; PneuMi Study Group (PMSG).Collaborators (39)Emanuela B, Annarita B, Milena B, Dorella B, Manuela B, Simona CC, Irene CM, Giacomo C, Laura de A, Silvia D, Francesca DN, Massimiliano D, Erica G, Vera G, Grazia GM, Franca L, Barbara L, Maddalena M, Elisabetta M, Gabriella MM, Anna M, Pilar N, Mariangela P, Damiano P, Michela P, Stefania P, Norberto P, Giulia R, Francesca R, Riccardo R, Natascia S, Vincenzo S, Giuseppina S, Maria TR, Mariangela T, Matteo T, Marta T, Maurizio V, Chiara V.
Vaccine.Vaccine.2014 Jan 23;32(5):527-34. doi: 10.1016/j.vaccine.2013.12.003. Epub 2013 Dec 14.
Few epidemiological data are available since the introduction of 13-valent pneumococcal vaccine (PCV13) in 2010. We conducted a cross-sectional study to estimate the prevalence of Streptococcus pneumoniae (SP) nasopharyngeal carriage in healthy Italian infants and young children and to evaluate the
PMID 24342249

Structure elucidation of capsular polysaccharides from Streptococcus pneumoniae serotype 33C, 33D, and revised structure of serotype 33B.

Lin FL1, Vinogradov E2, Deng C3, Zeller S3, Phelan L3, Green BA3, Jansen KU3, Pavliak V3.Author information 1Pfizer Vaccine Research, 401 N. Middletown Road, Pearl River, NY 10965, USA. Electronic address: fiona.lin@pfizer.com.2Institute for Biological Sciences, National Research Council, 100 Sussex Dr., Ottawa, ON K1A 0R6, Canada.3Pfizer Vaccine Research, 401 N. Middletown Road, Pearl River, NY 10965, USA.AbstractWe report herein the previously unknown structures of the pneumococcal capsular polysaccharides serotype 33C and 33D, and a revised structure of serotype 33B. The syntenic pair 33B/33D has nearly identical polysaccharide repeat units with the exception of one sugar residue (→2-α-Glcp in 33B and →2-α-Galp in 33D). Serotype 33C is structurally more similar to 33B/33D than 33A/33F, in that it also possesses a backbone ribitol-phosphate group and a →3-β-GalpNAc residue, both of which are absent in the repeat units of 33A/33F. Serotype 33C is notably different from all other serogroup 33 polysaccharides, as there is no →3-β-Glcp residue and the location of the O-acetylation of the →5-β-Galf residue (O-6) differs from the other serogroup 33 polysaccharides (O-2). This completes the structural assignments of polysaccharides within serogroup 33 and provides a framework for understanding the recognition of epitopes by serogroup 33 typing sera based on observed cross-reactivities reported in the literature.
Carbohydrate research.Carbohydr Res.2014 Jan 13;383:97-104. doi: 10.1016/j.carres.2013.11.006. Epub 2013 Nov 19.
We report herein the previously unknown structures of the pneumococcal capsular polysaccharides serotype 33C and 33D, and a revised structure of serotype 33B. The syntenic pair 33B/33D has nearly identical polysaccharide repeat units with the exception of one sugar residue (→2-α-Glcp in 33B and �
PMID 24334220

Japanese Journal

わが国における肺炎球菌ワクチンの定期接種化と今後の課題

呼吸器内科 = Respiratory medicine 28(1), 75-80, 2015-07
NAID 40020543970

肺炎球菌ワクチンの歴史と効果

呼吸器内科 = Respiratory medicine 28(1), 69-74, 2015-07
NAID 40020543958

Changes in the Distribution of Capsular Serotypes of Streptococcus pneumoniae Isolated from Adult Respiratory Specimens in Japan

Internal Medicine 54(11), 1337-1341, 2015
NAID 130005072948

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リンク元	「肺炎球菌多糖体ワクチン」「肺炎球菌莢膜多糖体ワクチン」「Pneumovax」「PPV」
関連記事	「pneumococcal」「polysaccharide」「polysaccharides」「pneumococcal polysaccharide」

「肺炎球菌多糖体ワクチン」

Pneumococcal polysaccharide vaccine
Vaccine description
Target disease	23 serotypes of Streptococcus pneumoniae
Type	?
Clinical data
AHFS/Drugs.com	Multum Consumer Information
MedlinePlus	a607021
Pregnancy; category	US: C (Risk not ruled out); ;
Routes of; administration	IM
Legal status
Legal status	US: ℞-only;
Identifiers
ATC code	J07AL01 (WHO)
ChemSpider	none
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