Development of a Vaccine against Human Cytomegalovirus: Advances, Barriers, and Implications for the Clinical Practice

Human cytomegalovirus (hCMV) is one of the most common causes of congenital infection in the post-rubella era, representing a major public health concern. Although most cases are asymptomatic in the neonatal period, congenital CMV (cCMV) disease can result in permanent impairment of cognitive develo...

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Bibliographic Details
Published in:Vaccines (Basel) 2021-05, Vol.9 (6), p.551
Main Authors: Scarpini, Sara, Morigi, Francesca, Betti, Ludovica, Dondi, Arianna, Biagi, Carlotta, Lanari, Marcello
Format: Article
Language:English
Subjects:
Acquired immune deficiency syndrome
AIDS
Animal models
Apoptosis
Asymptomatic
Clinical trials
Cognitive ability
congenital CMV
Congenital diseases
Congenital infection
Cytomegalovirus
Deoxyribonucleic acid
Disease prevention
DNA
DNA viruses
Fetuses
Fibroblasts
Gene expression
Gestational age
Glycoproteins
hCMV
Hearing loss
Immune response
Immune system
Immunocompromised hosts
Laboratories
Medical research
Microcephaly
Mortality
mRNA vaccines
Neonates
Nosocomial infections
Pregnancy
prevention
Proteins
Public health
Review
RNA viruses
Rubella
Transplants & implants
Ultrasonic imaging
vaccine
Vaccines
Virus-like particles
Womens health
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Summary:Human cytomegalovirus (hCMV) is one of the most common causes of congenital infection in the post-rubella era, representing a major public health concern. Although most cases are asymptomatic in the neonatal period, congenital CMV (cCMV) disease can result in permanent impairment of cognitive development and represents the leading cause of non-genetic sensorineural hearing loss. Moreover, even if hCMV mostly causes asymptomatic or pauci-symptomatic infections in immunocompetent hosts, it may lead to severe and life-threatening disease in immunocompromised patients. Since immunity reduces the severity of disease, in the last years, the development of an effective and safe hCMV vaccine has been of great interest to pharmacologic researchers. Both hCMV live vaccines—e.g., live-attenuated, chimeric, viral-based—and non-living ones—subunit, RNA-based, virus-like particles, plasmid-based DNA—have been investigated. Encouraging data are emerging from clinical trials, but a hCMV vaccine has not been licensed yet. Major difficulties in the development of a satisfactory vaccine include hCMV’s capacity to evade the immune response, unclear immune correlates for protection, low number of available animal models, and insufficient general awareness. Moreover, there is a need to determine which may be the best target populations for vaccine administration. The aim of the present paper is to examine the status of hCMV vaccines undergoing clinical trials and understand barriers limiting their development.
ISSN:2076-393X
2076-393X
DOI:10.3390/vaccines9060551