至今中國總共有三間生物公司的疫苗踏入Phase3狀態，包括為Cansino、Sinovac及Sinopharm。865Please respect copyright.ＰＥＮＡＮＡkA63QQsK2U
865Please respect copyright.ＰＥＮＡＮＡ8WUh3ZlWdX
其中Sinovac (Phase 3地點:巴西）及國營的Sinopharm(Ref2) (Phase 3地點:阿聯酋）兩間均用上滅活病毒疫苗(Inactivated Virus Vaccine)設計，本文將會就此作深入探討。865Please respect copyright.ＰＥＮＡＮＡYHDScQzXxL
865Please respect copyright.ＰＥＮＡＮＡ2WztA5krJR
865Please respect copyright.ＰＥＮＡＮＡju9bP15Byw
（圖1）滅活病毒疫苗，顧名思義就是將病毒除去感染能力，當作疫苗之用。865Please respect copyright.ＰＥＮＡＮＡQtaya6zGIY
865Please respect copyright.ＰＥＮＡＮＡvh5nleLhb2
下列為Sinovac製作滅活病毒疫苗的扼要流程(Ref3)865Please respect copyright.ＰＥＮＡＮＡObnqu72wqv
865Please respect copyright.ＰＥＮＡＮＡJ4tzs3s954
1.從一名進入深切治療部的中國病患肺部體液中抽取病毒。865Please respect copyright.ＰＥＮＡＮＡJYTnIDtfpi
865Please respect copyright.ＰＥＮＡＮＡjSH7cPCdZl
2.經過數輪實驗室細胞的培植，使病毒數量增加。865Please respect copyright.ＰＥＮＡＮＡhZnQRf1OEJ
865Please respect copyright.ＰＥＮＡＮＡssilhApbws
3.加入化學物消減病毒的感染力和多重過濾，取得弱化的武肺病毒。865Please respect copyright.ＰＥＮＡＮＡAQQtx147xn
865Please respect copyright.ＰＥＮＡＮＡODaq8XeOf1
4.將其製成可注射的疫苗。865Please respect copyright.ＰＥＮＡＮＡG2toCtUmeJ
865Please respect copyright.ＰＥＮＡＮＡNwbWncOPXz
865Please respect copyright.ＰＥＮＡＮＡSnbrqj9n7O
865Please respect copyright.ＰＥＮＡＮＡ6cpqo8maW5
（圖2）將滅活病毒疫苗注射到身體後，身體的免疫細胞便會製作對應弱化病毒的抗體。865Please respect copyright.ＰＥＮＡＮＡEmRwgmdV7n
865Please respect copyright.ＰＥＮＡＮＡKp9xcSB4JW
在繼續講述抗體之前，可先閱覽（圖3）溫故知新一下武肺入侵人體細胞的簡要過程，又或者可以到之前我所寫的文章觀看略為詳細的版本。865Please respect copyright.ＰＥＮＡＮＡ2mkWUbUFMY
https://www.penana.com/article/466568865Please respect copyright.ＰＥＮＡＮＡIzJzS70o9w
865Please respect copyright.ＰＥＮＡＮＡYAoN9Oauh6
865Please respect copyright.ＰＥＮＡＮＡunMpPl2VjL
865Please respect copyright.ＰＥＮＡＮＡ6Btw2MJHJx
865Please respect copyright.ＰＥＮＡＮＡ1PwDkhdYX4
865Please respect copyright.ＰＥＮＡＮＡKXQ9oYsjq8
865Please respect copyright.ＰＥＮＡＮＡkvKxRaQ02M
865Please respect copyright.ＰＥＮＡＮＡ2zFzrcUJ1w
865Please respect copyright.ＰＥＮＡＮＡuCVHllash1
（圖4）抗體（Antibody)頂多只能阻礙病毒進入細胞或者指示其他免疫細胞前來清滅病毒，並無獨立能力清滅病毒。865Please respect copyright.ＰＥＮＡＮＡ79Kw5EA8fM
865Please respect copyright.ＰＥＮＡＮＡ5o6sfgHruv
而能夠阻礙病毒進入細胞的抗體，我們將稱之為Neutralizing Antibody，而圖中已列出其中的兩款機制。865Please respect copyright.ＰＥＮＡＮＡ3fb4Fdjh8L
865Please respect copyright.ＰＥＮＡＮＡG7aayKbKg8
1.抗體與病毒的S protein合併，865Please respect copyright.ＰＥＮＡＮＡfYiNMCuaju
防止條件1的達成。865Please respect copyright.ＰＥＮＡＮＡoxpPFNE2Gy
865Please respect copyright.ＰＥＮＡＮＡdsFuOp77yn
2.抗體與病毒其他位置合併，865Please respect copyright.ＰＥＮＡＮＡKkks2ErLc9
防止條件3的達成。865Please respect copyright.ＰＥＮＡＮＡ1u8ZbcCT21
865Please respect copyright.ＰＥＮＡＮＡ96zaG8CpVl
865Please respect copyright.ＰＥＮＡＮＡAKvNVKeUlC
865Please respect copyright.ＰＥＮＡＮＡOgOTXK7j1s
（圖5）用上滅活病毒疫苗的話，抗體的製作便會針對病毒的各個位置而進行。865Please respect copyright.ＰＥＮＡＮＡKA1rmed3W3
基於並非所有抗體也能夠拼合在病毒的關鍵位置，不能夠阻礙病毒進入細胞的抗體，我們將稱之為Non-Neutralizing Antibody。865Please respect copyright.ＰＥＮＡＮＡScJSTDdVjY
865Please respect copyright.ＰＥＮＡＮＡnEtgDaMyJi
不過，就算是Non-Neutralizing Antibody，它亦能有能力標示病毒，指引其他免疫細胞前來清滅病毒。865Please respect copyright.ＰＥＮＡＮＡjNKmU8LDYC
865Please respect copyright.ＰＥＮＡＮＡrAsdglQAqd
865Please respect copyright.ＰＥＮＡＮＡwp0shU1OsP
865Please respect copyright.ＰＥＮＡＮＡ8geOAg9igh
865Please respect copyright.ＰＥＮＡＮＡ2TQ5V6ZhkS
（圖6）Non-Neutralizing Antibody的出現，將會引伸出一個名為Antibody Dependent Enhancement(ADE)的重要問題;865Please respect copyright.ＰＥＮＡＮＡhCGv9CSMBi
簡單來說，就是抗體適得其反地協助病毒入侵人體細胞。865Please respect copyright.ＰＥＮＡＮＡhc7fFG0Sye
865Please respect copyright.ＰＥＮＡＮＡxRfOOl6RQP
免疫細胞的表面上，有著接收器識辨抗體的某個區域。865Please respect copyright.ＰＥＮＡＮＡfjFZViZBby
865Please respect copyright.ＰＥＮＡＮＡN3gqLlcnh5
但若果有過多Non-Neutralizing Antibody黏在病毒裡頭的話，病毒就有機會可以無視之前那3條法則，不需要經過ACE2，而是透過免疫細胞的表面上識辨抗體的接收器進入細胞。865Please respect copyright.ＰＥＮＡＮＡk4BViZfsBB
865Please respect copyright.ＰＥＮＡＮＡXtDjCFNVMc
換句話說，抗體在這情況下變相成為幫兇或者25仔，輔助病毒進入細胞，這現象我們稱之為ADE。865Please respect copyright.ＰＥＮＡＮＡsrUd96ZIuK
865Please respect copyright.ＰＥＮＡＮＡd2sWwQzXpr
865Please respect copyright.ＰＥＮＡＮＡC2mcaAtfpY
865Please respect copyright.ＰＥＮＡＮＡD5hcIqXTnm
（圖7）武肺病毒進入細胞後，需要切割S protein才能夠開始進行繁殖工作。865Please respect copyright.ＰＥＮＡＮＡ8dLJr9vSDG
所以就算有Non-Neutralizing antibody做25仔，如果病毒幸運地有Neutralizing antibody保護S protein免受切割的話，病毒依舊無法作惡。865Please respect copyright.ＰＥＮＡＮＡulKXTFn1Oe
865Please respect copyright.ＰＥＮＡＮＡvpAJt92yB3
但若果無Neutralizing antibody保護的話，病毒就會利用免疫細胞作為寄主，避開一切免疫機制，大量製造病毒。865Please respect copyright.ＰＥＮＡＮＡb8s9wQERjn
情形就好像本身理應維護法紀的警察，突然之間搖身一變成為罪惡的溫床，窩藏及協助罪犯（病毒）滋生，導致情況一發不可收拾。865Please respect copyright.ＰＥＮＡＮＡvVkXpAGlza
865Please respect copyright.ＰＥＮＡＮＡwKZK9YJbS2
865Please respect copyright.ＰＥＮＡＮＡBxK5bFnjih
865Please respect copyright.ＰＥＮＡＮＡck5pouUEn6
（圖8）ADE這現象，科學家一直以來均有記錄及研究。（Ref4)865Please respect copyright.ＰＥＮＡＮＡeLln5xPvbA
以登革熱為例，病人染上登革熱病毒(Dengue Virus)的話，身體便會製造登革熱病毒抗體。865Please respect copyright.ＰＥＮＡＮＡOSYPSzzH2e
但基於登革熱病毒與寨卡病毒(Zika Virus)有頗為相似的地方，某部份的登革熱病毒抗體「幸運地」便成為寨卡病毒的Non-Neutralizing Antibody，透過ADE幫忙寨卡病毒入侵人體。865Please respect copyright.ＰＥＮＡＮＡwibAAKm5q2
865Please respect copyright.ＰＥＮＡＮＡDPm43k8GMk
亦即是說，擁有登革熱病毒抗體的人反而更有機會受到寨卡病毒入侵。865Please respect copyright.ＰＥＮＡＮＡJpF66aQiQZ
865Please respect copyright.ＰＥＮＡＮＡRdrJoj8vAH
865Please respect copyright.ＰＥＮＡＮＡEaJskuZtFc
865Please respect copyright.ＰＥＮＡＮＡDrvj4GbCn4
（圖9）有研究指出，03年SARS病毒亦會依靠未曾上市的疫苗所產生出的Non-Neutralizing Antibody，不需經過ACE2便能入侵免疫細胞。（Ref5)865Please respect copyright.ＰＥＮＡＮＡlRpwY30Oot
865Please respect copyright.ＰＥＮＡＮＡopBVVXGWfr
武肺會否出現同樣現象，暫時尚未清楚。865Please respect copyright.ＰＥＮＡＮＡtPuzPpKmkL
865Please respect copyright.ＰＥＮＡＮＡ2HKD2DvWmb
只不過各國進行Phase3中的疫苗，大多也是針對著武肺病毒S protein位置而設計，故此出現Non-Neutralizing antibody將會比用上整個武肺病毒而作為疫苗設計的那兩間公司為低，ADE的機率亦相對減少。865Please respect copyright.ＰＥＮＡＮＡiSEPEOOCRL
865Please respect copyright.ＰＥＮＡＮＡffdaa8oF0o
當然，另一方面來看，中國那兩間公司因為用上整個武肺病毒來設計疫苗，理論上所產生的抗體數量及濃度亦會為高，抵抗的效果亦會相對顯著，但ADE的機率出現亦會相對為高。865Please respect copyright.ＰＥＮＡＮＡRSFomKH7vT
865Please respect copyright.ＰＥＮＡＮＡ2Qj2mchFdw
865Please respect copyright.ＰＥＮＡＮＡ1Ykcl2OTrO
美國Moderna已表示Phase3的報告將會探討ADE的可能，但願中國Sinovac及國營Sinopharm的Phase3報告，也會在ADE方面進行深入探討吧！865Please respect copyright.ＰＥＮＡＮＡtRxwEKts9Z
865Please respect copyright.ＰＥＮＡＮＡ8N8URYocHf
如果想我快啲出文的話，請入去Penana網站科普專欄–薯不揀單俾一個like以及Bookmark，這對我非常之重要。865Please respect copyright.ＰＥＮＡＮＡyw1T4ZV7eU
865Please respect copyright.ＰＥＮＡＮＡpapmEPRyDs
Link: https://www.penana.com/story/66244/%E7%A7%91%E6%99%AE%E5%B0%88%E6%AC%84-%E8%96%AF%E4%B8%8D%E6%8F%80%E5%96%AE/toc865Please respect copyright.ＰＥＮＡＮＡePOmIos8zO
865Please respect copyright.ＰＥＮＡＮＡU3ZGkB84Js
同時亦可以在Penana網站裡按「買一嚿/半嚿薯仔」，以課金的方式推動我繼續搜羅資料寫文，多謝。865Please respect copyright.ＰＥＮＡＮＡsnaWSrUljT
865Please respect copyright.ＰＥＮＡＮＡ4EmYJEiSBa
Link:865Please respect copyright.ＰＥＮＡＮＡiOzPLoMLS2
https://www.penana.com/user/27349/%E8%96%AF%E4%BB%94%E8%81%9E%E8%8C%B1%E8%8E%89/portfolio865Please respect copyright.ＰＥＮＡＮＡeDGTY7gFL2
865Please respect copyright.ＰＥＮＡＮＡU1Bqa0enwY
865Please respect copyright.ＰＥＮＡＮＡNzDv9ezMrS
有興趣接收科普資訊的話，歡迎follow IG: potatopigtongue。865Please respect copyright.ＰＥＮＡＮＡZtl8UI9BTe
865Please respect copyright.ＰＥＮＡＮＡCXQ5tzrKtT
865Please respect copyright.ＰＥＮＡＮＡdZzCm5mrqf
Ref2:https://jamanetwork.com/journals/jama/fullarticle/2769612?fbclid=IwAR0sp9eU5V9FOzuLjz6ERw6LRFm-1yx3MJt1OEgqBDQKW1GA5mQeIIi5J7E865Please respect copyright.ＰＥＮＡＮＡ3mM7CPppL2
Ref3:https://science.sciencemag.org/content/369/6499/77?fbclid=IwAR29zOO06gVsQAC2jLU2uMJi-qcYbniz108Y4kcaWOr1iNuQyVM3jCFMHa4865Please respect copyright.ＰＥＮＡＮＡMCNmBevS6o
Ref4:https://www.nature.com/articles/s41586-020-2538-8.pdf865Please respect copyright.ＰＥＮＡＮＡ0MAy3oaO4m
Ref5:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7115629/865Please respect copyright.ＰＥＮＡＮＡ9KKqU4rfxM
Penana
search
登入arrow_drop_down
註冊arrow_drop_down
