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。842Please respect copyright.ＰＥＮＡＮＡG5Qtyh4N9G
842Please respect copyright.ＰＥＮＡＮＡ4kaxXcSkgZ
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。842Please respect copyright.ＰＥＮＡＮＡ44nIfg6GYu
842Please respect copyright.ＰＥＮＡＮＡTcC28Iikrk
842Please respect copyright.ＰＥＮＡＮＡ9xI3WxciGI
（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。842Please respect copyright.ＰＥＮＡＮＡ3G7iIb5XIF
842Please respect copyright.ＰＥＮＡＮＡOGmkrtRLdQ
下列為Sinovac製作滅活病毒疫苗的扼要流程(Ref3)842Please respect copyright.ＰＥＮＡＮＡUuFNUHchNJ
842Please respect copyright.ＰＥＮＡＮＡdcTeGHgU55
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。842Please respect copyright.ＰＥＮＡＮＡXAl2jPGaYY
842Please respect copyright.ＰＥＮＡＮＡqInmewKyip
2.經過數輪實驗室細胞的培植，使病毒數量增加。842Please respect copyright.ＰＥＮＡＮＡXUBJfIaRLP
842Please respect copyright.ＰＥＮＡＮＡQ1HlFqsXh2
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。842Please respect copyright.ＰＥＮＡＮＡEKHnOWj1vG
842Please respect copyright.ＰＥＮＡＮＡNA8cKJxDix
4.將其製成可注射的疫苗。842Please respect copyright.ＰＥＮＡＮＡX5wWz8QULH
842Please respect copyright.ＰＥＮＡＮＡOTCvcpdB3T
842Please respect copyright.ＰＥＮＡＮＡmZgano9E7c
842Please respect copyright.ＰＥＮＡＮＡdHo8o3sCb7
（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。842Please respect copyright.ＰＥＮＡＮＡCh2U9wEkwD
842Please respect copyright.ＰＥＮＡＮＡeQulaPkrPW
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。842Please respect copyright.ＰＥＮＡＮＡUsIUUvWIfd
https://www.penana.com/article/466568842Please respect copyright.ＰＥＮＡＮＡMpl9K2kUjR
842Please respect copyright.ＰＥＮＡＮＡq7Eb4DFYg4
842Please respect copyright.ＰＥＮＡＮＡvIUQ3SAECt
842Please respect copyright.ＰＥＮＡＮＡVjRF4fGIiL
842Please respect copyright.ＰＥＮＡＮＡ9d0ZI03JxV
842Please respect copyright.ＰＥＮＡＮＡ57sMs5XvX0
842Please respect copyright.ＰＥＮＡＮＡIe3AmdnWwT
842Please respect copyright.ＰＥＮＡＮＡg4G6m9jLWz
842Please respect copyright.ＰＥＮＡＮＡqmWUYKQVPz
（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。842Please respect copyright.ＰＥＮＡＮＡNteoOdkM5L
842Please respect copyright.ＰＥＮＡＮＡVopDmo1OFT
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。842Please respect copyright.ＰＥＮＡＮＡe5NYNTthwO
842Please respect copyright.ＰＥＮＡＮＡbZ0rm5Q7a8
1.抗體與病毒的S protein合併，842Please respect copyright.ＰＥＮＡＮＡdv5qlKXxMA
防止條件1的達成。842Please respect copyright.ＰＥＮＡＮＡU47pzGJK5O
842Please respect copyright.ＰＥＮＡＮＡe8LYH1zpel
2.抗體與病毒其他位置合併，842Please respect copyright.ＰＥＮＡＮＡ5tPZ7GUmso
防止條件3的達成。842Please respect copyright.ＰＥＮＡＮＡYaVyr2s0E8
842Please respect copyright.ＰＥＮＡＮＡsokh04qny1
842Please respect copyright.ＰＥＮＡＮＡXUgkSF1UEQ
842Please respect copyright.ＰＥＮＡＮＡoMwFVDfu5n
（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。842Please respect copyright.ＰＥＮＡＮＡCvVQWyuLJ8
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。842Please respect copyright.ＰＥＮＡＮＡ4WKv4V9J6U
842Please respect copyright.ＰＥＮＡＮＡU8Vlef1KSm
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。842Please respect copyright.ＰＥＮＡＮＡolQA6WdvF0
842Please respect copyright.ＰＥＮＡＮＡnfx8wkemBd
842Please respect copyright.ＰＥＮＡＮＡJWmVNZFtTP
842Please respect copyright.ＰＥＮＡＮＡvUv49VdluU
842Please respect copyright.ＰＥＮＡＮＡcLELKdA0I8
（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;842Please respect copyright.ＰＥＮＡＮＡYVlTYRRF3S
簡單來說，就是抗體適得其反地協助病毒入侵人體細胞。842Please respect copyright.ＰＥＮＡＮＡZjNcuh8qy7
842Please respect copyright.ＰＥＮＡＮＡAXI5iqTQF2
免疫細胞的表面上，有著接收器識辨抗體的某個區域。842Please respect copyright.ＰＥＮＡＮＡb0SuoKCKGG
842Please respect copyright.ＰＥＮＡＮＡfzoFX4C4V9
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。842Please respect copyright.ＰＥＮＡＮＡZT6AjFqZTO
842Please respect copyright.ＰＥＮＡＮＡzw6FDBngor
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。842Please respect copyright.ＰＥＮＡＮＡ41p23lQZDZ
842Please respect copyright.ＰＥＮＡＮＡEqeF5nQ8ah
842Please respect copyright.ＰＥＮＡＮＡrmYCZJ2HNH
842Please respect copyright.ＰＥＮＡＮＡr8iErxr6AR
（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。842Please respect copyright.ＰＥＮＡＮＡCWwqCsoObO
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。842Please respect copyright.ＰＥＮＡＮＡXkP9dhaBxb
842Please respect copyright.ＰＥＮＡＮＡY2AhCVMPl9
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。842Please respect copyright.ＰＥＮＡＮＡOSGifuiqsB
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。842Please respect copyright.ＰＥＮＡＮＡkEPaNCO89v
842Please respect copyright.ＰＥＮＡＮＡEB6nDC3Hjp
842Please respect copyright.ＰＥＮＡＮＡTDP1KYGDzW
842Please respect copyright.ＰＥＮＡＮＡRKoV13POwW
（圖8）ADE這現象，科學家一直以來均有記錄及研究。（Ref4)842Please respect copyright.ＰＥＮＡＮＡuFoQBubvNf
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。842Please respect copyright.ＰＥＮＡＮＡ9vTO78Y8mQ
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。842Please respect copyright.ＰＥＮＡＮＡ77tfPZkIRx
842Please respect copyright.ＰＥＮＡＮＡJj9BEyDcFQ
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。842Please respect copyright.ＰＥＮＡＮＡKKy29vezaL
842Please respect copyright.ＰＥＮＡＮＡisPqh9INE4
842Please respect copyright.ＰＥＮＡＮＡHJVDfHGQdZ
842Please respect copyright.ＰＥＮＡＮＡkyqSjn7T3b
（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)842Please respect copyright.ＰＥＮＡＮＡZsTIrFP4w5
842Please respect copyright.ＰＥＮＡＮＡSZq606CaNQ
武肺會否出現同樣現象，暫時尚未清楚。842Please respect copyright.ＰＥＮＡＮＡxx1R9gr7lD
842Please respect copyright.ＰＥＮＡＮＡtM7G6IdZSJ
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。842Please respect copyright.ＰＥＮＡＮＡCZszeMS7Zx
842Please respect copyright.ＰＥＮＡＮＡMF2Nae2okW
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。842Please respect copyright.ＰＥＮＡＮＡj2vKH9NNu9
842Please respect copyright.ＰＥＮＡＮＡoND0fh6EDR
842Please respect copyright.ＰＥＮＡＮＡXveUaVPyvc
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！842Please respect copyright.ＰＥＮＡＮＡ7b2wa6rdVI
842Please respect copyright.ＰＥＮＡＮＡ8z97ECQD1U
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。842Please respect copyright.ＰＥＮＡＮＡXxmbWKdudy
842Please respect copyright.ＰＥＮＡＮＡPloi098oj9
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/toc842Please respect copyright.ＰＥＮＡＮＡs2lgkcN8xy
842Please respect copyright.ＰＥＮＡＮＡJ4lVrVs5t8
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。842Please respect copyright.ＰＥＮＡＮＡat27xSVMNK
842Please respect copyright.ＰＥＮＡＮＡyf8MT4tcn8
Link:842Please respect copyright.ＰＥＮＡＮＡCAkzmvIuYI
https://www.penana.com/user/27349/%E8%96%AF%E4%BB%94%E8%81%9E%E8%8C%B1%E8%8E%89/portfolio842Please respect copyright.ＰＥＮＡＮＡYcbYWTqA9w
842Please respect copyright.ＰＥＮＡＮＡe6HTOxjlUZ
842Please respect copyright.ＰＥＮＡＮＡLLp96gkUqm
有興趣接收科普資訊的話，歡迎follow IG: potatopigtongue。842Please respect copyright.ＰＥＮＡＮＡrROL0qCXLL
842Please respect copyright.ＰＥＮＡＮＡDoxIlAId4C
842Please respect copyright.ＰＥＮＡＮＡsexyGyZaPM
Ref2:https://jamanetwork.com/journals/jama/fullarticle/2769612?fbclid=IwAR0sp9eU5V9FOzuLjz6ERw6LRFm-1yx3MJt1OEgqBDQKW1GA5mQeIIi5J7E842Please respect copyright.ＰＥＮＡＮＡNicEUUjt9R
Ref3:https://science.sciencemag.org/content/369/6499/77?fbclid=IwAR29zOO06gVsQAC2jLU2uMJi-qcYbniz108Y4kcaWOr1iNuQyVM3jCFMHa4842Please respect copyright.ＰＥＮＡＮＡW7EBkGeUV7
Ref4:https://www.nature.com/articles/s41586-020-2538-8.pdf842Please respect copyright.ＰＥＮＡＮＡkyTDFCrFYy
Ref5:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7115629/842Please respect copyright.ＰＥＮＡＮＡdYTUxblVUT
Penana
search
Loginarrow_drop_down
Registerarrow_drop_down
