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。800Please respect copyright.ＰＥＮＡＮＡFxshzg0raz
800Please respect copyright.ＰＥＮＡＮＡQ16CdCv2EJ
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。800Please respect copyright.ＰＥＮＡＮＡri2hHGLVLQ
800Please respect copyright.ＰＥＮＡＮＡs1vaEyqIOM
800Please respect copyright.ＰＥＮＡＮＡNEYbNx8EbP
（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。800Please respect copyright.ＰＥＮＡＮＡ5Pwgc2VewC
800Please respect copyright.ＰＥＮＡＮＡKpq2Rb1Y3p
下列為Sinovac製作滅活病毒疫苗的扼要流程(Ref3)800Please respect copyright.ＰＥＮＡＮＡ6NX8RRKjCP
800Please respect copyright.ＰＥＮＡＮＡ6tsFw9xgtY
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。800Please respect copyright.ＰＥＮＡＮＡRXMJq7c0KR
800Please respect copyright.ＰＥＮＡＮＡcktWD8sMAo
2.經過數輪實驗室細胞的培植，使病毒數量增加。800Please respect copyright.ＰＥＮＡＮＡIkA5QFVuk7
800Please respect copyright.ＰＥＮＡＮＡ1M5JVILb3H
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。800Please respect copyright.ＰＥＮＡＮＡ7pIDiTot7j
800Please respect copyright.ＰＥＮＡＮＡbmZTaBDs9R
4.將其製成可注射的疫苗。800Please respect copyright.ＰＥＮＡＮＡfCZtp8yEho
800Please respect copyright.ＰＥＮＡＮＡLIPPCq89HN
800Please respect copyright.ＰＥＮＡＮＡnu7DPVwrX8
800Please respect copyright.ＰＥＮＡＮＡmornDTZyrz
（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。800Please respect copyright.ＰＥＮＡＮＡAatRn7PMNL
800Please respect copyright.ＰＥＮＡＮＡLfT96mOWVh
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。800Please respect copyright.ＰＥＮＡＮＡqzNhUD9UdH
https://www.penana.com/article/466568800Please respect copyright.ＰＥＮＡＮＡSYILyYnQzq
800Please respect copyright.ＰＥＮＡＮＡuH8oCx2E1I
800Please respect copyright.ＰＥＮＡＮＡgsqWqlJwn7
800Please respect copyright.ＰＥＮＡＮＡ0BjR3ysctA
800Please respect copyright.ＰＥＮＡＮＡRME94xoT9S
800Please respect copyright.ＰＥＮＡＮＡRqV6hlc2UF
800Please respect copyright.ＰＥＮＡＮＡLvmtGToKlR
800Please respect copyright.ＰＥＮＡＮＡIgTsFKVlXm
800Please respect copyright.ＰＥＮＡＮＡVRTNNstS3c
（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。800Please respect copyright.ＰＥＮＡＮＡ99BrHLzuXh
800Please respect copyright.ＰＥＮＡＮＡOWPxKXLEKJ
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。800Please respect copyright.ＰＥＮＡＮＡBHCQfxVD5I
800Please respect copyright.ＰＥＮＡＮＡKqvLMKzLWs
1.抗體與病毒的S protein合併，800Please respect copyright.ＰＥＮＡＮＡ6EQv540NNa
防止條件1的達成。800Please respect copyright.ＰＥＮＡＮＡi5U2cXJKZP
800Please respect copyright.ＰＥＮＡＮＡrAtuU8upvG
2.抗體與病毒其他位置合併，800Please respect copyright.ＰＥＮＡＮＡ3Qy0LRFP7t
防止條件3的達成。800Please respect copyright.ＰＥＮＡＮＡPmRyl6FwdN
800Please respect copyright.ＰＥＮＡＮＡiP68O14ymU
800Please respect copyright.ＰＥＮＡＮＡ4bZk0L5mhh
800Please respect copyright.ＰＥＮＡＮＡWwCALZMAD4
（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。800Please respect copyright.ＰＥＮＡＮＡsFTV0uMwaq
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。800Please respect copyright.ＰＥＮＡＮＡ3z8HYQ5QyG
800Please respect copyright.ＰＥＮＡＮＡzbSEo9M81D
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。800Please respect copyright.ＰＥＮＡＮＡgwBslXivAO
800Please respect copyright.ＰＥＮＡＮＡpeakbALwFH
800Please respect copyright.ＰＥＮＡＮＡopdevo1XX3
800Please respect copyright.ＰＥＮＡＮＡo8Qn6pypml
800Please respect copyright.ＰＥＮＡＮＡVeTIwK3OXA
（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;800Please respect copyright.ＰＥＮＡＮＡSepExxBhd1
簡單來說，就是抗體適得其反地協助病毒入侵人體細胞。800Please respect copyright.ＰＥＮＡＮＡ9sMnN1s2H5
800Please respect copyright.ＰＥＮＡＮＡBuVWpYofiW
免疫細胞的表面上，有著接收器識辨抗體的某個區域。800Please respect copyright.ＰＥＮＡＮＡzmCqHGYVgC
800Please respect copyright.ＰＥＮＡＮＡifMcpynt6X
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。800Please respect copyright.ＰＥＮＡＮＡLHQg4WA0Tp
800Please respect copyright.ＰＥＮＡＮＡZGnKPE8hGT
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。800Please respect copyright.ＰＥＮＡＮＡYyWfjBAFno
800Please respect copyright.ＰＥＮＡＮＡVmxkh3tybJ
800Please respect copyright.ＰＥＮＡＮＡX14GdPlRzd
800Please respect copyright.ＰＥＮＡＮＡlBWVLH0QRW
（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。800Please respect copyright.ＰＥＮＡＮＡX2Jz2wB3sq
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。800Please respect copyright.ＰＥＮＡＮＡ3dkhXwWtUB
800Please respect copyright.ＰＥＮＡＮＡY75LEoQZU3
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。800Please respect copyright.ＰＥＮＡＮＡpLRxwYEHBu
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。800Please respect copyright.ＰＥＮＡＮＡTU1qLtKDLv
800Please respect copyright.ＰＥＮＡＮＡd9GinwRtHY
800Please respect copyright.ＰＥＮＡＮＡtgnvfaUSgh
800Please respect copyright.ＰＥＮＡＮＡ7okXYjUlxv
（圖8）ADE這現象，科學家一直以來均有記錄及研究。（Ref4)800Please respect copyright.ＰＥＮＡＮＡogUBDHnYI2
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。800Please respect copyright.ＰＥＮＡＮＡNH4LAPQqhd
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。800Please respect copyright.ＰＥＮＡＮＡ1YorXm5PvG
800Please respect copyright.ＰＥＮＡＮＡCc9cgHd4vv
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。800Please respect copyright.ＰＥＮＡＮＡUZaeq6xczb
800Please respect copyright.ＰＥＮＡＮＡfLRlD86hTj
800Please respect copyright.ＰＥＮＡＮＡz2KptJqItk
800Please respect copyright.ＰＥＮＡＮＡbDMd451WV6
（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)800Please respect copyright.ＰＥＮＡＮＡxMPyWizlQN
800Please respect copyright.ＰＥＮＡＮＡD8NuP7iMje
武肺會否出現同樣現象，暫時尚未清楚。800Please respect copyright.ＰＥＮＡＮＡsQr0o3ZXDD
800Please respect copyright.ＰＥＮＡＮＡvINFc1zncm
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。800Please respect copyright.ＰＥＮＡＮＡUnEz2sXd2G
800Please respect copyright.ＰＥＮＡＮＡv332aI85RS
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。800Please respect copyright.ＰＥＮＡＮＡHKUklpT31S
800Please respect copyright.ＰＥＮＡＮＡ7Jebd6fhuV
800Please respect copyright.ＰＥＮＡＮＡKeIqRpUw7J
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！800Please respect copyright.ＰＥＮＡＮＡUdWL5RVYBL
800Please respect copyright.ＰＥＮＡＮＡleWWSLUUIp
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。800Please respect copyright.ＰＥＮＡＮＡo7fLGZHHmp
800Please respect copyright.ＰＥＮＡＮＡa0J0xrfcXx
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/toc800Please respect copyright.ＰＥＮＡＮＡWM0pJ5O0XK
800Please respect copyright.ＰＥＮＡＮＡB5MfTKDr3n
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。800Please respect copyright.ＰＥＮＡＮＡzxxS4Z4moY
800Please respect copyright.ＰＥＮＡＮＡl9XDWsxjXd
Link:800Please respect copyright.ＰＥＮＡＮＡsHokYnr6KE
https://www.penana.com/user/27349/%E8%96%AF%E4%BB%94%E8%81%9E%E8%8C%B1%E8%8E%89/portfolio800Please respect copyright.ＰＥＮＡＮＡB2FkX8yb7b
800Please respect copyright.ＰＥＮＡＮＡeSXFvcMuyX
800Please respect copyright.ＰＥＮＡＮＡY2MN4ZnucV
有興趣接收科普資訊的話，歡迎follow IG: potatopigtongue。800Please respect copyright.ＰＥＮＡＮＡvTVgmPAYrN
800Please respect copyright.ＰＥＮＡＮＡNI3LPOLg4a
800Please respect copyright.ＰＥＮＡＮＡHBjgUk2lFs
Ref2:https://jamanetwork.com/journals/jama/fullarticle/2769612?fbclid=IwAR0sp9eU5V9FOzuLjz6ERw6LRFm-1yx3MJt1OEgqBDQKW1GA5mQeIIi5J7E800Please respect copyright.ＰＥＮＡＮＡIkkbyOFnZN
Ref3:https://science.sciencemag.org/content/369/6499/77?fbclid=IwAR29zOO06gVsQAC2jLU2uMJi-qcYbniz108Y4kcaWOr1iNuQyVM3jCFMHa4800Please respect copyright.ＰＥＮＡＮＡukiYbQAcRA
Ref4:https://www.nature.com/articles/s41586-020-2538-8.pdf800Please respect copyright.ＰＥＮＡＮＡCxpsWlxtNm
Ref5:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7115629/800Please respect copyright.ＰＥＮＡＮＡaph81eHsSj
Penana
search
Loginarrow_drop_down
Registerarrow_drop_down
