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。886Please respect copyright.ＰＥＮＡＮＡqAYtCwhf1b
886Please respect copyright.ＰＥＮＡＮＡyBhKVjJNzr
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。886Please respect copyright.ＰＥＮＡＮＡb7FWqKIPkn
886Please respect copyright.ＰＥＮＡＮＡo9mUGYR2do
886Please respect copyright.ＰＥＮＡＮＡLQrecvFX7j
（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。886Please respect copyright.ＰＥＮＡＮＡRH7xfSolCO
886Please respect copyright.ＰＥＮＡＮＡraugUL2cru
下列為Sinovac製作滅活病毒疫苗的扼要流程(Ref3)886Please respect copyright.ＰＥＮＡＮＡVn8JY3NobZ
886Please respect copyright.ＰＥＮＡＮＡOLxJy2KEp6
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。886Please respect copyright.ＰＥＮＡＮＡn4MqMXCQrE
886Please respect copyright.ＰＥＮＡＮＡN3eCnwlEm7
2.經過數輪實驗室細胞的培植，使病毒數量增加。886Please respect copyright.ＰＥＮＡＮＡMw2M301I2k
886Please respect copyright.ＰＥＮＡＮＡg7j7lVlOk4
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。886Please respect copyright.ＰＥＮＡＮＡMmvkl0p7Ja
886Please respect copyright.ＰＥＮＡＮＡrCrQc6D7iW
4.將其製成可注射的疫苗。886Please respect copyright.ＰＥＮＡＮＡ0jHvrwoUix
886Please respect copyright.ＰＥＮＡＮＡrnJ2PfuhMB
886Please respect copyright.ＰＥＮＡＮＡAvovFg644S
886Please respect copyright.ＰＥＮＡＮＡQsJvV32f2P
（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。886Please respect copyright.ＰＥＮＡＮＡtuCDARFTD3
886Please respect copyright.ＰＥＮＡＮＡPtJVeQerPy
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。886Please respect copyright.ＰＥＮＡＮＡ34g3b0RwR0
https://www.penana.com/article/466568886Please respect copyright.ＰＥＮＡＮＡ9A3eh0mxui
886Please respect copyright.ＰＥＮＡＮＡUoEZNfgSgq
886Please respect copyright.ＰＥＮＡＮＡaN8XZc8jav
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886Please respect copyright.ＰＥＮＡＮＡfM9tDWHjrc
886Please respect copyright.ＰＥＮＡＮＡignCw9T2OA
886Please respect copyright.ＰＥＮＡＮＡFLHcwZf8h8
（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。886Please respect copyright.ＰＥＮＡＮＡVFyM1d2yv0
886Please respect copyright.ＰＥＮＡＮＡiPBYqIjCmz
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。886Please respect copyright.ＰＥＮＡＮＡJJhdWvd2xS
886Please respect copyright.ＰＥＮＡＮＡiCyYYhknmR
1.抗體與病毒的S protein合併，886Please respect copyright.ＰＥＮＡＮＡsnHa9f2Yxo
防止條件1的達成。886Please respect copyright.ＰＥＮＡＮＡoFeduwk9KG
886Please respect copyright.ＰＥＮＡＮＡsBBcmH7ipl
2.抗體與病毒其他位置合併，886Please respect copyright.ＰＥＮＡＮＡ9QLklqO8nf
防止條件3的達成。886Please respect copyright.ＰＥＮＡＮＡSGRO1E0RRc
886Please respect copyright.ＰＥＮＡＮＡkZ1fcqmrbc
886Please respect copyright.ＰＥＮＡＮＡcP7Gpp8Rxs
886Please respect copyright.ＰＥＮＡＮＡ3xyw9fFLeg
（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。886Please respect copyright.ＰＥＮＡＮＡiYDaxNA4PB
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。886Please respect copyright.ＰＥＮＡＮＡgGe5E5CxRS
886Please respect copyright.ＰＥＮＡＮＡORbvRQ3ZUH
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。886Please respect copyright.ＰＥＮＡＮＡ9r2jY152EH
886Please respect copyright.ＰＥＮＡＮＡHtlAvruwhN
886Please respect copyright.ＰＥＮＡＮＡBuCoY05NjM
886Please respect copyright.ＰＥＮＡＮＡcvJwAHNx86
886Please respect copyright.ＰＥＮＡＮＡetrcsPIchi
（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;886Please respect copyright.ＰＥＮＡＮＡYDOlNMa2Xa
簡單來說，就是抗體適得其反地協助病毒入侵人體細胞。886Please respect copyright.ＰＥＮＡＮＡb4WWWnMghj
886Please respect copyright.ＰＥＮＡＮＡmnW0fW8vMU
免疫細胞的表面上，有著接收器識辨抗體的某個區域。886Please respect copyright.ＰＥＮＡＮＡcIpFoXsWbl
886Please respect copyright.ＰＥＮＡＮＡdjSG6vkGbr
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。886Please respect copyright.ＰＥＮＡＮＡOeobnXOKLa
886Please respect copyright.ＰＥＮＡＮＡTqKrtZEE7l
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。886Please respect copyright.ＰＥＮＡＮＡefc8rqXrkc
886Please respect copyright.ＰＥＮＡＮＡYuq36mCe0W
886Please respect copyright.ＰＥＮＡＮＡE7elfEpgRN
886Please respect copyright.ＰＥＮＡＮＡAEKfL4j7Gi
（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。886Please respect copyright.ＰＥＮＡＮＡdvfGvnU0OO
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。886Please respect copyright.ＰＥＮＡＮＡcyZpLt74bG
886Please respect copyright.ＰＥＮＡＮＡ2R0O0Sr0Gl
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。886Please respect copyright.ＰＥＮＡＮＡTXQIZ7zCZX
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。886Please respect copyright.ＰＥＮＡＮＡgESMNOpoeH
886Please respect copyright.ＰＥＮＡＮＡbzeZwDAXlQ
886Please respect copyright.ＰＥＮＡＮＡQe2Cwb8KtD
886Please respect copyright.ＰＥＮＡＮＡdpqgi4PmPh
（圖8）ADE這現象，科學家一直以來均有記錄及研究。（Ref4)886Please respect copyright.ＰＥＮＡＮＡe66ZykIhg4
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。886Please respect copyright.ＰＥＮＡＮＡXQDAMdsmll
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。886Please respect copyright.ＰＥＮＡＮＡZfYcfjL7iH
886Please respect copyright.ＰＥＮＡＮＡOBMEi3VUuw
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。886Please respect copyright.ＰＥＮＡＮＡY6dfr0yrh3
886Please respect copyright.ＰＥＮＡＮＡTFeqMbfW0T
886Please respect copyright.ＰＥＮＡＮＡ0Y4rTTKVyO
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（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)886Please respect copyright.ＰＥＮＡＮＡWloTR3FMc4
886Please respect copyright.ＰＥＮＡＮＡwasZ6c9ebR
武肺會否出現同樣現象，暫時尚未清楚。886Please respect copyright.ＰＥＮＡＮＡzEau8Eu6PC
886Please respect copyright.ＰＥＮＡＮＡS7EUeVnjjZ
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。886Please respect copyright.ＰＥＮＡＮＡWtTmdcPM6B
886Please respect copyright.ＰＥＮＡＮＡ2FEAZjhIln
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。886Please respect copyright.ＰＥＮＡＮＡhMxcRwx0gQ
886Please respect copyright.ＰＥＮＡＮＡ1q7e28OAP1
886Please respect copyright.ＰＥＮＡＮＡHuKFpXGUYq
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！886Please respect copyright.ＰＥＮＡＮＡE3VTRpAV7v
886Please respect copyright.ＰＥＮＡＮＡwzpha03b0K
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。886Please respect copyright.ＰＥＮＡＮＡSiB0U1lxkP
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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/toc886Please respect copyright.ＰＥＮＡＮＡLTmRv0nTJq
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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。886Please respect copyright.ＰＥＮＡＮＡrcOAN0svaY
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Link:886Please respect copyright.ＰＥＮＡＮＡT4QGrk50ng
https://www.penana.com/user/27349/%E8%96%AF%E4%BB%94%E8%81%9E%E8%8C%B1%E8%8E%89/portfolio886Please respect copyright.ＰＥＮＡＮＡuYr3HSODUY
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有興趣接收科普資訊的話，歡迎follow IG: potatopigtongue。886Please respect copyright.ＰＥＮＡＮＡ7nGaQVT2u2
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Ref2:https://jamanetwork.com/journals/jama/fullarticle/2769612?fbclid=IwAR0sp9eU5V9FOzuLjz6ERw6LRFm-1yx3MJt1OEgqBDQKW1GA5mQeIIi5J7E886Please respect copyright.ＰＥＮＡＮＡNPhHFsy9ni
Ref3:https://science.sciencemag.org/content/369/6499/77?fbclid=IwAR29zOO06gVsQAC2jLU2uMJi-qcYbniz108Y4kcaWOr1iNuQyVM3jCFMHa4886Please respect copyright.ＰＥＮＡＮＡNnS4gxmObg
Ref4:https://www.nature.com/articles/s41586-020-2538-8.pdf886Please respect copyright.ＰＥＮＡＮＡtpULLv7opJ
Ref5:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7115629/886Please respect copyright.ＰＥＮＡＮＡ1oL78S2mjW
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