[HTML][HTML] Correlates of protection against norovirus infection and disease—where are we now, where do we go?

S Ramani, MK Estes, RL Atmar - PLoS pathogens, 2016 - journals.plos.org
S Ramani, MK Estes, RL Atmar
PLoS pathogens, 2016journals.plos.org
Human noroviruses (NoV) are the leading cause of foodborne gastroenteritis and endemic
diarrheal disease across all ages in the United States, cause nearly 50% of all
gastroenteritis outbreaks worldwide, and are rapidly replacing rotavirus as the predominant
gastrointestinal pathogen in pediatric populations [1]. Modelling studies show that
vaccination can offer significant healthcare and economic benefits, depending on vaccine
cost, protective efficacy, and protection duration [2]. We stand at the threshold of exciting …
Human noroviruses (NoV) are the leading cause of foodborne gastroenteritis and endemic diarrheal disease across all ages in the United States, cause nearly 50% of all gastroenteritis outbreaks worldwide, and are rapidly replacing rotavirus as the predominant gastrointestinal pathogen in pediatric populations [1]. Modelling studies show that vaccination can offer significant healthcare and economic benefits, depending on vaccine cost, protective efficacy, and protection duration [2]. We stand at the threshold of exciting progress in NoV vaccine evaluation, with several vaccine candidates in development. Furthest along are virus-like particles (VLPs), composed of the NoV major capsid protein and produced in a recombinant baculovirus expression system. VLP vaccines are safe, immunogenic, and were efficacious in a proofof-principle human experimental infection study [3]. As development transitions from small preclinical and clinical studies to larger clinical trials—and eventually to applications for licensure—it is important to review the current knowledge on correlates of protection (CoPs) against NoV infection and disease (Table 1), as well as to identify and address the remaining challenges (Table 2). This is critical to understand the basis of vaccine efficacy and to provide direction for the design and implementation of future NoV vaccine studies.
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