{"id":3731,"date":"2020-12-17T15:23:24","date_gmt":"2020-12-17T14:23:24","guid":{"rendered":"https:\/\/www.mc-praha.cz\/mcp\/?p=3731"},"modified":"2020-12-17T16:21:21","modified_gmt":"2020-12-17T15:21:21","slug":"prehled-vakcin-proti-covid-19-mechanismy-ucinku-vyhody-a-nevyhody","status":"publish","type":"post","link":"https:\/\/www.mc-praha.cz\/mcp\/prehled-vakcin-proti-covid-19-mechanismy-ucinku-vyhody-a-nevyhody\/","title":{"rendered":"P\u0159ehled vakc\u00edn proti COVID-19: mechanismy \u00fa\u010dinku, v\u00fdhody a nev\u00fdhody"},"content":{"rendered":"

Nov\u00fd beta-koronavirus, ozna\u010dovan\u00fd SARS-CoV-2, je p\u016fvodcem onemocn\u011bn\u00ed COVID-19. Tento virus byl poprv\u00e9 objeven koncem roku 2019 v\u00a0\u010d\u00ednsk\u00e9m Wu-chanu. Onemocn\u011bn\u00ed se rychle roz\u0161\u00ed\u0159ilo a v\u00a0b\u0159eznu 2020 bylo ozna\u010deno za celosv\u011btovou pandemii. Jeliko\u017e zat\u00edm nen\u00ed dostupn\u00e1 \u00fa\u010dinn\u00e1 l\u00e9\u010dba tohoto onemocn\u011bn\u00ed, je kladen velk\u00fd d\u016fraz na v\u00fdvoj vakc\u00edn, kter\u00e9 by mohly pandemii zastavit a onemocn\u011bn\u00ed dostat trvale pod kontrolu. Situace ve v\u00fdvoji vakc\u00edn se neust\u00e1le prom\u011b\u0148uje a je t\u0159eba st\u00e1le sledovat aktu\u00e1ln\u00ed informace. Prvn\u00ed vakc\u00edny by m\u011bly b\u00fdt v\u00a0\u010cesk\u00e9 republice k\u00a0dispozici po\u010d\u00e1tkem roku 2021.<\/p>\n

V\u00a0sou\u010dasn\u00e9 dob\u011b je v ur\u010dit\u00e9 f\u00e1zi v\u00fdvoje v\u00edce ne\u017e 270 kandid\u00e1tn\u00edch vakc\u00edn. Ka\u017ed\u00e1 kandid\u00e1tn\u00ed vakc\u00edna mus\u00ed proj\u00edt preklinick\u00fdm a klinick\u00fdm hodnocen\u00edm. Laboratorn\u00ed v\u00fdvoj a preklinick\u00e9 hodnocen\u00ed zahrnuje definov\u00e1n\u00ed fyzik\u00e1ln\u00edch, chemick\u00fdch a biologick\u00fdch vlastnost\u00ed kandid\u00e1tn\u00ed vakc\u00edny, jej\u00ed z\u00e1kladn\u00ed imunogenitu a bezpe\u010dnost. Ve f\u00e1zi klinick\u00e9ho hodnocen\u00ed (tj. hodnocen\u00ed po pod\u00e1n\u00ed vakc\u00edny lidem-dobrovoln\u00edk\u016fm) je v\u00a0sou\u010dasnosti v\u00edce ne\u017e 55 vakc\u00edn. Klinick\u00e9 hodnocen\u00ed zahrnuje \u010dty\u0159i f\u00e1ze. V\u00a0prvn\u00edch t\u0159ech f\u00e1z\u00edch se mimo jin\u00e9 hodnot\u00ed tolerance vakc\u00edny lidsk\u00fdm organismem (m\u00edstn\u00ed i celkov\u00e1) a roz\u0161\u00ed\u0159en\u00e1 bezpe\u010dnost, \u0159e\u0161\u00ed se mno\u017estv\u00ed antigenu ve vakc\u00edn\u011b, nejvhodn\u011bj\u0161\u00ed vakcina\u010dn\u00ed sch\u00e9ma, velikost a po\u010det d\u00e1vek. D\u00e1le se hodnot\u00ed \u00fa\u010dinnost vakc\u00edny, d\u00e9lka ochrany s\u00a0p\u0159\u00edpadnou nutnost\u00ed p\u0159eo\u010dkov\u00e1n\u00ed a interakce s\u00a0jin\u00fdmi b\u011b\u017en\u011b pod\u00e1van\u00fdmi vakc\u00ednami. \u010ctvrt\u00e1 f\u00e1ze klinick\u00e9ho hodnocen\u00ed prob\u00edh\u00e1 a\u017e po schv\u00e1len\u00ed kandid\u00e1tn\u00ed vakc\u00edny a jej\u00ed aplikaci v\u00a0populaci. Tato f\u00e1ze je dlouhodob\u00e1 a hodnot\u00ed se nap\u0159\u00edklad ne\u017e\u00e1douc\u00ed \u00fa\u010dinky \u010di p\u0159etrv\u00e1v\u00e1n\u00ed dlouhodob\u00e9 ochrany.<\/p>\n

Je \u017e\u00e1douc\u00ed, aby kandid\u00e1tn\u00edch vakc\u00edn bylo co nejv\u00edce, jeliko\u017e se p\u0159edpokl\u00e1d\u00e1, \u017ee velk\u00fd po\u010det z\u00a0nich n\u011bkterou \u010d\u00e1st\u00ed hodnocen\u00ed neprojde. V sou\u010dasn\u00e9 dob\u011b jsou proti onemocn\u011bn\u00ed COVID-19 ve v\u00fdvoji zejm\u00e9na n\u00e1sleduj\u00edc\u00ed \u010dty\u0159i typy vakc\u00edn:<\/p>\n

    \n
  1. Inaktivovan\u00e9 nebo \u017eiv\u00e9 oslaben\u00e9 virov\u00e9 vakc\u00edny. <\/strong><\/li>\n<\/ol>\n

    Tyto vakc\u00edny pou\u017e\u00edvaj\u00ed formu viru SARS-CoV-2, kde je \u017eiv\u00fd virus oslaben (tzv. \u017eiv\u00e9 vakc\u00edny) nebo inaktivov\u00e1n, tedy usmrcen (tzv. inaktivovan\u00e9 vakc\u00edny). Takov\u00fd virus nezp\u016fsobuje onemocn\u011bn\u00ed, ale p\u0159esto generuje imunitn\u00ed odpov\u011b\u010f. Mezi \u017eiv\u00e9 vakc\u00edny pat\u0159\u00ed nap\u0159\u00edklad o\u010dkovac\u00ed l\u00e1tky proti p\u0159\u00edu\u0161nic\u00edm, zard\u011bnk\u00e1m nebo spalni\u010dk\u00e1m. Nev\u00fdhodou \u017eiv\u00e9 vakc\u00edny je jej\u00ed velmi zdlouhav\u00fd v\u00fdvoj a mo\u017enost, \u017ee se p\u016fvodci choroby znovu vr\u00e1t\u00ed schopnost vyvolat onemocn\u011bn\u00ed i se v\u0161emi nebezpe\u010dn\u00fdmi projevy. Z\u00a0tohoto d\u016fvodu se \u010dasto pou\u017e\u00edvaj\u00ed inaktivovan\u00e9 vakc\u00edny, kde je p\u016fvodce choroby zne\u0161kodn\u011bn nap\u0159\u00edklad vysokou teplotou, chemicky nebo oza\u0159ov\u00e1n\u00edm. Inaktivovan\u00fdmi vakc\u00ednami se o\u010dkuje nap\u0159\u00edklad proti obrn\u011b nebo \u017eloutence typu A. Mechanismus inaktivovan\u00e9 vakc\u00edny vyu\u017e\u00edvaj\u00ed v\u00a0sou\u010dasn\u00e9 dob\u011b i n\u011bkter\u00e9 t\u00fdmy pro v\u00fdvoj vakc\u00edn proti onemocn\u011bn\u00ed COVID-19. Mezi tyto v\u00fdrobce pat\u0159\u00ed nap\u0159\u00edklad spole\u010dnosti Sinopharm7,8<\/sup><\/strong>, Sinovac10<\/sup> <\/strong>\u010di Bharat Biotech International11<\/sup><\/strong>. Masovou v\u00fdrobu plnohodnotn\u00e9ho viru, kter\u00fd je n\u00e1sledn\u011b inaktivov\u00e1n, je ale t\u0159eba dokonale zabezpe\u010dit proti \u00faniku.<\/p>\n

    U \u017eiv\u00fdch a inaktivovan\u00fdch vakc\u00edn je t\u0159eba vybalancovat riziko, \u017ee mohou stimulovat imunitn\u00ed syst\u00e9m a\u017e p\u0159\u00edli\u0161, a velmi siln\u00e1 reakce v\u00a0ur\u010dit\u00e9m org\u00e1nu m\u016f\u017ee p\u0159\u00edslu\u0161n\u00fd org\u00e1n po\u0161kodit.<\/p>\n

    U tohoto druhu vakc\u00edn m\u016f\u017ee nastat probl\u00e9m tak\u00e9 s\u00a0vytvo\u0159en\u00fdmi protil\u00e1tkami. N\u011bkter\u00e9 z\u00a0protil\u00e1tek se v\u00e1\u017eou na virus ve spr\u00e1vn\u00fdch m\u00edstech a zne\u0161kodn\u00ed ho. Jin\u00e9 protil\u00e1tky se mohou nav\u00e1zat na jin\u00fdch m\u00edstech a virus nevy\u0159ad\u00ed z\u00a0\u010dinnosti, ale pouze ozna\u010d\u00ed. Takto ozna\u010den\u00fd virus pak p\u0159il\u00e1k\u00e1 b\u00edl\u00e9 krvinky, kter\u00e9 ho pohlt\u00ed a t\u00edmto zp\u016fsobem uchr\u00e1n\u00ed p\u0159ed ostatn\u00edmi slo\u017ekami imunity. Virus se tak m\u016f\u017ee v\u00a0b\u00edl\u00e9 krvince mno\u017eit a vyvolat onemocn\u011bn\u00ed. C\u00edlem tedy je, aby se po pod\u00e1n\u00ed vakc\u00edny tvo\u0159ily zejm\u00e9na zne\u0161kod\u0148uj\u00edc\u00ed protil\u00e1tky.<\/p>\n

      \n
    1. Virov\u00e9 vektorov\u00e9 vakc\u00edny. <\/strong><\/li>\n<\/ol>\n

      Tento druh vakc\u00edn pou\u017e\u00edv\u00e1 jin\u00fd oslaben\u00fd nepatogenn\u00ed virus jako vektor neboli nosi\u010d. V\u00a0p\u0159\u00edpad\u011b vakc\u00edn proti onemocn\u011bn\u00ed COVID-19 je takov\u00fdm virem nej\u010dast\u011bji adenovirus, kter\u00fd je upraven a slou\u017e\u00ed jako vektor pot\u0159ebn\u00e9 genetick\u00e9 informace. Geneticky upraven\u00fd adenovirus se dostane do bun\u011bk, kter\u00e9 pak na z\u00e1klad\u011b vnesen\u00e9 genetick\u00e9 informace produkuj\u00ed proteiny koronaviru. Jako reakci na tyto proteiny za\u010dne t\u011blo generovat bezpe\u010dnou imunitn\u00ed odpov\u011b\u010f. Nevznik\u00e1 tedy onemocn\u011bn\u00ed, ale je stimulov\u00e1na imunitn\u00ed odpov\u011b\u010f, kter\u00e1 v\u00a0ide\u00e1ln\u00edm p\u0159\u00edpad\u011b chr\u00e1n\u00ed p\u0159\u00edjemce p\u0159ed budouc\u00edmi setk\u00e1n\u00edmi se skute\u010dn\u00fdm virem.<\/p>\n

      V\u00fdhodou vektorov\u00fdch vakc\u00edn je, \u017ee se daj\u00ed snadno a relativn\u011b levn\u011b vyrobit. Vytvo\u0159en\u00fd vektor se d\u00e1 pou\u017e\u00edt pro r\u016fzn\u00e9 vakc\u00edny, li\u0161\u00ed se v\u017edy jen genetickou informac\u00ed. Rovn\u011b\u017e je v\u00fdhodou skute\u010dnost, \u017ee do organismu nep\u0159ijde cel\u00fd virus zp\u016fsobuj\u00edc\u00ed dan\u00e9 onemocn\u011bn\u00ed, ale pouze vektor s\u00a0pot\u0159ebnou genetickou informac\u00ed.<\/p>\n

      Nev\u00fdhodou lidsk\u00fdch adenovir\u016f je, \u017ee maj\u00ed \u0161irokou cirkulaci a mohou zp\u016fsobit b\u011b\u017en\u00e9 nachlazen\u00ed\/ch\u0159ipku. N\u011bkte\u0159\u00ed lid\u00e9 si uchov\u00e1vaj\u00ed protil\u00e1tky, kter\u00e9 mohou b\u00fdt nam\u00ed\u0159en\u00e9 proti vakc\u00edn\u011b, kter\u00e1 je pak ne\u00fa\u010dinn\u00e1.<\/p>\n

      Lidsk\u00e9 adenovirov\u00e9 vektory<\/strong> jsou pou\u017eity nap\u0159\u00edklad u vyv\u00edjen\u00e9 vakc\u00edny CanSino Biologics9<\/sup><\/strong>. Je zde pou\u017eit adenovirov\u00fd s\u00e9rotyp 5 (Ad5). V jedn\u00e9 studii uveden\u00e9 v\u00a0\u010dl\u00e1nku na webu The Scientist (odkaz n\u00ed\u017ee) bylo zji\u0161t\u011bno, \u017ee imunitu proti Ad5 m\u00e1 velk\u00fd po\u010det \u00fa\u010dastn\u00edk\u016f je\u0161t\u011b p\u0159ed pod\u00e1n\u00edm vakc\u00edny. Star\u0161\u00ed \u00fa\u010dastn\u00edci m\u011bli na vakc\u00ednu v\u00fdrazn\u011b ni\u017e\u0161\u00ed imunitn\u00ed odpov\u011b\u010f, co\u017e by znamenalo, \u017ee u nich vakc\u00edna nebude tak dob\u0159e fungovat. R\u016fzn\u00e9 populace a r\u016fzn\u00e9 v\u011bkov\u00e9 skupiny budou m\u00edt r\u016fzn\u00e9 \u00farovn\u011b imunity proti Ad5. S\u00a0v\u011bkem tak\u00e9 \u010dlov\u011bk hromad\u00ed imunitu v\u016f\u010di v\u00edce s\u00e9rotyp\u016fm. Vakc\u00edny s\u00a0Ad5 mohou b\u00fdt tedy m\u00e9n\u011b \u00fa\u010dinn\u00e9 u star\u0161\u00edch lid\u00ed.<\/p>\n

      Ad5 byl nap\u0159\u00edklad vyu\u017eit p\u0159i pr\u00e1ci na vakc\u00edn\u011b proti HIV.<\/p>\n

      Pro v\u00fdvoj vakc\u00edny Janssen Pharmaceutica4<\/sup> <\/strong>od spole\u010dnosti Johnson & Johnson se pou\u017e\u00edv\u00e1 vz\u00e1cn\u011bj\u0161\u00ed podtyp adenoviru Ad26. Protil\u00e1tky proti Ad26 jsou v\u00a0Evrop\u011b a USA neobvykl\u00e9 (10\u201320 % populace), \u010dast\u011bj\u0161\u00ed jsou v\u00a0jin\u00fdch \u010d\u00e1stech sv\u011bta. Vakc\u00edny s\u00a0Ad26 neb\u00fdvaj\u00ed potla\u010deny z\u00e1kladn\u00edmi protil\u00e1tkami proti Ad26 v\u00a0populaci.<\/p>\n

      Ad26 byl nap\u0159\u00edklad vyu\u017eit p\u0159i pr\u00e1ci na vakc\u00edn\u00e1ch proti HIV a ebole.<\/p>\n

      Vakc\u00edna Sputnik V5<\/sup><\/strong> obsahuje Ad26 i Ad5. C\u00edlem je obej\u00edt t\u00edmto zp\u016fsobem nev\u00fdhody vakc\u00edn s\u00a0virov\u00fdm vektorem, kdy po pod\u00e1n\u00ed prvn\u00ed d\u00e1vky je druh\u00e1 d\u00e1vka ji\u017e m\u00e9n\u011b \u00fa\u010dinn\u00e1 d\u00edky tvorb\u011b protil\u00e1tek po pod\u00e1n\u00ed prvn\u00ed d\u00e1vky.<\/p>\n

      Jako alternativa k\u00a0lidsk\u00e9mu adenoviru je opi\u010d\u00ed adenovirus<\/strong>. Protil\u00e1tky proti \u0161impanz\u00edmu adenoviru m\u00e1 asi 1 % lid\u00ed, pravd\u011bpodobn\u011b d\u00edky zk\u0159\u00ed\u017een\u00e9 reaktivit\u011b. Tento adenovirus pou\u017e\u00edv\u00e1 pro v\u00fdvoj vakc\u00edny spole\u010dnost Astra Zeneca1<\/sup>.<\/strong><\/p>\n

      \u0160impanz\u00ed adenovirus byl nap\u0159\u00edklad vyu\u017eit p\u0159i pr\u00e1ci na vakc\u00edn\u00e1ch proti HIV a mal\u00e1rii. Pokud se tento adenovirus vyu\u017eije ve vakc\u00edn\u011b proti COVID-19, nebude pak mo\u017eno jej vyu\u017e\u00edt pro mal\u00e1rii, jeliko\u017e lid\u00e9 ji\u017e budou m\u00edt protil\u00e1tky proti vektoru. Tuto situaci by mohl vy\u0159e\u0161it v\u00fdzkum dal\u0161\u00edch opi\u010d\u00edch vektor\u016f (nap\u0159. goril\u00edch). Vakc\u00edny proti COVID-19 s\u00a0pou\u017eit\u00edm zv\u00ed\u0159ec\u00edch vektor\u016f se nab\u00edzej\u00ed jako \u0159e\u0161en\u00ed p\u0159edev\u0161\u00edm v\u00a0oblastech, kde je vysok\u00e1 imunita proti lidsk\u00e9mu adenoviru.<\/p>\n

      Vektorov\u00e9 vakc\u00edny stimuluj\u00ed silnou imunitn\u00ed odpov\u011b\u010f, co\u017e je tak\u00e9 jedna z\u00a0jejich nev\u00fdhod. V\u00a0ojedin\u011bl\u00fdch p\u0159\u00edpadech mohou n\u00e1sledovat i extr\u00e9mn\u00ed reakce, hore\u010dka a k\u0159e\u010de. D\u011bti reaguj\u00ed na vektorov\u00e9 vakc\u00edny siln\u011bji ne\u017e dosp\u011bl\u00ed. U t\u011bchto vakc\u00edn se v\u017edy hled\u00e1 rovnov\u00e1ha tak, aby dob\u0159e fungovaly a z\u00e1rove\u0148 m\u011bly co nejm\u00e9n\u011b ne\u017e\u00e1douc\u00edch \u00fa\u010dink\u016f.<\/p>\n

      Ve v\u00fdvoji vakc\u00edn proti COVID-19 se rovn\u011b\u017e testuje vektor viru spalni\u010dek. Od adenovirov\u00fdch vektor\u016f se odli\u0161uje vektor spalni\u010dek t\u00edm, \u017ee se s\u00e1m replikuje. Pokud tedy podanou vakc\u00ednu zcela nezneutralizuj\u00ed v\u00a0organismu ji\u017e vytvo\u0159en\u00e9 protil\u00e1tky, replikuje se pak vakc\u00edna sama a tvo\u0159\u00ed protein koronaviru. Na t\u00e9to vakc\u00edn\u011b pracuje spole\u010dnost Merck, ale v\u00fdvoj vakc\u00edny je pozadu za ostatn\u00edmi.<\/p>\n

        \n
      1. Vakc\u00edny na b\u00e1zi b\u00edlkovin (protein\u016f)<\/strong><\/li>\n<\/ol>\n

        Vakc\u00edny tohoto druhu pou\u017e\u00edvaj\u00ed k bezpe\u010dn\u00e9mu vytvo\u0159en\u00ed imunitn\u00ed odpov\u011bdi ne\u0161kodn\u00e9 fragmenty protein\u016f nebo proteinov\u00fdch obal\u016f napodobuj\u00edc\u00edch virus SARS-CoV-2. Tyto proteinov\u00e9 \u010d\u00e1stice jsou vpraveny do t\u011bla a stimuluj\u00ed imunitn\u00ed odpov\u011b\u010f.<\/p>\n

        Proteinov\u00e9 vakc\u00edny jsou bezpe\u010dn\u00e9, ale mohou b\u00fdt m\u00e1lo imunogenn\u00ed, tj. nestimuluj\u00ed dostate\u010dnou tvorbu protil\u00e1tek. \u010casto pot\u0159ebuj\u00ed ke zlep\u0161en\u00ed sv\u00e9 \u00fa\u010dinnosti dal\u0161\u00ed l\u00e1tky, tzv. adjuvans. Proteinov\u00e9 vakc\u00edny proti virov\u00fdm podjednotk\u00e1m, tedy i podjednotk\u00e1m viru SARS-CoV-2, vy\u017eaduj\u00ed ke sv\u00e9\u00a0p\u0159\u00edprav\u011b metodu rekombinantn\u00edho genetick\u00e9ho in\u017een\u00fdrstv\u00ed. Geny k\u00f3duj\u00edc\u00ed pot\u0159ebn\u00e9 antigeny jsou klonov\u00e1ny nebo syntetizov\u00e1ny, exprimov\u00e1ny a purifikov\u00e1ny pomoc\u00ed r\u016fzn\u00fdch expresn\u00edch syst\u00e9m\u016f, v\u010detn\u011b hmyz\u00edch, bakteri\u00e1ln\u00edch, kvasinkov\u00fdch \u010di sav\u010d\u00edch bun\u011bk.<\/p>\n

        P\u0159\u00edkladem proteinov\u00e9 vakc\u00edny proti COVID-19 je vakc\u00edna vyv\u00edjen\u00e1 spole\u010dnost\u00ed Novavax6<\/sup><\/strong>, kter\u00e1 m\u00e1 jeden ze sv\u00fdch v\u00fdrobn\u00edch z\u00e1vod\u016f v\u00a0\u010cesk\u00e9 republice. Dal\u0161\u00ed spole\u010dnost\u00ed, kter\u00e1 vyv\u00edj\u00ed proti COVID-19 proteinovou vakc\u00ednu, je Anhui Zhifei Longcom Biopharmaceutical12<\/sup>.<\/strong><\/p>\n

        Vakc\u00edny na b\u00e1zi virov\u00fdch \u010d\u00e1stic (VLP)<\/strong> jsou podmno\u017einou proteinov\u00fdch vakc\u00edn. V\u00a0tomto p\u0159\u00edpad\u011b se nejedn\u00e1 o oslaben\u00e9 nebo mrtv\u00e9 viry, ale o jejich napodobeniny, kter\u00e9 jsou vyr\u00e1b\u011bny pomoc\u00ed nano\u010d\u00e1stic. VLP obsahuj\u00ed pouze povrchov\u00e9 b\u00edlkoviny vir\u016f, ale ne jejich geny. Tyto vakc\u00edny tedy nemohou v\u00a0\u017e\u00e1dn\u00e9m p\u0159\u00edpad\u011b zp\u016fsobit onemocn\u011bn\u00ed, proti kter\u00e9mu o\u010dkujeme. Tento mechanismus se pou\u017e\u00edv\u00e1 nap\u0159\u00edklad u HPV vakc\u00edn proti lidsk\u00e9mu papilomaviru. Ve v\u00fdvoji vakc\u00edn proti onemocn\u011bn\u00ed COVID-19 pou\u017e\u00edv\u00e1 VLP spole\u010dnost Medicago Inc13<\/sup><\/strong>.<\/p>\n

          \n
        1. DNA a RNA vakc\u00edny <\/strong><\/li>\n<\/ol>\n

          U t\u011bchto vakc\u00edn je vyu\u017e\u00edv\u00e1na um\u011ble nasyntetizovan\u00e1 DNA (deoxyribonukleov\u00e1 kyselina) nebo RNA (ribonukleov\u00e1 kyselina), podle nich\u017e si organismus s\u00e1m vytvo\u0159\u00ed p\u0159\u00edslu\u0161n\u00e9 proteiny p\u016fvodce choroby a na tyto proteiny pak vznik\u00e1 bezpe\u010dn\u00e1 imunitn\u00ed odpov\u011b\u010f organismu. Po vniknut\u00ed DNA vakc\u00edny do bu\u0148ky je genetick\u00e1 informace ulo\u017een\u00e1 ve dvou\u0161roubovici DNA p\u0159epsan\u00e1 do jednoduch\u00e9 \u0161roubovice RNA, kter\u00e1 pak slou\u017e\u00ed jako matrice pro synt\u00e9zu pot\u0159ebn\u00fdch protein\u016f p\u016fvodce choroby.<\/p>\n

          U DNA vakc\u00edn je probl\u00e9mem, \u017ee o\u010dkovac\u00ed l\u00e1tka mus\u00ed proniknout p\u0159\u00edmo do nitra bun\u011bk, mimo kter\u00e9 nefunguje. Ani pot\u00e9 nemus\u00ed b\u00fdt imunitn\u00ed odpov\u011b\u010f dostate\u010dn\u011b siln\u00e1 a je pot\u0159eba imunitn\u00ed reakci pos\u00edlit pomoc\u00ed adjuvans.<\/p>\n

          RNA vakc\u00edny poskytuj\u00ed p\u0159\u00edmo matrici pro synt\u00e9zu b\u00edlkovin. Jejich nev\u00fdhodou je, \u017ee RNA je podstatn\u011b k\u0159eh\u010d\u00ed ne\u017e DNA a v\u00a0organismu se rozkl\u00e1d\u00e1. RNA tedy pot\u0159ebuje v\u00a0t\u011ble ochranu, kterou tvo\u0159\u00ed obal z\u00a0tukov\u00fdch molekul. Mechanismus RNA vakc\u00edn je uplat\u0148ov\u00e1n p\u0159i v\u00fdvoji vakc\u00edn proti COVID-19 spole\u010dnostmi BioNTech\/Fosun Pharma\/Pfizer2<\/sup> a Moderna\/N\u00e1rodn\u00ed institut pro alergie a infek\u010dn\u00ed onemocn\u011bn\u00ed3<\/sup><\/strong>.<\/p>\n

          V\u00fdhodou DNA a RNA vakc\u00edn je relativn\u011b snadn\u00e1, rychl\u00e1 a levn\u00e1 v\u00fdroba ve velk\u00fdch mno\u017estv\u00edch a dobr\u00e1 bezpe\u010dnost.<\/p>\n

           <\/p>\n

          V\u00a0n\u00ed\u017ee uveden\u00e9 tabulce jsou za\u0159azeny vakc\u00edny, kter\u00e9 jsou ve\u00a0t\u0159et\u00ed f\u00e1zi klinick\u00e9ho hodnocen\u00ed:<\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n
          \u010c.<\/td>\nV\u00fdrobce<\/td>\nOzna\u010den\u00ed vakc\u00edny<\/td>\nTyp vakc\u00edny<\/td>\nPo\u010det d\u00e1vek<\/td>\n<\/tr>\n
          1<\/td>\nAstraZeneca\/Oxfordsk\u00e1 univerzita<\/strong>
          \n(Brit\u00e1nie, \u0160v\u00e9dsko)<\/td>\n          		ChAdOxnCoV-19 (AZD1222)<\/td>\nvektorov\u00e1 vyu\u017e\u00edvaj\u00edc\u00ed opi\u010d\u00ed adenovirus<\/td>\n2<\/td>\n<\/tr>\n
          2<\/td>\nBioNTech\/Fosun Pharma\/Pfizer
          \n<\/strong>(Spojen\u00e9 st\u00e1ty, N\u011bmecko, \u010c\u00edna)<\/td>\n          		BNT162<\/td>\ngenetick\u00e1 mRNA<\/td>\n2<\/td>\n<\/tr>\n
          3<\/td>\nModerna\/N\u00e1rodn\u00ed institut pro alergie
          \na infek\u010dn\u00ed onemocn\u011bn\u00ed<\/strong>
          \n(Spojen\u00e9 st\u00e1ty)<\/td>\n          		mRNA-1273<\/td>\ngenetick\u00e1 mRNA<\/td>\n2<\/td>\n<\/tr>\n
          4<\/td>\nJanssen Pharmaceutica (J & J)\/BIDMC<\/strong>
          \n(Spojen\u00e9 st\u00e1ty, Belgie, Izrael)<\/td>\n          		Ad26.COV2.S<\/td>\nvektorov\u00e1 vyu\u017e\u00edvaj\u00edc\u00ed lidsk\u00fd adenovirus Ad26<\/td>\n1<\/td>\n<\/tr>\n
          5<\/td>\n\u00dastav epidemiologick\u00e9ho a mikrobiologick\u00e9ho v\u00fdzkumu Nikolaje Gamaleji<\/strong>
          \n(Rusko)<\/td>\n          		Sputnik V
          \n(Gam-COVID-Vac)<\/td>\n          		vektorov\u00e1 vyu\u017e\u00edvaj\u00edc\u00ed lidsk\u00e9 adenoviry Ad26 a Ad5<\/td>\n2<\/td>\n<\/tr>\n
          6<\/td>\nNovavax<\/strong>
          \n(Spojen\u00e9 st\u00e1ty)<\/td>\n          		NVX-CoV2373<\/td>\nproteinov\u00e1 rekombinantn\u00ed<\/td>\n2<\/td>\n<\/tr>\n
          7<\/td>\nSinopharm Wu-chansk\u00fd biologick\u00fd institut
          \n<\/strong>(\u010c\u00edna)<\/td>\n          		WIBP\/BIBP<\/td>\nvirov\u00e1 inaktivovan\u00e1<\/td>\n2<\/td>\n<\/tr>\n
          8<\/td>\nSinopharm Pekingsk\u00fd biologick\u00fd institut<\/strong>
          \n(\u010c\u00edna)<\/td>\n          		BBIBP-CorV<\/td>\nvirov\u00e1 inaktivovan\u00e1<\/td>\n2<\/td>\n<\/tr>\n
          9<\/td>\nCanSino Biologics\/Pekingsk\u00fd biotechnologick\u00fd institut<\/strong>
          \n(\u010c\u00edna)<\/td>\n          		Ad5-nCoV<\/td>\nvektorov\u00e1 vyu\u017e\u00edvaj\u00edc\u00ed lidsk\u00fd adenovirus Ad5<\/td>\n1<\/td>\n<\/tr>\n
          10<\/td>\nSinovac<\/strong>
          \n(\u010c\u00edna)<\/td>\n          		CoronaVac<\/td>\nvirov\u00e1 inaktivovan\u00e1<\/td>\n2<\/td>\n<\/tr>\n
          11<\/td>\nBharat Biotech International<\/strong>
          \n(Indie)<\/td>\n          		COVAXIN<\/td>\nvirov\u00e1 inaktivovan\u00e1<\/td>\n2<\/td>\n<\/tr>\n
          12<\/td>\nAnhui Zhifei Longcom Biopharmaceutical\/\u010c\u00ednsk\u00e1 akademie v\u011bd<\/strong>
          \n(\u010c\u00edna)<\/td>\n          		<\/td>\nproteinov\u00e1<\/td>\n3<\/td>\n<\/tr>\n
          13<\/td>\nMedicago Inc.<\/strong>
          \n(Kanada)<\/td>\n          		<\/td>\nproteinov\u00e1 VLP<\/td>\n2<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

          Pro \u010cR jsou pl\u00e1novan\u00e9 vakc\u00edny AstraZeneca\/Oxfordsk\u00e1 univerzita, BioNTech\/Fosun Pharma\/Pfizer, Moderna\/N\u00e1rodn\u00ed institut pro alergie a infek\u010dn\u00ed onemocn\u011bn\u00ed, Janssen Pharmaceutica (J & J)\/BIDMC, Novavax. Krom\u011b uveden\u00fdch vakc\u00edn jsou pro \u010cR pl\u00e1novan\u00e9 tak\u00e9 vakc\u00edny od spole\u010dnost\u00ed Sanofi + GSK (rekombinantn\u00ed proteinov\u00e1 vakc\u00edna) a Curevac (genetick\u00e1 mRNA vakc\u00edna), kter\u00e9 jsou teprve ve druh\u00e9 f\u00e1zi klinick\u00e9ho hodnocen\u00ed.<\/p>\n

          Z\u00e1vazn\u011b jsou nyn\u00ed objedn\u00e1ny d\u00e1vky vakc\u00edn pro 6,9 milionu obyvatel \u010cR.<\/p>\n

          Jednou z\u00a0obav doprov\u00e1zej\u00edc\u00edch v\u00fdvoj vakc\u00edn proti onemocn\u011bn\u00ed COVID-19 je riziko, \u017ee imunitn\u00ed odpov\u011b\u010f na podanou vakc\u00ednu m\u016f\u017ee zp\u016fsobit vlastn\u00ed onemocn\u011bn\u00ed. Imunopatologie vyvolan\u00e1 o\u010dkov\u00e1n\u00edm se m\u016f\u017ee projevit jako akutn\u00ed odpov\u011b\u010f na samotnou vakc\u00ednu nebo jako zes\u00edlen\u00ed onemocn\u011bn\u00ed po virov\u00e9 infekci. Jeliko\u017e jsou tyto vakc\u00edny vyv\u00edjeny pom\u011brn\u011b rychle, je zcela z\u00e1sadn\u00ed zab\u00fdvat se bezpe\u010dnost\u00ed vakc\u00edn u\u017e v\u00a0ran\u00fdch f\u00e1z\u00edch procesu v\u00fdvoje.\u00a0 Z\u00a0tohoto d\u016fvodu je p\u0159i\u00a0klinick\u00e9m hodnocen\u00ed velk\u00e1 pozornost v\u011bnov\u00e1na pr\u00e1v\u011b bezpe\u010dnosti a \u00fa\u010dinnosti vakc\u00edn. D\u016fle\u017eit\u00e9 je rovn\u011b\u017e uva\u017eovat o v\u00fdrob\u011b vakc\u00edn v\u00a0glob\u00e1ln\u00edm m\u011b\u0159\u00edtku. K\u00a0dosa\u017een\u00ed kolektivn\u00ed imunity je t\u0159eba zajistit celosv\u011btov\u011b dostate\u010dn\u00e9 mno\u017estv\u00ed vakc\u00edn.<\/p>\n

           <\/p>\n

          V\u00a0\u010cR bude o\u010dkov\u00e1n\u00ed nepovinn\u00e9 a pl\u00e1nuje se postupn\u00e9 o\u010dkov\u00e1n\u00ed podle indika\u010dn\u00edch skupin 1\u20136:<\/p>\n

            \n
          1. Osoby ve v\u011bku \u2265 65 let, a bez ohledu na v\u011bk chronicky nemocn\u00ed pacienti (ur\u010dit\u00e1 onemocn\u011bn\u00ed)<\/li>\n
          2. Zdravotni\u010dt\u00ed pracovn\u00edci a pracovn\u00edci org\u00e1n\u016f ochrany ve\u0159ejn\u00e9ho zdrav\u00ed<\/li>\n
          3. Pracovn\u00edci a u\u017eivatel\u00e9 pobytov\u00fdch a odleh\u010dovac\u00edch soci\u00e1ln\u00edch slu\u017eeb, poskytovatel\u00e9 dom\u00e1c\u00ed zdravotn\u00ed p\u00e9\u010de<\/li>\n
          4. Pracovn\u00edci kritick\u00e9 infrastruktury dle z\u00e1kona \u010d. 240\/2000 Sb., o krizov\u00e9m \u0159\u00edzen\u00ed a o zm\u011bn\u011b n\u011bkter\u00fdch z\u00e1kon\u016f (krizov\u00fd z\u00e1kon), a na\u0159\u00edzen\u00ed vl\u00e1dy \u010d. 432\/2010 Sb., o krit\u00e9ri\u00edch pro ur\u010den\u00ed prvku kritick\u00e9 infrastruktury \u2013 tj. pracovn\u00edci integrovan\u00e9ho z\u00e1chrann\u00e9ho syst\u00e9mu, pracovn\u00edci energetiky, vl\u00e1da, krizov\u00e9 \u0161t\u00e1by, arm\u00e1da, pedagogi\u010dt\u00ed pracovn\u00edci a dal\u0161\u00ed<\/li>\n
          5. Ostatn\u00ed pracovn\u00edci org\u00e1n\u016f ochrany ve\u0159ejn\u00e9ho zdrav\u00ed prov\u00e1d\u011bj\u00edc\u00ed v\u00fdkon st\u00e1tn\u00edho zdravotn\u00edho dozoru, zam\u011bstnanci dal\u0161\u00edch org\u00e1n\u016f st\u00e1tn\u00ed spr\u00e1vy vykon\u00e1vaj\u00edc\u00edch kontroln\u00ed \u010dinnost (nap\u0159. SZPI, SVS \u010cR, \u010cI\u017dP, \u010cOI apod.)<\/li>\n
          6. Dal\u0161\u00ed poji\u0161t\u011bnci, kte\u0159\u00ed maj\u00ed z\u00e1jem o o\u010dkov\u00e1n\u00ed<\/li>\n<\/ol>\n

             <\/p>\n

            Na po\u010d\u00e1tku nebudou vakc\u00edny registrov\u00e1ny pro pediatrick\u00e9 pou\u017eit\u00ed, jeliko\u017e klinick\u00e9 studie prob\u00edhaj\u00ed zejm\u00e9na na skupin\u00e1ch dosp\u011bl\u00fdch dobrovoln\u00edk\u016f. Pouh\u00e9 schv\u00e1len\u00ed dan\u00e9 vakc\u00edny neznamen\u00e1, \u017ee bude ihned pou\u017eiteln\u00e1 pro lidi po cel\u00e9m sv\u011bt\u011b. Pro \u010cR je d\u016fle\u017eit\u00e1 registrace vakc\u00edny pro pou\u017eit\u00ed v\u00a0Evrop\u011b a jej\u00ed dostupnost pro n\u00e1\u0161 st\u00e1t.<\/p>\n

            V\u0161echny uveden\u00e9 informace jsou aktu\u00e1ln\u00ed k\u00a0datu zve\u0159ejn\u011bn\u00ed \u010dl\u00e1nku.<\/p>\n

             <\/p>\n

            RNDr. Martina \u0160indelkov\u00e1<\/p>\n

            Praha, 17. 12. 2020<\/p>\n

             <\/p>\n

            Pou\u017eit\u00e9 zdroje:<\/p>\n

             <\/p>\n

            Tregoning J.S., Brown E.S. et al. (2020): Vaccines for COVID\u201019. Clinical and Experimental Immunology, 202, 162\u2013192.<\/p>\n

            https:\/\/www.the-scientist.com\/news-opinion\/vector-based-vaccines-come-to-the-fore-in-the-covid-19-pandemic-67915<\/a><\/p>\n

            https:\/\/www.who.int\/emergencies\/diseases\/novel-coronavirus-2019\/covid-19-vaccines<\/a><\/p>\n

            https:\/\/koronavirus.mzcr.cz\/wp-content\/uploads\/2020\/12\/Strategie-ockovani-proti-nemoci-covid-19.pdf<\/a><\/p>\n

            https:\/\/www.sukl.cz\/sukl\/prehled-hodnocenych-leciv-na-nemoc-covid-19<\/a><\/p>\n

            https:\/\/ceskapozice.lidovky.cz\/tema\/nejnadejnejsi-vakciny-proti-koronaviru-mohou-narazit-na-vazny-problem.A200811_020928_pozice-tema_lube<\/a><\/p>\n

             <\/p>\n

             <\/p>\n

             <\/p>\n","protected":false},"excerpt":{"rendered":"

            Nov\u00fd beta-koronavirus, ozna\u010dovan\u00fd SARS-CoV-2, je p\u016fvodcem onemocn\u011bn\u00ed COVID-19. Tento virus byl poprv\u00e9 objeven koncem roku […]<\/p>\n","protected":false},"author":7,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"image","meta":{"_uag_custom_page_level_css":""},"categories":[1],"tags":[],"uagb_featured_image_src":{"full":false,"thumbnail":false,"medium":false,"medium_large":false,"large":false,"1536x1536":false,"2048x2048":false,"boldthemes_grid":false,"boldthemes_grid_11":false,"boldthemes_grid_22":false,"boldthemes_grid_21":false,"boldthemes_grid_12":false,"boldthemes_latest_posts":false,"boldthemes_grid_gallery":false},"uagb_author_info":{"display_name":"Jbednar","author_link":"https:\/\/www.mc-praha.cz\/mcp\/author\/jbednar\/"},"uagb_comment_info":0,"uagb_excerpt":"Nov\u00fd beta-koronavirus, ozna\u010dovan\u00fd SARS-CoV-2, je p\u016fvodcem onemocn\u011bn\u00ed COVID-19. Tento virus byl poprv\u00e9 objeven koncem roku […]","post_mailing_queue_ids":[],"_links":{"self":[{"href":"https:\/\/www.mc-praha.cz\/mcp\/wp-json\/wp\/v2\/posts\/3731"}],"collection":[{"href":"https:\/\/www.mc-praha.cz\/mcp\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.mc-praha.cz\/mcp\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.mc-praha.cz\/mcp\/wp-json\/wp\/v2\/users\/7"}],"replies":[{"embeddable":true,"href":"https:\/\/www.mc-praha.cz\/mcp\/wp-json\/wp\/v2\/comments?post=3731"}],"version-history":[{"count":17,"href":"https:\/\/www.mc-praha.cz\/mcp\/wp-json\/wp\/v2\/posts\/3731\/revisions"}],"predecessor-version":[{"id":3748,"href":"https:\/\/www.mc-praha.cz\/mcp\/wp-json\/wp\/v2\/posts\/3731\/revisions\/3748"}],"wp:attachment":[{"href":"https:\/\/www.mc-praha.cz\/mcp\/wp-json\/wp\/v2\/media?parent=3731"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.mc-praha.cz\/mcp\/wp-json\/wp\/v2\/categories?post=3731"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.mc-praha.cz\/mcp\/wp-json\/wp\/v2\/tags?post=3731"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}