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。738Please respect copyright.ＰＥＮＡＮＡSJsL3CAyx9
738Please respect copyright.ＰＥＮＡＮＡ1qbRLfE641
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。738Please respect copyright.ＰＥＮＡＮＡ96hhrRu38x
738Please respect copyright.ＰＥＮＡＮＡOcL1rw8xt1
738Please respect copyright.ＰＥＮＡＮＡu8X8PsfVlF
（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。738Please respect copyright.ＰＥＮＡＮＡrHEQMZzDzo
738Please respect copyright.ＰＥＮＡＮＡ3WMguWRkCr
下列為Sinovac製作滅活病毒疫苗的扼要流程(Ref3)738Please respect copyright.ＰＥＮＡＮＡjU3QgBjkCh
738Please respect copyright.ＰＥＮＡＮＡbfrhpdWKa3
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。738Please respect copyright.ＰＥＮＡＮＡVWaPPDYHmJ
738Please respect copyright.ＰＥＮＡＮＡSKaLsen5N2
2.經過數輪實驗室細胞的培植，使病毒數量增加。738Please respect copyright.ＰＥＮＡＮＡCah7KhybjX
738Please respect copyright.ＰＥＮＡＮＡQm02s7oNQF
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。738Please respect copyright.ＰＥＮＡＮＡ70ZbzDNICX
738Please respect copyright.ＰＥＮＡＮＡCMlmbrBBjj
4.將其製成可注射的疫苗。738Please respect copyright.ＰＥＮＡＮＡIe4mfLEMN0
738Please respect copyright.ＰＥＮＡＮＡ9VIVD5YkXh
738Please respect copyright.ＰＥＮＡＮＡ4UmXaKPGBr
738Please respect copyright.ＰＥＮＡＮＡwuAcrO4m7h
（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。738Please respect copyright.ＰＥＮＡＮＡAlQBHxmyqT
738Please respect copyright.ＰＥＮＡＮＡ7zrQ06xytk
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。738Please respect copyright.ＰＥＮＡＮＡbbKT16USRz
https://www.penana.com/article/466568738Please respect copyright.ＰＥＮＡＮＡJqFdTftIGT
738Please respect copyright.ＰＥＮＡＮＡbGPfgjfu53
738Please respect copyright.ＰＥＮＡＮＡ7TKLGs2xNZ
738Please respect copyright.ＰＥＮＡＮＡKLHVVPpyLs
738Please respect copyright.ＰＥＮＡＮＡsBaD7jT7LL
738Please respect copyright.ＰＥＮＡＮＡJdUSSJpC3S
738Please respect copyright.ＰＥＮＡＮＡww2KSX3FaH
738Please respect copyright.ＰＥＮＡＮＡ2BRoziyN8x
738Please respect copyright.ＰＥＮＡＮＡz4r0Y6w4Ak
（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。738Please respect copyright.ＰＥＮＡＮＡCSlS7eqPlY
738Please respect copyright.ＰＥＮＡＮＡqtH4QWFyDk
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。738Please respect copyright.ＰＥＮＡＮＡOEW0oSWssT
738Please respect copyright.ＰＥＮＡＮＡCmgkNTEyf1
1.抗體與病毒的S protein合併，738Please respect copyright.ＰＥＮＡＮＡyGjIBctIoc
防止條件1的達成。738Please respect copyright.ＰＥＮＡＮＡhrVE6M5INh
738Please respect copyright.ＰＥＮＡＮＡQpCbfzInJF
2.抗體與病毒其他位置合併，738Please respect copyright.ＰＥＮＡＮＡbyNCaNWZb3
防止條件3的達成。738Please respect copyright.ＰＥＮＡＮＡliefvG7tZ9
738Please respect copyright.ＰＥＮＡＮＡ0AezIuTiAd
738Please respect copyright.ＰＥＮＡＮＡkdeH8llWKh
738Please respect copyright.ＰＥＮＡＮＡ1jPMzb3YXO
（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。738Please respect copyright.ＰＥＮＡＮＡtMfxoxyaGF
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。738Please respect copyright.ＰＥＮＡＮＡu9hogqvuLs
738Please respect copyright.ＰＥＮＡＮＡYagsJaNaq9
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。738Please respect copyright.ＰＥＮＡＮＡfKWaChx25n
738Please respect copyright.ＰＥＮＡＮＡ5mSp5tBh01
738Please respect copyright.ＰＥＮＡＮＡ0FL9GOvHU7
738Please respect copyright.ＰＥＮＡＮＡQYgYugzo0U
738Please respect copyright.ＰＥＮＡＮＡW8Stuzewac
（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;738Please respect copyright.ＰＥＮＡＮＡMAtcgShArk
簡單來說，就是抗體適得其反地協助病毒入侵人體細胞。738Please respect copyright.ＰＥＮＡＮＡcxxVQnZJt4
738Please respect copyright.ＰＥＮＡＮＡ4zUcpaznvq
免疫細胞的表面上，有著接收器識辨抗體的某個區域。738Please respect copyright.ＰＥＮＡＮＡZc90ZVx1wo
738Please respect copyright.ＰＥＮＡＮＡ3hP3RxDp11
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。738Please respect copyright.ＰＥＮＡＮＡidJR88BwNj
738Please respect copyright.ＰＥＮＡＮＡWhq8rFvpvs
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。738Please respect copyright.ＰＥＮＡＮＡBgtXqMpb85
738Please respect copyright.ＰＥＮＡＮＡEN8zvFoq4v
738Please respect copyright.ＰＥＮＡＮＡlVRNhyq1eD
738Please respect copyright.ＰＥＮＡＮＡuuH7t4YGK3
（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。738Please respect copyright.ＰＥＮＡＮＡKSdubA4fjU
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。738Please respect copyright.ＰＥＮＡＮＡdKKCKKINFO
738Please respect copyright.ＰＥＮＡＮＡk4Hz5uEPiB
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。738Please respect copyright.ＰＥＮＡＮＡY9hrzLB6yg
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。738Please respect copyright.ＰＥＮＡＮＡ18t8NnnngA
738Please respect copyright.ＰＥＮＡＮＡT1kBNmJQDH
738Please respect copyright.ＰＥＮＡＮＡaZWtDP4k5R
738Please respect copyright.ＰＥＮＡＮＡDitJnqNvLM
（圖8）ADE這現象，科學家一直以來均有記錄及研究。（Ref4)738Please respect copyright.ＰＥＮＡＮＡ1Alqufdydc
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。738Please respect copyright.ＰＥＮＡＮＡ8gLTGmQDal
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。738Please respect copyright.ＰＥＮＡＮＡSq8NsdkJT7
738Please respect copyright.ＰＥＮＡＮＡtnRtnvyvh8
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。738Please respect copyright.ＰＥＮＡＮＡivqoKErOQu
738Please respect copyright.ＰＥＮＡＮＡtDySveD362
738Please respect copyright.ＰＥＮＡＮＡbAI9FBBrMD
738Please respect copyright.ＰＥＮＡＮＡvoFY2L47sj
（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)738Please respect copyright.ＰＥＮＡＮＡNyHjenpSzL
738Please respect copyright.ＰＥＮＡＮＡ1McYWwmUZd
武肺會否出現同樣現象，暫時尚未清楚。738Please respect copyright.ＰＥＮＡＮＡztRtUi3Qns
738Please respect copyright.ＰＥＮＡＮＡxjuq8Ai6ip
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。738Please respect copyright.ＰＥＮＡＮＡHTVv5kqjLp
738Please respect copyright.ＰＥＮＡＮＡPI9jxBAXoF
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。738Please respect copyright.ＰＥＮＡＮＡY7X6V6HPW4
738Please respect copyright.ＰＥＮＡＮＡDOXMbYLpOc
738Please respect copyright.ＰＥＮＡＮＡKoX4gO1EUI
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！738Please respect copyright.ＰＥＮＡＮＡIWCDXD7XsM
738Please respect copyright.ＰＥＮＡＮＡi7pwBTST6x
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。738Please respect copyright.ＰＥＮＡＮＡRqemyBYLrC
738Please respect copyright.ＰＥＮＡＮＡDjQjGRZKFH
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/toc738Please respect copyright.ＰＥＮＡＮＡrxgae9SMDF
738Please respect copyright.ＰＥＮＡＮＡbLW16q1EjW
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。738Please respect copyright.ＰＥＮＡＮＡHVRMBhWq1N
738Please respect copyright.ＰＥＮＡＮＡdqfxQvckwd
Link:738Please respect copyright.ＰＥＮＡＮＡMLxbFYzBH1
https://www.penana.com/user/27349/%E8%96%AF%E4%BB%94%E8%81%9E%E8%8C%B1%E8%8E%89/portfolio738Please respect copyright.ＰＥＮＡＮＡfHeVfZhZQy
738Please respect copyright.ＰＥＮＡＮＡcbRbXVxQTK
738Please respect copyright.ＰＥＮＡＮＡKvVXc19fyg
有興趣接收科普資訊的話，歡迎follow IG: potatopigtongue。738Please respect copyright.ＰＥＮＡＮＡC15k25vwJW
738Please respect copyright.ＰＥＮＡＮＡHFcO3trDjW
738Please respect copyright.ＰＥＮＡＮＡTCoUHulJ7v
Ref2:https://jamanetwork.com/journals/jama/fullarticle/2769612?fbclid=IwAR0sp9eU5V9FOzuLjz6ERw6LRFm-1yx3MJt1OEgqBDQKW1GA5mQeIIi5J7E738Please respect copyright.ＰＥＮＡＮＡlIYtoSwebP
Ref3:https://science.sciencemag.org/content/369/6499/77?fbclid=IwAR29zOO06gVsQAC2jLU2uMJi-qcYbniz108Y4kcaWOr1iNuQyVM3jCFMHa4738Please respect copyright.ＰＥＮＡＮＡ3QRjoRj0WJ
Ref4:https://www.nature.com/articles/s41586-020-2538-8.pdf738Please respect copyright.ＰＥＮＡＮＡ4yTVFDIiOV
Ref5:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7115629/738Please respect copyright.ＰＥＮＡＮＡukLCDoZT8Q
Penana
search
Loginarrow_drop_down
Registerarrow_drop_down
