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。810Please respect copyright.ＰＥＮＡＮＡaC3FvRpaWO
810Please respect copyright.ＰＥＮＡＮＡ1i1mJt9yvL
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。810Please respect copyright.ＰＥＮＡＮＡyyqOuBIcXm
810Please respect copyright.ＰＥＮＡＮＡCucnsABj4q
810Please respect copyright.ＰＥＮＡＮＡiyVE5h4Sks
（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。810Please respect copyright.ＰＥＮＡＮＡuq8b8ZmXH8
810Please respect copyright.ＰＥＮＡＮＡfCvtLK3rv5
下列為Sinovac製作滅活病毒疫苗的扼要流程(Ref3)810Please respect copyright.ＰＥＮＡＮＡIFHwPbNtwY
810Please respect copyright.ＰＥＮＡＮＡZ34zEKbVJS
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。810Please respect copyright.ＰＥＮＡＮＡO9WNyjmN2z
810Please respect copyright.ＰＥＮＡＮＡFoM5ZL0rlT
2.經過數輪實驗室細胞的培植，使病毒數量增加。810Please respect copyright.ＰＥＮＡＮＡG5okfilLuE
810Please respect copyright.ＰＥＮＡＮＡ6bCIB4lac2
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。810Please respect copyright.ＰＥＮＡＮＡnB0NlHW3Nm
810Please respect copyright.ＰＥＮＡＮＡU87QKh27mC
4.將其製成可注射的疫苗。810Please respect copyright.ＰＥＮＡＮＡB6I5q4uP9Y
810Please respect copyright.ＰＥＮＡＮＡYehIGZu2vU
810Please respect copyright.ＰＥＮＡＮＡ8lmPuNzfiz
810Please respect copyright.ＰＥＮＡＮＡbww3kL9mJw
（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。810Please respect copyright.ＰＥＮＡＮＡvdZPVg2PgZ
810Please respect copyright.ＰＥＮＡＮＡKUmhptrcDa
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。810Please respect copyright.ＰＥＮＡＮＡl3cOqetaqK
https://www.penana.com/article/466568810Please respect copyright.ＰＥＮＡＮＡB6cJLsD75j
810Please respect copyright.ＰＥＮＡＮＡxlym40nK0b
810Please respect copyright.ＰＥＮＡＮＡwoYwrGpxvU
810Please respect copyright.ＰＥＮＡＮＡ0dbwdC5IwD
810Please respect copyright.ＰＥＮＡＮＡ6mQaiRP9Qk
810Please respect copyright.ＰＥＮＡＮＡcXuRFvhgxY
810Please respect copyright.ＰＥＮＡＮＡ79tKZsBBPX
810Please respect copyright.ＰＥＮＡＮＡwUgLslGMrp
810Please respect copyright.ＰＥＮＡＮＡkHj2npO68t
（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。810Please respect copyright.ＰＥＮＡＮＡgPrvmEIlm4
810Please respect copyright.ＰＥＮＡＮＡ9M4nBpzm4z
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。810Please respect copyright.ＰＥＮＡＮＡ1TY4ohsCIi
810Please respect copyright.ＰＥＮＡＮＡ82qGoYoybK
1.抗體與病毒的S protein合併，810Please respect copyright.ＰＥＮＡＮＡIt3t17uwsn
防止條件1的達成。810Please respect copyright.ＰＥＮＡＮＡ7fnJu6orqw
810Please respect copyright.ＰＥＮＡＮＡSGXcDYH3Kp
2.抗體與病毒其他位置合併，810Please respect copyright.ＰＥＮＡＮＡpWvtKbRrFN
防止條件3的達成。810Please respect copyright.ＰＥＮＡＮＡBkVdHnRzb5
810Please respect copyright.ＰＥＮＡＮＡFKRQ8kSjxo
810Please respect copyright.ＰＥＮＡＮＡqLsf7ViM9i
810Please respect copyright.ＰＥＮＡＮＡ9haPL0enC0
（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。810Please respect copyright.ＰＥＮＡＮＡpoAJQk97vO
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。810Please respect copyright.ＰＥＮＡＮＡufXbpyu7eJ
810Please respect copyright.ＰＥＮＡＮＡSr36S2aiwa
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。810Please respect copyright.ＰＥＮＡＮＡU1E3UHLtgI
810Please respect copyright.ＰＥＮＡＮＡz7nvF0KA5V
810Please respect copyright.ＰＥＮＡＮＡjxquuTxisE
810Please respect copyright.ＰＥＮＡＮＡq87QsE3gqW
810Please respect copyright.ＰＥＮＡＮＡDcLW2bQ7Zc
（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;810Please respect copyright.ＰＥＮＡＮＡY9wBvjBbAV
簡單來說，就是抗體適得其反地協助病毒入侵人體細胞。810Please respect copyright.ＰＥＮＡＮＡMAceLU2Qk3
810Please respect copyright.ＰＥＮＡＮＡzMoKLj9jWw
免疫細胞的表面上，有著接收器識辨抗體的某個區域。810Please respect copyright.ＰＥＮＡＮＡmU95AphLmM
810Please respect copyright.ＰＥＮＡＮＡglb4j25Gdy
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。810Please respect copyright.ＰＥＮＡＮＡX3IZ9sCq5D
810Please respect copyright.ＰＥＮＡＮＡ2TS5KeB7U0
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。810Please respect copyright.ＰＥＮＡＮＡK9SOHDz6ag
810Please respect copyright.ＰＥＮＡＮＡdX0EfP8sdt
810Please respect copyright.ＰＥＮＡＮＡMdK2NWbFNu
810Please respect copyright.ＰＥＮＡＮＡHiSFyX4anj
（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。810Please respect copyright.ＰＥＮＡＮＡd1G7kRlpSS
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。810Please respect copyright.ＰＥＮＡＮＡkMURJogFry
810Please respect copyright.ＰＥＮＡＮＡF02JC2N9io
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。810Please respect copyright.ＰＥＮＡＮＡnqK4oWsJNW
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。810Please respect copyright.ＰＥＮＡＮＡ9pxmD8OO8a
810Please respect copyright.ＰＥＮＡＮＡwc1LaCLQiV
810Please respect copyright.ＰＥＮＡＮＡiU8MDsyMXj
810Please respect copyright.ＰＥＮＡＮＡCUtgSUY7Cj
（圖8）ADE這現象，科學家一直以來均有記錄及研究。（Ref4)810Please respect copyright.ＰＥＮＡＮＡnIvAKfSRmM
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。810Please respect copyright.ＰＥＮＡＮＡ4pRAF910Ph
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。810Please respect copyright.ＰＥＮＡＮＡQo7sAKDSXf
810Please respect copyright.ＰＥＮＡＮＡ36c79F5cWN
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。810Please respect copyright.ＰＥＮＡＮＡy9PpBddDer
810Please respect copyright.ＰＥＮＡＮＡGgHvQR2In3
810Please respect copyright.ＰＥＮＡＮＡfNKey5gDoz
810Please respect copyright.ＰＥＮＡＮＡYd5QU7BZbN
（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)810Please respect copyright.ＰＥＮＡＮＡLODxd0kI9E
810Please respect copyright.ＰＥＮＡＮＡXAIXodpFNa
武肺會否出現同樣現象，暫時尚未清楚。810Please respect copyright.ＰＥＮＡＮＡ7whjDpEvQ1
810Please respect copyright.ＰＥＮＡＮＡP1OOIt58I8
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。810Please respect copyright.ＰＥＮＡＮＡcOVpT220oO
810Please respect copyright.ＰＥＮＡＮＡK1SCOAsL3S
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。810Please respect copyright.ＰＥＮＡＮＡ8uo50MNL5C
810Please respect copyright.ＰＥＮＡＮＡHY0RAllkvC
810Please respect copyright.ＰＥＮＡＮＡ6nRBADOBsf
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！810Please respect copyright.ＰＥＮＡＮＡLfOFokBFKz
810Please respect copyright.ＰＥＮＡＮＡJkOR6Aq24g
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。810Please respect copyright.ＰＥＮＡＮＡ2qHmmCGrIg
810Please respect copyright.ＰＥＮＡＮＡaPLitq4gPV
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/toc810Please respect copyright.ＰＥＮＡＮＡ4OOgN2JNNO
810Please respect copyright.ＰＥＮＡＮＡg9LVgIw6Fq
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。810Please respect copyright.ＰＥＮＡＮＡRDgaVvFbWO
810Please respect copyright.ＰＥＮＡＮＡh1u5Aq0UIU
Link:810Please respect copyright.ＰＥＮＡＮＡjMbCeqMpWq
https://www.penana.com/user/27349/%E8%96%AF%E4%BB%94%E8%81%9E%E8%8C%B1%E8%8E%89/portfolio810Please respect copyright.ＰＥＮＡＮＡEQKd8Bdvqr
810Please respect copyright.ＰＥＮＡＮＡgecVo9hgD3
810Please respect copyright.ＰＥＮＡＮＡtnneO7d33K
有興趣接收科普資訊的話，歡迎follow IG: potatopigtongue。810Please respect copyright.ＰＥＮＡＮＡJgOcj1I5yy
810Please respect copyright.ＰＥＮＡＮＡbRTPgjgpJ7
810Please respect copyright.ＰＥＮＡＮＡncNjFThVO3
Ref2:https://jamanetwork.com/journals/jama/fullarticle/2769612?fbclid=IwAR0sp9eU5V9FOzuLjz6ERw6LRFm-1yx3MJt1OEgqBDQKW1GA5mQeIIi5J7E810Please respect copyright.ＰＥＮＡＮＡZdIOK03m1l
Ref3:https://science.sciencemag.org/content/369/6499/77?fbclid=IwAR29zOO06gVsQAC2jLU2uMJi-qcYbniz108Y4kcaWOr1iNuQyVM3jCFMHa4810Please respect copyright.ＰＥＮＡＮＡlMnHrtlAdG
Ref4:https://www.nature.com/articles/s41586-020-2538-8.pdf810Please respect copyright.ＰＥＮＡＮＡ1d6uMqJudh
Ref5:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7115629/810Please respect copyright.ＰＥＮＡＮＡ3JUDEyaUx6
8964 copyright protection806ＰＥＮＡＮＡndJTFNZx3w 維尼

3.17.73.197