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。870Please respect copyright.ＰＥＮＡＮＡlcBOn3KdVJ
870Please respect copyright.ＰＥＮＡＮＡ6bil3yhg2T
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。870Please respect copyright.ＰＥＮＡＮＡhncbztEXW2
870Please respect copyright.ＰＥＮＡＮＡRll3sncAGs
870Please respect copyright.ＰＥＮＡＮＡDlvTXGfkOG
（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。870Please respect copyright.ＰＥＮＡＮＡT4wUm0rCYL
870Please respect copyright.ＰＥＮＡＮＡXdqgJNkyZX
下列為Sinovac製作滅活病毒疫苗的扼要流程(Ref3)870Please respect copyright.ＰＥＮＡＮＡX21YzpBQfA
870Please respect copyright.ＰＥＮＡＮＡmBWxq9AsSv
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。870Please respect copyright.ＰＥＮＡＮＡh9i0IB0Tya
870Please respect copyright.ＰＥＮＡＮＡ2LaRtV7o59
2.經過數輪實驗室細胞的培植，使病毒數量增加。870Please respect copyright.ＰＥＮＡＮＡ5r0OJl8thU
870Please respect copyright.ＰＥＮＡＮＡSqMJX3ESkq
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。870Please respect copyright.ＰＥＮＡＮＡjr3p4v70uN
870Please respect copyright.ＰＥＮＡＮＡX2PrZX6Kw0
4.將其製成可注射的疫苗。870Please respect copyright.ＰＥＮＡＮＡhfCybYNstw
870Please respect copyright.ＰＥＮＡＮＡLJX0uPeoYS
870Please respect copyright.ＰＥＮＡＮＡnfDdaBWskH
870Please respect copyright.ＰＥＮＡＮＡ8Jmd5AYyhr
（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。870Please respect copyright.ＰＥＮＡＮＡFMb6nIM8Tw
870Please respect copyright.ＰＥＮＡＮＡCOVv71lBpr
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。870Please respect copyright.ＰＥＮＡＮＡiVlhKWO7iE
https://www.penana.com/article/466568870Please respect copyright.ＰＥＮＡＮＡtVUninT9GS
870Please respect copyright.ＰＥＮＡＮＡfvtqUgfqDb
870Please respect copyright.ＰＥＮＡＮＡ4JJOOGTYI0
870Please respect copyright.ＰＥＮＡＮＡ50HbNcCGfV
870Please respect copyright.ＰＥＮＡＮＡTTBO2Sv2wo
870Please respect copyright.ＰＥＮＡＮＡiqIu0c2wWW
870Please respect copyright.ＰＥＮＡＮＡP7mKIJBLt4
870Please respect copyright.ＰＥＮＡＮＡLQdI39U7YT
870Please respect copyright.ＰＥＮＡＮＡlwc6lXPlum
（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。870Please respect copyright.ＰＥＮＡＮＡRh8ODF5CKb
870Please respect copyright.ＰＥＮＡＮＡrBYQImUUWn
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。870Please respect copyright.ＰＥＮＡＮＡKaTldyq7iL
870Please respect copyright.ＰＥＮＡＮＡE8qPYz8Yqg
1.抗體與病毒的S protein合併，870Please respect copyright.ＰＥＮＡＮＡJG54eZ9jza
防止條件1的達成。870Please respect copyright.ＰＥＮＡＮＡxsfoITkLS1
870Please respect copyright.ＰＥＮＡＮＡKZICLFR9r7
2.抗體與病毒其他位置合併，870Please respect copyright.ＰＥＮＡＮＡQ6p5WonbiE
防止條件3的達成。870Please respect copyright.ＰＥＮＡＮＡRl8syPYQEC
870Please respect copyright.ＰＥＮＡＮＡ86bannMNWC
870Please respect copyright.ＰＥＮＡＮＡIm8yNEozfC
870Please respect copyright.ＰＥＮＡＮＡ7tIBxmFqei
（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。870Please respect copyright.ＰＥＮＡＮＡvtdMA2lptE
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。870Please respect copyright.ＰＥＮＡＮＡG8TnJ76zNj
870Please respect copyright.ＰＥＮＡＮＡE0SHd05sjr
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。870Please respect copyright.ＰＥＮＡＮＡiasixbUqBD
870Please respect copyright.ＰＥＮＡＮＡ6zC4h4MqnE
870Please respect copyright.ＰＥＮＡＮＡCPtC1kH1ra
870Please respect copyright.ＰＥＮＡＮＡdTczg5PzIv
870Please respect copyright.ＰＥＮＡＮＡs9SNULCS9p
（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;870Please respect copyright.ＰＥＮＡＮＡj4KBl2TIS5
簡單來說，就是抗體適得其反地協助病毒入侵人體細胞。870Please respect copyright.ＰＥＮＡＮＡFOeZA2ONCZ
870Please respect copyright.ＰＥＮＡＮＡGl6LNc7O3M
免疫細胞的表面上，有著接收器識辨抗體的某個區域。870Please respect copyright.ＰＥＮＡＮＡ2uge7oCsSI
870Please respect copyright.ＰＥＮＡＮＡzI5aVMgKJn
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。870Please respect copyright.ＰＥＮＡＮＡnm62IXTyzd
870Please respect copyright.ＰＥＮＡＮＡXa3whJurGc
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。870Please respect copyright.ＰＥＮＡＮＡkPfYjy7Yvo
870Please respect copyright.ＰＥＮＡＮＡwhTqe73Pd3
870Please respect copyright.ＰＥＮＡＮＡitBR82UVKt
870Please respect copyright.ＰＥＮＡＮＡ7ZLeC9bYDv
（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。870Please respect copyright.ＰＥＮＡＮＡgEt3Mnmw1b
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。870Please respect copyright.ＰＥＮＡＮＡ1lrWOMXwkf
870Please respect copyright.ＰＥＮＡＮＡdV6JZp6jXI
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。870Please respect copyright.ＰＥＮＡＮＡe81C4N2XMY
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。870Please respect copyright.ＰＥＮＡＮＡ9u5GsLzxct
870Please respect copyright.ＰＥＮＡＮＡR2cuvVHhLU
870Please respect copyright.ＰＥＮＡＮＡMAdfbjsAyd
870Please respect copyright.ＰＥＮＡＮＡ9Vm7bK575A
（圖8）ADE這現象，科學家一直以來均有記錄及研究。（Ref4)870Please respect copyright.ＰＥＮＡＮＡZCRgEtsH4V
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。870Please respect copyright.ＰＥＮＡＮＡ93oK19GnDh
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。870Please respect copyright.ＰＥＮＡＮＡOaG2LsB33K
870Please respect copyright.ＰＥＮＡＮＡNsp4UUqdmU
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。870Please respect copyright.ＰＥＮＡＮＡ3tNkQVSYsi
870Please respect copyright.ＰＥＮＡＮＡWzmHSgwQO0
870Please respect copyright.ＰＥＮＡＮＡTbzbg9FsGI
870Please respect copyright.ＰＥＮＡＮＡk1YjNxg8lO
（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)870Please respect copyright.ＰＥＮＡＮＡ7VjTL2KWSV
870Please respect copyright.ＰＥＮＡＮＡDDXgqrJmdK
武肺會否出現同樣現象，暫時尚未清楚。870Please respect copyright.ＰＥＮＡＮＡaZXueRhR4E
870Please respect copyright.ＰＥＮＡＮＡ8EhyO75TOT
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。870Please respect copyright.ＰＥＮＡＮＡNlpTZRNpVB
870Please respect copyright.ＰＥＮＡＮＡhDN4vGyIvv
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。870Please respect copyright.ＰＥＮＡＮＡWD9akAqcuQ
870Please respect copyright.ＰＥＮＡＮＡ7gVF5Dr0G9
870Please respect copyright.ＰＥＮＡＮＡhRxn6Bpd6l
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！870Please respect copyright.ＰＥＮＡＮＡKAJQHmjJ6o
870Please respect copyright.ＰＥＮＡＮＡFBS1xqIQdn
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。870Please respect copyright.ＰＥＮＡＮＡrhvnXo4IhV
870Please respect copyright.ＰＥＮＡＮＡ38sITDtOuJ
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/toc870Please respect copyright.ＰＥＮＡＮＡzz5j2ZuLBv
870Please respect copyright.ＰＥＮＡＮＡBjMV3U7dDI
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。870Please respect copyright.ＰＥＮＡＮＡZ5NqAMUsSp
870Please respect copyright.ＰＥＮＡＮＡxjSzjbS0JB
Link:870Please respect copyright.ＰＥＮＡＮＡBjZutjSqkM
https://www.penana.com/user/27349/%E8%96%AF%E4%BB%94%E8%81%9E%E8%8C%B1%E8%8E%89/portfolio870Please respect copyright.ＰＥＮＡＮＡdYDUSbNquI
870Please respect copyright.ＰＥＮＡＮＡUSgNCJdzzM
870Please respect copyright.ＰＥＮＡＮＡzjdEEoSHQF
有興趣接收科普資訊的話，歡迎follow IG: potatopigtongue。870Please respect copyright.ＰＥＮＡＮＡed4P6hLXtf
870Please respect copyright.ＰＥＮＡＮＡ9KrwWsRiRW
870Please respect copyright.ＰＥＮＡＮＡjIjA4C9IyJ
Ref2:https://jamanetwork.com/journals/jama/fullarticle/2769612?fbclid=IwAR0sp9eU5V9FOzuLjz6ERw6LRFm-1yx3MJt1OEgqBDQKW1GA5mQeIIi5J7E870Please respect copyright.ＰＥＮＡＮＡtEKBdC31Zg
Ref3:https://science.sciencemag.org/content/369/6499/77?fbclid=IwAR29zOO06gVsQAC2jLU2uMJi-qcYbniz108Y4kcaWOr1iNuQyVM3jCFMHa4870Please respect copyright.ＰＥＮＡＮＡdYFvUirsuK
Ref4:https://www.nature.com/articles/s41586-020-2538-8.pdf870Please respect copyright.ＰＥＮＡＮＡ1Expuk3txz
Ref5:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7115629/870Please respect copyright.ＰＥＮＡＮＡvOChk43GdK
8964 copyright protection866ＰＥＮＡＮＡgXOary1ECM 維尼

216.73.216.137