Journal
CURRENT OPINION IN GASTROENTEROLOGY
Volume 30, Issue 1, Pages 25-33Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/MOG.0000000000000022
Keywords
histoblood group antigens; norovirus epidemiology; variants; virus-like particle vaccines
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Funding
- NIH Public Health Service [P01 AI 57788, P30 DK56336]
- Agriculture and Food Research Initiative Competitive grant from the United States Department of Agriculture [USDA 2011-68003-30395]
- John S. Dunn Research Foundation
- NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES [P01AI057788] Funding Source: NIH RePORTER
- NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY DISEASES [P30DK056338, P30DK056336] Funding Source: NIH RePORTER
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Purpose of reviewNoroviruses (NoVs) are the most common cause of epidemic and sporadic cases of acute gastroenteritis worldwide. This review summarizes recent NoV disease burden estimates, epidemiology findings and provides an update on virus-like particle (VLP) vaccine studies.Recent findingsNoVs are the leading cause of food-borne gastroenteritis and are replacing rotavirus as the predominant gastrointestinal pathogen in pediatric populations. Genogroup II, genotype 4 NoVs (GII.4) remain the dominant genotype worldwide. Increased NoV activity reported in late 2012 was associated with the emergence of a new GII.4 variant called Sydney 2012. New studies suggest that human NoVs can bind a larger range of histoblood group antigens, a susceptibility factor for NoV illness, thus expanding the susceptible population pool for infection. Intranasal immunization with a monovalent GI NoV VLP vaccine showed proof-of-concept efficacy. Studies using intramuscular immunization with a bivalent formulation including GII.4 VLPs are now underway.SummaryThe importance of NoVs as a major gastrointestinal pathogen underscores the need for well tolerated and effective vaccines. Results of VLP vaccine trials appear promising. However, the rapid evolution of NoV genotypes through antigenic drift and changing glycan specificities provide new challenges to epidemiology studies and vaccine trials.
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