43．新刊書「ワクチン学」

2014/04/26

（社）予防衛生協会理事
東京大学名誉教授　山内一也

私は1956年北里研究所で天然痘ワクチンの製造と改良研究に従事したのを初めとして、国立予防衛生研究所（予研）で麻疹ワクチンの国家検定、東大医科学研究所で天然痘ワクチンをベクターとした組み換え牛疫ワクチンの開発を行ってきました。ウイルスワクチンが私の研究人生の大きな柱だったのです。その経験を通してみてきたワクチンの世界を紹介する本をこの度、細菌ワクチンの専門家の三瀬勝利先生との共著で、岩波書店から学術一般書として出版しました。三瀬先生は1963年に予研での赤痢菌ワクチンの開発研究を初めとして、各種細菌ワクチンの問題に取り組み、現在なお、医薬品医療機器総合機構のワクチン等審査部・専門委員をつとめています。私とは予研時代からの長いつきあいです。

まえがき、目次と参考文献をご紹介させていただきます。なお、まえがきに書いたように、参考文献は単行本だけにしぼったため、ここでは、元のすべての参考文献を掲載します。

まえがき

１９８０年世界保健機関（WHO）は有史以来人類を苦しめてきた天然痘が根絶されたことを宣言した。この偉業は、１８世紀終わりにジェンナーが始めたワクチン接種（種痘）により達成されたのである。この時代、細菌やウイルスは発見されていなかった。細菌が発見されたのは１９世紀半ば、ウイルスの発見は１９世紀終わりである。ジェンナーから１００年後、パスツールは細菌ワクチンとして家禽コレラ・ワクチン、炭疽ワクチンを開発し、続いて狂犬病ワクチンを開発した。細菌やウイルスの存在が認識される以前から、古典的ワクチンの時代は始まっていた。

２０世紀に入って細菌学、ウイルス学が進展しはじめ、それとともに近代的ワクチンの時代に入っていった。ワクチン学という新しい学問領域が誕生したのである。続々と開発されてきたワクチンにより、ジフテリア、百日咳、ポリオ、麻疹、風疹、B型肝炎など多くの感染症が制圧されてきた。現在、WHOは全世界で年間３００万人の命がワクチンにより救われていると推定している。

ワクチンには、毒性の低い細菌やウイルスを用いる生ワクチンと、細菌やウイルスを死滅させた不活化ワクチンがある。このようなワクチンを接種することにより、いわば軽い病気にかかった状態を人為的に作り出して免疫を与えているのである。病原体の弱毒化または不活化というワクチン技術は、１９８０年代からは、組み換えDNA技術を中心とした遺伝子工学が加わったことで、めざましい進展を示し始めている。それとともに、新しいワクチン開発の動きは２１世紀に入って急加速している。エイズ、新型インフルエンザをはじめ、デング熱、マラリアなど、公衆衛生面で重要な感染症のワクチンに加えて、癌、アルツハイマー病、糖尿病といった感染症以外の病気に対するワクチン開発も活発になっている。成人病や難病などで、病気の原因物質が見つかれば、それに対する免疫治療の手段としてワクチンが注目されているのである。

個々のワクチンが生まれてきた背景を眺めてみると、そこにはさまざまな歴史があり、多くの失敗と成功の物語が存在している。ワクチンの有効性や副作用の問題を正しく理解するためには、これらの背景を認識することが求められる。そのような視点にたったワクチンの一般的解説書は、欧米ではいくつも出版されているが、日本ではごく一部を除いて皆無といってよい。そこで、ウイルス学と細菌学それぞれの専門の立場から、本書をまとめることにした次第である。ワクチンの歴史を振り返り、今後の展望を眺めてみた結果、ワクチン学の領域が予想をはるかに超えて急速に進展してきたことに改めて驚かされている。巨大製薬企業がワクチン分野に進出してきた現在、ワクチン開発はさらに加速することが予想される。本書がワクチン専門家だけでなく、医学、生物学、バイオテクノロジーなど、色々な立場からワクチンに関心を持つ多くの読者に、広大かつ深遠なワクチンの世界を理解していただくのに役立つことを期待したい。

なお、参考文献は、当初は500編を超す文献を列記する予定であったが、紙数に制約があり、一般向け学術書という趣旨から単行本だけにしぼった。

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５章

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