BOOK REVIEWS
E. Ronald Ellis (ed.)
Combination vaccines. Development, clinical research and approval
Humana Press, Totowa, New Jersey, 1999. Single volume, 279 pages.
Combinig vaccines in order to reduce the number of doses administered is not a new practice. For more than 70 years a mixture of diphtheria, tetanus, and pertussis (DTP) vaccines has been in use, successfully reducing the vaccination schedule to a series of four injections that concludes with the oral administration of polio vaccine. When the so-called "triple-virus" vaccine (measles-mumps-rubella: MMR) became available, another injection was added to the vaccination schedule for children under two years.
The development of vaccines that can effectively prevent common diseases such as hepatitis A, hepatitis B, varicella, meningitis, and infections due to Haemophilus influenzae type b (Hib) or meningococcus (neisseria), as well as other diseases, will not take much long longer. New vaccines are beginning to complicate vaccination schedules because they increase the number of injections. This is uncomfortable for small children and may not be understood by some parents, thus increasing the possibility that the full vaccination schedule will not be carried out as a results of oversight, rejection, or other reasons. The psychosocial background of the family will probably become increasingly important. Researchers and the pharmaceutical industry are not oblivious to these problems. Studies are under way that are designed to simplify the vaccination calendar by combining vaccine extracts, without loss of their individual antigenic capacity, and administering a volume that minimizes discomfort and risk, particularly in small children.
This book coordinated by Dr. R. W. Ellis, examines these problems. The collaborators include distinguished researchers who have expert knowledge of a number of interesting topics, such as the pharmaceutical and immunological aspects of the effectiveness of vaccine combinations with the objetc of preventing the phenomenon known as interference, or reduction of extract antigenicity. Other chapters deal with specific vaccines, for instance the MMR vaccine mentioned and newer vaccines, such as vaccines against rotavirus, influenza virus, and Streptococcus pneumoniae. Finally, the monograph also examines more down-to-earth topics like vaccination calendars for children and adults and new proposals for vaccines that are already available.
In conclusion, this is a valuable monograph for medical practitioners and pediatricians, who are overwhelmed by partial information that is not always disinterested. This book provides a useful synthesis of current knowledge of the subject and its application in daily practice.
F. Muñoz. López
A. Caroline Hébert (ed.)
Chemokines in disease. Biology and clinical research
Humana Press, Totowa, New Jersey, 1999. Single volume, 330 pages.
In the present decade, the development of large groups, curently numbering about 50, of substances that in one way or another intervene in the specific chemotaxis of leukocytes (thus the generic designation of chemokines: chemotactic cytokines), is helping to clarify the mechanisms involved in different physiopathological processes. The importance of the work in terms of the effects that it may soon have on the clinical and therapeutic aspects of diseases has not been overlooked by anyone. Since the first substances became known, interleukin-8 (IL-8) (initially included in another group of cytokines) and macrophage inflammatory protein-1* (MIP-1*), the series has grown. Knowledge of their structure, obtained via bioinformatics, has increased and the possible chromosomal locations of inductor genes for different substances have been identified. As a result, the cytokines can be grouped according to whether they contain two molecules of cysteine together at the terminal end of the aminoacid chain (CC), or two molecules of cysteine separated by another amino acid (CXC). It is now known that the chromosomes involved are 17, 2, 9 and 16 for CC and 1 and 10 for CXC.
This monograph describes the development of this knowledge. This book also considers its implications for inflammatory diseases (respiratory processes like asthma and respiratory distress, allergic reactions, rheumatoid arthritis, etc.), transplant rejection, and tumor biology. It even suggests possible therapeutic uses of MIP-1*. The involvement of the chemokines in key mechanisms like angiogenesis and wound healing is also studied in this text, which is completed by several chapters dedicated to viral biology, particularly HIV. These chapters contain interesting contributions that may be applicable to the diagnosis and treatment of AIDS. Nonetheless, this information has been obtained mainly through animal experiments (knockout mice) and should be developed so that it can be extrapolated to human clinical practice, where its practical applications may be determined.
This interesting monograph, which targets researchers and academics, provides a clear synthesis of a topic that is currently attracting much interest. Numerous papers are being published in specialized journals, but without an overview like that given in this book, it can be difficult to understand the questions involved.
F. Muñoz-López
