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Cudurrada xilliyeedka ee hargabku waxay sababaan inta u dhaxaysa 290,000 iyo 650,000 cudurrada neef-mareenka ee u dhinta adduunka oo dhan sannad kasta. Dalku waxa uu la kulmaaya hargab halis ah jiilaalkan ka dib markii uu dhamaaday masiibada COVID-19. Tallaalka hargabku waa habka ugu waxtarka badan ee looga hortagi karo hargabka, laakiin tallaalka hargabka ee dhaqameed ee ku salaysan dhaqanka embriyaha digaaga ayaa leh cilladaha qaarkood, sida kala duwanaanta immunogenic, xaddididda wax soo saarka iyo wixii la mid ah.

Imaanshaha tallaalka infalawansada hidda-wadaha borotiinka ee dib-u-hagaajinta ayaa xallin kara cilladaha tallaalka dhaqameed ee embriyaha digaagga. Hadda, Guddiga La-talinta Mareykanka ee Dhaqanka Tallaalka (ACIP) waxay ku talinayaan tallaalka hargabka recombinant ee dadka waaweyn ≥65 sano jir. Si kastaba ha ahaatee, dadka da'doodu ka yar tahay 65 jir, ACIP kuma talinayso tallaalka hargabka ku habboon da'da mudnaan ahaan sababtoo ah la'aanta isbarbardhigga madax-ka-madaxa ee u dhexeeya noocyada kala duwan ee tallaalada.

Hemagglutinin quadrivalent recombinant (HA) tallaalka hargabka hidde ahaan loo farsameeyay (RIV4) ayaa loo oggolaaday suuqgeyn dalal dhowr ah tan iyo 2016 oo hadda ah tallaalka hargabka recombinant ee la isticmaalo. RIV4 waxaa la soo saaray iyadoo la adeegsanayo tignoolajiyada borotiinka ee dib-u-habaynta, taas oo ka gudbi karta cilladaha wax-soo-saarka tallaalka firfircoon ee dhaqameed ee xaddiday sahayda embriyaha digaagga. Waxaa intaa dheer, goobtani waxay leedahay wareeg wax soo saar gaaban, waxay ku habboon tahay beddelka waqtiga saxda ah ee noocyada tallaalka murashaxiinta, waxayna ka fogaan kartaa isbeddellada la qabsiga ee laga yaabo inay ku dhacaan habka wax soo saarka ee noocyada fayraska kuwaas oo saameyn kara saameynta ilaalinta tallaalada la dhammeeyey. Karen Midthun, oo markaa agaasime ka ah Xarunta Dib-u-eegida iyo Cilmi-baarista Bayolojiga ee Maamulka Cuntada iyo Dawooyinka ee Maraykanka (FDA), ayaa faallo ka bixisay in "imaanshaha tallaallada hargabka recombinant ay ka dhigan tahay horumar tignoolajiyadeed ee soo saarista tallaallada hargabka… Intaa waxaa dheer, RIV4 waxaa ku jira saddex jeer ka badan borotiinka hemagglutinin marka loo eego qiyaasta caadiga ah ee tallaalka hargabka caadiga ah, kaas oo leh difaac adag [2]. Daraasado jira ayaa muujiyay in RIV4 uu ka difaac badan yahay tallaalka heerka caadiga ah ee hargabka ee dadka waaweyn, iyo caddayn dhamaystiran ayaa loo baahan yahay si loo barbardhigo labada da'da da'da yar.

Diseembar 14, 2023, Joornaalka Caafimaadka ee New England (NEJM) ayaa daabacay Daraasad ay samaysay Amber Hsiao et al., Xarunta Daraasadda Tallaalka ee Kaiser Permanente, Nidaamka Caafimaadka ee KPNC, Oakland, USA. Daraasadu waa daraasad caalami ah oo adeegsatay hab-dad- randomed si loo qiimeeyo saamaynta ilaalinta RIV4 iyo tallaalka hargabka afar geesoodka ah (SD-IIV4) ee dadka da'doodu ka yar tahay 65 da'da inta lagu jiro labada xilli ee hargabka laga bilaabo 2018 ilaa 2020.

Iyada oo ku xidhan goobta adeega iyo baaxada xarunta ee xarumaha KPNC, waxa si aan kala sooc lahayn loogu qoondeeyay midkood kooxda A ama Kooxda B (Jaantuska 1), halkaas oo kooxda A ay heshay RIV4 usbuucii ugu horeeyay, Kooxda B waxa ay heshay SD-IIV4 todobaadkii ugu horeeyay, ka dibna xarun kasta waxa ay si kale u heshay labada tallaal todobaadkiiba ilaa dhamaadka xilliga hargabka hadda. Meesha ugu dambeysa ee daraasaddu waxay ahayd kiisaska hargabka PCR ee la xaqiijiyay, iyo qodobbada ugu dambeeya ee ay ka mid yihiin hargabka A, hargabka B, iyo cusbitaalada la xiriira hargabka. Dhakhaatiirta xarun kasta waxay sameeyaan baaritaanada PCR ee hargabka sida ay rabaan, iyagoo ku saleysan bandhigga bukaan-socodka, waxayna helaan bukaan-jiif iyo bukaan-socod, baaritaan shaybaar, iyo macluumaadka tallaalka iyagoo isticmaalaya diiwaannada caafimaadka elektaroonigga ah.

Daraasadda waxaa ku jiray dadka waaweyn ee da'doodu u dhaxayso 18 ilaa 64 sano, iyada oo 50 ilaa 64 sano ay yihiin kooxda da'da aasaasiga ah ee la falanqeeyay. Natiijooyinku waxay muujiyeen in saamaynta ilaalinta qaraabo (rVE) ee RIV4 marka la barbar dhigo SD-IIV4 ka dhanka ah hargabka PCR-la xaqiijiyay ay ahayd 15.3% (95% CI, 5.9-23.8) ee dadka da'doodu u dhaxayso 50 ilaa 64 sano. Ilaalinta qaraabada ee hargabka A waxay ahayd 15.7% (95% CI, 6.0-24.5). Ma jiro wax saamayn ah oo ka hortag ah oo la taaban karo oo lagu muujiyey hargabka B ama cusbitaalada la xidhiidha hargabka. Intaa waxaa dheer, falanqaynta sahaminta ayaa muujisay in dadka da'doodu u dhaxayso 18-49, labadaba hargabka (rVE, 10.8%; 95% CI, 6.6-14.7) ama hargabka A (rVE, 10.2%; 95% CI, 1.4-18.2), RIV4 waxay muujisay ilaalin ka wanaagsan 4.

Tijaabo caafimaad oo hore oo aan kala sooc lahayn, laba-indho la'aan, kontorool togan oo la xakameeyey ayaa muujisay in RIV4 ay ka ilaalin ka wanaagsan tahay SD-IIV4 ee dadka 50 sano iyo ka weyn (rVE, 30%; 95% CI, 10 ~ 47) [3]. Daraasadani waxay mar kale muujinaysaa iyada oo loo marayo xogta dhabta ah ee baaxadda weyn ee adduunka in tallaalada hargabka ee dib-u-dhaqaajinta ay bixiyaan difaac ka wanaagsan tallaallada aan firfircoonayn ee dhaqameed, oo ay buuxiyaan caddaynta in RIV4 ay sidoo kale bixiso ilaalin wanaagsan dadka da'da yar. Daraasadu waxay falanqaysay dhacdooyinka caabuqa neef-mareenka syncytial (RSV) ee labada kooxood (Infekshanka RSV waa inuu ahaadaa mid la mid ah labada kooxoodba sababtoo ah tallaalka hargabku kama hortagayo caabuqa RSV), oo laga saaray arrimo kale oo jahawareer ah, oo lagu xaqiijiyay xoojinta natiijooyinka iyada oo loo marayo falanqayn xasaasi ah oo badan.

Kooxda cusub ee habka naqshadaynta bakhtiyaanasiibka ah ee lagu qaatay daraasaddan, gaar ahaan tallaalka beddelka ah ee tallaalka tijaabada ah iyo tallaalka xakamaynta toddobaad kasta, ayaa si fiican isu dheellitiray arrimaha soo dhexgalaya labada kooxood. Si kastaba ha ahaatee, sababtoo ah kakanaanta naqshadeynta, shuruudaha fulinta cilmi-baarista ayaa sarreeya. Daraasaddan, sahayda tallaalka hargabka recombinant ee aan ku filnayn ayaa keentay in tiro badan oo dad ah oo ay ahayd in ay helaan RIV4 helaan SD-IIV4, taasoo keentay farqi weyn oo ka mid ah tirada ka qaybgalayaasha ee u dhexeeya labada kooxood iyo khatarta suurtagalka ah ee eexda. Intaa waxaa dheer, daraasaddan ayaa markii hore loo qorsheeyay in la qabto laga bilaabo 2018 ilaa 2021, iyo soo ifbaxa COVID-19 iyo ka hortagga iyo xakamaynta ayaa saameeya labadaba daraasadda iyo xoojinta faafitaanka hargabka, oo ay ku jiraan gaabin xilliga hargabka 2019-2020 iyo maqnaanshaha hargabka 2020-2021. Xogta laga helay laba xilli oo hargab oo "aan caadi ahayn" laga bilaabo 2018 ilaa 2020 ayaa la heli karaa, markaa cilmi baaris dheeraad ah ayaa loo baahan yahay si loo qiimeeyo bal in natiijooyinkani ay hayaan xilliyo badan, noocyo wareeg ah oo kala duwan iyo qaybaha tallaalka.

Isku soo wada duuboo, daraasaddan ayaa sii caddaynaysa suurtagalnimada tallaallada dib-u-habaynta hiddo-wadaha ee lagu dabaqay goobta tallaallada hargabka, waxayna sidoo kale aasaas farsamo adag u tahay cilmi-baarista mustaqbalka iyo horumarinta tallaallada cusub ee hargabka. Madal tignoolajiyada tallaalka injineernimada dib-u-habaynta kuma xirna embriyaha digaagga, waxayna leedahay faa'iidooyinka wareegga wax soo saarka gaaban iyo xasilloonida wax soo saarka sare. Si kastaba ha ahaatee, marka la barbar dhigo talaalada soo jireenka ah ee hargabka aan firfircoonayn, wax faa'iido ah oo la taaban karo kuma leh ilaalinta, wayna adagtahay in la xalliyo ifafaale fakashada difaaca ee ay sababaan fayrasyada hargabka oo aadka isu beddelay oo ka yimid sababta asalka ah. Si la mid ah tallaallada hargabka dhaqameed, saadaasha culeyska iyo beddelka antigen-ka ayaa loo baahan yahay sannad kasta.

Marka la eego kala duwanaanshaha hargabka ee soo baxaya, waa in aan wali fiiro gaar ah u yeelano horumarinta tallaalada hargabka caalamiga ah mustaqbalka. Samaynta tallaalka hargabka caalamiga ah waa in uu si tartiib tartiib ah u ballaariyo baaxadda ka hortagga noocyada fayraska, oo ugu dambeyntii laga gaaro ilaalin wax ku ool ah dhammaan noocyada kala duwan sannado kala duwan. Sidaa darteed, waa in aan sii wadnaa kor u qaadida naqshadeynta immunogen ballaaran oo ku salaysan borotiinka HA mustaqbalka, diiradda saara NA, borotiinka kale ee fayraska hargabka, oo ah bartilmaameedka tallaalka muhiimka ah, iyo diiradda saara waddooyinka tignoolajiyada tallaalka neefsashada kuwaas oo aad uga faa'iideysanaya soo saarista jawaabaha difaaca ee kala duwan oo ay ku jiraan difaaca unugyada gudaha (sida tallaalka sanka lagu buufiyo, tallaalka budada qalalan ee la neefsan karo, iwm). Sii wad kor u qaadida cilmi baarista tallaalada mRNA, tallaalada sideyaasha, adjuvants cusub iyo aaladaha kale ee farsamada, oo xaqiiji horumarinta tallaalada hargabka caalamiga ah ee ku habboon oo "ka jawaabaya dhammaan isbeddellada aan isbeddelin"