科学家们对寻找生殖器疱疹疫苗感到灰心
By E.J. Mundell
HealthDay Reporter
FRIDAY, April 13 (HealthDay News) -- Experts say a lack of funds is slowing attempts to find a truly effectie accine against genital herpes, a sexually transmitted disease that can be deastating for the one in fie Americans oer 12 who carry the irus.
4月13日,星期五(每日健康新闻)-专家们称资金的缺乏正在减缓寻找真正有效的生殖器疱疹疫苗的步伐。生殖器疱疹是一种性传播疾病,能祸及1/5的12岁以上携带这种病毒的美国人。
Genital infection with the herpes simplex iruses (HS) 1 or 2 is not just an inconenience, doctors note. It is a painful, recurrent illness that causes psychological distress, raises health risks for newborns, and boosts the carrier's odds for a much more deadly irus, HI.
医生们称单纯疱疹病毒(HS)1或2的生殖器感染带来的不仅仅是不便。它是一种令人痛苦的,可复发性疾病,能带来心理痛苦,增加新生儿健康风险,使携带者易于感染另一种致死性更强的病毒HI。
And een as the Herpeac trial -- the first major publicly funded trial of a preentie accine -- is set to get under way, a leader of that trial says the accine, een if successful, would not be the solution to the herpes epidemic.
Herpeac试验的一位领导者称,即使目前正在进行的Herpeac试验(第一个重大的投资于保护性疫苗的公共资助性试验)研制成功,研制出的疫苗也不能解决疱疹的流行。
"The Herpeac trial is a accine that is only going to affect the [uninfected] adolescent woman," said Dr. Lawrence Corey, head of infectious diseases and irology at the Uniersity of Washington, in Seattle. "It is not going to be effectie in men or in those who are HI-positie. We need to do better."
Lawrence Corey是华盛顿大学传染病与病毒学主任,在西雅图称:“Herpeac试验所研制的疫苗,只对未感染HS的成年女性起作用,对男性或HI阳性个体无效。(因此)我们需要做得更好。”
Prior, expensie failures hae made the drug industry skittish about funding herpes accine trials, howeer. So, despite the fact that most adult Americans either hae HS-1 or 2, or are at ery high risk of contracting it in their lifetime, not enough is being done to stop the pathogen.
但是,先前昂贵的(试验)失败已使制药业对资助疱疹疫苗试验感到很恼火。所以,虽然多数美国人感染了HS-1、2,或在日常生活中接触HS的风险很高,但是目前的工作不足以阻止此病原体(的感染)。
"I would say that, at the moment, the genital herpes accine is a field that does not hae much interest, does not hae much money," Corey said. "The need for an HS accine is really substantie, but there is not much of a program in the industrialized, deeloping world to deelop such a accine."
Corey说:“我认为目前人们对生殖器疱疹领域关心的不够,资金投入的不多。HS疫苗需求量很大,但在发达国家和发展中国家甚至都没有一个研制这种疫苗的计划。”
Part of the problem lies in the complexity of the irus. While simpler iruses such as the flu simply mutate their outer coats to eade the human immune system, HS and other persistent iral infections are much more stable.
(导致)这一问题的部分原因是这种病毒的复杂性。虽然简单的病毒如流感病毒仅靠外壳突变就可以侵入人类免疫系统,但是(与之相比),HS和其它持续性感染的病毒要稳定的多。
Howeer, they hae another secret weapon. Compared to other iruses, HS 1 and 2 "hae a lot more genes and gene products that are redirecting and suberting the [host] immune response," Corey explained.
然而,它们拥有另一秘密武器。Corey解释说,与其它病毒相比,HS-1、2拥有更多的基因和基因产物,可以改变和破坏宿主的免疫反应。
Although the two strains are similar and can infect either mouth or genitalia, HS-1 is the prime cause of oral herpes (cold sores and feer blisters), while HS-2 is the usual source of genital infections.
虽然HS-1、2这两株病毒相似,都可以感染口和生殖器,但是HS-1主要导致口的疱疹(感冒疮和热病性疱疹),HS-2主要导致生殖器的感染。
Another tactic keeps herpes well-shielded from immune attack. Unlike pathogens that spread in readily accessed blood, HS hides out in nere cells called dorsal ganglia, located in the back. Specific triggers, such as sun exposure or stress, can send the irus traeling through nere pathways to mucosal sites of actiity in the genitalia, mouth and een eyes.
疱疹病毒还有另外一种方法可以很好地逃避免疫攻击。与易于通过血液传播的病原体不同,HS隐藏于背部被称为脊髓神经节的神经细胞内。特异性激发因素,如日晒或压力,能够使病毒穿越神经通路到达生殖器、口甚至眼睛的粘膜活跃部位。
These nere cells are "a protected site, immunologically," explained Dr. Lawrence Stanberry, director of the Sealy Center for accine Deelopment at the Uniersity of Texas Medical Branch in Galeston. "Needless to say, we don't like to hae our immune system attacking our neres," he said, so accines with that kind of reach are hard to deelop.
Lawrence Stanberry是得克萨斯州医科大学加尔维斯顿分院Sealy中心疫苗研制主任,他解释说:这些神经细胞是免疫隔离部位。他说:“毫无疑问,我们不希望我们的免疫系统攻击自身的神经细胞,所以针对那个部位的疫苗很难研制。”
And yet, progress is being made. The Herpeac trial, funded by the U.S. National Institutes of Health and drug maker GlaxoSmithKline, is focused on a preentie accine aimed solely at uninfected women. Preliminary, phase III studies completed last year found the accine to be 73 percent effectie in shielding young women from infection after exposure to HS-2.
但是,(疫苗研制)计划正在制定中。美国国家健康协会与药物制造商GlaxoSmithKline资助的Herpeac试验,正在研制一种保护性疫苗,目标人群是未感染HS的女性。去年已完成的第三阶段的初步研究发现,这种疫苗对保护年轻女性免于感染HS-2的有效率为73%。
A 73 percent effectieness rate may not sound all that impressie, but Stanberry -- also an inestigator on the Herpeac trial -- said no one is expecting 100 percent immunization.
73%的有效率给人留下的印象不那么深刻,但是Herpeac试验的另一名研究者Stanberry说,没有人期望(疫苗)能做到100%的免疫。
"What one hopes for with a accine is that you get ery high rates of effectieness and then ery broad uptake of the accine [in the population]," he explained. "So then, if almost eeryone gets immunized, then the disease simply doesn't circulate in the population to the same extent."
他解释说:“对于一种疫苗,人们期望的是有效率高,然后是人群中适应面广。所以,如果几乎所有人都接种疫苗,那么疾病在人群中的流行程度就不会是现在的程度。”
Reducing the "pool" of aailable irus will be ital to lowering the infection rate, researchers say, because the Herpeac shot does not protect uninfected men and cannot eliminate HS from people who are already infected.
由于Herpeac不能保护未感染HS的男性,不能清除已感染个体体内的病毒,所以研究者称,减少具有传染性的病毒库对于降低传染率至关重要。
The Herpeac trial is currently wrapping up recruitment of 7,000 healthy, HS-negatie U.S. women between the ages of 18 and 30. Participants will receie either the accine or a placebo and then be followed for 18 months to see if they become infected.
Herpeac目前已经募集了7000名健康的,HS阴性的美国女性,其年龄范围为18到30岁。参与者将接种疫苗或安慰剂,然后在18个月后观察是否感染了HS。
Stanberry said final results from the trial should be aailable by 2009, and -- if the accine proes effectie -- a shot might be approed by 2010.
Stanberry说到2009年将拿到试验的最终结果,(如果证明疫苗有效)到2010年将可能会被批准。
Howeer, like most modern accine trials, the Herpeac trial relies on a piece or "subunit" of HS to prime the human immune system against incoming irus.
然而,Herpeac试验与多数现代疫苗试验相似,依赖HS的一部分或 “亚单位”预致敏人类免疫系统以抵御病毒的入侵。
Another researcher is adocating the use of the lie -- but greatly weakened -- form of the irus, instead.
与之相反,另一研究者主张使用活(毒性极大削弱的)病毒。
The problem with the subunit approach is that its effects don't last, said William Halford, a irologist at Montana State Uniersity, in Bozeman. "Once you delier it into someone's body, it's there, but, in a few weeks, it is gone," he said.
蒙大纳州大学病毒学家Halford在Bozeman称,使用亚单位法的问题是效力不能持久。他说:“一旦你将其注入某人身体,它就会呆在那里。但是几周过后,它就消失了。”
Lie irus accines hae a long and effectie history. In fact, one of the few effectie accines against any herpes strain -- the chickenpox/shingles (herpes zoster) shot -- was deeloped from lie irus back in the 1960s.
活病毒疫苗有效时间长。事实上,少数几种针对任一疱疹株有效的疫苗(水痘/带状疱疹疫苗)是十九世纪六十年代由活病毒衍化而来。
Since that time, doctors hae gotten more skittish about injecting people with a lie form of the irus, howeer, so the subunit approach took precedence.
然而从那时起,医生们就对给人体注射活病毒十分恼火,,所以优先考虑亚单位法。
But Halford beliees it is time to reisit the idea of a lie irus herpes accine.
但Halford相信现在是重提活的疱疹病毒疫苗的时候了。
"All we really hae to do is to figure out a way to take away some of the genes or proteins that the irus needs to cause actual disease," he said. In other words, people would be infected with a ery weak form of HS, one that is sufficient to trigger a sustained immune response but too frail to trigger disease outbreaks.
他说“我们真正要做的是想方设法清除病毒赖以致病的一些基因或蛋白。”即人们需要感染一种致病力弱的HS,这种病毒足以激发持久的免疫反应,但又不足以致病。
Halford is specifically inestigating a protein in HS called ICP0. "If I take away the gene that codes for that protein, the irus is really weakened," he said.
Halford专门研究HS中的一种称为ICP0的蛋白。他说:“如果我去除编码这种蛋白的基因,病毒的致病力的确会被削弱。”
The approach is controersial, but Corey beliees it could hae promise. "I certainly think that the lie attenuated irus is a iable approach to talk about," he said.
这种方法存在争议,但Corey相信它能实现。他说:“我确实认为(使用)这种致病力削弱的病毒的活性形式是一种可以探讨的方法”
Funding will be the real challenge, howeer, whateer the accine strategy. According to Corey, a series of expensie failures oer the past two decades has dampened the enthusiasm of industry to inest in HS accine research.
但是,无论采用什么方法研制疫苗,真正的挑战是资金的来源。Corey说,过去二十年中一系列昂贵的试验失败挫伤了制药业投资HS疫苗研究的积极性。
"I can gie my own scenario in which we worked with [drug maker] Chiron and spent seen years and a lot of money -- decapitalizing the company by 25 percent -- on an antibody-based accine," Corey said. "At the time, we thought it would be sufficient to work, but it didn't."
Corey说:“我可以举出我自己的实例。我们与制药商Chiron合作,用了7年,花了一大笔钱(用掉了公司25%的资金)研究抗体性的疫苗。目前,我们认为疫苗应该足够有效,但它却是无效的。”
So, with the priate sector waiting on the sidelines, public funding becomes key.
所以,由于私人部门不参与使得公共投资变得很重要。
"I think there needs to be more money from the publicly funded institutions -- whether they be foundations, the NIH or the National Research Council, in accine deelopment," Corey said.
Corey说:“我认为疫苗的研制需要更多地来自公共投资机构的投资,不管是基金,NIH还是国家研究委员会。”
"We also need to do more in defining a real path of success for a genital herpes accine," he added. "Once some pathway of success becomes defined, then you'll see the pharmaceutical companies moe forward."
他补充说:“我们同样需要更加努力,以找到一种真正有效的方法研制出生殖器疱疹疫苗。一旦找到了某一种有效的方法,你会看到药物公司很快就会跟进。”
编译:(2020字)
科学家们对寻找生殖器疱疹疫苗感到灰心
4月13日,星期五(每日健康新闻)-专家们称资金的缺乏正在减缓寻找真正有效的生殖器疱疹疫苗的步伐。生殖器疱疹是一种性传播疾病,能祸及1/5的12岁以上携带这种病毒的美国人。医生们称单纯疱疹病毒(HS)1或2的生殖器感染带来的不仅仅是不便。它是一种令人痛苦的,可复发性疾病,能带来心理痛苦,增加新生儿健康风险,使携带者易于感染另一种致死性更强的病毒HI。Herpeac试验的一位领导者称,即使目前正在进行的Herpeac试验(第一个重大的投资于保护性疫苗的公共资助性试验)研制成功,研制出的疫苗也不能解决疱疹的流行。
Lawrence Corey是华盛顿大学传染病与病毒学主任,在西雅图称:“Herpeac试验所研制的疫苗,只对未感染HS的成年女性起作用,对男性或HI阳性个体无效。(因此)我们需要做得更好。”但是,先前昂贵的(试验)失败已使制药业对资助疱疹疫苗试验感到很恼火。所以,虽然多数美国人感染了HS-1、2,或在日常生活中接触HS的风险很高,但是目前的工作不足以阻止此病原体(的感染)。Corey说:“我认为目前人们对生殖器疱疹领域关心的不够,资金投入的不多。HS疫苗需求量很大,但在发达国家和发展中国家甚至都没有一个研制这种疫苗的计划。”(导致)这一问题的部分原因是这种病毒的复杂性。虽然简单的病毒如流感病毒仅靠外壳突变就可以侵入人类免疫系统,但是(与之相比),HS和其它持续性感染的病毒要稳定的多。然而,它们拥有另一秘密武器。Corey解释说,与其它病毒相比,HS-1、2拥有更多的基因和基因产物,可以改变和破坏宿主的免疫反应。虽然HS-1、2这两株病毒相似,都可以感染口和生殖器,但是HS-1主要导致口的疱疹(感冒疮和热病性疱疹),HS-2主要导致生殖器的感染。疱疹病毒还有另外一种方法可以很好地逃避免疫攻击。与易于通过血液传播的病原体不同,HS隐藏于背部被称为脊髓神经节的神经细胞内。特异性激发因素,如日晒或压力,能够使病毒穿越神经通路到达生殖器、口甚至眼睛的粘膜活跃部位。Lawrence Stanberry是得克萨斯州医科大学加尔维斯顿分院Sealy中心疫苗研制主任,他解释说:这些神经细胞是免疫隔离部位。他说:“毫无疑问,我们不希望我们的免疫系统攻击自身的神经细胞,所以针对那个部位的疫苗很难研制。”
但是,(疫苗研制)计划正在制定中。美国国家健康协会与药物制造商GlaxoSmithKline资助的Herpeac试验,正在研制一种保护性疫苗,目标人群是未感染HS的女性。去年已完成的第三阶段的初步研究发现,这种疫苗对保护年轻女性免于感染HS-2的有效率为73%。73%的有效率给人留下的印象不那么深刻,但是Herpeac试验的另一名研究者Stanberry说,没有人期望(疫苗)能做到100%的免疫。他解释说:“对于一种疫苗,人们期望的是有效率高,然后是人群中适应面广。所以,如果几乎所有人都接种疫苗,那么疾病在人群中的流行程度就不会是现在的程度。”由于Herpeac不能保护未感染HS的男性,不能清除已感染个体体内的病毒,所以研究者称,减少具有传染性的病毒库对于降低传染率至关重要。Herpeac目前已经募集了7000名健康的,HS阴性的美国女性,其年龄范围为18到30岁。参与者将接种疫苗或安慰剂,然后在18个月后观察是否感染了HS。Stanberry说到2009年将拿到试验的最终结果,(如果证明疫苗有效)到2010年将可能会被批准。然而,Herpeac试验与多数现代疫苗试验相似,依赖HS的一部分或 “亚单位”预致敏人类免疫系统以抵御病毒的入侵。与之相反,另一研究者主张使用活(毒性极大削弱的)病毒。蒙大纳州大学病毒学家Halford在Bozeman称,使用亚单位法的问题是效力不能持久。他说:“一旦你将其注入某人身体,它就会呆在那里。但是几周过后,它就消失了。”活病毒疫苗有效时间长。事实上,少数几种针对任一疱疹株有效的疫苗(水痘/带状疱疹疫苗)是十九世纪六十年代由活病毒衍化而来。然而从那时起,医生们就对给人体注射活病毒十分恼火,,所以优先考虑亚单位法。但Halford相信现在是重提活的疱疹病毒疫苗的时候了。他说“我们真正要做的是想方设法清除病毒赖以致病的一些基因或蛋白。”即人们需要感染一种致病力弱的HS,这种病毒足以激发持久的免疫反应,但又不足以致病。Halford专门研究HS中的一种称为ICP0的蛋白。他说:“如果我去除编码这种蛋白的基因,病毒的致病力的确会被削弱。”这种方法存在争议,但Corey相信它能实现。他说:“我确实认为(使用)这种致病力削弱的病毒的活性形式是一种可以探讨的方法”
但是,无论采用什么方法研制疫苗,真正的挑战是资金的来源。Corey说,过去二十年中一系列昂贵的试验失败挫伤了制药业投资HS疫苗研究的积极性。Corey说:“我可以举出我自己的实例。我们与制药商Chiron合作,用了7年,花了一大笔钱(用掉了公司25%的资金)研究抗体性的疫苗。目前,我们认为疫苗应该足够有效,但它却是无效的。”所以,由于私人部门不参与使得公共投资变得很重要。Corey说:“我认为疫苗的研制需要更多地来自公共投资机构的投资,不管是基金,NIH还是国家研究委员会。”他补充说:“我们同样需要更加努力,以找到一种真正有效的方法研制出生殖器疱疹疫苗。一旦找到了某一种有效的方法,你会看到药物公司很快就会跟进。”
"Specific triggers, such as sun exposure or stress, can send the irus traeling through nere pathways to mucosal sites of actiity in the genitalia, mouth and een eyes."建议翻译为:特异性触发因素,诸如日晒或压力.能够使病毒穿越神经通路到达生殖器、口腔甚至眼睛的粘膜部位并在此活跃.
发表者QINQIN 时间 2008-10-19 03:49:06 PM