在免疫缺陷男性中未能清除持续的疫苗衍生的神经病毒性脊髓灰质炎病毒感染
Calman MacLennan1, Glynis Dunn, Aarnoud P Huissoon
1MRC Centre for Immune Regulation, Division of Immunity and Infection, University of Birmingham, Birmingham, UK. cmaclennan@mlw.medcol.mw
Lancet (London, England)
|May 12, 2004
概括
慢性脊髓灰质炎的脊髓灰质炎病毒分泌对全球根除工作构成重大挑战. 目前的治疗方法是无效的,这凸显了针对疫苗衍生的脊髓灰质炎病毒的新型治疗策略的需要.
科学领域:
- 病毒学 病毒学
- 免疫学 免疫学 免疫学
- 传染性疾病 传染性疾病
背景情况:
- 神经病毒性脊髓灰质炎病毒的慢性分泌,特别是疫苗衍生菌株,是全球脊髓灰质炎根除计划的一个主要问题.
- 低型环球蛋白血症是持续性脊髓灰质炎感染的已知的危险因素.
研究的目的:
- 研究治疗策略,以清除常见变异性免疫缺陷患者的持续性神经病毒性脊髓灰质炎感染.
主要方法:
- 通过使用口服免疫球蛋白,母乳,利巴维林和pleconaril进行了体外和体外研究.
- 进行病毒定量,抗体中和试验,药物敏感性测试和病毒基因测序.
主要成果:
- 鉴定了长期无症状的疫苗衍生的2型脊髓灰质炎病毒的分泌 (22岁以上) 在一个低血糖球蛋白血症的男性.
- 没有一种治疗成功清除病毒,尽管母乳暂时降低了排泄水平.
- 病毒对pleconaril的敏感性降低,序列分析显示了关键突变.
结论:
- 慢性疫苗相关的脊髓灰质炎病毒感染在低胺球蛋白血症是很难治疗的.
- 这种持续的感染对脊髓灰质炎终结策略和停止脊髓灰质炎疫苗接种构成风险.
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