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回复 亢龙有悔217 的帖子
科学从失败中学习, 如果一个概念具有科学价值和基础,研究人员就不会因失败而停止.
使用HBV疫苗治疗慢性乙型肝炎在动物模型中取得了成功,它们在早期临床试验中是安全的.
有几项最近的临床试验,其中HBeAg阴性, 低HBsAg的患者在多剂量HBV疫苗后进一步降低HBsAg.
所以古巴疫苗只是一个例子.
"古巴的治疗疫苗如果有效,那么患者注射后转氨酶马上会升高" - 这表明缺乏了解HBV特异性T细胞免疫, CTL, 如何在接种疫苗后发展. 这需要时间,需要很多步骤,例如:
1.递送; 2. APC细胞的抗原识别; 3:T细胞和B细胞的抗原呈递(antigen presentation); 4.共刺激(co-stimualtion); 5.T和T细胞克隆扩增(clonal expansion); 6.T和B免疫效应细胞活化(activation); 等等..
积极的反应取决于许多宿主和疫苗因素及其相互作用.
最后,我引用了YIC的发明者温玉梅教授,她是中国首次尝试治疗性疫苗:
Though this “sandwich” approach seems applicable, the short “window stage” of transient clearance of serum HBsAg is critical for successful treatment of CHB patients. “Add on” or different sequential protocols need
to be explored to make use of this stage, and potent active immunization should be explored. To avoid possible side effects, liver functions, humoral, and cellular immune responses should be closely monitored during this protocol of treatment. In addition, different active immunization regimens, such as, DNA vaccination, vector-mediated vaccines, usage of different adjuvants, etc., are all possible approaches that should be studied to maximize
the desired anti-HBV immune responses. As all
approaches for CHB functional cure can only be verified by clinical trials, we hope the approach presented in this article can be considered for international collaboration,
and granted approval for pilot clinical trials in the near future, to benefit patients suffering from the consequences of CHB.
尽管这种“三明治”方法似乎适用,但血清HBsAg短暂清除的短暂“窗口阶段”对于成功治疗CHB患者至关重要。 “添加”或不同的顺序协议需要
为探索利用这一阶段,应探索有效的主动免疫。为避免可能的副作用,应在本治疗方案中密切监测肝功能,体液和细胞免疫应答。此外,不同的主动免疫方案,例如DNA疫苗接种,载体介导的疫苗,不同佐剂的使用等,都是应该研究以最大化的可能方法。
期望的抗HBV免疫应答。所有
CHB功能治愈的方法只能通过临床试验来验证,我们希望本文提出的方法可以考虑用于国际合作,
并在不久的将来批准试点临床试验,以使患有CHB后果的患者受益。 |
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