Gastroenterology:抗轮状病毒蛋白有效缓解婴儿腹泻

2013-09-06 佚名 丁香园

轮状病毒是引起婴幼儿腹泻的主要病原体之一,其主要感染小肠上皮细胞,从而造成细胞损伤,引起腹泻。轮状病毒每年在夏秋冬季流行,感染途径为粪-口途径。轮状病毒感染从无症状、轻微发病到严重发病,严重时发生致命性胃肠炎、脱水及电解质平衡失调。轮状病毒胃肠炎的症状包括发烧、呕吐、腹痛以及无血色水样腹泻,症状可持续3~9天。全世界每年因轮状病毒感染导致的婴幼儿死亡的人数大约为90

轮状病毒是引起婴幼儿腹泻的主要病原体之一,其主要感染小肠上皮细胞,从而造成细胞损伤,引起腹泻。轮状病毒每年在夏秋冬季流行,感染途径为粪-口途径。轮状病毒感染从无症状、轻微发病到严重发病,严重时发生致命性胃肠炎、脱水及电解质平衡失调。轮状病毒胃肠炎的症状包括发烧、呕吐、腹痛以及无血色水样腹泻,症状可持续3~9天。全世界每年因轮状病毒感染导致的婴幼儿死亡的人数大约为900000人,其中大多数发生在发展中国家。在我国,0~2岁以内的婴幼儿人数约为4000万人(含新生儿),每年大约有1000万婴幼儿患轮状病毒感染性胃肠炎,占婴幼儿人数的1/4,是引起婴幼儿严重腹泻的最主要病原。对于轮状病毒感染性腹泻目前缺乏特异性有效治疗方案,一般的抗病毒治疗无明显效果,而抗生素治疗反而会加重疾病进展。因病毒感染为一自限性疾病,目前常规治疗为纠正电解质紊乱、防止脱水、避免合并其他感染等对症治疗。孟加拉国达卡腹泻疾病国家研究中心的Shafiqul A Sarker等人评估了一种来源于美洲驼抗体重链片段的蛋白叫做抗轮状病毒蛋白(ARP1),经随机对照实验证实该蛋白可改善男性婴儿感染轮状病毒后腹泻的严重程度和病程,该结果发表在2013出版的Gastroenterology上。【原文阅读】

作者进行的一项双盲、安慰剂对照的临床实验,包括176名年龄为6-24个月的男婴,经达卡医院诊断均为重度轮状病毒感染相关腹泻患儿。患儿被随机分为2组,一组给予口服抗轮状病毒蛋白(15-30mg/kg/d,n=88),另一组给予安慰剂麦芽糖糊精(n=88),给药时间最长为5天。初级结果评估为腹泻的严重程度、腹泻的病程长度以及大便排出轮状病毒。次级结果评估为需服用口服补液盐溶液、呕吐的严重程度以及血清中检测轮状病毒特异性IgA的水平。

研究发现在仅存在轮状病毒感染的患儿中,安慰剂组(n=63)累积粪便排出量为305.47g/kg(体重),服用抗轮状病毒蛋白组累积粪便排出量为237.03g/kg(n=61)。(差异68.44g/kg或22.5%,95%可信区间为18.27-118.59g/kg,P=0.0079)。与安慰剂组相比较,在口服抗轮状病毒蛋白组中粪便排出比率明显降低(61%,P=0.002)。在其他评估指标及合并其他感染存在的情况下,口服抗轮状病毒蛋白组与安慰剂组并无显著差异。口服抗轮状病毒蛋白未发现任何副作用。

在这项随机安慰剂对照的实验中证实抗轮状病毒蛋白可以减少重度轮状病毒感染所致腹泻男性患儿的粪便排出量。

原文阅读

Sarker SA, Jäkel M, Sultana S, Alam NH, Bardhan PK, Chisti MJ, Salam MA, Theis W, Hammarström L, Frenken LG.Anti-Rotavirus Protein Reduces Stool Output in Infants With Diarrhea: A Randomized Placebo-Controlled Trial.Gastroenterology. published online 08 July 2013.


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    2013-11-30 许安
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    2013-10-06 匿名用户

    蛋白吃下去不是会被蛋白酶水解吗,能顺利作用到小肠大肠吗?

    0

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