Nat Commun & EClinical Medicine:无需“基因编辑婴儿”,两项研究带来实现新生儿无“艾”新成果

2020-01-13 不详 生物探索

消除艾滋病(HIV)是联合国2030年可持续发展议程提出的目标之一,阻断HIV母婴传播是“迈向零艾滋”的重要举措。据统计,全世界每年有18万多名儿童感染HIV,其中90%以上的感染是由于母婴传播。有一种观点认为,这或许与新生儿接受治疗的时间有关。

消除艾滋病(HIV)是联合国2030年可持续发展议程提出的目标之一,阻断HIV母婴传播是“迈向零艾滋”的重要举措。据统计,全世界每年有18万多名儿童感染HIV,其中90%以上的感染是由于母婴传播。有一种观点认为,这或许与新生儿接受治疗的时间有关。

最近,发表在《Nature》子刊和《柳叶刀》子刊的两项研究报告揭示了治疗时机与新生儿感染艾滋病毒之间的关系。更为重要的是,其中一项新的非人灵长类动物研究首次提出,通过单剂量的抗体治疗可消灭新生儿体内的艾滋病毒。

何时接受治疗?

艾滋病毒是一种逆转录病毒,暴露于艾滋病毒的婴儿应当在出生后尽快接受抗逆转录病毒治疗。此前有研究者提出,在婴儿出生数小时内开始抗逆转录病毒疗法疗效更佳。哥伦比亚大学的科学家对此进行了探索,其研究报告于1月8日发布在《EClinical Medicine》上。


https://doi.org/10.1016/j.eclinm.2019.100241

在这项研究中,科学家筛选了73名接触了艾滋病毒的新生儿,了解他们出生后14天内开始接受抗逆转录病毒治疗的情况。结果显示,大约75%的婴儿获得了病毒抑制效果,但只有52%的婴儿获得了持续抗击病毒的效果。46名在出生2天内接受治疗的婴儿(51%)和27名出生后2-14天开始治疗的婴儿(54%)获得并维持病毒抑制的成功率相似。这表明,抗逆转录病毒“早期治疗”不一定意味着要在出生后数小时内完成,在头两周内开始治疗的结果与两天内开始的结果相似。

当然,科学家也提出,抗逆转录病毒疗法要求新生儿频繁用药,而这些药物的可口性差,这或许影响了新生儿用药的依从性,导致治疗结果不够理想。

那么,是否有更简单却又更有效的治疗方法?

更理想的治疗方法

2014年8月,刊登在《PNAS》的一项研究表明,有周期性地给患者注射中和HIV的特殊抗体(bNAbs),能够在不使用抗逆转录病毒药物的情况下有效控制HIV。1月7日,发表在《Nature Communications》的一项研究报告再次证实了这一疗法的效果。


https://doi.org/10.1038/s41467-019-13972-y

这项由美国俄勒冈健康与科学大学的科学家带来的非人灵长类动物研究报告首次表明,单剂量广谱中和抗体(bNAbs)能够清除新生幼猴体内源自母猴的艾滋病毒。当然,什么时候接受单剂量注射是关键。科学家发现,幼猴在出生后30小时接受两种抗体的联合治疗,体内的HIV病毒得到了有效清除。

这项研究也表明,进行更短的抗逆转录病毒疗法或许也可以防止新生儿感染艾滋病毒。一般而言,感染HIV的婴儿将接受鸡尾酒药物治疗(艾滋病常见治疗方法,将多种药物混合均匀使用),连续6周服用多种药物。但是在这项新研究中,科学家发现,在幼猴出生后48小时开始为期3周的抗逆转录病毒药物治疗,就能够有效抵御HIV病毒。

接下来,俄勒冈健康与科学大学的科学家计划进一步了解不同抗体或者抗体与抗逆转录病毒疗法的组合是否可能更有效,以及实验中的抗体是否确实消除了艾滋病毒,还是仅阻止了其复制。

从艾滋病被发现的那天起,人们就没有停止过寻找治疗它的方法。随着科学家的不断探索,相信在不久之后,会有更多有效的疗法帮助接触过艾滋病毒的新生儿健康长大。

原始出处:

[1]Louise Kuhn, Renate Strehlau, Stephanie Shiau, et.al. Early antiretroviral treatment of infants to attain HIV remission. EClinical Medicine VOLUME 18, 100241, JANUARY 01, 2020

[2]Mariya B. Shapiro, Tracy Cheever, Delphine C. Malherbe, et.al. Single-dose bNAb cocktail or abbreviated ART post-exposure regimens achieve tight SHIV control without adaptive immunity. Nature Communications 07 January 2020

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    2020-10-24 jeanqiuqiu
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    2020-09-12 kalseyzl
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    2020-12-01 liuli5079
  4. 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encryptionId=33915836275, topicName=新成果)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4193478, createdName=wgx306, createdTime=Fri Nov 06 23:54:00 CST 2020, time=2020-11-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1884076, encodeId=c86e18840e6b4, content=<a href='/topic/show?id=3b2112532d8' target=_blank style='color:#2F92EE;'>#Nat#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12532, encryptionId=3b2112532d8, topicName=Nat)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2e6f107, createdName=liye789132251, createdTime=Sat Aug 01 01:54:00 CST 2020, time=2020-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1507701, encodeId=d184150e70142, content=<a href='/topic/show?id=8764484014' target=_blank style='color:#2F92EE;'>#clinical#</a>, beContent=null, objectType=article, 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encodeId=0a90158235949, content=<a href='/topic/show?id=31804186540' target=_blank style='color:#2F92EE;'>#基因编辑婴儿#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=41865, encryptionId=31804186540, topicName=基因编辑婴儿)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=544e16907624, createdName=ms1692810954239974, createdTime=Wed Jan 15 00:54:00 CST 2020, time=2020-01-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1610192, encodeId=00b3161019282, content=<a href='/topic/show?id=eb6b1145939' target=_blank style='color:#2F92EE;'>#Med#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11459, encryptionId=eb6b1145939, topicName=Med)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=552a19396740, createdName=ms3994565386320060, createdTime=Wed Jan 15 00:54:00 CST 2020, time=2020-01-15, status=1, ipAttribution=)]
    2020-11-06 wgx306
  5. 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encodeId=0a90158235949, content=<a href='/topic/show?id=31804186540' target=_blank style='color:#2F92EE;'>#基因编辑婴儿#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=41865, encryptionId=31804186540, topicName=基因编辑婴儿)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=544e16907624, createdName=ms1692810954239974, createdTime=Wed Jan 15 00:54:00 CST 2020, time=2020-01-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1610192, encodeId=00b3161019282, content=<a href='/topic/show?id=eb6b1145939' target=_blank style='color:#2F92EE;'>#Med#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11459, encryptionId=eb6b1145939, topicName=Med)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=552a19396740, createdName=ms3994565386320060, createdTime=Wed Jan 15 00:54:00 CST 2020, time=2020-01-15, status=1, ipAttribution=)]
    2020-08-01 liye789132251
  6. 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createdName=ms3994565386320060, createdTime=Wed Jan 15 00:54:00 CST 2020, time=2020-01-15, status=1, ipAttribution=)]
    2020-01-15 zll0628
  7. 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  8. 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