Keller M A, Stiehm E R
Department of Pediatrics, UCLA School of Medicine, Harbor-UCLA Medical Center, Torrance, California 90509-2910, USA.
Clin Microbiol Rev. 2000 Oct;13(4):602-14. doi: 10.1128/CMR.13.4.602.
Antibodies have been used for over a century in the prevention and treatment of infectious disease. They are used most commonly for the prevention of measles, hepatitis A, hepatitis B, tetanus, varicella, rabies, and vaccinia. Although their use in the treatment of bacterial infection has largely been supplanted by antibiotics, antibodies remain a critical component of the treatment of diptheria, tetanus, and botulism. High-dose intravenous immunoglobulin can be used to treat certain viral infections in immunocompromised patients (e.g., cytomegalovirus, parvovirus B19, and enterovirus infections). Antibodies may also be of value in toxic shock syndrome, Ebola virus, and refractory staphylococcal infections. Palivizumab, the first monoclonal antibody licensed (in 1998) for an infectious disease, can prevent respiratory syncytial virus infection in high-risk infants. The development and use of additional monoclonal antibodies to key epitopes of microbial pathogens may further define protective humoral responses and lead to new approaches for the prevention and treatment of infectious diseases.
抗体用于预防和治疗传染病已有一个多世纪。它们最常用于预防麻疹、甲型肝炎、乙型肝炎、破伤风、水痘、狂犬病和牛痘。尽管它们在治疗细菌感染方面的应用在很大程度上已被抗生素所取代,但抗体仍然是治疗白喉、破伤风和肉毒中毒的关键组成部分。高剂量静脉注射免疫球蛋白可用于治疗免疫功能低下患者的某些病毒感染(如巨细胞病毒、细小病毒B19和肠道病毒感染)。抗体在中毒性休克综合征、埃博拉病毒和难治性葡萄球菌感染中可能也有价值。帕利珠单抗是1998年首个获批用于传染病的单克隆抗体,可预防高危婴儿的呼吸道合胞病毒感染。针对微生物病原体关键表位开发和使用更多单克隆抗体可能会进一步明确保护性体液反应,并带来预防和治疗传染病的新方法。