Le Guerhier Franck, Thermet Alexandre, Guerret Sylvianne, Chevallier Michèle, Jamard Catherine, Gibbs Craig S, Trépo Christian, Cova Lucyna, Zoulim Fabien
INSERM Unit 271, 151 cours Albert Thomas, 69003 Lyon, France.
J Hepatol. 2003 Mar;38(3):328-34. doi: 10.1016/s0168-8278(02)00425-7.
BACKGROUND/AIMS: Combination of antiviral drugs with immunotherapeutic approaches may be a promising approach for the treatment of chronic hepatitis B. We used the duck HBV (DHBV) infection model to evaluate the efficacy of the combination of adefovir with DNA-immunization by comparison with the respective monotherapies.
Pekin ducks chronically infected with DHBV received adefovir treatment alone or in association with intramuscular immunization with a plasmid (pCI-preS/S) expressing the DHBV large envelope protein. Ducks immunized with pCI-preS/S plasmid alone and two control groups receiving empty plasmid injections or no treatment were followed in parallel.
All animals treated with adefovir showed a marked drop in viremia titers during drug administration, followed by a rebound of viral replication after drug withdrawal. Eight weeks after the third DNA boost, the median of viremia within the duck group receiving the combination therapy tended to be lower compared to that of the other groups. In addition, our results suggest a trend to an additive effect of adefovir and DNA vaccine since a 51% decrease in DHBV DNA was observed in autopsy liver samples from combination therapy group, whereas pCI-preS/S or adefovir monotherapies decreased intrahepatic viral DNA by 38 and 14%, respectively. This effect was sustained since it was observed 12 weeks after the end of therapy.
Our results suggest that combination of adefovir with DNA-vaccine may be able to induce a sustained antiviral effect in vivo.
背景/目的:抗病毒药物与免疫治疗方法联合使用可能是治疗慢性乙型肝炎的一种有前景的方法。我们使用鸭乙肝病毒(DHBV)感染模型,通过与各自的单一疗法比较,评估阿德福韦与DNA免疫联合治疗的疗效。
慢性感染DHBV的北京鸭单独接受阿德福韦治疗,或与肌肉注射表达DHBV大包膜蛋白的质粒(pCI-preS/S)联合免疫。同时对单独用pCI-preS/S质粒免疫的鸭以及接受空质粒注射或不治疗的两个对照组进行跟踪观察。
所有接受阿德福韦治疗的动物在给药期间病毒血症滴度均显著下降,但停药后病毒复制出现反弹。第三次DNA加强免疫后8周,联合治疗组鸭群的病毒血症中位数与其他组相比有降低趋势。此外,我们的结果表明阿德福韦和DNA疫苗有相加作用趋势,因为联合治疗组尸检肝脏样本中DHBV DNA下降了51%,而pCI-preS/S或阿德福韦单一疗法分别使肝内病毒DNA下降了38%和14%。这种效果在治疗结束12周后仍可观察到,具有持续性。
我们的结果表明,阿德福韦与DNA疫苗联合使用可能能够在体内诱导持续的抗病毒效果。