Wu Jashin J, Huang David B, Pang Katie R, Tyring Stephen K
Center for Clinical Studies, Houston, Texas, USA.
J Am Acad Dermatol. 2004 Apr;50(4):495-528; quiz 529-32. doi: 10.1016/j.jaad.2003.12.003.
Although the development of antimicrobial drugs has advanced rapidly in the past several years, such agents act against only certain groups of microbes and are associated with increasing rates of resistance. These limitations of treatment force physicians to continue to rely on prevention, which is more effective and cost-effective than therapy. From the use of the smallpox vaccine by Jenner in the 1700s to the current concerns about biologic warfare, the technology for vaccine development has seen numerous advances. The currently available vaccines for viral illnesses include Dryvax for smallpox; the combination measles, mumps, and rubella vaccine; inactivated vaccine for hepatitis A; plasma-derived vaccine for hepatitis B; and the live attenuated Oka strain vaccine for varicella zoster. Vaccines available against bacterial illnesses include those for anthrax, Haemophilus influenzae, and Neisseria meningitidis. Currently in development for both prophylactic and therapeutic purposes are vaccines for HIV, herpes simplex virus, and human papillomavirus. Other vaccines being investigated for prevention are those for cytomegalovirus, respiratory syncytial virus, parainfluenza virus, hepatitis C, and dengue fever, among many others. Fungal and protozoan diseases are also subjects of vaccine research. Among immunoglobulins approved for prophylactic and therapeutic use are those against cytomegalovirus, hepatitis A and B, measles, rabies, and tetanus. With this progress, it is hoped that effective vaccines soon will be developed for many more infectious diseases with cutaneous manifestations.
尽管在过去几年中抗菌药物的研发进展迅速，但这类药物仅对某些微生物群体起作用，且耐药率不断上升。治疗上的这些局限性迫使医生继续依赖预防措施，因为预防比治疗更有效且更具成本效益。从18世纪詹纳使用天花疫苗到如今对生物战的担忧，疫苗研发技术取得了众多进展。目前可用于病毒疾病的疫苗包括用于天花的冻干痘苗；麻疹、腮腺炎和风疹联合疫苗；甲型肝炎灭活疫苗；乙型肝炎血浆源性疫苗；以及水痘带状疱疹减毒活疫苗。可用于细菌疾病的疫苗包括炭疽、流感嗜血杆菌和脑膜炎奈瑟菌疫苗。目前正在研发用于预防和治疗目的的疫苗有针对艾滋病毒、单纯疱疹病毒和人乳头瘤病毒的疫苗。正在研究用于预防的其他疫苗包括巨细胞病毒、呼吸道合胞病毒、副流感病毒、丙型肝炎和登革热等多种疾病的疫苗。真菌和原生动物疾病也是疫苗研究的对象。在已批准用于预防和治疗的免疫球蛋白中，有针对巨细胞病毒、甲型和乙型肝炎、麻疹、狂犬病和破伤风的免疫球蛋白。随着这些进展，人们希望不久能为更多有皮肤表现的传染病研发出有效的疫苗。
