Chiavaroli Carlo, Moore Adrian
Preclinical Development, OM PHARMA, Meyrin/Geneva, Switzerland.
BioDrugs. 2006;20(3):141-9. doi: 10.2165/00063030-200620030-00001.
Extracts of lysed pathogenic bacteria were developed approximately 4 decades ago as oral vaccines in order to stimulate efficient specific immune and proinflammatory responses in patients experiencing recurrent infections, the ultimate aim being to rid the patient of the pathogen responsible for the infections. OM-89, a lysate of Escherichia coli, is clinically effective in patients who experience recurrent urinary tract infections by activating both innate and adaptive immunity. If immune activation is necessary to combat infectious pathogens, it may appear at first sight to be detrimental in patients with autoimmune diseases. However, OM-89 has also shown clear efficacy in patients with rheumatoid arthritis or with undifferentiated spondyloarthropathies, probably through oral tolerance and the long-term activation of regulatory cells. These phenomena may be explained by a hypothesis that immune exclusion and oral tolerance, both key functions of the gut, may be boosted by adjuvant-like molecules within orally administered OM-89.
大约40年前，人们开发了裂解致病细菌提取物作为口服疫苗，以刺激反复感染患者产生有效的特异性免疫和促炎反应，最终目的是使患者摆脱引起感染的病原体。OM-89是一种大肠杆菌裂解物，通过激活先天免疫和适应性免疫，对反复发生尿路感染的患者具有临床疗效。如果免疫激活对于对抗感染性病原体是必要的，那么乍一看，它可能对自身免疫性疾病患者有害。然而，OM-89在类风湿性关节炎或未分化脊柱关节病患者中也显示出明显疗效，这可能是通过口服耐受和调节性细胞的长期激活实现的。这些现象可以用一个假说来解释，即肠道的两个关键功能——免疫排斥和口服耐受，可能会被口服OM-89中的佐剂样分子增强。
