Nagarajan T, Rupprecht Charles E, Dessain Scott K, Rangarajan P N, Thiagarajan D, Srinivasan V A
Indian Immunologicals Limited Gachibowli Post, Hyderabad, India.
Curr Top Microbiol Immunol. 2008;317:67-101. doi: 10.1007/978-3-540-72146-8_3.
Rabies, being a major zoonotic disease, significantly impacts global public health. It is invariably fatal once clinical signs are apparent. The majority of human rabies deaths occur in developing countries. India alone reports more than 50% of the global rabies deaths. Although it is a vaccine-preventable disease, effective rabies prevention in humans with category III bites requires the combined administration of rabies immunoglobulin (RIG) and vaccine. Cell culture rabies vaccines have become widely available in developing countries, virtually replacing the inferior and unsafe nerve tissue vaccines. Limitations inherent to the conventional RIG of either equine or human origin have prompted scientists to look for monoclonal antibody-based human RIG as an alternative. Fully human monoclonal antibodies have been found to be safer and equally efficacious than conventional RIG when tested in mice and hamsters. In this chapter, rabies epidemiology, reservoir control measures, post-exposure prophylaxis of human rabies, and combination therapy for rabies are discussed. Novel human monoclonal antibodies, their production, and the significance of plants as expression platforms are emphasized.
狂犬病作为一种主要的人畜共患病，对全球公共卫生有重大影响。一旦出现临床症状，狂犬病必然致命。大多数人类狂犬病死亡病例发生在发展中国家。仅印度一国报告的狂犬病死亡病例就占全球的50%以上。尽管狂犬病是一种可用疫苗预防的疾病，但对于III级暴露的人类进行有效的狂犬病预防需要联合使用狂犬病免疫球蛋白（RIG）和疫苗。细胞培养狂犬病疫苗在发展中国家已广泛可得，实际上已取代了质量较差且不安全的神经组织疫苗。传统的马源或人源RIG固有的局限性促使科学家寻找基于单克隆抗体的人源RIG作为替代品。在小鼠和仓鼠身上进行测试时，已发现全人源单克隆抗体比传统RIG更安全且疗效相当。在本章中，将讨论狂犬病流行病学、宿主控制措施、人类狂犬病暴露后预防以及狂犬病联合治疗。重点介绍新型人源单克隆抗体、其生产以及植物作为表达平台的意义。
