困境中的希望:HIV 疫苗是否可行?

Sang Froid in a time of trouble: is a vaccine against HIV possible?

机构信息

University of Pennsylvania, Philadelphia, PA, USA.

出版信息

J Int AIDS Soc. 2009 Feb 2;12:2. doi: 10.1186/1758-2652-12-2.

Abstract

Since the announcement of the STEP trial results in the past months, we have heard many sober pronouncements on the possibility of an HIV vaccine. On the other hand, optimistic quotations have been liberally used, from Shakespeare's Henry V's "Once more unto the breach, dear friends" to Winston Churchill's definition of success as "going from one failure to another with no loss of enthusiasm". I will forgo optimistic quotations for the phrase "Sang Froid", which translates literally from the French as "cold blood"; what it really means is to avoid panic when things look bad, to step back and coolly evaluate the situation. This is not to counsel easy optimism or to fly in face of the facts, but I believe that while the situation is serious, it is not desperate.I should stipulate at the outset that I am neither an immunologist nor an expert in HIV, but someone who has spent his life in vaccine development. What I will try to do is to provide a point of view from that experience.There is no doubt that the results of STEP were disappointing: not only did the vaccine fail to control viral load, but may have adversely affected susceptibility to infection. But HIV is not the only vaccine to experience difficulties; what lessons can we glean from prior vaccine development?

摘要

自过去几个月 STEP 试验结果公布以来,我们听到了许多关于 HIV 疫苗可能性的冷静陈述。另一方面,人们也大量引用了乐观的语录,从莎士比亚的《亨利五世》中的“再一次,亲爱的朋友们,冲向缺口”到温斯顿·丘吉尔对成功的定义“从一个失败走向另一个失败,热情不减”。我将放弃使用乐观的语录,转而使用“冷静”这个词,这个词从法语直译过来的意思是“冷血”;它真正的意思是在情况看起来很糟糕时避免恐慌,退后一步冷静地评估情况。这并不是为了轻易地乐观或无视事实,而是我相信,虽然情况很严重,但还没有到绝望的地步。我应该首先说明,我既不是免疫学家,也不是 HIV 方面的专家,而是一个毕生从事疫苗开发的人。我将尝试从我的经验出发提供一个观点。

毫无疑问,STEP 的结果令人失望:疫苗不仅未能控制病毒载量,而且可能对感染易感性产生了不利影响。但 HIV 并不是唯一一个遇到困难的疫苗;我们可以从之前的疫苗开发中吸取哪些教训呢?

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f99/2647531/34e21f6aebb2/1758-2652-12-2-1.jpg

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