Klinman Dennis M, Tross Debra
Cancer and Inflammation Program, National Cancer Institute, Frederick, MD 21702, United States.
Vaccine. 2009 Mar 13;27(12):1811-5. doi: 10.1016/j.vaccine.2009.01.094.
Exposure to anthrax leaves susceptible hosts at prolonged risk of infection since spores can persist in vivo for months before germinating to cause life-threatening disease. Anthrax vaccine adsorbed (AVA, the licensed US vaccine) induces immunity too slowly to protect susceptible individuals post-exposure. Antibiotics prevent the proliferation of vegetative bacilli but do not block latent spores from germinating. Thus, anthrax-exposed individuals must remain on antibiotic therapy for months to eliminate the threat posed by delayed spore germination. Unfortunately, long-term antibiotic treatment is poorly tolerated and frequently discontinued. This work explores whether administering a single dose of a long-acting antibiotic (Dalbavancin) combined with a rapidly immunogenic vaccine/adjuvant combination can provide seamless protection from anthrax with minimal patient compliance. Results show that significant protection is achieved by delivering a single dose of this therapeutic combination any time before through 3 days after anthrax exposure.
接触炭疽会使易感宿主长期面临感染风险，因为孢子可在体内持续数月，然后才发芽引发危及生命的疾病。吸附型炭疽疫苗（AVA，美国获批使用的疫苗）诱导免疫的速度过慢，无法在暴露后保护易感个体。抗生素可阻止营养型杆菌的增殖，但无法阻止潜伏孢子发芽。因此，接触炭疽的个体必须持续接受数月的抗生素治疗，以消除延迟孢子发芽带来的威胁。不幸的是，长期抗生素治疗耐受性差，且经常中断。本研究探讨了给予单剂量长效抗生素（达巴万星）联合快速免疫原性疫苗/佐剂组合，是否能以最低的患者依从性为炭疽提供无缝保护。结果表明，在接触炭疽前至接触后3天内的任何时间给予单剂量这种治疗组合，均可实现显著保护。
