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[精神病学中的疫苗接种]

[Vaccinations in psychiatry].

作者信息

Dols A, van den Brink W, Eikelenboom P

机构信息

GGZ BuitenAmstel, Amsterdam.

出版信息

Tijdschr Psychiatr. 2009;51(10):751-9.

Abstract

BACKGROUND

Vaccination is a well-known strategy for preventing and treating infections. The purpose of vaccinations is to render antigens harmless by the production of antibodies. In psychiatry there are also situations where antigens that have been introduced from outside or that have developed during an illness constitute a threat to the patient's health.

AIM

To explore the possible applications of vaccination in psychiatry.

METHOD

In this article we discuss the applications of vaccination in psychiatry on the basis of two examples.

RESULTS

In addiction research, trials are being conducted with antibodies against substances such as cocaine and nicotine in order to prevent such addictive substances from crossing the blood-brain barrier and thereby initiating their rewarding effect. The first clinical results are very promising, but vaccines have not yet been applied clinically. With regard to Alzheimer's disease it has been shown by means of animal models that specific antibodies can prevent AlphaBeta aggregation and dissolve existing aggregates. On the basis of these findings various large-scale clinical trials have begun in order to study immunotherapy for Alzheimer's disease. The first clinical results showed little neurocognitive effects. A wellknown study had to be terminated because of side-effects of the therapy, in the form of neuro-encephalitis.

CONCLUSION

Our tentative conclusion is that the clinical application of immunotherapy in psychiatry still has its limitations, but is indeed promising.

摘要

背景

接种疫苗是预防和治疗感染的一项众所周知的策略。疫苗接种的目的是通过产生抗体使抗原无害。在精神病学领域,也存在从外部引入或在疾病过程中产生的抗原对患者健康构成威胁的情况。

目的

探讨疫苗接种在精神病学中的可能应用。

方法

在本文中,我们基于两个例子讨论疫苗接种在精神病学中的应用。

结果

在成瘾研究中,正在进行针对可卡因和尼古丁等物质的抗体试验,以防止此类成瘾物质穿过血脑屏障,从而引发其奖赏效应。首批临床结果非常有前景,但疫苗尚未应用于临床。关于阿尔茨海默病,通过动物模型已表明特定抗体可防止β淀粉样蛋白聚集并溶解现有的聚集体。基于这些发现,已开展了各种大规模临床试验以研究阿尔茨海默病的免疫疗法。首批临床结果显示神经认知效应甚微。一项著名的研究因治疗的副作用,即神经性脑炎,而不得不终止。

结论

我们的初步结论是,免疫疗法在精神病学中的临床应用仍有其局限性,但确实很有前景。

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