Razonable Raymund R
Division of Infectious Diseases, Mayo Clinic, Marian Hall 5, 200 First Street SW, Rochester, MN 55905, USA.
Immunotherapy. 2010 Jan;2(1):117-30. doi: 10.2217/imt.09.82.
Immune fitness is critical in the pathogenesis and outcome of cytomegalovirus (CMV) infection. CMV disease is seen almost exclusively among individuals with an immature or defective immune system, such as patients with AIDS, transplant recipients and the developing fetus. These observations have generated interest in immune-based strategies for the management of CMV disease. Among the immune-based therapies that have been investigated in experimental and clinical settings are: passive immunotherapy with immunoglobulin; CMV vaccination; adoptive CMV-specific T-cell immunotherapy; and immune reconstitution strategies (HAART in AIDS patients, and a reduction in pharmacologic immunosuppression among transplant recipients). However, except for immune reconstitution strategies, there is no widely accepted immune-based strategy that is proven to be highly effective for CMV disease management. The benefits of immunoglobulins remain debated in an era when antiviral therapy is widely available. CMV vaccination and adoptive immunotherapy, on the other hand, remain experimental, but have had encouraging preliminary results.
免疫适应性在巨细胞病毒（CMV）感染的发病机制及转归中至关重要。CMV疾病几乎仅见于免疫系统不成熟或有缺陷的个体，如艾滋病患者、移植受者及发育中的胎儿。这些观察结果引发了人们对基于免疫的CMV疾病管理策略的兴趣。在实验和临床环境中研究过的基于免疫的疗法包括：用免疫球蛋白进行被动免疫疗法；CMV疫苗接种；过继性CMV特异性T细胞免疫疗法；以及免疫重建策略（艾滋病患者采用高效抗逆转录病毒治疗，移植受者减少药物免疫抑制）。然而，除免疫重建策略外，尚无被广泛接受的、经证实对CMV疾病管理高度有效的基于免疫的策略。在抗病毒治疗广泛可用的时代，免疫球蛋白的益处仍存在争议。另一方面，CMV疫苗接种和过继性免疫疗法仍处于实验阶段，但已取得了令人鼓舞的初步结果。
