University of British Columbia & Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada.
Immunotherapy. 2010 Mar;2(2):269-82. doi: 10.2217/imt.10.3.
Transmissible spongiform encephalopathies (TSEs) represent a unique form of infectious disease based on the misfolding of a self-protein into a pathological conformation. While other human diseases are also attributed to protein misfolding, the TSEs are unique in their zoonotic potential and iatrogenic infectivity. These characteristics are of particular importance in the aftermath of the UK bovine spongiform encephalopathy (BSE) outbreak due to the dual concerns that a subpopulation of individuals exposed to the infectious agent may be serving as asymptomatic carriers, and that TSEs of other food animals may also threaten human health. These potentials, in addition to the ongoing baseline of familial and sporadic human prion diseases, necessitate development of effective treatment options. While TSEs represent a novel paradigm of infection, there is nevertheless the opportunity to apply traditional approaches of medicine for disease treatment and prevention, including vaccines for immunotherapy and immunoprophylaxis. However, vaccine development for TSEs is complicated by the challenges and potential dangers associated with induction of immune responses to a self-epitope, as well as the obstacles to treatment of a chronic infection through immunotherapy. The ongoing threat of TSEs to human health, together with the opportunity to apply information emerging from these investigations to other protein misfolding disorders, justifies the efforts required to overcome these obstacles.
传染性海绵状脑病（TSEs）代表了一种独特形式的传染病，其基础是一种自身蛋白质错误折叠成病理性构象。虽然其他人类疾病也归因于蛋白质错误折叠，但 TSEs 在其动物源性病原体和医源性感染性方面具有独特性。这些特征在英国牛海绵状脑病（BSE）爆发后尤为重要，因为人们担心接触到感染因子的亚人群可能作为无症状携带者，而其他食用动物的 TSEs 也可能威胁人类健康。除了持续存在的家族性和散发性人类朊病毒病的基线之外，这需要开发有效的治疗选择。虽然 TSEs 代表了一种新型感染范例，但仍然有机会应用医学的传统方法来治疗和预防疾病，包括用于免疫治疗和免疫预防的疫苗。然而，TSE 疫苗的开发受到一些挑战和潜在危险的限制，这些挑战和潜在危险与诱导针对自身表位的免疫反应有关，也与通过免疫疗法治疗慢性感染的障碍有关。TSEs 对人类健康的持续威胁，以及从这些研究中获得的信息应用于其他蛋白质错误折叠疾病的机会，证明了克服这些障碍所需的努力是合理的。
