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使用广泛中和抗毒素单克隆抗体预防艰难梭菌感染。

Protection against Clostridium difficile infection with broadly neutralizing antitoxin monoclonal antibodies.

机构信息

Progenics Pharmaceuticals, Inc, Tarrytown, New York, USA.

出版信息

J Infect Dis. 2012 Sep 1;206(5):706-13. doi: 10.1093/infdis/jis416. Epub 2012 Jun 25.

Abstract

The spore-forming bacterium Clostridium difficile represents the principal cause of hospital-acquired diarrhea and pseudomembranous colitis worldwide. C. difficile infection (CDI) is mediated by 2 bacterial toxins, A and B; neutralizing these toxins with monoclonal antibodies (mAbs) provides a potential nonantibiotic strategy for combating the rising prevalence, severity, and recurrence of CDI. Novel antitoxin mAbs were generated in mice and were humanized. The humanized antitoxin A mAb PA-50 and antitoxin B mAb PA-41 have picomolar potencies in vitro and bind to novel regions of the respective toxins. In a hamster model for CDI, 95% of animals treated with a combination of humanized PA-50 and PA-41 showed long-term survival relative to 0% survival of animals treated with standard antibiotics or comparator mAbs. These humanized mAbs provide insight into C. difficile intoxication and hold promise as potential nonantibiotic agents for improving clinical management of CDI.

摘要

产芽孢细菌艰难梭菌是全世界医院获得性腹泻和伪膜性结肠炎的主要病原体。艰难梭菌感染(CDI)是由 2 种细菌毒素 A 和 B 介导的;用单克隆抗体(mAb)中和这些毒素为对抗 CDI 的发病率、严重程度和复发率不断上升提供了一种非抗生素策略。在小鼠中生成了新型抗毒素 mAb 并进行了人源化。人源化抗毒素 A mAb PA-50 和抗毒素 B mAb PA-41 在体外具有皮摩尔效力,并结合各自毒素的新区域。在艰难梭菌感染的仓鼠模型中,与用标准抗生素或对照 mAb 治疗的动物 0%的存活率相比,用组合的人源化 PA-50 和 PA-41 治疗的 95%的动物表现出长期存活。这些人源化 mAb 深入了解了艰难梭菌中毒,并有望成为改善 CDI 临床管理的潜在非抗生素药物。

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