Bryson Y J
Department of Pediatrics, University of California, School of Medicine, Los Angeles 90024.
J Am Acad Dermatol. 1988 Jan;18(1 Pt 2):212-8. doi: 10.1016/s0190-9622(88)70031-6.
We now have a basis for a more rational approach to rapid evaluation and development of antiviral drugs by screening for activity in vitro, testing for toxicity and efficacy in animals, and clinical testing in humans. Acyclovir is a prototype of this improved process. Interferon has a beneficial effect against CMV infection in renal transplant patients and has promising results in the treatment of papillomas and rhinovirus infections. It does not seem to be as effective against genital herpes or varicella zoster as acyclovir. Ribavirin is effective against respiratory syncytial virus infections and Lassa fever. Varicella-zoster virus is highly sensitive to bromovinyl deoxyuridine in vitro. Phosphonoformate is effective in herpes simplex in animals but of little clinical benefit topically in human recurrent A2 herpes. Zidovudine may decrease mortality rates and infectious complications in patients with acquired immunodeficiency syndrome. DHPG (9-(1,3-dihydroxy-2-propoxymethyl]guanine is useful in treatment of cytomegalovirus and infection in immunocompromised patients. The prodrug of acyclovir results in high blood levels of acyclovir and shows promise in the treatment of varicella-zoster infections. Many halogenated pyrimidine nucleoside analogs are being developed. Buciclovir is another acyclic guanosine analog effective against herpes simplex virus in vitro. 2'-nor-cyclic guanosine monophosphate has a broad antiviral spectrum of action. Interleukin-2 is being investigated. Combined therapies of two or more antiviral drugs or antiviral drugs and other treatments are being studied.
我们现在有了一个更合理的基础,可通过体外活性筛选、动物毒性和疗效测试以及人体临床试验,来快速评估和开发抗病毒药物。阿昔洛韦就是这一改进过程的一个范例。干扰素对肾移植患者的巨细胞病毒感染有有益作用,在治疗乳头瘤和鼻病毒感染方面也有很有前景的结果。它对生殖器疱疹或水痘带状疱疹的疗效似乎不如阿昔洛韦。利巴韦林对呼吸道合胞病毒感染和拉沙热有效。水痘带状疱疹病毒在体外对溴乙烯脱氧尿苷高度敏感。膦甲酸在动物单纯疱疹治疗中有效,但对人类复发性A2疱疹局部治疗临床益处不大。齐多夫定可能降低获得性免疫缺陷综合征患者的死亡率和感染并发症。DHPG(9-(1,3-二羟基-2-丙氧基甲基)鸟嘌呤)对免疫功能低下患者的巨细胞病毒感染治疗有用。阿昔洛韦的前药可使阿昔洛韦在血液中达到高浓度,并在水痘带状疱疹感染治疗中显示出前景。许多卤代嘧啶核苷类似物正在研发中。布昔洛韦是另一种在体外对单纯疱疹病毒有效的无环鸟苷类似物。2'-去甲环鸟苷单磷酸有广泛的抗病毒作用谱。白细胞介素-2正在研究中。两种或更多种抗病毒药物的联合疗法或抗病毒药物与其他治疗方法的联合疗法正在研究中。