Preclinical Safety, Biologics, Novartis AG, Basel, Switzerland.
Microbiol Spectr. 2015 Apr;3(2):AID-0026-2014. doi: 10.1128/microbiolspec.AID-0026-2014.
Antibodies and passive antibody therapy in the treatment of infectious diseases is the story of a treatment concept which dates back more than 120 years, to the 1890s, when the use of serum from immunized animals provided the first effective treatment options against infections with Clostridium tetani and Corynebacterium diphtheriae. However, after the discovery of penicillin by Fleming in 1928, and the subsequent introduction of the much cheaper and safer antibiotics in the 1930s, serum therapy was largely abandoned. However, the broad and general use of antibiotics in human and veterinary medicine has resulted in the development of multi-resistant strains of bacteria with limited to no response to existing treatments and the need for alternative treatment options. The combined specificity and flexibility of antibody-based treatments makes them very valuable tools for designing specific antibody treatments to infectious agents. These attributes have already caused a revolution in new antibody-based treatments in oncology and inflammatory diseases, with many approved products. However, only one monoclonal antibody, palivizumab, for the prevention and treatment of respiratory syncytial virus, is approved for infectious diseases. The high cost of monoclonal antibody therapies, the need for parallel development of diagnostics, and the relatively small markets are major barriers for their development in the presence of cheap antibiotics. It is time to take a new and revised look into the future to find appropriate niches in infectious diseases where new antibody-based treatments or combinations with existing antibiotics, could prove their value and serve as stepping stones for broader acceptance of the potential for and value of these treatments.
抗体和被动抗体疗法在传染病治疗中的应用是一个可以追溯到 120 多年前的治疗概念，这要追溯到 19 世纪 90 年代，当时使用免疫动物的血清为破伤风梭菌和白喉棒状杆菌感染提供了最初有效的治疗选择。然而，自从弗莱明于 1928 年发现青霉素以来，以及随后在 20 世纪 30 年代引入更便宜、更安全的抗生素以来，血清疗法已基本被摒弃。然而，抗生素在人类和兽医医学中的广泛应用导致了对现有治疗方法反应有限或没有反应的多耐药菌株的发展，需要替代治疗方法。抗体治疗的结合特异性和灵活性使其成为设计针对传染病原体的特异性抗体治疗的非常有价值的工具。这些属性已经在肿瘤学和炎症性疾病中的新型抗体治疗中引发了一场革命，许多产品已经获得批准。然而，只有一种用于预防和治疗呼吸道合胞病毒的单克隆抗体——帕利珠单抗，被批准用于传染病。单克隆抗体治疗的高成本、诊断平行开发的需求以及相对较小的市场，是在廉价抗生素存在的情况下开发这些治疗方法的主要障碍。现在是时候重新审视未来，寻找传染病中的合适利基市场，在这些市场中，新的抗体治疗方法或与现有抗生素的联合应用，可能会证明其价值，并为更广泛地接受这些治疗的潜力和价值铺平道路。
