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人类利什曼病:药物治疗还是疫苗治疗?

Leishmaniasis in humans: drug or vaccine therapy?

作者信息

Ghorbani Masoud, Farhoudi Ramin

机构信息

Department of Viral Vaccine Production, Pasteur Institute of Iran, Research and Production Complex, Karaj, Iran.

出版信息

Drug Des Devel Ther. 2017 Dec 22;12:25-40. doi: 10.2147/DDDT.S146521. eCollection 2018.

Abstract

Leishmania is an obligate intracellular pathogen that invades phagocytic host cells. Approximately 30 different species of Phlebotomine sand flies can transmit this parasite either anthroponotically or zoonotically through their bites. Leishmaniasis affects poor people living around the Mediterranean Basin, East Africa, the Americas, and Southeast Asia. Affected regions are often remote and unstable, with limited resources for treating this disease. Leishmaniasis has been reported as one of the most dangerous neglected tropical diseases, second only to malaria in parasitic causes of death. People can carry some species of Leishmania for long periods without becoming ill, and symptoms depend on the form of the disease. There are many drugs and candidate vaccines available to treat leishmaniasis. For instance, antiparasitic drugs, such as amphotericin B (AmBisome), are a treatment of choice for leishmaniasis depending on the type of the disease. Despite the availability of different treatment approaches to treat leishmaniasis, therapeutic tools are not adequate to eradicate this infection. In the meantime, drug therapy has been limited because of adverse side effects and unsuccessful vaccine preparation. However, it can immediately make infections inactive. According to other studies, vaccination cannot eradicate leishmaniasis. There is no perfect vaccine or suitable drug to eradicate leishmaniasis completely. So far, no vaccine or drug has been provided to induce long-term protection and ensure effective immunity against leishmaniasis. Therefore, it is necessary that intensive research should be performed in drug and vaccine fields to achieve certain results.

摘要

利什曼原虫是一种专性细胞内病原体,可侵入吞噬性宿主细胞。大约30种不同种类的白蛉可以通过叮咬以人传人或动物传人的方式传播这种寄生虫。利什曼病影响着生活在地中海盆地、东非、美洲和东南亚周边的贫困人口。受影响地区往往偏远且不稳定,治疗这种疾病的资源有限。利什曼病已被报告为最危险的被忽视热带病之一,在寄生虫致死原因中仅次于疟疾。人们可以长期携带某些种类的利什曼原虫而不生病,症状取决于疾病的类型。有许多药物和候选疫苗可用于治疗利什曼病。例如,抗寄生虫药物,如两性霉素B(安必素),根据疾病类型是治疗利什曼病的首选药物。尽管有不同的治疗方法可用于治疗利什曼病,但治疗工具不足以根除这种感染。与此同时,由于副作用和疫苗制备不成功,药物治疗受到限制。然而,它可以立即使感染不活跃。根据其他研究,接种疫苗无法根除利什曼病。没有完美的疫苗或合适的药物可以完全根除利什曼病。到目前为止,还没有提供能诱导长期保护并确保对利什曼病产生有效免疫力的疫苗或药物。因此,有必要在药物和疫苗领域进行深入研究以取得一定成果。

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