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硝唑尼特治疗原发性免疫缺陷和风疹病毒相关性肉芽肿病例系列患者的结果。

Outcomes for Nitazoxanide Treatment in a Case Series of Patients with Primary Immunodeficiencies and Rubella Virus-Associated Granuloma.

机构信息

Division of Viral Diseases, Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA, USA.

Division of Hematology, CHOC Children's Hospital, Orange, CA, USA.

出版信息

J Clin Immunol. 2019 Jan;39(1):112-117. doi: 10.1007/s10875-019-0589-0. Epub 2019 Jan 24.

DOI:10.1007/s10875-019-0589-0
PMID:30680653
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6383808/
Abstract

PURPOSE

Nitazoxanide was recently reported as having in vitro effectiveness against the rubella virus. Immunodeficiency-related vaccine-derived rubella occurs in some patients who have an inherited immunodeficiency and who received the MMR vaccine. This study investigated the in vivo effectiveness of nitazoxanide therapy.

METHODS

This is a retrospective analysis of seven patients treated with nitazoxanide as salvage therapy for immunodeficiency-related vaccine-derived rubella infection. The patients were recruited from an ongoing rubella detection surveillance project.

RESULTS

Seven patients with persistent rubella were treated with nitazoxanide and one demonstrated significant clinical improvement. Two additional patients exhibited diminished viral capsid production with one patient having transient slowing of progression. The cohort overall generally had low T cell counts and had a high burden of comorbidities. There were three deaths. Two deaths were from PML and one was related to hematopoietic stem cell transplantation.

CONCLUSIONS

Nitazoxanide has limited in vivo anti-viral effects for immunodeficiency-related vaccine-derived rubella. Most patients did not exhibit clinical improvement.

摘要

目的

硝唑尼特最近被报道具有体外抗风疹病毒的作用。一些患有遗传性免疫缺陷并接种了 MMR 疫苗的患者会发生与免疫缺陷相关的疫苗衍生性风疹。本研究调查了硝唑尼特治疗的体内疗效。

方法

这是对七名接受硝唑尼特作为免疫缺陷相关疫苗衍生性风疹感染挽救治疗的患者进行的回顾性分析。这些患者是从正在进行的风疹检测监测项目中招募的。

结果

七名持续性风疹患者接受了硝唑尼特治疗,其中一名患者的临床症状显著改善。另外两名患者的病毒衣壳产量减少,其中一名患者的病情进展暂时减缓。该队列的总体 T 细胞计数通常较低,且合并症负担较重。共有三人死亡。两例死亡与进行性多灶性白质脑病有关,一例与造血干细胞移植有关。

结论

硝唑尼特对免疫缺陷相关疫苗衍生性风疹的体内抗病毒作用有限。大多数患者的临床症状没有改善。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6c65/6383808/67c5ff69b246/nihms-1519538-f0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6c65/6383808/44868ef5a459/nihms-1519538-f0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6c65/6383808/67c5ff69b246/nihms-1519538-f0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6c65/6383808/44868ef5a459/nihms-1519538-f0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6c65/6383808/67c5ff69b246/nihms-1519538-f0002.jpg

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本文引用的文献

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Antiviral Res. 2017 Nov;147:58-66. doi: 10.1016/j.antiviral.2017.09.019. Epub 2017 Sep 30.
2
A prospective study on the natural history of patients with profound combined immunodeficiency: An interim analysis.一项关于严重联合免疫缺陷患者自然病史的前瞻性研究:中期分析。
J Allergy Clin Immunol. 2017 Apr;139(4):1302-1310.e4. doi: 10.1016/j.jaci.2016.07.040. Epub 2016 Sep 19.
3
Rubella persistence in epidermal keratinocytes and granuloma M2 macrophages in patients with primary immunodeficiencies.
一名免疫功能正常女性的风疹病毒相关皮肤肉芽肿病
Eur J Clin Microbiol Infect Dis. 2024 Jun;43(6):1255-1257. doi: 10.1007/s10096-024-04828-5. Epub 2024 Apr 22.
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Surveillance for rubella virus in samples obtained from non-immunodeficient individuals.对从非免疫缺陷个体获取的样本进行风疹病毒监测。
Pediatr Allergy Immunol. 2024 Jan;35(1):e14082. doi: 10.1111/pai.14082.
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Rubella virus chronic inflammatory disease and other unusual viral phenotypes in inborn errors of immunity.风疹病毒慢性炎症性疾病和其他先天性免疫缺陷中的异常病毒表型。
Immunol Rev. 2024 Mar;322(1):113-137. doi: 10.1111/imr.13290. Epub 2023 Nov 27.
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Nucleoside analogs NM107 and AT-527 are antiviral against rubella virus.核苷类似物NM107和AT-527具有抗风疹病毒的活性。
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Rubella arthritis in adults. Isolation of virus, cytology and other aspects of the synovial reaction.成人风疹性关节炎。病毒分离、细胞学及滑膜反应的其他方面
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Humoral immune responses in congenital rubella.先天性风疹中的体液免疫反应。
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