Department of Infectious Diseases, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
Department of Infectious Diseases, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
Lancet Infect Dis. 2019 Aug;19(8):e284-e294. doi: 10.1016/S1473-3099(19)30040-4. Epub 2019 Apr 30.
Meningococcal disease was first clinically characterised by Gaspard Vieusseux in 1805, and its causative agent was identified by Anton Weichselbaum in 1887, who named it Diplococcus intracellularis menigitidis. From the beginning, the disease was dreaded because of its epidemic nature, predilection for previously healthy children and adolescents, and high mortality. In the last decade of the 19th century, the concept of serum therapy for toxin-related bacterial diseases was identified. This concept was applied to meningococcal disease therapy, in an independent way, by Wilhelm Kolle, August von Wasserman, and Georg Jochmann in Germany, and Simon Flexner in the USA, resulting in the first successful approach for the treatment of meningococcal disease. During the first three decades of the 20th century, serum therapy was the standard treatment for meningococcal disease. With the advent of sulphamides first and then antibiotics, serum therapy was abandoned. The great challenges that infectious diseases medicine is facing and the awaiting menaces in the future in terms of increasing antibiotic resistance, emergence of new pathogens, and re-emergence of old ones without effective therapy, make passive immunotherapy a promising tool. Acknowledging the achievements of our predecessors might teach us some lessons to bring light to our future.
脑膜炎球菌病于 1805 年由加斯帕德·维苏埃克斯首次临床描述,其病原体于 1887 年由安东·魏肖鲍姆确定,他将其命名为脑膜炎双球菌。从一开始,由于该病具有流行性质、偏爱健康的儿童和青少年以及高死亡率,因此该病就令人恐惧。19 世纪末,人们发现了针对与毒素相关的细菌性疾病的血清疗法的概念。该概念被德国的威廉·科勒、奥古斯特·冯·瓦瑟曼和格奥尔格·约赫曼以及美国的西蒙·弗莱克斯纳独立应用于脑膜炎球菌病的治疗,从而首次成功地治疗了脑膜炎球菌病。在 20 世纪的头三十年里,血清疗法是脑膜炎球菌病的标准治疗方法。随着磺胺类药物的出现和抗生素的出现,血清疗法被放弃了。传染病医学面临的巨大挑战以及未来抗生素耐药性增加、新病原体出现以及旧病原体重新出现而没有有效治疗方法等威胁,使得被动免疫疗法成为一种有前途的工具。了解我们前辈的成就可能会给我们一些启示,为我们的未来带来光明。