巨细胞病毒治疗的进展。
Advances in the treatment of cytomegalovirus.
机构信息
Department of Medicine, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK.
Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA.
出版信息
Br Med Bull. 2019 Sep 19;131(1):5-17. doi: 10.1093/bmb/ldz031.
Abstract
BACKGROUND
Human cytomegalovirus (HCMV) is a threat to immunologically weak patients. HCMV cannot yet be eliminated with a vaccine, despite recent advances.
SOURCES OF DATA
Sources of data are recently published research papers and reviews about HCMV treatments.
AREAS OF AGREEMENT
Current antivirals target the UL54 DNA polymerase and are limited by nephrotoxicity and viral resistance. Promisingly, letermovir targets the HCMV terminase complex and has been recently approved by the FDA and EMA.
AREAS OF CONTROVERSY
Should we screen newborns for HCMV, and use antivirals to treat sensorineural hearing loss after congenital HCMV infection?
GROWING POINTS
Growing points are developing drugs against latently infected cells. In addition to small molecule inhibitors, a chemokine-based fusion toxin protein, F49A-FTP, has shown promise in killing both lytically and latently infected cells.
AREAS TIMELY FOR DEVELOPING RESEARCH
We need to understand what immune responses are required to control HCMV, and how best to raise these immune responses with a vaccine.
摘要
背景
人巨细胞病毒（HCMV）对免疫功能较弱的患者构成威胁。尽管最近取得了一些进展，但 HCMV 仍无法通过疫苗消除。
数据来源
数据来源是最近关于 HCMV 治疗的研究论文和综述。
共识领域
目前的抗病毒药物针对 UL54 DNA 聚合酶，但存在肾毒性和病毒耐药性的限制。有希望的是，来特莫韦针对 HCMV 端粒酶复合物，最近已获得 FDA 和 EMA 的批准。
争议领域
我们是否应该对新生儿进行 HCMV 筛查，并在先天性 HCMV 感染后使用抗病毒药物治疗感觉神经性听力损失？
新的研究领域
新的研究领域是针对潜伏感染细胞的药物。除了小分子抑制剂外，一种基于趋化因子的融合毒素蛋白 F49A-FTP 已显示出在杀死裂解和潜伏感染细胞方面的潜力。
需要及时开展研究的领域
我们需要了解控制 HCMV 需要哪些免疫反应，以及如何通过疫苗最好地提高这些免疫反应。
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