Stalder H
Yale J Biol Med. 1977 Sep-Oct;50(5):507-32.
The current status of antiviral therapy is reviewed, including discussion of older approaches together with more recently developed chemotherapy. Following the introduction dealing with pathophysiological aspects of virus disease, the different approaches to antiviral therapy are presented. The reasons for the slow progress in antiviral therapy are discussed. These include: 1. the necessity of intracellular penetration of drugs acting on viral replication; 2. the severe toxicity of most antiviral drugs; 3. the narrow antiviral spectrum of most of these agents; 4. the difficulty of making a rapid etiological diagnosis in view of the necessity of starting (specific?) treatment early in the course of the disease; 5. the difficult evaluation of beneficial as compared with deleterious effects of antiviral therapy. After a detailed review of clinically tested substances, including immunoglobulins, synthetic antiviral drugs (amantadine, nucleoside analogs, thiosemicarbazones and photodynamic dyes) and interferon, a guide concerning indications and application of specific antiviral therapy is presented. Although at present there are few indications, clinicians should be aware of the (present and future) possibilities of antiviral therapy.
本文综述了抗病毒治疗的现状,包括对传统方法以及最近开发的化学疗法的讨论。在介绍了病毒疾病的病理生理学方面之后,阐述了抗病毒治疗的不同方法。讨论了抗病毒治疗进展缓慢的原因。这些原因包括:1. 作用于病毒复制的药物需要穿透细胞;2. 大多数抗病毒药物具有严重毒性;3. 这些药物大多抗病毒谱狭窄;4. 鉴于疾病早期需要开始(特异性?)治疗,难以快速做出病因诊断;5. 难以评估抗病毒治疗的有益效果与有害效果。在详细回顾了经过临床测试的物质,包括免疫球蛋白、合成抗病毒药物(金刚烷胺、核苷类似物、硫代半卡巴腙和光动力染料)以及干扰素之后,给出了关于特异性抗病毒治疗的适应证和应用指南。尽管目前适应证较少,但临床医生应了解抗病毒治疗(当前和未来)的可能性。