Bretscher Peter A
Department of Biochemistry, Microbiology and Immunology, University of Saskatchewan, Heath Sciences Building, 105 Wiggins Road, Saskatoon, SK S5N 5E5, Canada.
Antibiotics (Basel). 2022 Mar 10;11(3):371. doi: 10.3390/antibiotics11030371.
Koch attempted to treat tuberculosis in the late 1800s by administering an antigenic extract derived from the pathogen to patients. He hoped to bolster the patient's protective immunity. The treatment had diverse results. In some, it improved the patient's condition and in others led to a worsening state and even to death. Koch stopped giving his experimental treatment. I consider here three issues pertinent to realizing Koch's vision. Rational immunotherapy requires a knowledge of what constitutes protective immunity; secondly, how on-going immune responses are regulated, so the patient's immunity can be modulated to become optimally protective; thirdly, a simple methodology by which treatment might be realized. I deliberately cast my account in simple terms to transcend barriers due to specialization. The proposed immunotherapeutic treatment, if realizable, would significantly contribute to overcoming problems of treatment posed by antibiotic resistance of the pathogen.
19世纪后期,科赫试图通过给患者注射源自该病原体的抗原提取物来治疗肺结核。他希望增强患者的保护性免疫力。这种治疗产生了不同的结果。在一些患者中,病情得到改善,而在另一些患者中,病情恶化甚至导致死亡。科赫停止了他的实验性治疗。在此,我考虑与实现科赫的设想相关的三个问题。合理的免疫疗法需要了解构成保护性免疫力的因素;其次,要了解正在进行的免疫反应是如何调节的,以便能够调节患者的免疫力,使其达到最佳的保护状态;第三,要有一种能够实现治疗的简单方法。我特意用简单的语言来阐述,以跨越因专业分工造成的障碍。如果所提议的免疫治疗方法可行,将对克服由病原体的抗生素耐药性所带来的治疗问题做出重大贡献。