Chang T W, Heel R C
Drugs. 1981 Aug;22(2):111-28. doi: 10.2165/00003495-198122020-00002.
A considerable amount of information has accumulated during the past 10 years in the search for antiviral agents. Ribavirin and inosiplex are 2 interesting developments to come out of this search. Ribavirin, a synthetic nucleoside, has an unusually wide spectrum of antiviral activity, especially when tested in vitro. A large number of RNA and DNA viruses are sensitive, especially herpes viruses, poxvirus, influenza, parainfluenza, reovirus, togavirus, and RNA tumour viruses. The in vivo antiviral spectrum of activity is much narrower, with activity against herpes virus, influenza, parainfluenza, measles and adenoviruses. However, controlled clinical trials have not been uniformly successful in treating influenza, hepatitis, herpes simplex and herpes zoster. Inosiplex has been shown to have antiviral activity in vivo against influenza, herpes simplex, rhinovirus and vaccinia virus infections. However, antiviral activity has not been consistently demonstrated, and this observation led to further studies which revealed its immunomodulating effects. The accumulated evidence has indicated that inosiplex is more a prohost agent rather than an antiviral drug. Immune functions which are depressed during viral infection can be restored to normal by inosiplex therapy. At present, neither ribavirin nor inosiplex alone has been shown to be uniformly successful in the treatment of human viral diseases. Nevertheless, their potential place in chemotherapy should not be neglected, although further data are needed to determine what this place will be. Whether combining them with other antiviral agents such as interferon, acyclovir, Ara-A, and so on, would produce a potentiation of action and improved antiviral chemotherapy, will be an interesting area for further study.
在过去十年中，为寻找抗病毒药物积累了大量信息。利巴韦林和肌苷已成为这一探索过程中的两项有趣进展。利巴韦林是一种合成核苷，具有异常广泛的体外抗病毒活性谱。大量的RNA和DNA病毒都敏感，尤其是疱疹病毒、痘病毒、流感病毒、副流感病毒、呼肠孤病毒、披膜病毒和RNA肿瘤病毒。其体内抗病毒活性谱则窄得多，对疱疹病毒、流感病毒、副流感病毒、麻疹病毒和腺病毒有活性。然而，对照临床试验在治疗流感、肝炎、单纯疱疹和带状疱疹方面并非都取得成功。已证明肌苷在体内对流感、单纯疱疹、鼻病毒和牛痘病毒感染具有抗病毒活性。然而，其抗病毒活性并未得到持续证实，这一观察结果促使进一步研究，揭示了其免疫调节作用。积累的证据表明，肌苷更像是一种宿主支持剂而非抗病毒药物。病毒感染期间受抑制的免疫功能可通过肌苷治疗恢复正常。目前，单独使用利巴韦林或肌苷在治疗人类病毒性疾病方面均未被证明普遍成功。尽管如此，它们在化疗中的潜在地位不应被忽视，尽管还需要更多数据来确定其确切地位。将它们与其他抗病毒药物如干扰素、阿昔洛韦、阿糖腺苷等联合使用是否会产生增效作用并改善抗病毒化疗，将是一个值得进一步研究的有趣领域。
