Casadevall A, Scharff M D
Department of Medicine, Albert Einstein College of Medicine, Bronx, New York 10461, USA.
Clin Infect Dis. 1995 Jul;21(1):150-61. doi: 10.1093/clinids/21.1.150.
In the preantibiotic era, passive antibody administration (serum therapy) was useful for the treatment of many infectious diseases. The introduction of antimicrobial chemotherapy in the 1940s led to the rapid abandonment of many forms of passive antibody therapy. Chemotherapy was more effective and less toxic than antibody therapy. In this last decade of the 20th century the efficacy of antimicrobial chemotherapy is diminishing because of the rapidly escalating number of immunocompromised individuals, the emergence of new pathogens, the reemergence of old pathogens, and widespread development of resistance to antimicrobial drugs. This diminishment in the effectiveness of chemotherapy has been paralleled by advances in monoclonal antibody technology that have made feasible the generation of human antibodies. This combination of factors makes passive antibody therapy an option worthy of serious consideration. We propose that for every pathogen there exists an antibody that will modify the infection to the benefit of the host. Such antibodies are potential antimicrobial agents. Antibody-based therapies have significant advantages and disadvantages relative to standard chemotherapy. The reintroduction of antibody-based therapy would require major changes in the practices of infectious disease specialists.
在抗生素出现之前的时代，被动抗体给药（血清疗法）对许多传染病的治疗很有用。20世纪40年代抗菌化疗的引入导致许多形式的被动抗体疗法迅速被弃用。化疗比抗体疗法更有效且毒性更小。在20世纪的最后十年，由于免疫功能低下个体数量迅速增加、新病原体的出现、旧病原体的再度出现以及对抗菌药物耐药性的广泛发展，抗菌化疗的疗效正在降低。化疗效果的这种降低与单克隆抗体技术的进步同时出现，单克隆抗体技术使得产生人源抗体成为可能。这些因素的综合使得被动抗体疗法成为一个值得认真考虑的选择。我们提出，对于每种病原体都存在一种抗体，它能改变感染情况从而有利于宿主。这样的抗体是潜在的抗菌剂。相对于标准化疗，基于抗体的疗法有显著的优点和缺点。重新引入基于抗体的疗法将需要传染病专家的实践做出重大改变。
