Bernstein D I, Miller R L, Harrison C J
James N. Gamble Institute of Medical Research, Cincinnati, OH 45219.
Antiviral Res. 1993 Jan;20(1):45-55. doi: 10.1016/0166-3542(93)90058-q.
We evaluated the effects of the immunomodulator, imiquimod (R-837) applied topically, alone and in combination with i.p. acyclovir (ACV) on acute, recurrent and neural HSV-2 genital infection in guinea-pigs when 10 days of therapy was begun after HSV lesions developed. The combined therapy was most effective, significantly reducing the severity of the acute disease, as early as 2 days (P < 0.05), and vaginal viral shedding (P < 0.05) as early as 1 day after therapy was begun. The total lesion score for the acute disease was also significantly less in the group receiving imiquimod and ACV (5.4 +/- 0.5) compared to controls (13.1 +/- 1.2, P < 0.001) or imiquimod alone (9.8 +/- 1.2, P < 0.05). Therapy, however, had no significant effect on the number of days with recurrent lesions. Imiquimod increased the lymphoproliferative response to HSV (P < 0.01), while combined therapy reduced HSV antibody titers (P < 0.01) on day 28 compared to placebo and also reduced the effect of imiquimod alone on the lymphoproliferative response. The combination of this effective immunomodulator, imiquimod, and acyclovir appears to provide effective therapy for acute genital HSV-2 infection even when begun after lesion development.
我们评估了局部应用免疫调节剂咪喹莫特（R - 837）单独及与腹腔注射阿昔洛韦（ACV）联合使用时，对豚鼠急性、复发性和神经性单纯疱疹病毒2型生殖器感染的影响。在单纯疱疹病毒损伤出现后开始10天的治疗。联合治疗最为有效，早在治疗开始2天后就能显著降低急性疾病的严重程度（P < 0.05），早在治疗开始1天后就能显著减少阴道病毒脱落（P < 0.05）。与对照组（13.1 ± 1.2）或单独使用咪喹莫特组（9.8 ± 1.2）相比，接受咪喹莫特和阿昔洛韦联合治疗组急性疾病的总损伤评分也显著更低（5.4 ± 0.5，P < 0.001）。然而，治疗对复发性损伤的天数没有显著影响。咪喹莫特增加了对单纯疱疹病毒的淋巴细胞增殖反应（P < 0.01），而与安慰剂相比，联合治疗在第28天降低了单纯疱疹病毒抗体滴度（P < 0.01），并且也降低了单独使用咪喹莫特对淋巴细胞增殖反应的影响。即使在损伤出现后开始治疗，这种有效的免疫调节剂咪喹莫特与阿昔洛韦的联合应用似乎也能为急性生殖器单纯疱疹病毒2型感染提供有效的治疗。
