Gümbel H, Cinatl J, Rabenau H, Vogel J U, Doerr H W, Ohrloff C
Zentrum der Augenheilkunde, Universität Frankfurt/Main.
Ophthalmologe. 1995 Dec;92(6):840-3.
In AIDS patients cytomegalovirus (HCMV) retinitis is one of the most frequent opportunistic infections. Antiviral therapy aims at preserving vision as long as possible, but more and more HCMV isolates are proving to be resistant to ganciclovir (GCV) and foscarnet (PFA) in vitro. We tested whether desferrioxamine (DFO), an iron chelator with antiherpetic activity, can inhibit clinical virus isolates and laboratory strains. Clinical isolates were obtained from urine samples of AIDS patients with HCMV retinitis. The concentrations of DFO required for 50% and 90% reduction of the production of HCMV in several HCMV strains ranged from 3.1 to 4.9 microns and from 14.2 to 17.3 microns, respectively, Inhibitory effects of DFO on HCMV replication were completely prevented by co-incubation with stoichiometric amounts of FE3+.
DFO was administered by daily dose of 1 g i.v. to a patient with AIDS in whom HCMV retinitis continued to progress despite combination therapy with GCV and PFA. The addition of DFO to the combination inhibited progression of the disease. No relapse of HCMV retinitis was seen with 3 months of DFO therapy. The treatment was free of side effects.
在艾滋病患者中,巨细胞病毒(HCMV)视网膜炎是最常见的机会性感染之一。抗病毒治疗旨在尽可能长时间地保留视力,但越来越多的HCMV分离株在体外被证明对更昔洛韦(GCV)和膦甲酸钠(PFA)耐药。我们测试了具有抗疱疹病毒活性的铁螯合剂去铁胺(DFO)是否能抑制临床病毒分离株和实验室菌株。临床分离株取自患有HCMV视网膜炎的艾滋病患者的尿液样本。在几种HCMV菌株中,使HCMV产生量减少50%和90%所需的DFO浓度分别为3.1至4.9微米和14.2至17.3微米。通过与化学计量的Fe3+共同孵育,完全阻止了DFO对HCMV复制的抑制作用。
一名艾滋病患者尽管接受了GCV和PFA联合治疗,但HCMV视网膜炎仍在进展,每天静脉注射1 g DFO。在联合治疗中加入DFO可抑制疾病进展。DFO治疗3个月未见HCMV视网膜炎复发。该治疗无副作用。