Casadevall A
Albert Einstein College of Medicine, Bronx, New York 10461, USA.
Emerg Infect Dis. 1996 Jul-Sep;2(3):200-8. doi: 10.3201/eid0203.960306.
In the 19th century, it was discovered that immune sera were useful in treating infectious diseases. Serum therapy was largely abandoned in the 1940s because of the toxicity associated with the administration of heterologous sera and the introduction of effective antimicrobial chemotherapy. Recent advances in the technology of monoclonal antibody production provide the means to generate human antibody reagents and reintroduce antibody therapies, while avoiding the toxicities associated with serum therapy. Because of the versatility of antibodies, antibody-based therapies could, in theory, be developed against any existing pathogen. The advantages of antibody-based therapies include versatility, low toxicity, pathogen specificity, enhancement of immune function, and favorable pharmacokinetics; the disadvantages include high cost, limited usefulness against mixed infections, and the need for early and precise microbiologic diagnosis. The potential of antibodies as antiinfective agents has not been fully tapped. Antibody-based therapies constitute a potentially useful option against newly emergent pathogens.
19世纪,人们发现免疫血清在治疗传染病方面很有用。由于使用异种血清存在毒性以及有效抗菌化疗方法的出现,血清疗法在20世纪40年代基本被摒弃。单克隆抗体制备技术的最新进展提供了生产人源抗体试剂并重新引入抗体疗法的手段,同时避免了血清疗法相关的毒性。由于抗体具有多功能性,理论上可以开发基于抗体的疗法来对抗任何现存病原体。基于抗体的疗法的优点包括多功能性、低毒性、病原体特异性、免疫功能增强以及良好的药代动力学;缺点包括成本高、对混合感染的效用有限以及需要早期精确的微生物学诊断。抗体作为抗感染剂的潜力尚未得到充分挖掘。基于抗体的疗法是对抗新出现病原体的一个潜在有用选择。