Smithells D
Department of Paediatrics and Child Health, University of Leeds, England.
Drug Saf. 1998 Nov;19(5):339-41. doi: 10.2165/00002018-199819050-00001.
The proposed association between thalidomide and second generation birth defects is an improbable hypotheses which lacks, so far, any credible scientific foundation. However, the media have chosen to give it extensive coverage. So much so that even the hard-headed scientist may start wondering if there is anything in it. However, there is no reason to suppose that people with birth defects caused by exposure to thalidomide during embryonic life have any greater or lesser chance of producing children with birth defects. This appears to be the case in practice. The question could be reworded to, 'Can thalidomide be responsible for identical, or similar, birth defects in 2 generations of the same family?' For such a phenomenon to be possible, a mechanism must be proposed and there appear to be only 2 possible candidates. The first is that the defects in the parent, originating during embryonic life, have somehow been transmitted to the next generation. The second is that thalidomide is a mutagen as well as a teratogen. The first mechanism can be excluded, since Lamarckism has long since been abandoned by scientists. The hypothesis that thalidomide is a mutagen and might be responsible for birth defects in the children of thalidomide-damaged people is without any scientific foundation. Birth defects appear to be no more common amongst the children of thalidomide-affected parents than in the general population. It is important that thalidomide-affected adults are firmly reassured on this point. Most of them have now completed their own families, but they may still worry about their grandchildren. Therefore, unless and until further supportive evidence is reported by a separate and independent source, the answer to the question, 'Can thalidomide cause second generation defects?' is a very definite 'No.'
所提出的沙利度胺与第二代出生缺陷之间的关联是一个不太可能成立的假说，迄今为止，该假说缺乏任何可信的科学依据。然而，媒体却对其进行了广泛报道。以至于就连头脑冷静的科学家也可能开始怀疑其中是否确有其事。然而，没有理由认为，在胚胎期接触沙利度胺而导致出生缺陷的人，生育有出生缺陷孩子的几率会更高或更低。实际情况似乎就是如此。这个问题可以重新表述为：“沙利度胺能否导致同一家族两代人出现相同或相似的出生缺陷？”要使这种现象成为可能，必须提出一种机制，而似乎只有两种可能的情况。第一种情况是，父母在胚胎期出现的缺陷以某种方式遗传给了下一代。第二种情况是，沙利度胺既是一种致畸剂，也是一种诱变剂。第一种机制可以排除，因为拉马克主义早已被科学家们摒弃。关于沙利度胺是一种诱变剂，可能导致沙利度胺致伤人群的子女出现出生缺陷的假说，没有任何科学依据。在沙利度胺所致出生缺陷患者的子女中，出生缺陷的发生率似乎并不高于普通人群。让受沙利度胺影响的成年人在这一点上得到坚定的 reassured 是很重要的。他们中的大多数人现在已经组建了自己的家庭，但可能仍然担心自己的孙辈。因此，除非有独立的其他来源报告进一步的支持性证据，否则“沙利度胺会导致第二代缺陷吗？”这个问题的答案非常明确，是“不会”。 （注：reassured 此处原英文拼写有误，正确拼写为 reassured，意为“使安心”，这里翻译为“得到坚定的安心”稍显生硬，可根据语境灵活调整表述方式，比如“得到明确的答复以安心”等，但按要求保留原文翻译形式）
