恢复免疫保护艾滋病患者免受机会主义感染

由哥伦比亚研究员领导的一项新的研究证明了艾滋病毒感染者对抗逆转录病毒药物的患者可以安全地放弃抗生素以防止某些机会性感染。哈勒姆医院中心的传染病司司长瓦法阿尔·萨格尔博士和哥伦比亚大学医师和外科医生临床医学教授，介绍了该研究，其中包括在全国15个中心的患者。该研究的报告将出现在4月13日的新英格兰医学杂志上。根据美国公共卫生服务指南，艾滋病毒感染患者CD4 +细胞计数低于50毫米血液，应具有抗生素治疗，以预防分枝杆菌植分体（MAC）疾病，严重和潜在的致命情况。CD4 +细胞是对抗感染并受艾滋病病毒攻击的免疫系统细胞。这些细胞的水平是一种人免疫系统强度和艾滋病毒感染的严重程度的衡量标准。El-Sadr博士和她的同事推出了该研究，以确定预防的HIV患者是否需要CD4 +细胞计数在用抗逆转录病毒治疗后每立方毫米高于100升高的患者。研究人员注册了520名患者，中位CD4 +细胞计数为每立方毫米血液230次。所有研究参与者在过去的某个点处有50以下50以下的CD4 +水平，但自开始抗逆转录病毒治疗以来有100个或更多的连续CD4 +细胞计数。一半的患者每周服用氮霉素，而一半占据了安慰剂。 Patients were followed for an average of 12.7 months. None developed MAC disease during the study. Three patients taking azithromycin and five patients taking the placebo developed bacterial pneumonia. During the study, 19 patients taking azithromycin and three of the patients in the placebo group dropped out because of adverse effects of the drug. Dr. El-Sadr and colleagues describe several benefits that would result from allowing this group of HIV-infected patients to defer taking prophylactic antibiotics. Studies have shown that people who take antibiotics regularly are more likely to develop infections with antibiotic-resistant bacteria. Also, patients on antiretroviral therapy for HIV infection already take several drugs, and adding one more to the regimen increases the risk of drug interaction and also makes following treatment more difficult. Infectious disease and immunology experts had questioned whether CD4+ cells reconstituted by antiretroviral therapy would be as protective against infection as normal CD4+ cells. This study suggests that antiretroviral therapy does reconstitute protective immunity, according to Dr. El-Sadr. “The event rate for all opportunistic infections was actually pretty low across the board,” she explains. “The lower event rate suggests that these individuals are protected against these complications.” The study was funded by a grant from the National Institute of Allergy and Infectious Diseases. “Our study results are promising as they provide a foundation for evaluating drugs that could slow down the progression of ALS,” says Dr. Friedlander, senior author of the study. “Although much more research needs to be conducted in this area, our research does bring us one step closer to finding a treatment for this tragic disease.” ALS is characterized by progressive loss of the motor neurons in the brain, brainstem, and spinal cord. On average, people who develop ALS die within five years of contracting the disease. Roughly 10 percent to 20 percent of ALS cases are hereditary.

研究中的所有小鼠植入渗透泵，渗透泵输送ZVAD-FMK或安慰剂，进入大脑的心室。当疾病的症状尚未出现并持续接受ZVAD-FMK或安慰剂56天，他们接受了60天的泵。通过定时测量小鼠的电动机功能，它们能够保持在称为旋钮的旋转跑步机上的旋转跑步装置上的一定速度。接受最高剂量的ZVAD-FMK的小鼠平均存活153天，与其未经处理的凋落物126天相比，并且平均症状持续20天。

该研究由国家神经障碍和中风研究所，肌营养不良协会，ALS协会和项目ALS资助。