基于宿主基因定向治疗耐多药结核病：机遇与挑战

摘要/Abstract

摘要： 结核病是由单一病原体感染所致的、严重危害人类健康的重大传染病,是继艾滋病之后威胁人类健康的最大杀手。虽然目前已有治疗敏感结核菌感染的药物,但仍有3%~9%接受短程化疗的患者复发。更严峻的是,由于耐药结核的发生,尤其是严重耐多药结核的发生使得结核病正面临无药可治的地步。因此,寻找新型有效治疗结核病药物/方案是当前结核病防控的重大课题。与传统抗生素和化疗药直接作用于细菌不同,新近热点研究的基于宿主定向治疗（host-directed therapy,HDT）结核病策略,则是通过干预宿主基因功能来增加宿主抗结核免疫以清除感染的结核菌,减轻病理损害等机制来实现治疗结核病的目的。HDT可以避免交叉耐药的发生,不仅为耐药结核的治疗提供了全新的思路,同时也为提高敏感结核菌感染的治疗效果,特别是缩短抗结核病疗程,以及减轻治疗后遗的病理损害提供了新的可能。

关键词: 结核病, 宿主定向治疗, 耐药

Abstract: Tuberculosis (TB), caused by Mycobacterium tuberculosis (MTB), is still one of the major causes of mortality worldwide. Despite the availability of effective antibiotics for tuberculosis (TB), 3%~9% patients relapse after receiving DOTS treatment. Furthermore, the spread of drug-resistant TB (DR-TB), expecially multidrug-resistant TB (MDR-TB) and extensively drug-resistant TB (XDR-TB) makes it more difficult to cure. Novel drugs/strateges are urgently needed to arrest global transmission and prevent the uncontrolled development of MDR-TB. Unlike antibiotics and chemotherapy drugs, which directly kill Mtb, Host-directed therapy (HDT) enhances the host response against MTB infection to reduce excess inflammation, prevent tissue damage, repair damaged tissues and enhance the effectiveness of TB drug therapy. Therefore, HDT offers one potential solution to cure MDR-TB and improve the efficacy of anti-TB treatment.

Key words: Tuberculosis, Host-direct therapy, Drug resistance

陈心春, 温志华. 基于宿主基因定向治疗耐多药结核病：机遇与挑战[J]. 新发传染病电子杂志, 2017, 2(3): 129-132.

CHEN Xin-chun, WEN Zhi-hua. Host-direct therapy for tuberculosis:opportunity and challenges[J]. Electronic Journal of Emerging Infectious Diseases, 2017, 2(3): 129-132.

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