AIDS therapy: new push for clinical trials.
AIDS therapy: new push for clinical trials.
复制标题
艾滋病治疗：临床试验的新推动。
作者：
C. Norman
显然，要开发出治疗获得性免疫缺陷综合症（艾滋病）的有效疗法，还有很长的路要走。然而，美国联邦政府近几个月来在这方面的努力有所加强。美国国会批准了一项大规模的资金注入--一项2.4亿美元的预算，其中很大一部分被指定用于测试对艾滋病病毒有一定希望的药物。国家过敏和传染病研究所（NIAID）正在建立一个医疗中心网络，对经过有限毒性测试的有希望的化合物进行II期试验，预计到1986年底将有2000名患者参加这些试验。除了提供协调和重点的努力，美国国立卫生研究院（NIH）已经建立了一个药物评估委员会。艾滋病研究者面临的三大难题首先，艾滋病病毒成为它感染的细胞的一部分，这表明它可能永远不会完全从体内清除。第二，现在已知病毒会感染大脑，这意味着药物必须穿过血脑屏障。第三，即使可以找到中断病毒生命周期的药物，患者的免疫系统可能已经被破坏，这表明需要额外的治疗来重建免疫系统。看来艾滋病患者的整个生命过程中很可能不得不间断地服用药物。目前在美国进行有限临床试验的4种化合物（苏拉明、叠氮胸苷、利巴韦林和HPA-23）中，在艾滋病晚期给药时，似乎没有一种能提供很大的临床改善。将来可能会开发针对艾滋病病毒生命周期特定特征的药物。希望是，如果能在艾滋病患者的免疫系统被破坏之前给他们一种安全有效的抗病毒药物，他们的免疫功能可能会自发再生，或者通过额外的药物治疗来重建。
There is clearly a long way to go before an effective therapy is developed for acquired immunodeficiency syndrome (AIDS). However in the US federal efforts in this area have stepped up in recent months. The US Congress has approved a massive infusion of funds--a budget of US$240 million of which a substantial portion has been earmarked for testing drugs that show some promise against the AIDS virus. The National Institute of Allergy and Infectious Diseases (NIAID) is establishing a network of medical centers to carry out phase II trials of promising compounds that have undergone limited toxicity testing and 2000 patients are expected to be enrolled in these trials by late 1986. In addition to provide coordination and focus to the effort the National Institutes of Health (NIH) has established a drug evaluation committee. 3 major difficulties face AIDS researchers. First the AIDS virus becomes part of the cell it infects suggesting that it may never be removed entirely from the body. Second the virus is now known to infect the brain meaning that drugs must cross the blood-brain barrier. Third even if a drug can be found to interrupt the life cycle of the virus the patients immune system may already have been destroyed indicating a need for additional therapy to reconstitute the immune system. It appears likely that drugs will have to be administered on an intermittent basis throughout an AIDS patients life. Of the 4 compounds currently in limited clinical trials in the US (suramin azidothymidine ribavirin and HPA-23) none seems to offer much clinical improvement when given in the late stages of AIDS. In the future it may be possible to develop drugs that are targeted toward specific features of the life cycle of the AIDS virus. The hope is that if a safe and effective antiviral drug can be given to AIDS patients before their immune systems are destroyed their immune functions may regenerate spontaneously or be reconstituted through additional drug therapy.