A historical perspective on the discovery and elucidation of the hepatitis B virus
A historical perspective on the discovery and elucidation of the hepatitis B virus
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DOI：
10.1016/j.antiviral.2016.04.012
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发表时间：
2016-07-01
影响因子：
7.6
通讯作者：
Bray, Mike
中科院分区：
文献类型：
--
作者：
Block, Timothy M.;Alter, Harvey J.;Bray, Mike
1965年发现的“澳大利亚抗原”，后来被确定为肝炎B病毒表面抗原（HBsAg），是病毒学的分水岭事件，通常被认为标志着肝炎研究的开始，但更准确地说，它被视为理解传染性肝炎发病机制的长期努力的关键突破。早在世纪之前，魏尔啸就对“卡他性黄疸”做出了权威性的解释，并不认为这是一种感染性病因，但在1885年的两次暴发中，人们清楚地发现了黄疸是通过人类血清传播的，到20世纪20年代初，人们才认识到“感染性”肝炎和“血清性”肝炎之间的区别。由于无法在实验室动物中培养病毒或复制任何一种综合征，人们在人类志愿者中进行了大量研究;到第二次世界大战结束时，人们已经知道这些疾病是由不同的可过滤媒介引起的，1947年，“甲型肝炎”和“B”这两个术语被引入（尽管当时指定为B的一些长期潜伏病例必须追溯到丙型肝炎）。在20世纪50年代，一些肝功能检查的发展导致了对无黄疸感染和慢性携带者存在的认识，但在确定感染因子之前，几乎没有什么可以做的。一旦Blumberg及其同事发现了一种特定的病毒标志物，大量积累的流行病学和临床数据，以及大量储存的血清样本，使人们对B型肝炎的了解迅速取得进展，并揭示了亚洲，大洋洲和非洲存在大量慢性感染者。在这篇文章中，我们将澳大利亚抗原的识别放在病毒性肝炎研究的历史背景下。根据1865年至1965年的时间顺序回顾，我们总结了这一发现如何提高输血安全性，开发高效疫苗以及最终识别丙型肝炎，D型肝炎和E型肝炎病毒。这篇文章是抗病毒研究专题讨论会的一部分，主题是“一个未完成的故事：从澳大利亚抗原的发现到慢性B型肝炎新治疗方法的发展”。“（C）2016 Elsevier B. V.保留所有权利。
The discovery in 1965 of the "Australia antigen," subsequently identified as the hepatitis B virus surface antigen (HBsAg), was such a watershed event in virology that it is often thought to mark the beginning of hepatitis research, but it is more accurately seen as a critical breakthrough in a long effort to understand the pathogenesis of infectious hepatitis. A century earlier, Virchow provided an authoritative explanation of "catarrhal jaundice," which did not consider an infectious etiology, but the transmission of jaundice by human serum was clearly identified in two outbreaks in 1885, and the distinction between "infectious" and "serum" hepatitis was recognized by the early 1920s. The inability to culture a virus or reproduce either syndrome in laboratory animals led to numerous studies in human volunteers; by the end of World War II, it was known that the diseases were caused by different filterable agents, and the terms "hepatitis A" and "B" were introduced in 1947 (though some long-incubation cases then designated B must in retrospect have been hepatitis C). The development of a number of liver function tests during the 1950s led to the recognition of anicteric infections and the existence of chronic carriers, but little more could be done until an infectious agent had been identified. Once Blumberg and colleagues had found a specific viral marker, the vast amount of accumulated epidemiologic and clinical data, together with huge numbers of stored serum samples, enabled rapid progress in understanding hepatitis B, and revealed the existence of a vast population of chronically infected people in Asia, Oceania and Africa. In this article, we place the identification of the Australia antigen within the historical context of research on viral hepatitis. Following a chronological review from 1865 to 1965, we summarize how the discovery led to improved safety of blood transfusion, the development of a highly effective vaccine and the eventual identification of the hepatitis C, D and E viruses. This article forms part of a symposium in Antiviral Research on "An unfinished story: from the discovery of the Australia antigen to the development of new curative therapies for chronic hepatitis B." (C) 2016 Elsevier B.V. All rights reserved.