Pathogenesis, Treatment and Prevention of Diseases Associated with Bioterrorism

该项目目前的研究主要集中在四个方面。这些包括2001年炭疽病袭击幸存者的特征；对细胞因子致病的潜在因素的评估；新出现的呼吸道感染的特征，包括SARS和流感；以及禽流感新疗法的开发。炭疽病研究招募了一群志愿者，他们目前正在接受广泛的诊断评估。一项对非人类灵长类动物的研究确定，暴露后接种疫苗加抗生素比单独使用抗生素更能防止接触炭疽孢子后发生吸入性炭疽病。为了准备应对新出现的呼吸道传染病，已经制定了一项方案，对出现相容症状复合体的患者进行系统研究。这一方案得到了治疗方案的开发的补充，该方案将利用对SARS病毒的高免疫Ig。为了应对禽流感的威胁，与世界卫生组织、欢迎信托基金以及一系列学术和政府组织合作，在东南亚建立了一个临床研究网络，该网络将能够开展以新出现的流感疫情的特征和治疗为重点的研究。该网络中的第一个方案将检查标准剂量和双倍剂量奥司他韦治疗严重流感病例的效果。为了探索禽流感的新治疗方法，正在制定一项方案，用H5N1疫苗对正常志愿者进行高度免疫。如果能以这种方式产生强烈的免疫反应，这些志愿者的血浆将被用来产生高度免疫的Ig。

Research in this project is currently focused on four areas. These are characterization of the survivors of the anthrax attacks of 2001; evaluation of the factors underlying pathogenicity in cytokine expressing ectromelia; characterization of emerging respiratory infections including SARS and influenza; and development of novel therapies for avian flu. The anthrax study has enrolled a cohort of volunteers who are currently undergoing an extensive diagnostic evaluation. A study in non-human primates determined that post-exposure vaccination plus antibiotics was superior to antibiotics alone as a means of preventing the development of inhalational anthrax following exposure to anthrax spores. To be ready to deal with emerging infectious diseases of the respiratory tract, a protocol has been developed to systematically study patients presenting with a compatible symptom complex. This protocol has been complemented by the development of treatment protocol that will utilize hyperimmune Ig to the SARS virus. In response to the threat of avian influenza, in collaboration with the World Health Organization, the Welcome Trust and a series of academic and government organizations, a clinical research network has been established in SE Asia that will be able to conduct studies focused on the characterization and treatment of emerging influenza outbreaks. The first protocol in this network will examine the effects of standard vs. double dose oseltamivir in treating severe cases of influenza. To explore novel therapeutic approaches to avian influenza a protocol is in development to hyperimmunize normal volunteers with an H5N1 vaccine. If a strong immune response can be generated in this way; the plasma from these volunteers will be utilized to generate a hyperimmune Ig.