「艾友来稿」理性看待清除HIV病毒药物功效

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「艾友来稿」理性看待清除HIV病毒药物功效 。
托法替尼药品详情:托法替尼和托法替布。「艾友来稿」理性看待清除HIV病毒药物功效最近有几条关于tofacitinib(药物名Xeljanz,中文名托法替尼,由辉瑞制药生产)和ruxolitinib(药物名Jakafi,中文名鲁索利替尼,由瑞士诺华生产),可使hiv病毒库被消除的新闻在很多【微信号:yaodaoyaofang】群里被转发——【微信:india2080】与讨论的热度非常高,由于这两种药物已经在早些年面市,有的小伙伴甚至着急问我怎样购买到?价钱怎样等等非常关心的问题。对此,我通过查阅大量文献,不否认这两种药物对抗hiv病毒有一定的作用,但是对于彻底消除体内hiv病毒库,我认为应该理性看待。tofacitinib和ruxolitinib这两种药物均属于激酶抑制剂,能抑制Janus相关激酶(JAKs),可阻断几种对于淋巴细胞的活化、功能和增殖不可或缺的细胞因子的信号。因此我们在接下来的内容中都统一称为JAK药物。其次,在最近一篇标题为“Selective suppression of inflammation could deplete HIV and controlHIV activation”的文章中提到:负责试验研究的资深【微信号:yaodaoyaofang】Sékaly博士认为“病毒库是作为少数将基因整合到免疫细胞中的病毒。因为处于休眠状态,完全无法被免疫系统识别。感染HIV病毒的患病者一旦停止ART治疗,病毒将重新被激活。文章中还提到通过Sékaly博士最近发现,如果使用JAK抑制剂治疗HIV,将能够杀死这些病毒库。这篇让很多感染者【关注我们请加微信:yaodaoyaofang 】的文章,我们通过查询相关信息了解到,当初涉及JAK抑制剂治疗HIV的研究,共有37名hiv感染者参与试验,但最初的研究目的有以下几个方面:1.评估在hiv病毒载量检查不到的情况下,JAK药物的安全特性和耐受性。2.评估JAK药物是否能减少炎症与激活体内免疫功能。3.评估JAK药物是否会影响血液中艾滋病毒的水平,以及和其他抗HIV药物的互相作用。研究小组对试验对象的筛选有以下几个条件:年龄在18~75岁阶段的男性或者女性hiv感染者1.患病者持续抗HIV治疗的时间在2年以上2.HIV病毒载量在检查下限3.患病者CD4细胞计数高于350研究小组对该项试验的安排:1.患病者被随机分组,要么接受为期5周的JAK治疗(通过口服,每天两次),要么不给予JAK治疗。2.两组患病者都必须持续服用目前的ART药物。3.对所有患病者的观察及研究长达12周。研究小组试图通过以上试验达到最初的研究目的。通过试验观察到的现象,研究小组还认为JAK药物能够促进HIV病毒库的凋亡。研究小组还通过实验室实验证明,JAK抑制剂能够防止HIV病毒感染到附近的健康细胞。但是对于最终的试验结果,研究小组并未完整说明这37名感染者在试验后的身体健康状况,以及能够论证JAK药物可促进HIV病毒库的凋亡、阻止HIV病毒感染到附近健康细胞这一观点的试验数据。仔细阅读过“Selective suppression of inflammation could deplete HIV and controlHIV activation”这篇文章后,我们还查阅了之前类似研究相关文章,发现早在2014年4月,一篇标题为“Ruxolitinib and Tofacitinib ArePotent and Selective Inhibitors of HIV-1 Replication and Virus Reactivation In Vitro”的文章,也已经提到过能够使用JAK药物对抗HIV病毒,文章中内容指出JAK药物能够让受感染的巨噬细胞与淋巴细胞有一个明显的靶标,它们通常是病毒的藏身之所,通过靶标的标示达到HIV病毒被抑制和减少炎症的目的,但是,这依然是通过体外实验获得的发现,并没有任何人体临床实验数据加以说明。目前不少新闻中提到能够用来对抗HIV病毒的Ruxolitinib 和Tofacitinib药物,它们分别是FDA批准主要用来治疗类风湿性关节炎和骨髓纤维化的药物,在此之前也并没有对治疗HIV的作用进行更多更深入的研究。只是通过相关试验发现这两种药物具有对抗HIV-1,HIV-2,和猿类免疫缺陷病毒RT-SHIV的作用,而且没有明显的细胞毒性。因此,JAK药物被认为可作为HIV病毒靶向抑制剂,可能在新的作用机制下有效抑制潜伏HIV-1病毒在淋巴细胞和巨噬细胞中的复制,抑制耐受药物性HIV-1病毒的复制,防止病毒再活化,为HIV病毒感染者的免疫重建提供药物选择。最后,通过对目前有关JAK药物在抗HIV作用方面的文章介绍,也给我们带来几方面思考:1. 既然面市药物JAK早在2014年已经被发现具有抗hiv病毒、调节免疫的功效,现也时隔3年多的时间,如果该药物的功能强大到彻底消除人体内病毒库,这样的消息可能在之前更早的时候就会被热门报导。2. 尽管JAK药物在人体外以及其他动物模型的试验中显示出抗hiv病毒的能力,但是目前依然没有充分的证据证明JAK能实现功能性治愈甚至治愈的目的,也没有数据证实JAK药物通过对病毒库的影响延迟病毒载量的反弹。3. 很多感染者都迫切希望自己获得治愈、有的甚至在看到JAK治疗hiv有关的新闻报导之后急于通过各种渠道选购JAK药物企图治愈HIV,这样的心情能够理解。虽然通过海善时、李辉时空、HIV前沿资讯等等这些媒体平台去了解最新的治疗进展有利于缓解过度紧张的压力、将来可能更早获得更好治疗条件。但是我认为对于各种医科学研究的新闻报导,应该冷静下来客观分析,再结合主治医生的专业建议后定夺是否更换治疗方法。千万不要自己给自己诊疗断定与治疗。在HIV病毒的治愈性研究方面,目前为止固然取得了很多可喜的成绩,但对于人体临床实验方面的计划安排及实质进展,依然提示着我们HIV的治愈任重而道远。【参考文献】

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