推 pharmawind:酷!!!! 感謝分享!!! 給你個讚!!! [like] 11/02 00:45
※ 編輯: REIOX 來自: 114.38.103.50 (11/02 02:52)
推 MikeFreeway:這真是一個重大的發展啊~~~ 11/05 20:57
推 pharmawind:其實這篇也可以M起來 很棒的翻譯 很棒的故事 11/06 02:29
MAN has vanquished only one disease, smallpox. In 2007 Bill Gates set out to
eradicate another, malaria. The World Health Organisation (WHO) was soon
rallying its troops to the cause and a flood of money followed. $612m went to
research in 2009 alone. This week the Bill & Melinda Gates Foundation
trumpeted another announcement: results from a phase III trial (the more
extensive process of testing drugs in people) of a malaria vaccine called
RTS,s. This is the world's most advanced vaccine for malaria and the results,
published in the New England Journal of Medicine, were encouraging.
It is an important step in combating a disease that still kills more than
70o,ooo people a year and debilitates millions more. But it is also a
reminder of how much work remains to be done.
目前人們只解決了唯一一種疾病，天花。在2007年 比爾蓋茲著手根除另一樣疾病"瘧疾"
WHO接著招集了防疫人員而且投入了大筆的金錢，注入了約6.12億的研究經費。這個禮拜，
Bill & Melinda Gates Foundation 宣告了一項聲明:RTS,S這個進入PHASE III的瘧疾疫苗
。而這個目前最先進的瘧疾疫苗也著實令人振奮、其結果同時發布於NEJM上。
這也是對抗這個每年奪去70萬人生命並且造成數百萬人罹患的疾病重要的一步。
但這也提醒了依舊還有不少需要工作必須要執行的
Mr Gates is only malaria's latest adversary. The parasite has plagued man
for millennia. Chinese texts from 2700BC de-scribe plants to treat its
fevers. More recently, in 1955, the WHO embarked on its first
malaria-eradication effort. But transmission rates in Africa seemed
intractable. After 14 years the WHO gave up. The last time the world tried to
eliminate malaria, some scientists lament, the world eliminated
malariologists.
Mr Gates是唯一目前對抗瘧疾的最後旗手。這個寄生蟲千年以來不斷的困
擾人類。中國的典籍早在西元2700年前就已經記載有植物可以治療這個寄生蟲引起的發燒
(應該是青蒿吧...沒記錯的話)。最近直到了1955年，WHO才著手進行瘧疾的根除工作。
在非洲的傳染率看來令人感到棘手的。14年後WHO放棄了，因此有些科學家對於這個上次，
也是最後一次的嘗試消滅瘧疾感到嘆息。
The new wave of enthusiasm came with the founding of the Roll Back Malaria
Partnership in 1998 (to co-ordinate planning), the PATH Malaria Vaccine
Initiative in 1999 (with money from the Gates Foundation) and the United Nations'
Global Fund to Fight AIDS, Tuberculosis and Malaria in 2002.
This culminated in Mr Gates's call to arms four years ago and has helped to
lower the number of malaria deaths by 20% over the past decade.
這個新的熱浪來自於1998年的Roll Back 瘧疾合作計畫、1999年瘧疾疫苗展新路徑、以及
2002來自美國環球資金所對抗的AIDS、肺結核、瘧疾其中的一個部分。滿意的是四年前
也達到了Mr Gates目標，而且過去十年之間降低了20%的瘧疾死亡人數。
More progress will be difficult. The existing tools of insecticide-treated
bed nets and treatment drugs require careful co-ordination and good health
systems. Eliminating malaria in a stable country is dramatically easier than
doing so in a turbulent one. Worryingly, these tools may become less
effective. Parasites in South-East Asia, for example, seem to be develop-ing
resistance to artemisininbased treatments. To achieve eradication-or
any-thing close to it-new weapons are needed.
越來越多的程序將會是困難的。現存的驅蟲劑、蚊帳和治療藥物需要良好的協調和衛生
系統。根絕瘧疾對於穩定的國家中是非常簡單的，但是在動亂的國家則否。例如在東南亞
寄生蟲對於青蒿素為主的療法已經出現抗性了。為了跟除瘧疾，新的武器將是必要的。
RTS,s, developed by GlaxoSmithKline (GSK), a British pharmaceutical company,
will help. The vaccine tries to stop one type of malaria parasite, Plasmodium
falciparum, before it has a chance to wreak havoc. A mosquito's bite delivers
malaria to the body. Travelling swiftly to the liver, the parasites hide,
mature and multiply before staging a grand second act in the blood-stream,
where they invade red blood cells, multiply again, and invade more cells.
RTS,s combines a circumsporozoite protein, which exists on the parasite's
surface, with a protein from a hepatitis B vaccine. Together, these trigger
an immune response which can fight off invading para-sites before the second
act.
RTS,S，這個由英國GSK藥廠開發的疫苗將會幫得上忙。這種疫苗試圖要阻止這種造成
以往造成瘧疾大舉肆虐的寄生蟲Plasmodium falciparum。而這種寄生蟲造成感染的路徑是
快入進入肝臟之中，然後迅速的成長，第二階段接著入侵幹細胞當中，再快速的成長，進
而侵蝕更多細胞。RTS,S結合了存在寄生蟲中的環包蛋白以及來自B肝疫苗中的蛋白，她可
以在第二階段反應前快速觸發對抗入侵寄生蟲的免疫反應。
GSK tested the vaccine in 6,ooo infants across sub-Saharan Africa. It reduced
the risk of clinical malaria by 56% and severe malaria by 47%. This efficacy
was "on the positive side of what we were expecting," says Christian Loucq of
the PATH Malaria Vaccine Initiative, GSK's partner on RTS,s.
GSK測試了6000個非洲沙哈拉以南的新生兒。降低56%臨床瘧疾的風險以及47%的嚴重
瘧疾。GSK在RTS,s上的研究夥伴，the PATH Malaria Vaccine Initiative，Christian
Loucq，表示"這正是我們所期待的正面結果"
However, more is to come. The trial examined children aged 5-17 months.
Results for younger babies will follow. Still uncertain is how long the
vaccine's protection lasts. The first year that the vaccine might be used
would be 2015, and that is if every-thing goes as planned. Even then, it is
unclear how RTS,s might be deployed. Its price is uncertain and its power
limited. "We realise that RTS,S is not the ultimate malaria vaccine," says
David Brandling-Bennett of the Gates Foundation. "But it will have some role.
The challenge is figuring out what that role is."
然而，問題隨之到來。有項結果檢視了5-17個月大的幼兒。結果顯示抗體將會持續。但是
仍不確定疫苗的保護效果會有多長。如果一切順利的話，第一批的疫苗將會在2015年全面
開打。即使RTS,S有這些不清楚的地方，依舊可能被散佈開來。而價格也尚未明朗，效力
也是有限的。Gates基金會的David Brandling-Bennett說"我們明白RTS,S將非最終的瘧疾
疫苗，但是他仍會扮演一定的角色。現在這項挑戰就是明白她的角色"
GSK Researchers are already working on the next generation of vaccines. GSK
hopes to induce a stronger immune response by combining RTS,s with a vaccine
from Cru-cell, another drug firm. Scientists are also keen to develop vaccines
that target different kinds of malaria parasites and in different ways-for
example, in mosquitoes' guts. All of this work requires further investment
at a time when global health programmes must compete fiercely for cash. Mr
Gates has helped to spur progress. Sustaining it is the next challenge.
GSK的研究團隊已經開始研發下一代的疫苗，GSK希望藉由結合RTS,s以及來自Cru-cell的
疫苗能產生更強大的免疫反應。科學家也密切發展不同的方法路徑，對付不同種類的寄生
蟲，例如蚊子的內臟。 這些工作同時皆是需要更多的資金，同時其他衛生議題也在猛烈的
競爭資金。Mr Gate 已經獲得了激勵的進展，而持續下去則是另一項挑戰。
from :[The.Economist].Volume.401.Number.8756.Oct.22nd
Nejm :
First Results of Phase 3 Trial of RTS,S/AS01 Malaria Vaccine in African
Children
http://www.nejm.org/doi/full/10.1056/NEJMoa1102287#t=article
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