呼吸道合胞病毒的治疗药物研发进展

Research progress on drugs in treatment of respiratory syncytial virus

呼吸道合胞病毒(RSV)是婴幼儿、老年人和免疫功能低下者诱发下呼吸道感染的主要原因。RSV引起严重的呼吸系统疾病,与长期喘息和后期哮喘风险增加有关。虽然RSV疫苗的开发已经有50多年,仍然没有批准上市的疫苗,对于预防和治疗RSV感染的疫苗和有效治疗药物尚未满足临床需求。帕利珠单抗和利巴韦林目前可用于RSV感染的预防和治疗,但不完全有效。因此需要针对RSV的预防和治疗提出新的疗法,用于满足临床医疗需求。近10年来,新抗病毒药物和单克隆抗体的研发,已经显示出对RSV治疗的临床应用前景,并且可能在未来几年陆续上市。尽管RSV融合蛋白(F蛋白)已成为小分子抑制剂和单克隆抗体最受欢迎的靶点,但靶向病毒其他蛋白质的新方法也得到了发展。同时针对逃逸株,可能会采用联合用药,用于RSV病毒的治疗。对处于不同临床研发阶段的抗RSV病毒药物和单克隆抗体进行了综述。

Respiratory syncytial virus（RSV） is the major cause inducing lower respiratory tract infection for infants, the elderly, and immunocompromised persons. Respiratory diseases caused by RSV are associated with long-term breath and an increased risk of later asthma. Although the development of RSV vaccine has been for 50 years, there is still no approved vaccine for the prevention and treatment of RSV infection. The vaccine and effective drugs in treatment of RSV infection has not meet clinical needs. Palivizumab and ribavirin are currently the only available in the prevention and treatment of RSV infection, but not completely effective. Therefore it is necessary for the prevention and treatment of RSV new therapies to meet the clinical medical needs. In the past 10 years, the development of new antiviral drugs and monoclonal antibody has shown the prospect of clinical application of RSV treatment, and may become available in the next few years. Although the RSV fusion protein（F protein） has become the most popular target for small molecule inhibitors and monoclonal, the new method to other virus protein targets has also been developed. At the same time for the escape mutants, the drug combination may be used in treatment of RSV virus. In this paper, anti RSV drugs and monoclonal antibodies in different clinical stages are reviewed.