bnab在HIV治疗中的未来

IF 4.4 2区 医学 Q2 INFECTIOUS DISEASES
Pablo Tebas
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引用次数: 0

摘要

综述目的:广泛中和抗体(bNAbs)代表了HIV治疗、预防和治愈策略的新途径。随着研究的深入,bnab的临床应用也在不断发展。这篇综述探讨了bNAbs在HIV管理中的潜在作用,阐述了它们的作用机制、目前的局限性和未来的发展方向。最近的发现:最近的研究表明,bNAbs可以通过靶向病毒包膜上的保守表位有效地中和多种HIV毒株。临床试验表明,在没有抗逆转录病毒治疗(ART)的情况下,bNAb组合可以维持病毒抑制,尽管先前存在的耐药性仍然是一个主要挑战。正在探索诸如Fc工程和替代递送机制(例如AAV, mRNA, DNA)等策略来增强bNAb的功效和耐久性。尽管有令人鼓舞的数据,但与现有的抗逆转录病毒治疗或暴露前预防(PrEP)方案相比,bNAbs尚未显示出优越的有效性。虽然bNAbs为长效HIV治疗提供了令人兴奋的可能性,但它们的广泛使用受到后勤挑战、高生产成本和预先存在的病毒耐药性的限制。bNAb的未来可能在于与小分子抗逆转录病毒药物的联合策略、遗传传递系统和基于疫苗的方法来诱导内源性bNAb的产生。需要进一步的研究来完善这些策略并确定bNAbs在HIV护理中的最佳作用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Future of bNAbs in HIV Treatment.

Purpose of review: Broadly neutralizing antibodies (bNAbs) represent a novel approach to HIV treatment, prevention, and cure strategies. As research advances, the clinical application of bNAbs continues to evolve. This review explores the potential role of bNAbs in HIV management, addressing their mechanisms of action, current limitations, and future directions.

Recent findings: Recent studies have demonstrated that bNAbs can effectively neutralize a broad range of HIV strains by targeting conserved epitopes on the viral envelope. Clinical trials have shown that bNAb combinations can maintain viral supression in the absence of antiretroviral therapy (ART), though pre-existing resistance remains a major challenge. Strategies such as Fc engineering and alternative delivery mechanisms (e.g., AAV, mRNA, DNA) are being explored to enhance bNAb efficacy and durability. Despite promising data, bNAbs have not yet demonstrated superior effectiveness compared to existing ART or pre-exposure prophylaxis (PrEP) options. While bNAbs offer exciting possibilities for long-acting HIV therapy, their widespread use is limited by logistical challenges, high production costs, and pre-existing viral resistance. The future of bNAbs may lie in combination strategies with small-molecule antiretrovirals in maintenance strategies, genetic delivery systems, and vaccine-based approaches to induce endogenous bNAb production. Further research is needed to refine these strategies and determine the optimal role of bNAbs in HIV care.

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来源期刊
Current HIV/AIDS Reports
Current HIV/AIDS Reports INFECTIOUS DISEASES-
CiteScore
8.10
自引率
2.20%
发文量
45
期刊介绍: This journal intends to provide clear, insightful, balanced contributions by international experts that review the most important, recently published clinical findings related to the diagnosis, treatment, management, and prevention of HIV/AIDS. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as antiretroviral therapies, behavioral aspects of management, and metabolic complications and comorbidity. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research. Commentaries from well-known figures in the field are also provided.
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