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高血压患者的希望：用疫苗代替药片
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Vaccine could replace pills for hypertensive patients 高血压患者的希望：用疫苗代替药片 MedWire News: A novel vaccine that acts on angiotensin II appears to be well tolerated and effective at lowering daytime ambulatory blood pressure (BP ) levels, reveal phase IIa clinical trial findings reported at the American Heart Association Annual Scientific Sessions in Orlando, Florida. 医学新闻在线：一种作用于血管紧张素II的新的疫苗具有良好的耐受性，并能有效的 降低动态血压水平。这一发现报道于佛罗里达Orlando举行的美国心脏协会年会上。 If the findings are borne out in further research, the vaccine could help hypertensive patients control their blood pressure by obviating the need to take medication - often a combination of different tablets - on a daily basis . 如果这一发现得到进一步研究的支持，疫苗就能帮助高血压患者控制血压，而不再需 要每天服用几种不同的药物。 Lead investigator Juerg Nussberger (Centre Hospitalier Université Vaudois , Lausanne, Switzerland) explained: "Despite the fact that effective drugs are available, only about one out of four people has their blood pressure successfully controlled. Many patients are unable or unwilling to take pills every day for the rest of their lives. If we could add or substitute a vaccine that would need to be given just every few months, I think we could achieve better control of high blood pressure." 研究领导者Nussberger解释说：“事实上尽管有效的药物能够发挥作用，但是只有四 分之一的人血压控制良好。很多病人不能或不愿意终生服药。如果能用几个月给一次 的疫苗代替药物，我想高血压可能会控制的更好。 The study showed that the vaccine blunted the early morning surge in BP. Early morning surges are associated with a very high risk for cardiovascular events - and current pharmacologic interventions are often at their least effective during this time. 研究表明疫苗减弱了早间的血压波动，而早间的血压波动是心血管时间的高危因素， 目前的药物在这个时段发挥的作用较小。 The vaccine - CYT006-AngQb - is a virus-like particle, coupled with an angiotensin II peptide to provoke an immune response against angiotensin II. CYT006-AngQb 疫苗是一种病毒样颗粒，上面结合有血管紧张素II 活性肽，以激活免 疫反应对抗血管紧张素II的作用。 Nussberger and team studied the tolerability and exploratory efficacy of CYT006 -AngQb in 72 patients with mild-to-moderate hypertension, defined as 140-179 /90-109 mmHg. Nussberger研究组在72个轻中度高血压患者（血压为140-179/90-109mmHg）中观察了 CYT006-AngQb的耐受性及作用。 Patients were assigned to receive three injections of 100 ?g or 300 ?g of the vaccine or placebo at 0, 1, and 3 months and then followed-up for 8 months . 患者在0、1、3个月时分别注射疫苗100μg、300μg或安慰剂后，随访8个月。 Results at 12 months showed that the vaccine was well tolerated. Most adverse events were mild and were related to local injection site reactions, and there were no serious treatment-related adverse events. 12个月后结果表明疫苗具有良好的耐受性。绝大多数的副反应都很轻微，仅局限在注 射局部，没有出现严重的治疗相关的副反应。 Antibody responses to angiotensin II were strong after vaccination and greater at the higher dose (p<0.01), Nussberger reported. Nussberger 发现使用疫苗后产生大量的血管紧张素II抗体，且高剂量组的更多（P<0 .01）。 Furthermore, daytime ambulatory BP levels were reduced by the vaccine at both doses, significantly so at the higher dose. At 14 weeks, daytime systolic BP and diastolic BP were reduced from baseline levels by 5.6 mmHg (p=0.007 ) and 2.8 mmHg (p=0.034), respectively, in the 300 μg group. This decrease in systolic BP was also significant compared with the placebo group. 此外，两种剂量的疫苗都降低了日常活动中的血压水平，高剂量组降低更明显。14周 后，300μg 组白天的收缩压和舒张压都从基础水平分别减少了5.6mmHg、208mmHg。 The vaccine had a pronounced BP-lowering effect in the early morning, between the hours of 05.00 am and 08.00 am. After correcting for placebo changes, the average systolic and diastolic BP levels at 08.00 am were 25 and 13 mmHg lower, respectively, than baseline levels. 在早上5点到8点，疫苗具有显著的降压作用。通过与安慰组矫正后，早上8点平均收缩 压和舒张压比基础水平分别降低了25mmHg、13mmHg。 Commenting on how the vaccine could be so potent early in the morning, co- author Martin Bachman (Cytos Biotechnology AG, Zurich, Switzerland) likened its action to that of a sponge. "The sponge empties out during the night when little angiotensin II is produced, so it is able to take up all the angiotensin II produced early in the morning," he said. 讨论疫苗在早间为什么能有如此显著的作用时，共同作者Bachman把它比喻为海绵，他 说：“夜间血管紧张素II产生的较少，海绵就是空的，所以能够吸收早间生成的血管 紧张素 II。” Nussberger said the next step in developing the vaccine will be to determine the optimal dose and injection regimen. Nussberger说下一步将研究疫苗的使用剂量和注射方法。 American Heart Association Annual Scientific Sessions; Orlando, Florida: 4 -7 September 编译整理：（710字） 高血压患者的希望：用疫苗代替药片 医学新闻在线：一种作用于血管紧张素II的新的疫苗具有良好的耐受性，并能有效的 降低动态血压水平。这一发现报道于佛罗里达Orlando举行的美国心脏协会年会上。如 果这一发现得到进一步研究的支持，疫苗就能帮助高血压患者控制血压，而不再需要 每天服用几种不同的药物。研究领导者Nussberger解释说：“事实上尽管有效的药物 能够发挥作用，但是只有四分之一的人血压控制良好。很多病人不能或不愿意终生服 药。如果能用几个月给一次的疫苗代替药物，我想高血压可能会控制的更好。 研究表明疫苗减弱了早间的血压波动，而早间的血压波动是心血管时间的高危因素， 目前的药物在这个时段发挥的作用较小。CYT006-AngQb 疫苗是一种病毒样颗粒，上面 结合有血管紧张素II 活性肽，以激活免疫反应对抗血管紧张素II的作用。 Nussberger研究组在72个轻中度高血压患者（血压为140-179/90-109mmHg）中观察了 CYT006-AngQb的耐受性及作用。患者在0、1、3个月时分别注射疫苗100μg、300μg或 安慰剂后，随访8个月。 12个月后结果表明疫苗具有良好的耐受性。绝大多数的副反应都很轻微，仅局限在注 射局部，没有出现严重的治疗相关的副反应。Nussberger 发现使用疫苗后产生大量的 血管紧张素II抗体，且高剂量组的更多（P<0.01）。此外，两种剂量的疫苗都降低了 日常活动中的血压水平，高剂量组降低更明显。14周后，300μg 组白天的收缩压和舒 张压都从基础水平分别减少了5.6mmHg、208mmHg。在早上5点到8点，疫苗具有显著的 降压作用。通过与安慰组矫正后，早上8点平均收缩压和舒张压比基础水平分别降低了 25mmHg、13mmHg。 讨论疫苗在早间为什么能有如此显著的作用时，共同作者Bachman把它比喻为海绵，他 说：“夜间血管紧张素II产生的较少，海绵就是空的，所以能够吸收早间生成的血管 紧张素 II。”Nussberger说下一步将研究疫苗的使用剂量和注射方法。 |
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