抗腺病毒药物
研究方向是寻求治疗腺病毒的药物。几种治疗 HIV 感染的药物和其他一些新分子药物可能比较有希望,并且已进入 II 期临床试验。现已发现扎西他滨、sanilbudine、stampidine、干扰素β、aganocide和抗骨桥蛋白肽等药物的抗腺病毒作用。抗腺病毒作用主要见于核苷逆转录酶(扎西他滨和sanilbudine)抑制剂,而不是非核苷逆转录酶抑制剂或蛋白酶抑制剂。[72]D'Cruz OJ, Uckun FM. Stampidine: a selective oculo-genital microbicide. J Antimicrob Chemother. 2005;56:10-19.http://www.ncbi.nlm.nih.gov/pubmed/15919769?tool=bestpractice.com[73]Gordon YJ, Romanowski EG, McDermott AM. A review of antimicrobial peptides and their therapeutic potential as anti-infective drugs. Curr Eye Res. 2005;30:505-515.http://www.ncbi.nlm.nih.gov/pubmed/16020284?tool=bestpractice.com其他可用药物包括更昔洛韦和聚维酮碘 (povidone-iodine, PVI)。对 18 名患者进行的一项随机对照研究发现,与无防腐剂组相比,更昔洛韦组患者的疾病持续时间减少了一半以上,从约 18.5 天减少到约 7.7 天。上皮下浸润的并发症也减少约 70%。[68]Colin J. Ganciclovir ophthalmic gel, 0.15%: a valuable tool for treating ocular herpes. Clin Ophthalmol. 2007;1:441-453.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2704535/http://www.ncbi.nlm.nih.gov/pubmed/19668521?tool=bestpractice.com研究发现 PVI (0.8%) 游离腺病毒暴露 10 分钟后即可消除其感染性,但对细胞内腺病毒效果较弱,[74]Monnerat N, Bossart W, Thiel MA. Povidone-iodine for treatment of adenoviral conjunctivitis: an in vitro study [in German]. Klin Monbl Augenheilkd. 2006;223:349-352.http://www.ncbi.nlm.nih.gov/pubmed/16705502?tool=bestpractice.com另一项研究则发现 PVI (1.25%) 无效。[23]Isenberg SJ, Apt L, Valenton M, et al. A controlled trial of povidone-iodine to treat infectious conjunctivitis in children. Am J Ophthalmol. 2002;134:681-688.http://www.ncbi.nlm.nih.gov/pubmed/12429243?tool=bestpractice.com联合使用 PVI (0.4%) 和地塞米松 (0.1%) 5 天后 DNA 复制显著减少。[75]Pelletier JS, Stewart K, Trattler W, et al. A combination povidone-iodine 0.4%/dexamethasone 0.1% ophthalmic suspension in the treatment of adenoviral conjunctivitis. Adv Ther. 2009;26:776-783.http://www.ncbi.nlm.nih.gov/pubmed/19756415?tool=bestpractice.com局部用钴螯合剂 CTC-96(又称多西维尔)在体外显示出抗腺病毒活性。[76]Epstein SP, Pashinsky YY, Gershon D, et al. Efficacy of topical cobalt chelate CTC-96 against adenovirus in a cell culture model and against adenovirus keratoconjunctivitis in a rabbit model. BMC Ophthalmol. 2006;6:22.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1502138/http://www.ncbi.nlm.nih.gov/pubmed/16753060?tool=bestpractice.com