(本文選自《經濟學人》20200418期)
背景介紹：
恢復期血漿是指從處於恢復期的患者血液中分離出來的帶有抗體的血漿。恢復期血漿治療本質上是抗體治療，它最早是由德國科學家埃米爾·阿道夫·馮·貝林和日本科學家北裡柴三郎於1890年開創的。新冠肺炎康復者們所捐獻的恢復期血漿正在幫助越來越多的人渡過難關。
Convalescent plasma and artificial antibodies: Survivors as saviours
During the flu pandemic of 1918-19 doctors at an American naval hospital developed a treatment which, according to the American Journal of Public Health, had 「a decided influence in shortening the course of the disease and in lowering the mortality」.
據《美國公共衛生雜誌》報導稱，在1918年至1919年的流感大流行期間，美國一家海軍醫院的醫生研發了一種能夠「有效縮短疾病病程並降低患者死亡率」的治療方法。It involved clotting and then centrifuging blood from people who had got over the disease so as to separate out the antibodies it contained, then giving those antibodies to patients in dire need.
該方法是對處於恢復期的病人的血液進行採集和離心，進而分離出含有抗體的血漿，然後將其用於那些亟待治療的患者。Since then antibody-rich 「convalescent plasma」 (CP) has been used as a treatment for various diseases, including SARS and the pandemic strains of H1N1 and H5N1 influenza. Now covid-19 has joined the list.
從那時起，富含抗體的「恢復期血漿」被廣泛用於治療包括SARS以及H1N1和H5N1流感大流行在內的各種疾病。如今，新冠肺炎也也位列其中。A recent study in Wuhan found that severely ill covid-19 patients treated with CP did significantly better than patients matched with them by age, gender and severity of infection had done earlier in the epidemic.
最近在武漢進行的一項研究發現，相比疫情早期那些年齡、性別和病情相當的新冠肺炎患者，接受恢復期血漿治療的重症患者的治療效果明顯要好一些。Michael Joyner of the Mayo Clinic, which leads a CP research effort in America, expects randomised control trials to begin in a few weeks. They will not just look at CP’s potential as a treatment, but also as a prophylactic. If that worked, it would be a sort of halfway house on the road to a vaccine.
梅約醫學中心的麥可·喬伊納領導著美國一項有關恢復期血漿的研究計劃，他預計將在幾周內開始進行隨機對照試驗。他們不僅將恢復期血漿視為一種潛在的治療手段，同時還將其視為一種預防手段。如果這種方法行之有效，那麼它將為疫苗的研發奠定基礎。Even though CP donors get the other components of their blood—cells, platelets and the like—returned to them after the antibodies have been removed, the process is still something of a palaver, requiring a lot of medical attention. Despite the fact that various companies are trying to make a go of it, it is hard to see it scaling up all that far.
儘管在分離出抗體後，血液中的其他成分（血細胞、血小板等）會被輸送回恢復期血漿捐獻者的體內，但整個過程仍然十分繁瑣，需要投入大量醫護。雖然許多公司都在努力推進恢復期血漿的製備，但規模難以擴大。But there is an alternative. Antibodies are proteins, and that means a bit of genetic engineering will allow cell lines at biotechnology and pharma companies to mass produce them. The resulting product should be less prone to contamination, more consistent, and easier to scale up than CP.
不過，還有另一種選擇。抗體本質上是蛋白質，這意味著一些生物技術和製藥公司能夠通過基因工程技術對其進行大規模生產。由此得到的抗體相比恢復期血漿更不容易受到汙染、更穩定、更易於實現規模化生產。This approach has already been successful against Ebola. Regeneron, an American biotech company, developed a cocktail of three antibodies which recognised different parts of the protein’s coat.
這種方法已經成功地被用於對抗伊波拉病毒了。再生元公司（一家美國生物技術公司）研發了一種由三種抗體（可識別蛋白質外殼上的不同位點）組成的混合抗體。Trials in the Democratic Republic of Congo showed this therapy to be better than remdesivir, a drug designed to block the Ebola virus’s reproduction which is now, as it happens, being tested as a medicine for covid-19.
據他們在剛果民主共和國進行的試驗顯示，其療效優於瑞德西韋，瑞德西韋本是一種用於阻止伊波拉病毒複製的藥物，目前正被用作治療新冠肺炎的藥物進行試驗。Regeneron is now making a pair of antibodies that target the SARS-CoV-2 spike protein. It hopes to have produced enough to start trials soon. As with CP, it is possible that such antibodies may temporarily confer immunity on the uninfected, as well as helping the infected fight the disease.
再生元公司目前正在研發一種針對新冠病毒突刺蛋白的抗體。該公司希望能夠生產出足夠的抗體，從而儘快開展試驗。就像恢復期血漿一樣，這種抗體或能暫時賦予未感染者以抵抗力，並幫助感染者與病魔作鬥爭。本文翻譯：Vinnie
校核：Vinnie
編輯：Vinnie
在1918年的西班牙大流感中，美國一家海軍醫院的醫生首次將恢復期血漿治療法進行了廣泛的應用，並取得了很好的治療效果。此後，恢復期血漿治療法在SARS、H5N1禽流感、伊波拉、中東呼吸症候群等疾病的治療同樣起到了非常重要的作用。而在如今的新冠肺炎疫情中，康復者捐獻的血漿也正在幫助越來越多的感染者戰勝病魔。
convalescent [ˌkɑːnvəˈlesnt] adj. 康復的；恢復期的 n. 恢復期病人saviour [ˈseɪvjər] n. 救世主；救星；救助者antibody [ˈæntibɑːdi] n. 抗體prophylactic [ˌproʊfəˈlæktɪk] adj. 預防性的 n. 預防性藥物；預防性措施temporarily [ˌtempəˈrerəli] adv. 臨時地每天一篇雙語經濟學人沒有看夠！
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