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有效治療發炎性疾病 3醫學教授摘唐獎桂冠

唐獎生技醫藥獎召集人、中央研究院院士張文昌今(19日)宣布,2020年唐獎生技醫藥獎頒發給美國的查爾斯·迪納雷羅(Charles Dinarello)教授、英國與澳洲籍的馬克·費爾德曼(Marc Feldmann)教授及日本的岸本忠三(Tadamitsu Kishimoto)教授,表彰其促成細胞激素成為生物製劑之作用標的,用以治療發炎性疾病。

美國科羅拉多大學醫學教授迪納雷羅發現並選殖出關鍵的發燒與發炎機制調控者 IL-1β,進而催生各種以 IL-1 為標的的治療新方向。英國牛津大學的費爾德曼教授發現 TNF 是類風濕性關節炎中,關鍵的促發炎細胞激素,開創性發現用抗體抑制 TNF 可以成功治療類風濕性關節炎。日本大阪大學教授岸本忠三發現與選殖出 IL-6 及其受體,並製作抑制性的抗體,一路從基礎研究推進到臨床應用。TNF、IL-1及IL-6為目前最重要的三樣作為生物製劑標的之細胞激素,能有效治療發炎性疾病。

細胞激素作為免疫系統內細胞間關鍵的訊息傳遞者,與發炎性疾病有什麼關係?中央研究院院士龔行健巧妙比喻,當小偷入侵(病原體感染)身體時,防盜鈴大響(即細胞激素發出求救的訊號)請求保全公司(免疫系統)調度保全人員(免疫細胞)打擊不速之客(人體發炎反應以消滅病原體或防止其擴散)。然而當防盜鈴響而不止、細胞激素分泌過量時,引來過多的保全人員,甚至招來裝甲部隊,造成過度的免疫及發炎反應,不僅小偷被抓走了,正常、健康的細胞也遭魚池之殃。以細胞激素為標靶的生物製劑療法,能提供較高的療效及較少的副作用,將防盜鈴關掉、抑制細胞激素作用,讓免疫反應回歸正常。中央研究院副院長劉扶東表示,這三位得獎人在以生物製劑鎖定細胞激素來抑制發炎疾病的相關研究歷程中,扮演最關鍵的那一大步,獲頒唐獎乃眾望所歸。

過度活化的免疫反應可能導致嚴重的「細胞激素風暴」,例如約10%的COVID-19患者為重症病患,發展出嚴重的肺炎症狀,多為自體引發的細胞激素風暴之受害者。

岸本忠三表示,他與藥廠共同開發的IL-6 受體療法(anti-IL-6 receptor antibody)已造福眾多飽受自體發炎疾病如類風溼性關節炎等之患者,目前IL-6 受體療法,已在些許臨床試驗中成功防止COVID-19引發的細胞激素風暴。若其最後被證實能有效治療由COVID-19所產生的嚴重肺炎症狀,他將感到「非常驕傲」。

費爾德曼表示,他贊助並協助設計了兩個COVID-19臨床試驗,一個為靜脈注射,另一個為皮下注射。靜脈注射是針對醫院內的病人,避免他們因為細胞激素風暴進入加護病房;皮下注射是給尚未需要住院的人預防性的保護。結果未知,但他認為有樂觀的理由,因為對目前已經在使用anti-TNF藥物的風濕病人,看起來效果不錯。

他說學者通常都是為了共同福利而努力,同儕對其成就的認同有時候來自升等或獲選為科學院士等等,但是最高的榮耀是能夠獲得世界上少數的那些國際獎項,而唐獎是其中之一。

自基礎科學研究至臨床治療,這三位獲獎人卓實體現了唐獎生技醫藥獎的精神,即表彰具原創性的基礎科學研究,並對醫學治療和人體健康有明確的正向影響力。

 

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