山梨医科大学雑誌　第7巻4号　137-149(1992)

＜総説＞AIDSとその薬物療法

伊藤正彦

抄 録：AIDSの治療薬においては逆転写酵素阻害剤であるAZTやddIが用いられている。延命効果もみられるが副作用や薬剤耐性ウイルスが出現してくる。HIV感染者の低下した免疫能を高めるために免疫調節剤を用いることも考えられるが，強い免疫調節剤投与により免疫細胞からTumor necrosis factorを含む cytokineが数多く産生される。これらの cytokineの多くはHIVの増殖を非常に促すので，このことが免疫調節剤を用いることを困難にしている。一方甘草の主成分であるグリチルリチンに抗HIV抑制効果があることを見出した。臨床的にも単剤およびddIとの併用で有効性が認められつつあり，かつ重篤な副作用もみられない。完全なる治療剤が見出せない現状では作用の異なる薬剤を併用することが必要なことと思われる。

キーワード　AIDS，HIV，AZT，ddI，グリチルリチン



Chemotherapeutic Approaches to AIDS

Masahiko Ito

For the treatment of acquired immunodeficiency syndrome (AIDS), reverse transcriptase inhibitors such as AZT and ddI have been used. These compounds are effective to lengthen the life of patients with AIDS, however, they have severe side effects and the virus becomes to show resistance to these compounds. It is possible that the drugs which have the immunomodulating action may be effectivbe for the treatment of human immunodeficiency virus (HIV)-infected patients in order to augment their lowered immunity. However, the administration of potent immunomodulators is known to stimulate the immune cells to produce cytokines including tumor necrosis factor. Since most of cytokines enhance HIV proliferation, it is difficult to use the immunomodulators for the treatment of patients with AIDS.
Meanwhile, we had demonstrated that glycyrrhizin, a substance present in the aqueous extract of liquorice root (Glycyrrhiza radix), has an inhibitory effect on HIV replication in vitro. In clinical trials, glycyrrhizin alone or that in combination with ddI has become to be evaluated for the effectiveness, and in addition, severe side effect has not been observed. As the complete chemotherapy for AIDS has not been established, it is considered that the combination of drugs which have the different mode of action may be necessary for the treatment of AIDS.

Key words: AIDS, HIV, AZT, ddI, glycyrrhizin



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