血管活性肠肽(VIP)拮抗剂
血管活性肠肽 (VIP) 是一种神经递质,作为一种强效的促分泌素发挥作用,使小肠分泌水和电解质。在动物研究中,使用 VIP 拮抗剂可以减少对大肠杆菌毒素的分泌反应。然而,VIP 拮抗剂还未用于人体临床试验。[50]Banks MR, Farthing MJ, Robberecht P, et al. Antisecretory actions of a novel vasoactive intestinal polypeptide (VIP) antagonist in human and rat small intestine. Br J Pharmacol. 2005 Apr;144(7):994-1001.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1576079/http://www.ncbi.nlm.nih.gov/pubmed/15711593?tool=bestpractice.com
噬菌体疗法
噬菌体是感染细菌的病毒。噬菌体疗法目前尚未广泛应用,仅在格鲁吉亚共和国可进行人体应用。该疗法的基本原理在于噬菌体可以感染细菌细胞,使其更易受到宿主免疫系统或抗生素的攻击。已有研究探讨了对大肠杆菌感染进行噬菌体治疗的效果,[51]Brüssow H. Phage therapy: the Escherichia coli experience. Microbiology. 2005 Jul;151(Pt 7):2133-40.http://www.ncbi.nlm.nih.gov/pubmed/16000704?tool=bestpractice.com[52]Mushtaq N, Redpath MB, Luzio JP, et al. Treatment of experimental Escherichia coli infection with recombinant bacteriophage-derived capsule depolymerase. J Antimicrob Chemother. 2005 Jul;56(1):160-5.http://jac.oxfordjournals.org/cgi/content/full/56/1/160http://www.ncbi.nlm.nih.gov/pubmed/15914489?tool=bestpractice.com 主要考虑在家畜中应用,从而降低人感染的风险。
疫苗
目前已研制出相关疫苗,一些临床研究在动物[53]Smith DR, Moxley RA, Peterson RE, et al. A two-dose regimen of a vaccine against Escherichia coli O157:H7 type III secreted proteins reduced environmental transmission of the agent in a large-scale commercial beef feedlot clinical trial. Foodborne Pathog Dis. 2008 Oct;5(5):589-98.http://www.ncbi.nlm.nih.gov/pubmed/18681791?tool=bestpractice.com 以及 2-5 岁儿童。[54]Ahmed A, Li J, Shiloach Y, et al. Safety and immunogenicity of Escherichia coli O157 O-specific polysaccharide conjugate vaccine in 2-5-year-old children. J Infect Dis. 2006 Feb 15;193(4):515-21.https://academic.oup.com/jid/article/193/4/515/825248/Safety-and-Immunogenicity-of-Escherichia-coli-O157http://www.ncbi.nlm.nih.gov/pubmed/16425130?tool=bestpractice.com 目前有观点认为霍乱疫苗 (Dukoral®) 可以有效预防产肠毒素大肠杆菌 (ETEC) 感染,因为霍乱毒素的重组亚单位与 ETEC 的不耐热肠毒素具有抗原相似性。一项针对该疫苗和其他特异性预防 ETEC 疫苗的 Cochrane 综述,共纳入了 11 项研究,结果表明尚无充分证据证明这些疫苗的有效性。[8]Ahmed T, Bhuiyan TR, Zaman K, et al. Vaccines for preventing enterotoxigenic Escherichia coli (ETEC) diarrhoea. Cochrane Database Syst Rev. 2013 Jul 5;(7):CD009029.http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD009029.pub2/fullhttp://www.ncbi.nlm.nih.gov/pubmed/23828581?tool=bestpractice.com