19.6 免疫系统紊乱
Section outline
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Allergy Eyes
::过敏眼that are red, watery, and itchy are typical of an allergic reaction known as allergic rhinitis. Commonly called hay fever, allergic rhinitis is an immune system reaction, typically to the pollen of certain plants. Your immune system usually protects you from and keeps you well. However, like any other body system, the immune system itself can develop problems. Sometimes, it responds to harmless foreign substances as though they were pathogens. This is the basis of like hay fever.
::红、水和痒都是一种常见的过敏反应,被称为过敏犀牛炎。 通常被称为干热,过敏犀牛炎是一种免疫系统反应,通常针对某些植物的花粉。你的免疫系统通常保护你不受污染并保护你。然而,与其他任何身体系统一样,免疫系统本身也会产生问题。有时,它会像病原体一样对无害的外国物质作出反应。这是干热的基础。Allergies
::过敏过敏An allergy is a disorder in which the immune system makes an to a harmless antigen . It occurs when the immune system is hypersensitive to an antigen in the environment that causes little or no response in most people. Allergies are strongly familial. Allergic parents are more likely to have allergic children, and those children’s allergies are likely to be more severe, which is evidence that there is a heritable tendency to develop allergies. Allergies are more common in children than adults, because many children outgrow their allergies by .
::过敏是免疫系统使一种无害抗原成为无害抗原的一种疾病,当免疫系统对环境中的抗原具有高度敏感性,而这种抗原很少或没有引起大多数人的反应时,就会发生。过敏是很强的家庭。过敏的父母更有可能有过敏的孩子,而那些孩子的过敏程度可能更严重,这证明有一种发展过敏的遗传倾向。过敏在儿童中比成年人更为常见,因为许多儿童在过敏期后长大。Allergens
::过原反应原Any antigen that causes an allergy is called an allergen . Common allergens are plant pollens, dust mites, , specific foods (such as peanuts or shellfish), insect stings, and certain common medications (such as aspirin and penicillin). Allergens may be inhaled or ingested, or they may come into contact with the skin or eyes. Symptoms vary depending on the type of exposure, and the severity of the immune system response. Two common causes of allergies are shown in the figure : ragweed and poison ivy. Inhaling ragweed pollen may cause symptoms of allergic rhinitis, such as sneezing and red itchy eyes. Skin contact with oils in poison ivy may cause an itchy rash. This type of allergy is called contact dermatitis.
::引起过敏的任何抗原都称为过敏。常见的过敏原是植物授粉、灰尘虫、特定食物(如花生或贝类)、昆虫刺切和某些常见药物(如阿司匹林和青霉素)。过敏的原可能是吸入的或摄入的,或可能与皮肤或眼睛接触。症状因接触类型和免疫系统反应的严重程度而异。该图中显示了过敏的两个常见原因:薄草和毒脂。吸入的粗湿的花粉可能会引起过敏性鼻炎症状,如喷雾和红性眼炎。与毒性易腐中的油接触可能会导致皮疹。这种过敏性作用被称为接触皮肤炎。Common causes of allergies include ragweed (top) and poison ivy (bottom).
::过敏的常见原因包括粗草(顶部)和毒藤(底部)。Prevalence of Allergies
::过敏流行率There has been a significant increase in the prevalence of allergies over the past several decades, especially in the rich nations of the world, where allergies are now very common disorders. In the developed countries, about 20 percent of people have or have had hay fever, another 20 percent have had contact dermatitis, and about six percent have food allergies. In the poorer nations of the world, on the other hand, allergies of all types are much less common.
::在过去几十年中,过敏的流行率大幅上升,特别是在世界上的富裕国家,过敏症现在非常常见。 在发达国家,大约20%的人曾经或曾经有过干热,另外20%的人有过皮炎,大约6%的人有过敏症。 另一方面,在世界较贫穷的国家中,所有类型的过敏症都远没有那么常见。One explanation for the rise in allergies in the developed world is the hygiene hypothesis . According to this hypothesis, people in developed countries live in relatively sterile environments because of hygienic practices and sanitation systems. As a result, people in these countries are exposed to fewer pathogens than their immune system evolved to cope with. To compensate, their immune system “keeps busy” by attacking harmless antigens in allergic responses.
::发达国家过敏率上升的一个解释是卫生假设。 根据这一假设,发达国家的人们由于卫生习惯和卫生系统而生活在相对不育的环境中。 结果,这些国家的病原体接触率低于其免疫系统所演变应付的病原体。 为了补偿,他们的免疫系统通过在过敏反应中攻击无害抗原“保持繁忙 ” , 从而“保持繁忙 ” 。How Allergies Occur
::如何过过过过过过过过过过过过过过过过过过过过过过过过过过过过过过过过过过过过过过过过过过过过过过过过过过过过过过过过过过过过过过过过过过过过过过过过过过过过过过过过过The diagram shows how an allergic reaction occurs. At the first exposure to an allergen, B cells are activated to form plasma cells that produce large amounts of antibodies to the allergen. These antibodies attach to leukocytes called mast . Subsequently, every time the person encounters the allergen again, the mast cells are already primed and ready to deal with it. The primed mast cells immediately release cytokines and histamines , which in turn cause inflammation and recruitment of leukocytes, among other responses. These responses are responsible for the signs and symptoms of allergies.
::图表显示了过敏反应是如何发生的。 在第一次接触过敏反应时, B 细胞被激活形成血浆细胞, 产生大量抗体给过敏体。 这些抗体附着于列心科动物身上, 称为鼻梁。 随后, 每次人再次接触过敏体时, 胸腺细胞就已经准备就绪, 并且可以处理。 质定的管状细胞立即释放细胞皮和甲胺, 而这反过来又会引发血清炎, 并招生血清。 这些反应对过敏症的迹象和症状负有责任。This diagram shows how the adaptive immune system is activated by an otherwise harmless antigen on ragweed pollen, responding to the allergen as though it was a pathogen.
::这个图显示了适应性免疫系统是如何被 一种本来无害的抗原激活的 在抹花花粉上的抗原, 对过敏反应 似乎它是一种病原体。Treating Allergies
::处理过敏The symptoms of allergies can range from mild to life-threatening. Mild allergy symptoms are often treated with antihistamines . These are drugs that reduce or eliminate the effects of the histamines that produce allergy symptoms.
::过敏症状从温和到威胁生命不等。 低过敏症状通常用抗脑胺治疗,这些药物可以减少或消除产生过敏症状的脑胺的影响。Treating Anaphylaxis
::治疗抗药性The most severe allergic reaction is a systemic reaction called anaphylaxis . This is a life-threatening response caused by a massive release of histamines. Many of the signs and symptoms of anaphylaxis are shown in the figure . Some of them include a drop in , changes in heart rate, shortness of breath, and swelling of the tongue and throat, which may threaten the patient with suffocation unless emergency treatment is given. People who have had anaphylactic reactions may carry an epinephrine autoinjector (widely known by its brand name EpiPen®) so they can inject themselves with epinephrine if they start to experience an anaphylactic response. The epinephrine helps control the immune reaction until medical care can be provided. Epinephrine constricts to increase blood pressure, relaxes smooth muscles in the lungs to reduce wheezing and improve , modulates heart rate, and works to reduce swelling that may otherwise block the airways.
::最严重的过敏反应是一种称为厌食性反应的系统反应,它是一种由大量释放类胺引起的威胁生命的反应。许多厌食性症状和症状都显示在图中。其中一些症状和症状包括:心率下降、心率变化、呼吸短促、舌和喉肿胀,除非紧急治疗,否则可能会对病人造成窒息的威胁。有过节食性反应的人可能会携带肾上腺自注射器(其品牌为EpiPen),这样他们就可以注射肾上腺素,如果他们开始经历厌食性反应的话。肾上腺素有助于控制免疫反应,直到能够提供医疗护理。肾上腺素会增加血压,放松肺部的滑动肌肉,以降低呼吸系统,改善呼吸系统,调节心脏速率,并努力减少否则会堵住呼吸道的肿胀。Anaphylaxis is a rapid, systemic reaction to allergens that may lead to life-threatening symptoms.
::抗生素是一种对过敏基因的快速、系统反应,可能导致危及生命的症状。Immunotherapy for Allergies
::过敏性免疫治疗Another way to treat allergies is called immunotherapy, commonly called “allergy shots.” This approach may actually cure specific allergies, at least for several years if not permanently. It may be particularly beneficial for allergens that are difficult or impossible to avoid (such as pollen). First, however, patients must be tested to identify the specific allergens that are causing their allergies. As shown in the photo , this may involve scratching tiny amounts of common allergens into the skin, and then observing whether there is a localized reaction to any of them. Each allergen is applied in a different numbered location on the skin, so if there is a reaction — such as redness or swelling — the responsible allergens can be identified. Then, through periodic injections (usually weekly or monthly), patients are gradually exposed to larger and larger amounts of the allergens. Over time, generally from months to years, the immune system becomes desensitized to the allergens. This method of treating allergies is often effective for allergies to pollen or insect stings, but its usefulness for allergies to food is unclear.
::治疗过敏的另一种方法叫免疫疗法,通常称为“过敏射击 ” 。 这种方法实际上可以治愈特定的过敏,如果不是永久的,至少几年。它可能对难以避免或无法避免的过敏基因(如花粉)特别有益。 但是,首先,病人必须接受检测,以确定导致过敏的特定过敏基因。正如照片所示,这可能涉及将少量普通过敏基因划入皮肤,然后观察是否对皮肤有局部反应。每种过敏都应用在不同的编号地点皮肤上,因此,如果有反应(如红度或膨胀),则可以确定负责任的过敏基因。然后,通过定期注射(通常每周或每月一次),病人会逐渐暴露在更大和更大的范围内。随着时间的推移,一般从数月到数年,免疫系统会变得对过敏,对过敏基因是否发生反应。这种处理过敏的方法通常对过敏性食物的用途有效,但对于过敏性食品的用途则不甚清晰。Skin testing for common allergens is one way to identify the cause(s) of a patient’s allergic symptoms.
::常见过敏基因皮肤测试是确定病人过敏症状原因的一种方法。Autoimmune Diseases
::汽车免疫疾病occur when the immune system fails to recognize the body’s own molecules as self. As a result, instead of ignoring the body’s healthy cells, it attacks them, causing damage to tissues and altering organ growth and function. Most often, B cells are at fault for autoimmune responses. They are generally the cells that lose tolerance for self. Why does this occur? Some autoimmune diseases are thought to be caused by exposure to pathogens that have antigens similar to the body’s own molecules. After this exposure, the immune system responds to as though they were pathogens, as well.
::当免疫系统不承认人体自己的分子为自我时,免疫系统就会发生。 结果,它没有忽视人体的健康细胞,而是攻击细胞,对组织造成伤害,改变器官的生长和功能。 多数情况下,B细胞对自免疫反应有错。 它们一般都是细胞,失去自我的耐受力。 为什么会发生这种情况呢?有些自免疫疾病被认为是由于接触病原体造成的,病原体的抗原与人体自己的分子相似。 接触后,免疫系统的反应就像病原体一样。Certain individuals are genetically susceptible to developing autoimmune diseases. These individuals are also more likely to develop more than one such disease. Gender is also a risk factor for autoimmunity. Females are much more likely than males to develop autoimmune diseases, probably in part because of gender differences in sex hormones .
::某些个人在遗传上容易发展自发性免疫疾病,这些个人也更有可能发展一种以上的这种疾病,性别也是自发性的一个风险因素,女性比男性更有可能发展自发性免疫疾病,可能部分原因是性别激素方面的性别差异。At a level, autoimmune diseases are less common where are more common. The hygiene hypothesis has been proposed to explain the inverse relationship between infectious and autoimmune diseases, as well as the prevalence of allergies. According to the hypothesis, without infectious diseases to “keep it busy,” the immune system may attack the body’s own cells instead.
::在某种水平上,自发性免疫疾病在比较常见的地方比较不常见。 卫生假设是为了解释传染病和自发性免疫疾病之间的反比关系,以及过敏的流行。 根据这一假设,没有传染病“保持繁忙 ” , 免疫系统反而会攻击人体自己的细胞。Common Autoimmune Diseases
::共同自主疾病An estimated 15 million or more people worldwide have one or more autoimmune diseases. Two of the most common autoimmune diseases are type I and multiple sclerosis . I n terms of the specific body cells that are attacked by the immune system, b oth are localized diseases. In the case of type I diabetes, the immune system attacks and destroys insulin-secreting islet cells in the pancreas . In the case of multiple sclerosis, the immune system attacks and destroys the myelin sheaths that normally insulate the axons of and allow rapid transmission of .
::估计全世界有1 500万或1 500万以上的人患有一种或多种自产免疫疾病,两种最常见的自产免疫疾病是I型和多发性硬化,就免疫系统攻击的特定身体细胞而言,这两种疾病都是局部性疾病,就I型糖尿病而言,免疫系统攻击并摧毁胰腺中胰岛素保密的分泌细胞;就多发性硬化而言,免疫系统攻击并摧毁通常绝缘和允许迅速传播的甲状腺细胞。Some relatively common autoimmune diseases are systemic — or body-wide — diseases. They include rheumatoid arthritis and systemic lupus erythematosus (SLE). In these diseases, the immune system may attack and injure many tissues and organs. For example, as you can see in the figure , symptoms of SLE may involve the muscular, skeletal, integumentary, respiratory, and cardiovascular systems.
::某些相对常见的自发性疾病是系统性的疾病,或整个身体的疾病,包括风湿性关节炎和系统性风湿性红喉病(SLE),在这些疾病中,免疫系统可能攻击和伤害许多组织和器官,例如,从图中可以看出,SLE的症状可能涉及肌肉、骨骼、肿瘤、呼吸道和心血管系统。Systemic lupus erythematosus is an autoimmune disease that may cause symptoms of body-wide tissue damage.
::系统性脊椎骨红色体突变是一种自体免疫疾病,可能造成全身组织损伤的症状。Treatment for Autoimmune Diseases
::自动免疫疾病治疗None of these common autoimmune diseases can be cured, although all of them have treatments that may help relieve symptoms and prevent some of the long-term damage they may cause. Traditional treatments for autoimmune diseases include immunosuppressive drugs to block the immune response , as well as anti-inflammatory drugs to quell inflammation. replacement may be another option. T ype I diabetes, for example, is treated with injections of the hormone insulin , because islet cells in the pancreas can no longer secrete it.
::这些常见的自发性疾病都无法治愈,尽管它们都拥有有助于缓解症状和防止其可能造成的长期损害的治疗方法;自发性疾病的传统治疗方法包括阻塞免疫反应的免疫抑制药物,以及消炎药物来消炎。 替代可能是另一种选择。 例如,I型糖尿病用注射荷尔蒙胰岛素进行治疗,因为胰岛素细胞无法再隐藏。Immunodeficiency
::免疫缺陷免疫缺陷病毒occurs when the immune system is not working properly, generally because one or more components of the immune system are inactive. As a result, the immune system may be unable to fight off pathogens or cancers that a normal immune system would be able to resist. Immunodeficiency may occur for a variety of reasons.
::通常由于免疫系统的一个或几个组成部分不活动,免疫系统不能正常的免疫系统能够抵抗的病原体或癌症,免疫系统可能无法抗病原体或癌症。Causes of Immunodeficiency
::艾滋病毒/艾滋病Dozens of rare genetic diseases can result in a defective immune system. This type of immunodeficiency is called primary immunodeficiency . One is born with one of these diseases, rather than acquiring it after birth. Probably the best known of these primary immunodeficiency diseases is severe combined immunodeficiency (SCID). It is also known as “bubble boy disease,” because people with this disorder are extremely vulnerable to infectious diseases, and some of them have become well known for living inside a bubble that provides a sterile environment. SCID is most often caused by an X-linked recessive that interferes with normal B cell and T cell production.
::数十种稀有遗传疾病可导致有缺陷的免疫系统。这种类型的免疫机能丧失症被称为初级免疫机能丧失病毒。一个人生来就患有这些疾病,而不是在出生后获得这种疾病。 这些主要免疫机能丧失疾病中最著名的可能是严重的综合免疫机能丧失症(SCID ) 。 它也被称为“泡泡男孩病 ” , 因为患有这种疾病的人极易感染传染病,其中一些人因生活在无菌环境中的泡沫中而广为人知。 性免疫机能丧失症往往是由干扰正常B细胞和T细胞生产的X连锁断裂引起的。Other types of immunodeficiency are not present at birth, but are acquired due to experiences or exposures that occur after birth. Acquired immunodeficiency is called secondary immunodeficiency because it is secondary to some other event or exposure. Secondary immunodeficiency may occur for a number of different reasons:
::后天免疫机能丧失综合症被称作二级免疫机能丧失综合症,因为它是某种其他事件或接触的次要疾病或接触的次要疾病。-
The immune system naturally becomes less effective as people get older.
This age-related decline — called immunosenescence — generally begins around the age of 50 and worsens with increasing age. Immunosenescence is
the reason
older people are generally more susceptible to disease than younger people.
::免疫系统自然会随着人们的年老而变得不那么有效,这种与年龄有关的衰落——称为免疫机能丧失症——通常始于50岁左右,随着年龄的增加而恶化,免疫机能丧失是老年人普遍比年轻人更容易患病的原因。 -
The immune system may be damaged by another disorder, such as
obesity
, alcoholism, or the abuse of other drugs.
::免疫系统可能因肥胖、酗酒或滥用其他药物等其他疾病而受损。 -
In developing countries, malnutrition is the most common cause of immune system damage and immunodeficiency.
Inadequate
intake is especially damaging to the immune system. It can lead to impaired complement system activity,
phagocyte
malfunction, and lower-than-normal production of antibodies and cytokines.
::在发展中国家,营养不良是造成免疫系统受损和免疫缺陷的最常见原因,摄入不足对免疫系统特别有害,可能导致补充系统活动受损、发形机能故障、抗体和细胞皮的产量低于正常水平。 -
Certain medications can suppress the immune system.
This is the intended effect of immunosuppressant drugs given to people with transplanted organs so they do not reject them. In many cases, however, immunosuppression is an unwanted side effect of drugs used to treat other disorders.
::某些药物可以抑制免疫系统,这是给移植器官患者的免疫抑制药物的预期效果,因此他们不会拒绝这些药物,但在许多情况下,免疫抑制是治疗其他疾病药物的副作用。 -
Some pathogens attack and destroy immune system cells.
An example is the
known as
, which attacks and destroys
T
cells
.
::一些病原体攻击和摧毁免疫系统细胞,例如所谓的T细胞攻击和摧毁。
Focus on HIV
::关注艾滋病毒Human immunodeficiency virus (HIV) is the most common cause of immunodeficiency in the world today. HIV infections of human hosts are a relatively recent phenomenon. Scientists think that the virus originally infected monkeys, but then jumped to human populations, probably sometime during the early to mid-1900s. This most likely occurred in West Africa, but the virus soon spread around the world. HIV was first identified by medical researchers in 1981. Since then, HIV has killed almost 40 million people worldwide, and its economic toll has also been enormous. The hardest hit countries are in Africa, where the virus has infected human populations the longest, and medications to control the virus are least available.
::人类免疫机能丧失病毒(HIV)是当今世界最常见的致免疫机能丧失的原因。人类宿主的艾滋病毒感染是一个相对较新的现象。科学家认为病毒最初感染了猴子,但后来又跳到人类中去,可能发生在19世纪初到中期的某个时候。这很可能发生在西非,但病毒很快会传播到世界各地。1981年,医学研究人员首次发现艾滋病毒。自那时以来,艾滋病毒已在全世界造成近4 000万人死亡,其经济损失也非常巨大。受感染最严重的国家是非洲国家,那里感染病毒的人最多,控制病毒的药物也最少。HIV Transmission
::艾滋病毒传播HIV is transmitted through direct contact of mucous membranes or body fluids such as , semen , or breast milk. As shown in the figure , transmission of the virus can occur through sexual contact or the use of contaminated hypodermic needles . It can also be transmitted from an infected mother’s blood during late or childbirth, or through breast milk after birth. In the past, HIV was also transmitted occasionally through blood transfusions. Because donated blood is now screened for HIV, the virus is no longer transmitted this way.
::艾滋病毒是通过粘膜、精液或母乳等体液直接接触传染的,如图所示,病毒的传播可以通过性接触或使用受污染的皮下针头进行,也可以通过受感染母亲的血液在晚期或分娩期间或通过产后母乳传播,过去,艾滋病毒也偶尔通过输血传播,由于捐赠的血液现在被检测为艾滋病毒,病毒不再以这种方式传播。HIV may be transmitted in all of the ways shown here.
::艾滋病毒可能以这里显示的所有方式传播。HIV and the Immune System
::艾滋病毒和免疫系统HIV infects and destroys helper T cells , the type of lymphocytes that regulate the immune response. This process is illustrated in the diagram . The virus injects its own into a helper T cell and uses the T cell’s “machinery” to make copies of itself. In the process, the helper T cell is destroyed, and the virus copies go on to infect other helper T cells. HIV is able to evade the immune system and keep destroying helper T cells by mutating frequently so its surface antigens keep changing, and by using the host cell’s membrane to hide its own antigens.
::艾滋病毒感染和摧毁了控制免疫反应的淋巴细胞类型T类辅助细胞。这个过程在图表中有所说明。病毒将自身注入T类辅助细胞,并使用T类“机器”复制自己。 在这一过程中,T类辅助细胞被摧毁,病毒副本被感染到T类其他辅助细胞。 艾滋病毒能够避开免疫系统,通过经常变异来不断摧毁T类辅助细胞,使其表面抗原不断变换,并利用主机细胞的膜隐藏自己的抗原。This diagram shows how HIV infects and destroys helper T cells.
::这个图表显示了艾滋病毒感染和摧毁T型帮手细胞的方式。Acquired immunodeficiency syndrome (AIDS) may result from years of damage to the immune system by HIV. It occurs when helper T cells fall to a very low level and opportunistic diseases occur (see the graph ). Opportunistic diseases are infections and tumors that are rare, except in people with a damaged immune system. The diseases take advantage of the “opportunity” presented by people whose immune system cannot fight back. Opportunistic diseases are usually the direct cause of death for people with AIDS.
::后天免疫机能丧失综合症(艾滋病)可能由于艾滋病毒对免疫系统多年的损害而导致,如果帮助T细胞降到非常低的水平,出现机会性疾病(见图),则会发生这种情况。机会性疾病是感染和肿瘤的罕见,免疫系统受损者除外,这些疾病利用免疫系统无法反击的人提供的“机会”。机会性疾病通常是艾滋病患者死亡的直接原因。It typically takes several years after infection with HIV for the drop in helper T cells to damage the immune system to the point where opportunistic infections start to appear. Note that the y-axis is labeled CD4+ cells, which is another designation for helper T cells.
::通常需要几年时间才能将T型助手细胞的艾滋病毒感染率降低到免疫系统开始出现机会性感染的地步。 请注意,y轴被贴上CD4+细胞的标签,这是T型助手细胞的另一个名称。Treating HIV/AIDS
::治疗艾滋病毒/艾滋病For patients who have access to HIV medications, infection with the virus is no longer the death sentence that it once was. By 1995, combinations of drugs called “highly active antiretroviral therapy” were developed. For some patients, these drugs can reduce the amount of virus they are carrying to undetectable levels. However, some level of virus always hides in the body’s immune cells, and it will multiply again if a patient stops taking the medications. Researchers are trying to develop drugs to kill these hidden viruses, as well. If their efforts are successful, it could end AIDS.
::对于能够获得艾滋病毒药物治疗的病人来说,病毒感染不再是从前的死刑。 到1995年,已经开发出称为“高度活跃抗逆转录病毒疗法”的药物组合。 对一些病人来说,这些药物可以将携带的病毒数量降低到不可检测的水平。 然而,某种程度的病毒总是隐藏在人体的免疫细胞中,如果病人停止服用这些药物,病毒感染就会再次增加。 研究人员也试图研制药物来杀死这些隐藏的病毒。 如果他们的努力取得成功,它就能结束艾滋病。Feature: Human Biology in the News
::特著:《新闻》中的人类生物学EpiPens® and their sole manufacturer (pharmaceutical company Mylan) were featured in headlines in 2016, but not for a good reason. The media outburst was triggered by a drastic price hike in EpiPens® — and Mylan’s apparent greed.
::EpiPens及其唯一的制造商(制药公司Mylan)在2016年成为头条新闻,但并非出于一个好的理由。 媒体的暴动是由EpiPens的大幅涨价 — — 以及Mylan的明显的贪婪所引发的。EpiPens® are auto-injectable syringes preloaded with a measured dose of epinephrine, a drug that can rapidly stop a life-threatening anaphylactic response to an allergen. Using the device is easy and does not require any special training. The injector just needs to be jammed against the thigh, which can be done through clothing or on bare skin. Each year, doctors write millions of prescriptions for EpiPens®. Many people with severe allergies always carry two of the devices with them, just in case they experience anaphylaxis, although most of them never need to use them. Other people with severe allergies have literally had their lives saved multiple times by EpiPens® when they had anaphylactic reactions. Even when the devices haven’t been used, they must be replaced each year due to expiration of the epinephrine.
::EpiPens是自动注射的注射器,预先装有一定剂量的肾上腺素,这种药物可以迅速阻止对过敏者进行威胁生命的过敏反应。使用该装置很容易,不需要任何特殊训练。注射器只需要卡在大腿上,可以通过衣服或裸皮来做。每年医生都为EpiPens写数以百万计的处方。许多严重过敏者总是携带两种器械,即使他们患有厌食症,但大部分都不需要使用。 其他严重过敏者在有过过敏反应时,实际上已经多次被EpiPens挽救了生命。 即使没有使用过,由于肾上腺素过期,每年也必须更换它们。You might think that EpiPens® would be relatively inexpensive, given their life-saving potential. As recently as 2009, a two-pack of EpiPens® cost about $100. However, in just seven years, the cost of the same two-pack of EpiPens® skyrocketed by an incredible 400 percent! By 2016, the cost was $600 or more. Mylan apparently raised the price for the sole purpose of increasing profits. The company also raised prices significantly on many other drugs. The price hike in EpiPens® alone was certainly profitable. In 2015, the sale of EpiPens® earned Mylan $1 billion. Mylan’s CEO took home almost $19 million the same year, which was an increase of more than 600 percent over her prior salary.
::你可能会认为EpiPens(EpiPens)将相对便宜,因为他们有拯救生命的潜力。 就在2009年,两包EpiPens(EpiPens)的成本约为100美元。然而,仅仅7年,同样的两包EpiPens(EpiPens)的成本就以400 % 的令人难以置信的速度飙升了。 到2016年,成本为600美元或以上。 Mylan(Mylan)显然提高了价格只是为了增加利润。 该公司还大幅提高了其他许多药品的价格。 仅EpiPens(EpiPens)的价格上涨当然是有利可图的。 2015年,EpiPens(EpiPen)的销售就赚到了10亿美元。 同一年,Mylan的首席执行官就拿了近1,900万美元回家,比她以前的工资增加了600%以上。News coverage of the price hike in EpiPens® began in the summer of 2016 after a price increase in May of that year. Both private citizens and elected officials expressed outrage over the price increase, especially when coupled with the gluttonous profits of the company and its CEO. By late August, Mylan responded to the backlash by offering discount coupons for EpiPens®. A few days later, the company promised to introduce a cheaper, generic version of the device. Analysts quickly determined that selling a generic version would allow Mylan to make more money on the product than reducing the price of the name-brand device, which they still declined to do. By September of 2016, Mylan was being investigated for antitrust violations related to sales of EpiPens® to public schools in New York City.
::2016年5月物价上涨后,EpiPens开始对EpiPensen市价格上涨的新闻报道于2016年夏天开始。 私人公民和当选官员都对物价上涨表示愤慨,特别是当公司及其首席执行官的贪婪利润同时出现时。 到8月底,Mylan对反弹的反应是向EpiPens提供折扣优惠券。 几天后,该公司承诺推出更便宜的通用设备版本。 分析家们很快确定,出售通用版本将使Mylan在产品上赚更多的钱,而不是降低名称品牌装置的价格,他们仍然拒绝这样做。 到2016年9月,Mylan因向纽约市公立学校出售EpiPen而违反反托拉斯法的行为而受到调查。The Mylan/EpiPen® story may still be making the news. But whatever its outcome, the story has already added fuel to public and private debates about important ethical issues — issues such as the excessive costs of life-saving drugs and the huge profits of big pharma. What is the most recent news on EpiPens® and Mylan? If you are interested, you can check the headlines online to find out. What are your views on the ethical issues they raise?
::Mylan/EpiPen的故事可能仍然在播报新闻,但不管结果如何,这个故事已经为关于重要的伦理问题的公开和私下辩论增添了动力,这些问题包括救生药物的过高成本和大药厂的巨额利润。关于EpiPens和Mylan的最新消息是什么?如果你感兴趣,你可以在网上查看头条新闻以了解。你对它们提出的伦理问题有什么看法?Summary
::摘要-
An allergy is a disorder in which the immune system makes an inflammatory response to a harmless antigen. Any antigen that causes allergies is called an allergen. Common allergens include pollen, dust mites, mold, specific foods (such as peanuts), insect stings, and certain medications (such as aspirin).
::过敏是一种疾病,免疫系统对无害抗原作出煽动性反应。 任何导致过敏的抗原都被称为过敏。 常见的过敏原包括花粉、粉尘模型、霉素、特定食品(如花生)、昆虫刺和某些药物(如阿司匹林 ) 。 -
The prevalence of allergies has been increasing for decades, especially in developed countries, where they are much more common than in developing countries. The hygiene hypothesis posits that this has occurred because humans evolved to cope with more pathogens than we now typically face in our relatively sterile environments in developed countries. As a result, the immune system “keeps busy” by attacking harmless antigens.
::几十年来,过敏的流行一直在增加,特别是在发达国家,发达国家比发展中国家更为常见。 卫生假设认为,之所以出现这种情况,是因为人类在发达国家的相对不育的环境中,已经发展到与我们现在通常面对的病原体相比更多的程度。 结果,免疫系统通过攻击无害抗原“保持繁忙 ” 。 -
Allergies occur when B cells are first activated to produce large amounts of antibodies to an otherwise harmless allergen, and the antibodies attach to mast cells. On subsequent exposures to the allergen, the mast cells immediately release cytokines and histamines that cause inflammation.
::当B细胞首先被激活以产生大量抗体来达到本来无害的过敏体,而抗体附着在螺旋细胞上时,就会发生过敏。 在随后接触过敏细胞时,管状细胞会立即释放出引发炎症的细胞和甲胺。 -
Mild allergy symptoms are frequently treated with antihistamines that counter histamines and reduce allergy symptoms. A severe systemic allergic reaction, called anaphylaxis, is a medical emergency that is usually treated with injections of epinephrine. Immunotherapy for allergies involves injecting increasing amounts of allergens to desensitize the immune system to them.
::低过敏症状经常用抗脑膜炎和减少过敏症状的抗脊髓灰质炎治疗。 严重的系统过敏反应(称为厌食性麻痹 ) , 是一种通常通过注射肾上腺素治疗的紧急医疗反应。 过敏的免疫疗法包括注射越来越多的过敏基因,让免疫系统失去知觉。 -
Autoimmune diseases occur when the immune system fails to recognize the body’s own molecules as self and attacks them, causing damage to tissues and organs. A family history of autoimmunity and female gender are risk factors for autoimmune diseases.
::当免疫系统不承认人体的分子是自我分子并攻击它们,从而对组织和器官造成损害时,就会发生自发性疾病。 家庭自发性和女性性的历史是自发性疾病的危险因素。 -
In some autoimmune diseases, such as type I diabetes, the immune system attacks and damages specific body cells. In other autoimmune diseases, such as systemic lupus erythematosus, many different tissues and organs may be attacked and injured. Autoimmune diseases generally cannot be cured, but their symptoms can often be managed with drugs or other treatments.
::在一些自发性疾病中,如I型糖尿病、免疫系统攻击和损害特定身体细胞;在其他自发性疾病中,如系统性脑膜炎等,许多不同的组织和器官可能受到攻击和伤害;自发性疾病一般无法治愈,但其症状往往可以用药物或其他治疗方法来控制。 -
Immunodeficiency occurs when the immune system is not working properly, generally because one or more of its components are inactive. As a result, the immune system is unable to fight off pathogens or cancers that a normal immune system would be able to resist.
::当免疫系统不能正常运转时,即发生免疫缺陷,这一般是因为其一个或一个以上部件不活动,因此免疫系统无法对抗正常免疫系统能够抵抗的病原体或癌症。 -
Primary immunodeficiency is present at birth and caused by rare genetic diseases. An example is severe combined immunodeficiency. Secondary immunodeficiency occurs because of some event or exposure experienced after birth. Possible causes include aging, certain medications, infections with pathogens, and other disorders, such as obesity or malnutrition.
::初生先天免疫机能丧失症存在于出生时,由罕见遗传疾病造成,严重合并免疫机能丧失症就是一个例子,由于出生后发生的某些事件或接触而发生二级免疫机能丧失症,可能的原因包括衰老、某些药物、病原体感染以及肥胖或营养不良等其他疾病。 -
The most common cause of immunodeficiency in the world today is human immunodeficiency virus (HIV), which infects and destroys helper T cells. HIV is transmitted through mucous membranes or body fluids. The virus may eventually lead to such low levels of helper T cells that opportunistic infections occur. When this happens, the patient is diagnosed with acquired immunodeficiency syndrome (AIDS). Medications can control the multiplication of HIV in the human body — but they don't eliminate the virus completely.
::人体免疫机能丧失病毒(HIV)是当今世界造成免疫机能丧失症的最常见原因,它感染和摧毁了T类帮手细胞。艾滋病毒是通过粘膜膜或体液传播的。病毒最终可能导致T类帮手细胞的低水平,从而造成机会性感染。一旦发生这种情况,病人被诊断患有后天免疫机能丧失综合症(艾滋病 ) 。药物可以控制人体中艾滋病毒的倍增,但不能完全消灭病毒。
Review
::回顾1. What are allergies? What causes them?
::1. 什么是过敏,是什么原因?2. Compare the prevalence of allergies in developed and developing countries. How does the hygiene hypothesis explain the differences in prevalence?
::2. 比较发达国家和发展中国家过敏的流行率,卫生假设如何解释流行率的差异?3. Why do allergies occur?
::3. 为什么发生过敏?4. How are mild allergy symptoms treated?
::4. 如何治疗轻微过敏症状?5. What is anaphylaxis, and how is it treated?
::5. 什么是厌食症,如何治疗?6. How does immunotherapy for allergies work?
::6. 过敏免疫疗法如何运作?7. What are autoimmune diseases?
::7. 自我免疫疾病是什么?8. Identify two risk factors for autoimmune diseases.
::8. 查明自动免疫疾病的两个风险因素。9. Autoimmune diseases may be specific to particular tissues, or they may be systemic. Give an example of each type of autoimmune disease.
::9. 自发性免疫疾病可能是特定组织特有的,也可能是系统性的,例如每一种自发性疾病。10. What is immunodeficiency?
::10. 什么是免疫机能丧失综合症?11. Compare and contrast primary and secondary immunodeficiency. Give an example of each.
::11. 比较和比较初级和二级免疫机能丧失综合症,举一个例子。12. What is the most common cause of immunodeficiency in the world today? How does this affect the immune system?
::12. 当今世界最常见的造成免疫机能丧失的原因是什么?这如何影响免疫系统?13. Distinguish between HIV and AIDS.
::13. 区分艾滋病毒和艾滋病。14. True or False: Allergies and autoimmune diseases both result from an over-reactive immune system.
::14. 真实或假:过敏和自发免疫疾病都是由反应过度的免疫系统造成的。15. True or False: An anaphylactic reaction can be stopped by administering a shot of histamine.
::15. 真实的或假的:通过注射一剂异丙胺可以阻止一种窒息性反应。Explore More
::探索更多Have you ever heard the story of the " b oy in the bubble?" If not, learn more here:
::你听过"泡泡男孩"的故事吗?Peanut allergies are on the rise in the United States . Learn more here:
::花生过敏在美国呈上升趋势。 -
The immune system naturally becomes less effective as people get older.
This age-related decline — called immunosenescence — generally begins around the age of 50 and worsens with increasing age. Immunosenescence is
the reason
older people are generally more susceptible to disease than younger people.
