疫苗可以帮助消灭由EBV引起的癌症吗？

10月，英国癌症研究（CRUK）推出了癌症研究英国大挑战赛- 一项1亿英镑的计划，以应对理解和治疗癌症的七个最大挑战。

And in a series of posts over the next two months they will be exploring each ofthe seven Grand Challenge questionsset by a panel of the world’s leading cancer experts, the second of whichis posing the question:我们可以消灭由爱泼斯坦巴尔病毒引起的癌症吗？

这Epstein-Barr Virus（EBV）是人类最常见的病毒感染之一 - 每20个成年人中约有19个病毒。就被感染的人数而言，它是世界上最多产的病毒之一。

And in most of us, it appears to cause no harm at all. But there’s a sinister side to the virus too. In some people, it can cause cancer. In fact, EBV was the首先发现在人类中引起癌症。我们现在知道，每年EBV感染会引发全球200,000例新的癌症病例，并导致超过140,000例死亡。

这se are mainly certain forms of lymphoma, as well as cancers that start at the back of the nose and throat (the鼻咽），以及一些胃癌。

EBV生产的分子可以将受感染的细胞转移到超速驱动器中，告诉它们继续分裂。但是，饮食，遗传学和对其他感染的接触也在癌症发展中起重要作用。

在世界某些地区，这种相对常见的感染的黑暗面比其他地区更具感受。中国和东南亚部分地区的癌症发生率提高，而EBV连接的淋巴瘤的发生率尤其遭受了撒哈拉以南非洲的某些部位。

And while expert teams dotted around the globe have chipped away at the challenge of tackling EBV-linked cancers, some believe the geographical spread of these cancers – hitting mainly the developing world – may have stifled interest in studying them.

现在可以将其设置为更改。

A defined and achievable goal

Professor Sir David Lane – Scientific Director of the Ludwig Institute for Cancer Research, Chief Scientist at Singapore’s Agency for Science, Technology and Research (A*STAR) and one of the members of our Grand Challenge Advisory Panel – believes that understanding the trigger behind these tumors actually gives us a real chance of tackling them.

“我这一挑战的一个令人兴奋的事情s that it has a very defined – and in my opinion achievable – goal,” he explains.

“These cancers have a known cause: a virus. And we have a long and successful history of dealing with viruses – either preventing people being infected using vaccines, or successfully treating infections. “There’s no reason we can’t do the same with EBV.”

Lane sees the attempt to stop people becoming infected in the first place, for example through vaccination, as a key focus for this challenge. “There’s a precedent with the success story of vaccines against the human papillomavirus (HPV), which causes几种类型的癌症，，，，notably cervical cancers,” he says.

HPV vaccines在1990年代初期开始他们的发展，并作为一项全国计划的一部分推出，该计划于2008年在英国免疫女学生。预计该疫苗接种计划将在未来挽救数千人的生命。

And finding a similar way to prevent EBV infection could stop cancers caused by the virus developing, and save lives. But for Lane, there are potentially even bigger benefits ahead – and it’s not just about vaccines.

“There are definitely some cancers we know are caused by EBV. But science is an ever-moving field, and there may be other cancers linked to the virus we don’t know about yet.”

莱恩说：“一种理论是，与感染作斗争可能会耗尽或抑制我们的免疫反应，这可能有助于其他类型的癌症逃避免疫破坏。”

“The important point is that the solution isn’t necessarily a vaccine. There may be ways of uncloaking the virus to immune cells, helping people get rid of the infection themselves rather than having low level infection for years – sometimes their whole lives.”

‘不是缺乏想法使我们退缩了”

Research into EBV-linked cancers has been ongoing for 50 years. And there are a lot of scientists with in depth knowledge of the virus.

但是莱恩（Lane）认为，到目前为止，缺乏将研究转变为解决该疾病的新方法所需的势头。

巨大的挑战将大大推动疫苗研究界的努力

---

Professor Alan Rickinson

“We’ve had a patchwork of researchers dotted about the world, but no real large, united front to tackle this head on,” he says. “And this is where the Grand Challenge could really turn the tables.”

领导该指控的科学家之一是艾伦·里金森（Alan Rickinson）教授。

他认为，EBV疫苗并没有尽可能地进展的某些原因是缺乏政治意愿，并且从制药行业获得了有限的支持。

他说：“并不是缺乏想法使我们退缩了。”“我们长期以来一直在开发一种疫苗，以保护人们免受病毒感染。HPV疫苗的成功是科学可以实现的闪亮例子。”

But viruses are very different from one another, and the development of the HPV vaccine doesn’t automatically mean it will be simple to make an effective EBV vaccine too.

那是因为EBV与HPV大不相同。EBV是一种称为“疱疹病毒”的病毒，目前尚无针对任何人类疱疹病毒的保护性疫苗。里金森说：“ EBV戳戳将是第一个，这是一个非常重要的首先！”

“巨大的挑战将大大推动疫苗研究界的努力。”

Beyond the vaccine

但是，尽管疫苗将是向前迈出的一大步，但迫切需要为每年诊断为EBV连接的癌症诊断出的200,000名患者更好地治疗。

Dr Emma King, a leading head and neck surgeon at the University of Southampton, is carrying out clinical trials testing new ways to boost the immune response against cancers, many of which are caused by the HPV virus.

她解释说：“全球大量的癌症病例是由病毒引起的。”“而且我们仍然需要回答的一个大问题之一是，为什么有些人的免疫系统识别并摆脱病毒，而其他人则无法清除感染并有患癌症的风险。”

它可能涉及将疫苗与阻止隐藏免疫细胞的癌细胞的药物结合。

根据金的说法，有几个关键因素可能起作用 - 免疫系统必须应对的病毒，其他感染，生活方式因素，当然还有我们的遗传学。

她认为，治愈这些癌症将需要进行多管齐下的攻击，并且患者之间可能会有所不同。例如，它可能涉及将疫苗与阻止免疫细胞隐藏的癌细胞或放疗与免疫促进药物相结合的药物。

她说：“每个步骤都是朝着正确的方向迈出的一步。”“但是科学很昂贵，大挑战将通过将来自不同领域的专家聚集在一起，帮助我们互相学习，从而帮助提高进步。”

这patient perspective

- 特里（Terry），大挑战赛的患者小组成员

Research has revealed a lot about EBV – and other viruses linked to cancer – over the past 50 years, but the story is just beginning. The viruses themselves are only part of the picture; our genetics and environment also combine to play a role in cancer developing.

但是，凭借我们拥有的所有知识，可以治愈或预防EBV连接的癌症，似乎可以实现这一目标 - 只需要投资就可以使其成为现实。巨大的挑战可以完全提供这一点。

莱恩说：“'大挑战'的整个想法令人兴奋。”“这是另一种研究方法。它通过结合各种技能，知识和技术来将世界各地的科学家融合在一起，并解决了这些大问题。”

而且，随着全球每年挽救14万寿命的潜力，它肯定会产生很大的影响。

如果您是研究人员，并且想组建一个团队来应对这一挑战，访问CRUK的网站，以了解如何申请。