【经济学人】咬人者反被咬 | 2016.11.19 | 总第743期

KILLING mosquitoes of the genusAnopheles, the sort that transmit malaria, is a serious business—so serious that some doctors would like to do it by using people as bait. Their idea is to dose those in malarious areas with a drug called ivermectin. This will not protect the dosees directly, for it does not act on the parasite that causes the disease. But it may protect them indirectly, by making their blood poisonous toAnopheles. Mosquitoes do not tend to fly far from the place they hatch, and experiments suggest that if most of a village’s inhabitants were to take ivermectin they could collectively do serious damage to the localAnophelespopulation. That would substantially reduce the number of cases of malaria in an area.

消灭带有疟蚊（传播疟疾的蚊子）基因的蚊子是一项很重要的事情。一些医生他想用人作诱饵。他们的方法是让疟疾流行区的人们服用一种名为伊维菌素的药物。此药物不是用在导致疾病的寄生虫身上。所以并不能直接保护服药者。但它能使服药者的血液对疟蚊产生毒性从而间接地起到保护作用。蚊群往往不会飞到距繁殖地较远的地方。实验表明，如果一个村庄的大多数居民都服用了伊维菌素就可以使当地疟蚊数量锐减。这将大幅度减少疟疾地区的患者数量。

• Anopheles：n.疟蚊

• ivermectin：n.伊维菌素

• substantially：adv.大量地

来呀~互相伤害呀~~~

Whether this is ethical is debated. Ivermectin is used routinely to treat filariasis, river blindness, scabies and several other diseases. But drugging healthy people is generally frowned on. At the moment, though, there is a more practical objection. Ivermectin does not hang around in the body long enough to make a concerted anti-mosquito campaign that relies on it look like a realistic proposition. And it is this that Robert Langer of the Massachusetts Institute of Technology and Giovanni Traverso at Brigham and Women’s Hospital, in Boston, hope to change. As they report inScience Translational Medicine, they think they have devised a means to keep ivermectin concentrations in the blood at mosquito-killing levels for far longer than has previously been possible.

此举是否符合道德伦理仍未有定论。伊维菌素通常用于治疗丝虫病、盘尾丝虫病、疥疮等疾病，但一般不赞成用在健康人身上。使此前提议设想有现实意义的关键，现在遇到了一个更现实的问题，那就是伊维菌素在体内的存留时间不够长，无法使全身血液都对蚊子有毒。麻省理工学院的Robert Langer和波士顿布里格姆妇女医院的Giovanni Traverso希望改变这一情况。正如他们在《科学转化医学》期刊上发表的论文中所写的那样，他们认为已经找到了一种能使血液中伊维菌素浓度维持在灭蚊浓度，并更加持久的方法。

• filariasis：n.丝虫病

• river blindness：n.盘尾丝虫病

• scabies：n.疥疮

• frowned on：不悦；不满

The starting point for their device is a material called poly E-caprolactone (PCL). They melted this and blended it with powdered ivermectin. Then they tested the resulting composite in an acidic solution intended to mimic conditions found in the human stomach, to see how well it protected the drug, and also the rate at which ivermectin migrated out of it. They found that the PCL did indeed protect the ivermectin from the acid. It also let the drug diffuse out steadily over the course of 14 days.

他们的灵感源自于一种叫做聚已内酯的材料。他们将其融化并与粉末状伊维菌素混合。随后将混合物置于与人类胃内环境相似的酸性溶液中进行测试，观察此材料是如何保护药物以及伊维菌素从PCL上释放的速率。他们发现PCL确实能在酸性环境中保护伊维菌素并使其在14天内稳步扩散。

• poly E-caprolactone：聚已内酯

• diffuse：v.扩散；传播

粉末状伊维菌素

Encouraged by this finding, the two researchers pondered how to arrange for a block of ivermectin-doped PCL to stay in the stomach that long, rather than passing through to the intestine and thence, ultimately, to the outside world. Their solution was a star-shaped structure 4cm across (see picture) with a flexible polyurethane core and arms made of ivermectin-laden PCL.

受此鼓舞两位研究员开始思考如何使一粒添加有伊维菌素的PCL药物在胃内停留足够长的时间，而不会通过肠道最终排出体外。他们的解决方案是一个周长为4厘米的星状结构（如图），此结构的核心是柔软的聚氨酯，四周是带有伊维菌素PCL的臂状结构。

• ponder：v.考虑；沉思

For delivery, this is folded up inside a gelatine capsule, so that it can be swallowed. Once it arrives in the stomach, the gelatine is rapidly digested and the star unfolds into something large enough to avoid being expelled into the intestine, but insubstantial enough not to obstruct the passage of semi-digested food through the alimentary canal. After careful experiment, the researchers came up with an ivermectin-PCL mixture that disintegrates as it gives up its payload. Once the arms, which are made of this mixture, have dissolved, the core is small enough to pass to the intestine and out of the body

他们将药物折叠置于胶囊中以便吞下并运送到体内。当其到达胃部，胶囊迅速被消化，星型结构展开到足够大以避免被排到小肠，又不会阻碍食糜通过消化道。经过仔细实验，研究人员制成一种当伊维菌素消耗殆尽时可以自动分解的PCL伊维菌素混合物。一旦混合物制成的臂状结构溶解后，其小小的核就能通过肠道排出体外。

• gelatine：n.胶质

• alimentary canal：消化道

Laboratory tests suggested this arrangement would work, so the researchers tried it out on animals—specifically, a dozen Yorkshire pigs. These are a common breed, and the passages between their stomachs and their intestines are similar in size to those of people.

实验表明这一装置可行，所以研究人员决定进行动物实验并特别选定了约克郡猪。因为这种猪很常见，并且其胃肠通道与人的差不多大。

Using X-rays, they monitored the stars’ movements through the pigs’ guts. They also sampled the animals’ blood, to work out how much ivermectin was getting into it. As they had hoped, the stars were able to release mosquito-killing doses of ivermectin for up to two weeks. And, as intended, when their payloads were expended they collapsed and passed safely through the remainder of the digestive system without causing any obvious ill effects.

他们用X射线来监测星型结构在猪内脏里的运动轨迹。他们也采集了动物血液标本以检验伊维菌素在血液中的含量。正像他们所希望的那样，星型结构能够连续2周释放可以杀灭疟蚊剂量的伊维菌素。并且当药量耗尽后会自动分解，安全地通过余下的消化系统，还不会带来任何明显的副作用。

• collapse：v.倒塌；崩溃

灭了你这只不乖的疟蚊

Dr Langer and DrTraverso hope to start human trials next year. But they also wonder if they have come up with something that might be more widely deployed. Taking repeated doses of any drug to keep its level up is a faff. If the stars could be impregnated with other drugs, then things now requiring daily or more frequent doses might be delivered on a one-horse-pill-per-fortnight basis. That would almost certainly improve compliance.

Langer博士和drtraverso博士希望明年开始进行人体试验。但他们也在怀疑此药是否还有别的用途。期待您的翻译，您可以将翻译留言到文章底部，第二天会有详细解析哦。

• be impregnated with：充满

Which, if any, other drugs might be delivered in this way remains to be seen. But, even if the stars work only for ivermectin (assuming they do), they will still be a useful addition to the armoury being deployed against malaria. And that, alone, could save many lives a year.

不知是否别的药物也能用这种方式服用，如果有的话，让我们拭目以待吧。不过即使星型结构仅对伊维菌素适用的话（仅仅是假设），它们无疑将会成为对抗疟疾兵器库里的强有力武器。并且只此一项每年就可挽救无数人的生命。

翻译 ▍栏目二第五组

审核 ▍椰子

编辑 ▍澜意

若你想跟着M社一起练翻译，请点击M社邀请函~