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By Jesse Emspak: Subscribe to Jesse's RSS feed
August 25, 2010 3:45 PM EDT
Researchers at the U.S. Army Medical Research Institute of Infectious Diseases have found a class of drugs that could provide treatment for Ebola and Marburg hemorrhagic fever.
The new drugs are called "antisense" compounds, and they allow the immune system to attack the viruses before they can do enough damage to kill the patient. Travis Warren, research scientist at USAMRIID, said while the work is still preliminary -- the drugs have been tested only on primates -- the results are so far promising. In the case of Ebola, five of eight monkeys infected with the virus lived, and with Marburg, all survived.
The drugs were developed as part of a program to deal with possible bioterrorist threats, in partnership with AVI Biopharma.
Ebola and Marburg both operate by taking over the machinery of human cells. When a cell is infected, it starts producing more of the virus, and can do so for some time before it eventually dies.
Ebola kills because it makes cells release chemicals called cytokines, which cause inflammation and damage the lining of blood vessels. The proteins released by the virus also cause problems with blood clotting. All this leads to massive bleeding and organ failure. Marburg operates in similar fashion. Both diseases have very high mortality rates, between 60 and 90 percent.
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Neither is contagious by casual contact; the diseases spread through contact with body fluids such as blood or saliva. In areas where outbreaks occur transmission is between patients and caregivers in close contact. The first symptoms of Ebola take a few days and resemble the flu. After that there is muscle pain and bleeding, both internal and external. Most patients die within three weeks. There is no treatment, and survival is largely luck. "It's really a race between the virus and your immune system," Warren said.
The antisense drugs help the immune system win that race, by locking onto the virus' genetic material, which is just a single strand of ribonucleic acid, or RNA. The molecule fits into a certain part of the RNA and stops any other molecule from attaching in the same place. That includes the enzymes the virus uses to reproduce itself. With the virus slowed down, the immune system has time to fight and clear the virus from the body.
These drugs, Warren said, are given after exposure to the virus. They can also work after symptoms appear. Vaccines, by contrast, have to be administered before infection. For Ebola, what experimental vaccines there are must be used several months before infection.
Both Ebola and Marburg could be weaponized if used in an aerosol spread through the air, said Warren, which is one reason the focus was developing a post-exposure treatment.
Even without the threat of bioterrorism there are natural outbreaks that occur. In 2008 there was an outbreak of an Ebola strain in the Philippines. That strain didn't appear to be harmful to humans, but the next time people might not be so lucky.
Warren brought up the case of a Dutch woman who contracted Marburg on a trip to Africa in 2008. She returned home and died in the Netherlands. "She could have spread the disease to everyone on the plane," he said.
Before the drug can be distributed or sold it has to go through more tests to prove it is effective in animals, Warren said. Human trials would be unethical (as well as impractical) so that is enough for the Food and Drug Administration. It will probably be at least three years before it sees any use in people, he added.
The work on antisense drugs isn't limited to deadly viruses such as Ebola and Marburg. Others could be tackled as well, though the specific molecules would be different. "It's a useable idea for influenza," he said, noting that it would reduce the need for vaccines every year and offer a way to treat people once they are infected. Antisense drugs could also be a good solution for dengue and Lassa fever. "Even SARS could be targeted," Warren said.
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