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Kwon T. Utilizing non-human primate models to combat recent COVID-19/SARS-CoV-2 and viral infectious disease outbreaks. J Med Primatol 2024; 53:e12689. [PMID: 38084001 DOI: 10.1111/jmp.12689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 11/01/2023] [Accepted: 12/01/2023] [Indexed: 02/13/2024]
Abstract
In recent times, global viral outbreaks and diseases, such as COVID-19 (SARS-CoV-2), Zika (ZIKV), monkeypox (MPOX), Ebola (EBOV), and Marburg (MARV), have been extensively documented. Swiftly deciphering the mechanisms underlying disease pathogenesis and devising vaccines or therapeutic interventions to curtail these outbreaks stand as paramount imperatives. Amidst these endeavors, animal models emerge as pivotal tools. Among these models, non-human primates (NHPs) hold a position of particular importance. Their proximity in evolutionary lineage and physiological resemblances to humans render them a primary model for comprehending human viral infections. This review encapsulates the pivotal role of various NHP species-such as rhesus macaques (Macaca mulatta), cynomolgus macaques (Macaca fascicularis), african green monkeys (Chlorocebus sabaeus/aethiops), pigtailed macaques (Macaca nemestrina/Macaca leonina), baboons (Papio hamadryas/Papio anubis), and common marmosets (Callithrix jacchus)-in investigations pertaining to the abovementioned viral outbreaks. These NHP models play a pivotal role in illuminating key aspects of disease dynamics, facilitating the development of effective countermeasures, and contributing significantly to our overall understanding of viral pathogenesis.
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Affiliation(s)
- Taeho Kwon
- Primate Resources Center, Korea Research Institute of Bioscience and Biotechnology (KRIBB), Jeongeup-si, Jeonbuk, Korea
- Department of Functional Genomics, KRIBB School of Bioscience, Korea National University of Science and Technology (UST), Daejeon, Korea
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2
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Barker D, Han X, Wang E, Dagley A, Anderson DM, Jha A, Weaver SC, Julander J, Nykiforuk C, Kodihalli S. Equine Polyclonal Antibodies Prevent Acute Chikungunya Virus Infection in Mice. Viruses 2023; 15:1479. [PMID: 37515166 PMCID: PMC10384969 DOI: 10.3390/v15071479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 06/23/2023] [Accepted: 06/25/2023] [Indexed: 07/30/2023] Open
Abstract
Chikungunya virus (CHIKV) is a mosquito-transmitted pathogen that causes chikungunya disease (CHIK); the disease is characterized by fever, muscle ache, rash, and arthralgia. This arthralgia can be debilitating and long-lasting, seriously impacting quality of life for years. Currently, there is no specific therapy available for CHIKV infection. We have developed a despeciated equine polyclonal antibody (CHIKV-EIG) treatment against CHIKV and evaluated its protective efficacy in mouse models of CHIKV infection. In immunocompromised (IFNAR-/-) mice infected with CHIKV, daily treatment for five consecutive days with CHIKV-EIG administered at 100 mg/kg starting on the day of infection prevented mortality, reduced viremia, and improved clinical condition as measured by body weight loss. These beneficial effects were seen even when treatment was delayed to 1 day after infection. In immunocompetent mice, CHIKV-EIG treatment reduced virus induced arthritis (including footpad swelling), arthralgia-associated cytokines, viremia, and tissue virus loads in a dose-dependent fashion. Collectively, these results suggest that CHIKV-EIG is effective at preventing CHIK and could be a viable candidate for further development as a treatment for human disease.
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Affiliation(s)
- Douglas Barker
- Emergent BioSolutions Canada Inc., Winnipeg, MB R3T 5Y3, Canada
| | - Xiaobing Han
- Emergent BioSolutions Canada Inc., Winnipeg, MB R3T 5Y3, Canada
| | - Eryu Wang
- Institute for Human Infections and Immunity, Department of Microbiology and Immunology, University of Texas Medical Branch Galveston, Galveston, TX 77555, USA
| | - Ashley Dagley
- Institute for Antiviral Research, Utah State University, Logan, UT 84322, USA
| | | | - Aruni Jha
- Emergent BioSolutions Canada Inc., Winnipeg, MB R3T 5Y3, Canada
| | - Scott C Weaver
- Institute for Human Infections and Immunity, Department of Microbiology and Immunology, University of Texas Medical Branch Galveston, Galveston, TX 77555, USA
| | - Justin Julander
- Institute for Antiviral Research, Utah State University, Logan, UT 84322, USA
| | - Cory Nykiforuk
- Emergent BioSolutions Canada Inc., Winnipeg, MB R3T 5Y3, Canada
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3
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History and impact of the mouse-adapted Ebola virus model. Antiviral Res 2023; 210:105493. [PMID: 36567023 DOI: 10.1016/j.antiviral.2022.105493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 12/09/2022] [Accepted: 12/12/2022] [Indexed: 12/24/2022]
Abstract
Ebola virus (EBOV) is a member of the filoviridae family, which are comprised of negative sense, enveloped RNA hemorrhagic fever viruses that can cause severe disease and high lethality rates. These viruses require BSL-4 containment laboratories for study. Early studies of EBOV pathogenesis relied heavily on the use of nonhuman primates, which are expensive and cumbersome to handle in large numbers. Guinea pig models were also developed, but even to this day limited reagents are available in this model. In 1998, Mike Bray and colleagues developed a mouse-adapted EBOV (maEBOV) that caused lethality in adult immunocompetent mice. This model had significant advantages, including being inexpensive, allowing for higher animal numbers for statistical analysis, availability of reagents for studying pathogenesis, and availability of a vast array of genetically modified strains. The model has been used to test vaccines, therapeutic drugs, EBOV mutants, and pathogenesis, and its importance is demonstrated by the hundreds of citations referencing the original publication. This review will cover the history of the maEBOV model and its use in filovirus research.
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Bradfute SB. The discovery and development of novel treatment strategies for filoviruses. Expert Opin Drug Discov 2021; 17:139-149. [PMID: 34962451 DOI: 10.1080/17460441.2022.2013800] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
INTRODUCTION Filoviruses are negative-stranded, enveloped RNA viruses that can cause hemorrhagic fever in humans and include Ebola and Marburg viruses. Lethality rates can reach 90% in isolated outbreaks. The 2013-2016 Ebola virus epidemic demonstrated the global threat of filoviruses and hastened development of vaccines and therapeutics. There are six known filoviruses that cause disease in humans, but still few therapeutics are available for treatment. AREAS COVERED This review summarizes identification, testing, and development of therapeutics based on the peer-reviewed scientific literature beginning with the discovery of filoviruses in 1967. Small molecules, antibodies, cytokines, antisense, post-exposure vaccination, and host-targeted therapeutic approaches are discussed. An emphasis is placed on therapeutics that have shown promise in in vivo studies. EXPERT OPINION Two monoclonal antibody regimens are approved for use in humans for one filovirus (Ebola virus), and preclinical nonhuman primate studies suggest that other monoclonal-based therapies are likely to be effective against other filoviruses. Significant progress has been made in small-molecule antivirals and host-targeted approaches. An important consideration is the necessity of pan-filovirus therapeutics via broadly effective small molecules, antibody cocktails, and cross-reactive antibodies. The use of filovirus therapeutics as prophylactic treatment or in chronically infected individuals should be considered.
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Affiliation(s)
- Steven B Bradfute
- Center for Global Health, Department of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, USA
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5
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Hansen F, Feldmann H, Jarvis MA. Targeting Ebola virus replication through pharmaceutical intervention. Expert Opin Investig Drugs 2021; 30:201-226. [PMID: 33593215 DOI: 10.1080/13543784.2021.1881061] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Introduction. The consistent emergence/reemergence of filoviruses into a world that previously lacked an approved pharmaceutical intervention parallels an experience repeatedly played-out for most other emerging pathogenic zoonotic viruses. Investment to preemptively develop effective and low-cost prophylactic and therapeutic interventions against viruses that have high potential for emergence and societal impact should be a priority.Areas covered. Candidate drugs can be characterized into those that interfere with cellular processes required for Ebola virus (EBOV) replication (host-directed), and those that directly target virally encoded functions (direct-acting). We discuss strategies to identify pharmaceutical interventions for EBOV infections. PubMed/Web of Science databases were searched to establish a detailed catalog of these interventions.Expert opinion. Many drug candidates show promising in vitro inhibitory activity, but experience with EBOV shows the general lack of translation to in vivo efficacy for host-directed repurposed drugs. Better translation is seen for direct-acting antivirals, in particular monoclonal antibodies. The FDA-approved monoclonal antibody treatment, Inmazeb™ is a success story that could be improved in terms of impact on EBOV-associated disease and mortality, possibly by combination with other direct-acting agents targeting distinct aspects of the viral replication cycle. Costs need to be addressed given EBOV emergence primarily in under-resourced countries.
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Affiliation(s)
- Frederick Hansen
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT, USA
| | - Heinz Feldmann
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT, USA
| | - Michael A Jarvis
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT, USA.,School of Biomedical Sciences, University of Plymouth, Plymouth, Devon, UK.,The Vaccine Group, Ltd, Plymouth, Devon, UK
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6
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O'Donnell KL, Marzi A. Immunotherapeutics for Ebola Virus Disease: Hope on the Horizon. Biologics 2021; 15:79-86. [PMID: 33776420 PMCID: PMC7987275 DOI: 10.2147/btt.s259069] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 03/04/2021] [Indexed: 11/23/2022]
Abstract
Ebola virus disease (EVD) remains among the biggest public health threats in Africa, even though recently a vaccine was approved for human use. However, in outbreak situations treatment strategies are needed in combination with vaccination campaigns to impact and stop the spread of the disease. Here, we discuss the development of the immunotherapeutics against EDV both targeting the virus itself and bolstering the immunological environment of the host at both the pre-clinical and clinical level. The early development of antibody therapy in preclinical settings and the early pitfalls in the implementation of this therapeutic strategy are discussed. We also consider the advancement of the production, modulation, and specificity of the antibody treatment that garnered increased success in preclinical studies to the point that it was warranted to test them in a clinical setting. Initial clinical trials in an outbreak scenario proved difficult to definitively confirm the efficacy of the implemented treatment. Upon further modification and with the experiences from the challenging outbreak conditions in mind, the PALM clinical trial demonstrated efficacy of an antibody cocktail which recently received approval for human use.
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Affiliation(s)
- Kyle L O'Donnell
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT, USA
| | - Andrea Marzi
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, MT, USA
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7
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Misasi J, Sullivan NJ. Immunotherapeutic strategies to target vulnerabilities in the Ebolavirus glycoprotein. Immunity 2021; 54:412-436. [PMID: 33691133 DOI: 10.1016/j.immuni.2021.01.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 01/15/2021] [Accepted: 01/20/2021] [Indexed: 12/18/2022]
Abstract
The 2014 Ebola virus disease (EVD) outbreak in West Africa and the subsequent outbreaks of 2018-2020 in Equator and North Kivu provinces of the Democratic Republic of the Congo illustrate the public health challenges of emerging and reemerging viruses. EVD has a high case fatality rate with a rapidly progressing syndrome of fever, rash, vomiting, diarrhea, and bleeding diathesis. Recently, two monoclonal-antibody-based therapies received United States Food and Drug Administration (FDA) approval, and there are several other passive immunotherapies that hold promise as therapeutics against other species of Ebolavirus. Here, we review concepts needed to understand mechanisms of action, present an expanded schema to define additional sites of vulnerability on the viral glycoprotein, and review current antibody-based therapeutics. The concepts described are used to gain insights into the key characteristics that represent functional targets for immunotherapies against Zaire Ebolavirus and other emerging viruses within the Ebolavirus genus.
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Affiliation(s)
- John Misasi
- National Institutes of Health, National Institute of Allergy and Infectious Diseases, Vaccine Research Center, 40 Convent Drive, Bethesda, MD 20892, USA
| | - Nancy J Sullivan
- National Institutes of Health, National Institute of Allergy and Infectious Diseases, Vaccine Research Center, 40 Convent Drive, Bethesda, MD 20892, USA.
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8
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Kuzmina NA, Younan P, Gilchuk P, Santos RI, Flyak AI, Ilinykh PA, Huang K, Lubaki NM, Ramanathan P, Crowe JE, Bukreyev A. Antibody-Dependent Enhancement of Ebola Virus Infection by Human Antibodies Isolated from Survivors. Cell Rep 2019; 24:1802-1815.e5. [PMID: 30110637 DOI: 10.1016/j.celrep.2018.07.035] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Revised: 06/12/2018] [Accepted: 07/10/2018] [Indexed: 12/20/2022] Open
Abstract
Some monoclonal antibodies (mAbs) recovered from survivors of filovirus infections can protect against infection. It is currently unknown whether natural infection also induces some antibodies with the capacity for antibody-dependent enhancement (ADE). A panel of mAbs obtained from human survivors of filovirus infection caused by Ebola, Bundibugyo, or Marburg viruses was evaluated for their ability to facilitate ADE. ADE was observed readily with all mAbs examined at sub-neutralizing concentrations, and this effect was not restricted to mAbs with a particular epitope specificity, neutralizing capacity, or subclass. Blocking of specific Fcγ receptors reduced but did not abolish ADE that was associated with high-affinity binding antibodies, suggesting that lower-affinity interactions still cause ADE. Mutations of Fc fragments of an mAb that altered its interaction with Fc receptors rendered the antibody partially protective in vivo at a low dose, suggesting that ADE counteracts antibody-mediated protection and facilitates dissemination of filovirus infections.
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Affiliation(s)
- Natalia A Kuzmina
- Department of Pathology, University of Texas Medical Branch, Galveston, TX 77555, USA; Galveston National Laboratory, Galveston, TX 77550, USA
| | - Patrick Younan
- Department of Pathology, University of Texas Medical Branch, Galveston, TX 77555, USA; Galveston National Laboratory, Galveston, TX 77550, USA
| | - Pavlo Gilchuk
- Vanderbilt Vaccine Center, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Rodrigo I Santos
- Department of Pathology, University of Texas Medical Branch, Galveston, TX 77555, USA; Galveston National Laboratory, Galveston, TX 77550, USA
| | - Andrew I Flyak
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University, Nashville, TN 37232, USA
| | - Philipp A Ilinykh
- Department of Pathology, University of Texas Medical Branch, Galveston, TX 77555, USA; Galveston National Laboratory, Galveston, TX 77550, USA
| | - Kai Huang
- Department of Pathology, University of Texas Medical Branch, Galveston, TX 77555, USA; Galveston National Laboratory, Galveston, TX 77550, USA
| | - Ndongala M Lubaki
- Department of Pathology, University of Texas Medical Branch, Galveston, TX 77555, USA; Galveston National Laboratory, Galveston, TX 77550, USA
| | - Palaniappan Ramanathan
- Department of Pathology, University of Texas Medical Branch, Galveston, TX 77555, USA; Galveston National Laboratory, Galveston, TX 77550, USA
| | - James E Crowe
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University, Nashville, TN 37232, USA; Vanderbilt Vaccine Center, Vanderbilt University Medical Center, Nashville, TN 37232, USA; Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN 37232, USA.
| | - Alexander Bukreyev
- Department of Pathology, University of Texas Medical Branch, Galveston, TX 77555, USA; Galveston National Laboratory, Galveston, TX 77550, USA; Department of Microbiology & Immunology, University of Texas Medical Branch, Galveston, TX 77555, USA.
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9
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Smatti MK, Al Thani AA, Yassine HM. Viral-Induced Enhanced Disease Illness. Front Microbiol 2018; 9:2991. [PMID: 30568643 PMCID: PMC6290032 DOI: 10.3389/fmicb.2018.02991] [Citation(s) in RCA: 91] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Accepted: 11/19/2018] [Indexed: 12/24/2022] Open
Abstract
Understanding immune responses to viral infections is crucial to progress in the quest for effective infection prevention and control. The host immunity involves various mechanisms to combat viral infections. Under certain circumstances, a viral infection or vaccination may result in a subverted immune system, which may lead to an exacerbated illness. Clinical evidence of enhanced illness by preexisting antibodies from vaccination, infection or maternal passive immunity is available for several viruses and is presumptively proposed for other viruses. Multiple mechanisms have been proposed to explain this phenomenon. It has been confirmed that certain infection- and/or vaccine-induced immunity could exacerbate viral infectivity in Fc receptor- or complement bearing cells- mediated mechanisms. Considering that antibody dependent enhancement (ADE) is a major obstacle in vaccine development, there are continues efforts to understand the underlying mechanisms through identification of the epitopes and antibodies responsible for disease enhancement or protection. This review discusses the recent findings on virally induced ADE, and highlights the potential mechanisms leading to this condition.
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Affiliation(s)
- Maria K Smatti
- Biomedical Research Center, Qatar University, Doha, Qatar
| | | | - Hadi M Yassine
- Biomedical Research Center, Qatar University, Doha, Qatar
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10
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Supramaniam A, Lui H, Bellette BM, Rudd PA, Herrero LJ. How myeloid cells contribute to the pathogenesis of prominent emerging zoonotic diseases. J Gen Virol 2018; 99:953-969. [DOI: 10.1099/jgv.0.001024] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Affiliation(s)
- Aroon Supramaniam
- 1Institute for Glycomics, Griffith University, Gold Coast Campus, Southport, QLD, Australia
| | - Hayman Lui
- 2School of Medicine, Griffith University, Gold Coast Campus, Southport, QLD, Australia
| | | | - Penny A. Rudd
- 1Institute for Glycomics, Griffith University, Gold Coast Campus, Southport, QLD, Australia
| | - Lara J. Herrero
- 1Institute for Glycomics, Griffith University, Gold Coast Campus, Southport, QLD, Australia
- 2School of Medicine, Griffith University, Gold Coast Campus, Southport, QLD, Australia
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Bodine EN, Cook C, Shorten M. The potential impact of a prophylactic vaccine for Ebola in Sierra Leone. MATHEMATICAL BIOSCIENCES AND ENGINEERING : MBE 2018; 15:337-359. [PMID: 29161839 DOI: 10.3934/mbe.2018015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The 2014 outbreak of Ebola virus disease (EVD) in West Africa was multinational and of an unprecedented scale primarily affecting the countries of Guinea, Liberia, and Sierra Leone. One of the qualities that makes EVD of high public concern is its potential for extremely high mortality rates (up to 90%). A prophylactic vaccine for ebolavirus (rVSV-ZEBOV) has been developed, and clinical trials show near-perfect efficacy. We have developed an ordinary differential equations model that simulates an EVD epidemic and takes into account (1) transmission through contact with infectious EVD individuals and deceased EVD bodies, (2) the heterogeneity of the risk of becoming infected with EVD, and (3) the increased survival rate of infected EVD patients due to greater access to trained healthcare providers. Using fitted parameter values that closely simulate the dynamics of the 2014 outbreak in Sierra Leone, we utilize our model to predict the potential impact of a prophylactic vaccine for the ebolavirus using various vaccination strategies including ring vaccination. Our results show that an rVSV-ZEBOV vaccination coverage as low as 40% in the general population and 95% in healthcare workers will prevent another catastrophic outbreak like the 2014 outbreak from occurring.
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Affiliation(s)
- Erin N Bodine
- Rhodes College, Department of Mathematics and Computer Science, 2000 N. Parkway, Memphis, TN 38112, United States
| | - Connor Cook
- Rhodes College, Department of Mathematics and Computer Science, 2000 N. Parkway, Memphis, TN 38112, United States
| | - Mikayla Shorten
- Rhodes College, Department of Mathematics and Computer Science, 2000 N. Parkway, Memphis, TN 38112, United States
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13
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Glennon EE, Restif O, Sbarbaro SR, Garnier R, Cunningham AA, Suu-Ire RD, Osei-Amponsah R, Wood JLN, Peel AJ. Domesticated animals as hosts of henipaviruses and filoviruses: A systematic review. Vet J 2017; 233:25-34. [PMID: 29486875 DOI: 10.1016/j.tvjl.2017.12.024] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Revised: 08/24/2017] [Accepted: 12/29/2017] [Indexed: 01/10/2023]
Abstract
Bat-borne viruses carry undeniable risks to the health of human beings and animals, and there is growing recognition of the need for a 'One Health' approach to understand their frequently complex spill-over routes. While domesticated animals can play central roles in major spill-over events of zoonotic bat-borne viruses, for example during the pig-amplified Malaysian Nipah virus outbreak of 1998-1999, the extent of their potential to act as bridging or amplifying species for these viruses has not been characterised systematically. This review aims to compile current knowledge on the role of domesticated animals as hosts of two types of bat-borne viruses, henipaviruses and filoviruses. A systematic literature search of these virus-host interactions in domesticated animals identified 72 relevant studies, which were categorised by year, location, design and type of evidence generated. The review then focusses on Africa as a case study, comparing research efforts in domesticated animals and bats with the distributions of documented human cases. Major gaps remain in our knowledge of the potential ability of domesticated animals to contract or spread these zoonoses. Closing these gaps will be necessary to fully evaluate and mitigate spill-over risks of these viruses, especially with global agricultural intensification.
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Affiliation(s)
- Emma E Glennon
- Department of Veterinary Medicine, University of Cambridge, Cambridge, UK.
| | - Olivier Restif
- Department of Veterinary Medicine, University of Cambridge, Cambridge, UK
| | | | - Romain Garnier
- Department of Veterinary Medicine, University of Cambridge, Cambridge, UK
| | - Andrew A Cunningham
- Institute of Zoology, Zoological Society of London, Regent's Park, London, UK
| | | | | | - James L N Wood
- Department of Veterinary Medicine, University of Cambridge, Cambridge, UK
| | - Alison J Peel
- Environmental Futures Research Institute, Griffith University, Nathan, Australia
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14
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Ebola virus disease: an update on post-exposure prophylaxis. THE LANCET. INFECTIOUS DISEASES 2017; 18:e183-e192. [PMID: 29153266 DOI: 10.1016/s1473-3099(17)30677-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 09/20/2017] [Accepted: 10/03/2017] [Indexed: 12/11/2022]
Abstract
The massive outbreak of Ebola virus disease in west Africa between 2013 and 2016 resulted in intense efforts to evaluate the efficacy of several specific countermeasures developed through years of preclinical work, including the first clinical trials for therapeutics and vaccines. In this Review, we discuss how the experience and data generated from that outbreak have helped to advance the understanding of the use of these countermeasures for post-exposure prophylaxis against Ebola virus infection. In future outbreaks, post-exposure prophylaxis could play an important part in reducing community transmission of Ebola virus by providing more immediate protection than does immunisation as well as providing additional protection for health-care workers who are inadvertently exposed over the course of their work. We propose provisional guidance for use of post-exposure prophylaxis in Ebola virus disease and identify the priorities for future preparedness and further research.
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15
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Shuai L, Wang X, Wen Z, Ge J, Wang J, Zhao D, Bu Z. Genetically modified rabies virus-vectored Ebola virus disease vaccines are safe and induce efficacious immune responses in mice and dogs. Antiviral Res 2017; 146:36-44. [DOI: 10.1016/j.antiviral.2017.08.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Revised: 08/09/2017] [Accepted: 08/16/2017] [Indexed: 10/19/2022]
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16
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Recent advances in vaccine development against Ebola threat as bioweapon. Virusdisease 2017; 28:242-246. [PMID: 29291209 DOI: 10.1007/s13337-017-0398-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Accepted: 08/29/2017] [Indexed: 12/19/2022] Open
Abstract
With the increasing rate of Ebola virus appearance, with multiple natural outbreaks of Ebola hemorrhagic fever, it is worthy of consideration as bioweapon by anti-national groups. Further, with the non-availability of the vaccines against Ebola virus, concerns about the public health emerge. In this regard, this review summarizes the structure, genetics and potential of Ebola virus to be used as a bioweapon. We highlight the recent advances in the treatment strategies and vaccine development against Ebola virus. The understanding of these aspects might lead to effective treatment practices which can be applied during the future outbreaks of Ebola.
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17
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Chen T, Li D, Song Y, Yang X, Liu Q, Jin X, Zhou D, Huang Z. A heterologous prime-boost Ebola virus vaccine regimen induces durable neutralizing antibody response and prevents Ebola virus-like particle entry in mice. Antiviral Res 2017; 145:54-59. [PMID: 28733113 DOI: 10.1016/j.antiviral.2017.07.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Revised: 07/06/2017] [Accepted: 07/13/2017] [Indexed: 11/29/2022]
Abstract
Ebola virus (EBOV) is one of the most virulent pathogens known to humans. Neutralizing antibodies play a major role in the protection against EBOV infections. Thus, an EBOV vaccine capable of inducing a long-lasting neutralizing antibody response is highly desirable. We report here that a heterologous prime-boost vaccine regimen can elicit durable EBOV-neutralizing antibody response in mice. A chimpanzee serotype 7 adenovirus expressing EBOV GP (denoted AdC7-GP) was generated and used for priming. A truncated version of EBOV GP1 protein (denoted GP1t) was produced at high levels in Drosophila S2 cells and used for boosting. Mouse immunization studies showed that the AdC7-GP prime/GP1t boost vaccine regimen was more potent in eliciting neutralizing antibodies than either the AdC7-GP or GP1t alone. Neutralizing antibodies induced by the heterologous prime-boost regimen sustained at high titers for at least 18 weeks after immunization. Significantly, in vivo challenge studies revealed that the entry of reporter EBOV-like particles was efficiently blocked in mice receiving the heterologous prime-boost regimen even at 18 weeks after the final dose of immunization. These results suggest that this novel AdC7-GP prime/GP1t boost regimen represents an EBOV vaccine approach capable of establishing long-term protection, and therefore warrants further development.
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Affiliation(s)
- Tan Chen
- Vaccinology Division, CAS Key Laboratory of Molecular Virology & Immunology, Institut Pasteur of Shanghai, Chinese Academy of Sciences, Shanghai 200031, China
| | - Dapeng Li
- Vaccinology Division, CAS Key Laboratory of Molecular Virology & Immunology, Institut Pasteur of Shanghai, Chinese Academy of Sciences, Shanghai 200031, China
| | - Yufeng Song
- Vaccinology Division, CAS Key Laboratory of Molecular Virology & Immunology, Institut Pasteur of Shanghai, Chinese Academy of Sciences, Shanghai 200031, China
| | - Xi Yang
- Vaccinology Division, CAS Key Laboratory of Molecular Virology & Immunology, Institut Pasteur of Shanghai, Chinese Academy of Sciences, Shanghai 200031, China
| | - Qingwei Liu
- Vaccinology Division, CAS Key Laboratory of Molecular Virology & Immunology, Institut Pasteur of Shanghai, Chinese Academy of Sciences, Shanghai 200031, China
| | - Xia Jin
- Vaccinology Division, CAS Key Laboratory of Molecular Virology & Immunology, Institut Pasteur of Shanghai, Chinese Academy of Sciences, Shanghai 200031, China
| | - Dongming Zhou
- Vaccinology Division, CAS Key Laboratory of Molecular Virology & Immunology, Institut Pasteur of Shanghai, Chinese Academy of Sciences, Shanghai 200031, China.
| | - Zhong Huang
- Vaccinology Division, CAS Key Laboratory of Molecular Virology & Immunology, Institut Pasteur of Shanghai, Chinese Academy of Sciences, Shanghai 200031, China.
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More S, Bøtner A, Butterworth A, Calistri P, Depner K, Edwards S, Garin‐Bastuji B, Good M, Gortázar Schmidt C, Michel V, Miranda MA, Nielsen SS, Raj M, Sihvonen L, Spoolder H, Stegeman JA, Thulke H, Velarde A, Willeberg P, Winckler C, Baldinelli F, Broglia A, Beltrán Beck B, Kohnle L, Morgado J, Bicout D. Assessment of listing and categorisation of animal diseases within the framework of the Animal Health Law (Regulation (EU) No 2016/429): Ebola virus disease. EFSA J 2017; 15:e04890. [PMID: 32625555 PMCID: PMC7009972 DOI: 10.2903/j.efsa.2017.4890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Ebola virus disease has been assessed according to the criteria of the Animal Health Law (AHL), in particular criteria of Article 7 on disease profile and impacts, Article 5 on the eligibility of Ebola virus disease to be listed, Article 9 for the categorisation of Ebola virus disease according to disease prevention and control rules as in Annex IV and Article 8 on the list of animal species related to Ebola virus disease. The assessment has been performed following a methodology composed of information collection and compilation, expert judgement on each criterion at individual and, if no consensus was reached before, also at collective level. The output is composed of the categorical answer, and for the questions where no consensus was reached, the different supporting views are reported. Details on the methodology used for this assessment are explained in a separate opinion. According to the assessment performed, Ebola virus disease can be considered eligible to be listed for Union intervention as laid down in Article 5(3) of the AHL. The disease would comply with the criteria as in Sections 4 and 5 of Annex IV of the AHL, for the application of the disease prevention and control rules referred to in points (d) and (e) of Article 9(1). The animal species to be listed for Ebola virus disease according to Article 8(3) criteria are some species of non‐human primates, pigs and rodents as susceptible species and some species of fruit bats as reservoir, as indicated in the present opinion.
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Bozzo J, Jorquera JI. Use of human immunoglobulins as an anti-infective treatment: the experience so far and their possible re-emerging role. Expert Rev Anti Infect Ther 2017; 15:585-604. [PMID: 28480779 DOI: 10.1080/14787210.2017.1328278] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Pooled human immunoglobulins (IGs) are prepared from plasma obtained from healthy donors as a concentrated antibody-containing solution. In addition, high-titer IGs (hyperimmune) against a specific pathogen can be obtained from vaccinated or convalescing donors. Currently, IGs can be used for the treatment of a variety of infections for which no specific therapy exists or that remain difficult to treat. Moreover, the recent pathogen outbreaks for which there is no approved treatment have renewed attention to the role of convalescent plasma and IGs. Areas covered: In this review, a historical perspective of the use of sera and IGs in humans as anti-infective agents (any viral, bacterial, parasitic infection), excluding immunodeficient patients, is presented from early development to the latest clinical studies. A Medline search was conducted to examine the peer-reviewed literature, with no date limits. Expert commentary: Human pooled plasma-derived IG products benefit from the polyclonal response of every individual donor and from the interindividual variability in such response. The trend to increased availability of vaccines for infectious diseases also opens new potential applications of hyperimmune IGs for emerging or re-emerging infectious diseases (e.g.: Ebola, Zika, Dengue), for the prevention and treatment in the general population, healthcare personnel and caregivers.
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Affiliation(s)
- Jordi Bozzo
- a Global Scientific & Medical Affairs , Grifols , Barcelona , Spain
| | - Juan I Jorquera
- b Bioscience Industrial Group, Research & Development , Grifols , Barcelona , Spain
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Pyankov OV, Setoh YX, Bodnev SA, Edmonds JH, Pyankova OG, Pyankov SA, Pali G, Belford S, Lu L, La M, Lovrecz G, Volchkova VA, Chappell KJ, Watterson D, Marsh G, Young PR, Agafonov AA, Farmer JF, Volchkov VE, Suhrbier A, Khromykh AA. Successful post-exposure prophylaxis of Ebola infected non-human primates using Ebola glycoprotein-specific equine IgG. Sci Rep 2017; 7:41537. [PMID: 28155869 PMCID: PMC5290740 DOI: 10.1038/srep41537] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Accepted: 12/19/2016] [Indexed: 12/31/2022] Open
Abstract
Herein we describe production of purified equine IgG obtained from horses immunized with plasmid DNA followed by boosting with Kunjin replicon virus-like particles both encoding a modified Ebola glycoprotein. Administration of the equine IgG over 5 days to cynomolgus macaques infected 24 hours previously with a lethal dose of Ebola virus suppressed viral loads by more than 5 logs and protected animals from mortality. Animals generated their own Ebola glycoprotein-specific IgG responses 9-15 days after infection, with circulating virus undetectable by day 15-17. Such equine IgG may find utility as a post-exposure prophylactic for Ebola infection and provides a low cost, scalable alternative to monoclonal antibodies, with extensive human safety data and WHO-standardized international manufacturing capability available in both high and low income countries.
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Affiliation(s)
- Oleg V. Pyankov
- State Center for Virology and Biotechnology Vector, Koltsovo, Russian Federation
| | - Yin Xiang Setoh
- Australian Infectious Diseases Research Centre, School of Chemistry and Molecular Biosciences, University of Queensland, St Lucia, Brisbane, QLD, Australia
| | - Sergey A. Bodnev
- State Center for Virology and Biotechnology Vector, Koltsovo, Russian Federation
| | - Judith H. Edmonds
- Australian Infectious Diseases Research Centre, School of Chemistry and Molecular Biosciences, University of Queensland, St Lucia, Brisbane, QLD, Australia
| | - Olga G. Pyankova
- State Center for Virology and Biotechnology Vector, Koltsovo, Russian Federation
| | - Stepan A. Pyankov
- State Center for Virology and Biotechnology Vector, Koltsovo, Russian Federation
| | - Gabor Pali
- Australian Infectious Diseases Research Centre, School of Chemistry and Molecular Biosciences, University of Queensland, St Lucia, Brisbane, QLD, Australia
| | | | - Louis Lu
- Bio Medical Manufacturing, Fermentation and Protein Production Facility, CSIRO, Clayton, VIC, Australia
| | - Mylinh La
- Bio Medical Manufacturing, Fermentation and Protein Production Facility, CSIRO, Clayton, VIC, Australia
| | - George Lovrecz
- Bio Medical Manufacturing, Fermentation and Protein Production Facility, CSIRO, Clayton, VIC, Australia
| | - Valentina A. Volchkova
- Molecular Basis of Viral Pathogenicity, CIRI, INSERM, U1111-CNRS UMR5308, Université de Lyon, Université Claude Bernard Lyon 1, Ecole Normale Supérieure de Lyon, France
| | - Keith J. Chappell
- Australian Infectious Diseases Research Centre, School of Chemistry and Molecular Biosciences, University of Queensland, St Lucia, Brisbane, QLD, Australia
| | - Daniel Watterson
- Australian Infectious Diseases Research Centre, School of Chemistry and Molecular Biosciences, University of Queensland, St Lucia, Brisbane, QLD, Australia
| | - Glenn Marsh
- Australian Animal Health Laboratory, CSIRO Health and Biosecurity, Geelong, VIC, Australia
| | - Paul R. Young
- Australian Infectious Diseases Research Centre, School of Chemistry and Molecular Biosciences, University of Queensland, St Lucia, Brisbane, QLD, Australia
| | | | | | - Victor E. Volchkov
- Molecular Basis of Viral Pathogenicity, CIRI, INSERM, U1111-CNRS UMR5308, Université de Lyon, Université Claude Bernard Lyon 1, Ecole Normale Supérieure de Lyon, France
| | - Andreas Suhrbier
- QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Alexander A. Khromykh
- Australian Infectious Diseases Research Centre, School of Chemistry and Molecular Biosciences, University of Queensland, St Lucia, Brisbane, QLD, Australia
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21
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Green RJ. Emerging Zoonotic and Vector-Borne Viral Diseases. VIRAL INFECTIONS IN CHILDREN, VOLUME I 2017. [PMCID: PMC7114986 DOI: 10.1007/978-3-319-54033-7_5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Many vector-borne and zoonotic diseases are considered to be emerging; since they are either newly reported to cause human disease, or are causing disease in geographical locations or species not previously documented. In the past 15 years, significant outbreaks of Severe Acute Respiratory Syndrome (or SARS) and Middle Eastern Respiratory Syndrome (or MERS), Nipah and Hendra, Ebola virus disease and Zika fever and others have been reported. In this chapter the clinical characteristics, epidemiological aspects, treatment and prevention and information related to the laboratory investigation of important zoonotic and vector-borne diseases that have emerged in the past 10 years, and how this affects children, will be discussed. Furthermore rabies, considered a neglected viral disease with the majority of victims in Africa being children, will also be addressed.
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Affiliation(s)
- Robin J. Green
- Department of Paediatrics and Child Health, University of Pretoria, School of Medicine, Pretoria, ZA, South Africa
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22
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Abstract
Ebola virus disease (EVD) in humans is associated with four ebolaviruses: Ebola virus (EBOV), Sudan virus (SUDV), Bundibugyo virus (BDBV), and Taï Forest virus. To date, no documented cases of human disease have been associated with Reston virus. Here, we describe the nonhuman primate (NHP) models that currently serve as gold standards for testing ebolavirus vaccines and therapeutic agents and elucidating underlying mechanisms of pathogenesis. Although multiple models have been explored over the past 50 years, the predominance of published work has been performed in macaque models. This chapter will focus on the most commonly used models.
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23
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Connor J, Kobinger G, Olinger G. Therapeutics Against Filovirus Infection. Curr Top Microbiol Immunol 2017; 411:263-290. [PMID: 28653190 DOI: 10.1007/82_2017_12] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Therapies for filovirus infections are urgently needed. The paradoxical issue facing therapies is the need for rigorous safety and efficacy testing, adhering to the principle tenant of medicine to do no harm, while responding to the extreme for a treatment option during an outbreak. Supportive care remains a primary goal for infected patients. Years of research into filoviruses has provided possible medical interventions ranging from direct antivirals, host-factor supportive approaches, and passive immunity. As more basic research is directed toward understanding these pathogens and their impact on the host, effective approaches to treat patients during infection will be identified. The ability to manage outbreaks with medical interventions beyond supportive care will require clinical trial design that will balance the benefits of the patient and scientific community.
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Affiliation(s)
- John Connor
- Department of Microbiology, National Emerging Infectious Diseases Laboratories, Boston University School of Medicine, 620 Albany Street, Boston, MA, 02118, USA.
| | - Gary Kobinger
- Department of Microbiology, Immunology and Infectious Diseases, Faculty of Medicine, Universite Laval, 2705 Boulevard Laurier, RC-709, Ville de Québec, QC G1V 4G2, Canada
| | - Gene Olinger
- Department of Medicine, National Emerging Infectious Diseases Laboratories, Boston University School of Medicine, 620 Albaney Street, Boston, MA, 02118, USA
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Jin X, Zhang W, Ding Z, Wang H, Wu D, Xie X, Lin T, Fu Y, Zhang N, Cao Y. Efficacy of the Rabbit Polyclonal Anti-leptospira Antibody against Homotype or Heterotype Leptospira Infection in Hamster. PLoS Negl Trop Dis 2016; 10:e0005191. [PMID: 28027297 PMCID: PMC5189943 DOI: 10.1371/journal.pntd.0005191] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Accepted: 11/17/2016] [Indexed: 01/09/2023] Open
Abstract
Leptospirosis, caused by Leptospira, is one of the most important of neglected emerging zoonotic diseases that has important impacts on public health worldwide. Polyclonal antibody (pcAb) therapy is a potential method to process a series of pathogens for which there are limited determination of treatment, such as leptospirosis. First, we evaluated the efficacy of pcAb, derived from the sera of rabbits inoculated with Leptospira, against homotype (Leptospira interrogans serovar Lai) or heterotype (Leptospira interrogans serovar Autumnalis) Leptospira infection in a lethal hamster model. The pcAb treatment improved survival compared to the controls. The histopathology's of the infected kidney, liver and lung were also examined by hematoxylin and eosin staining. Using real-time quantitative PCR, we determined that most of the leptospires in the primary organs were almost completely removed by pcAb. In the second experiment, treatments, including antibiotic, pcAb, and combination, were started immediately after occurrence of the first serious sickness mouse in any group. No significant difference in survival rate between pcAb group and antibiotic group was found, but the combination therapy group significantly improved survival rate compared to the others (P<0.05). We conclude that the rabbit pcAb treatment may cure both the homotype and the heterotype lethal Leptospira infections in hamster, and combination therapy improved survival compared to antibiotic group in the late treatment of homotype leptospirosis.
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Affiliation(s)
- Xuemin Jin
- Department of Clinical Science, College of Veterinary Medicine, Jilin University, Changchun, People's Republic of China, China
| | - Wenlong Zhang
- Department of Clinical Science, College of Veterinary Medicine, Jilin University, Changchun, People's Republic of China, China
| | - Zhuang Ding
- Department of Infectious Disease, College of Veterinary Medicine, Jilin University, Changchun, People’s Republic of China, China
| | - Hai Wang
- College of Animal Science and Veterinary Medicine, Heilongjiang Bayi Agricultural University, Daqing, People's Republic of China, China
| | - Dianjun Wu
- Department of Clinical Science, College of Veterinary Medicine, Jilin University, Changchun, People's Republic of China, China
| | - Xufeng Xie
- Department of Clinical Science, College of Veterinary Medicine, Jilin University, Changchun, People's Republic of China, China
| | - Tao Lin
- Department of Chemistry and Biochemistry, South Dakota State University, Brookings, SD, United States
| | - Yunhe Fu
- Department of Clinical Science, College of Veterinary Medicine, Jilin University, Changchun, People's Republic of China, China
| | - Naisheng Zhang
- Department of Clinical Science, College of Veterinary Medicine, Jilin University, Changchun, People's Republic of China, China
| | - Yongguo Cao
- Department of Clinical Science, College of Veterinary Medicine, Jilin University, Changchun, People's Republic of China, China
- Key Laboratory for Zoonosis Research, College of Veterinary Medicine, Jilin University, Changchun, People's Republic of China, China
- * E-mail:
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25
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Cardile AP, Warren TK, Martins KA, Reisler RB, Bavari S. Will There Be a Cure for Ebola? Annu Rev Pharmacol Toxicol 2016; 57:329-348. [PMID: 27959624 DOI: 10.1146/annurev-pharmtox-010716-105055] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Despite the unprecedented Ebola virus outbreak response in West Africa, no Ebola medical countermeasures have been approved by the US Food and Drug Administration. However, multiple valuable lessons have been learned about the conduct of clinical research in a resource-poor, high risk-pathogen setting. Numerous therapeutics were explored or developed during the outbreak, including repurposed drugs, nucleoside and nucleotide analogues (BCX4430, brincidofovir, favipiravir, and GS-5734), nucleic acid-based drugs (TKM-Ebola and AVI-7537), and immunotherapeutics (convalescent plasma and ZMapp). We review Ebola therapeutics progress in the aftermath of the West Africa Ebola virus outbreak and attempt to offer a glimpse of a path forward.
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Affiliation(s)
- Anthony P Cardile
- US Army Medical Research Institute of Infectious Diseases, Frederick, Maryland 21702;
| | - Travis K Warren
- US Army Medical Research Institute of Infectious Diseases, Frederick, Maryland 21702;
| | - Karen A Martins
- US Army Medical Research Institute of Infectious Diseases, Frederick, Maryland 21702;
| | - Ronald B Reisler
- US Army Medical Research Institute of Infectious Diseases, Frederick, Maryland 21702;
| | - Sina Bavari
- US Army Medical Research Institute of Infectious Diseases, Frederick, Maryland 21702;
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26
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Martyushev A, Nakaoka S, Sato K, Noda T, Iwami S. Modelling Ebola virus dynamics: Implications for therapy. Antiviral Res 2016; 135:62-73. [PMID: 27743917 DOI: 10.1016/j.antiviral.2016.10.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Revised: 09/29/2016] [Accepted: 10/09/2016] [Indexed: 10/20/2022]
Abstract
Ebola virus (EBOV) causes a severe, often fatal Ebola virus disease (EVD), for which no approved antivirals exist. Recently, some promising anti-EBOV drugs, which are experimentally potent in animal models, have been developed. However, because the quantitative dynamics of EBOV replication in humans is uncertain, it remains unclear how much antiviral suppression of viral replication affects EVD outcome in patients. Here, we developed a novel mathematical model to quantitatively analyse human viral load data obtained during the 2000/01 Uganda EBOV outbreak and evaluated the effects of different antivirals. We found that nucleoside analogue- and siRNA-based therapies are effective if a therapy with a >50% inhibition rate is initiated within a few days post-symptom-onset. In contrast, antibody-based therapy requires not only a higher inhibition rate but also an earlier administration, especially for otherwise fatal cases. Our results demonstrate that an appropriate choice of EBOV-specific drugs is required for effective EVD treatment.
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Affiliation(s)
- Alexey Martyushev
- Centre for Vascular Research, University of New South Wales, Sydney, New South Wales, 2052, Australia
| | - Shinji Nakaoka
- Institute of Industrial Sciences, The University of Tokyo, Tokyo, 1538505, Japan
| | - Kei Sato
- Laboratory of Viral Pathogenesis, Institute for Virus Research, Kyoto University, Kyoto, Kyoto, 6068507, Japan; CREST, JST, Kawaguchi, Saitama, 3320012, Japan
| | - Takeshi Noda
- Laboratory of Ultrastructural Virology, Institute for Virus Research, Kyoto University, Kyoto, 6068507, Japan; CREST, JST, Kawaguchi, Saitama, 3320012, Japan; PRESTO, JST, Kawaguchi, Saitama, 3320012, Japan.
| | - Shingo Iwami
- Mathematical Biology Laboratory, Department of Biology, Faculty of Sciences, Kyushu University, Fukuoka, 8128581, Japan; PRESTO, JST, Kawaguchi, Saitama, 3320012, Japan; CREST, JST, Kawaguchi, Saitama, 3320012, Japan.
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27
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Liu PC, Chen CA, Chen CM, Yen CH, Lee MH, Chuang CK, Tu CF, Su BL. Application of xenogeneic anti-canine distemper virus antibodies in treatment of canine distemper puppies. J Small Anim Pract 2016; 57:626-630. [PMID: 27726133 DOI: 10.1111/jsap.12557] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Revised: 07/10/2016] [Accepted: 07/31/2016] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The clinical feasibility of passive immunotherapy has not been demonstrated in dogs naturally infected with canine distemper. In this study, porcine anti-canine distemper virus IgG and F(ab')2 antibody fragments were used to treat infected puppies. METHODS A total of 41 naturally infected puppies (age Äsix months) exhibiting severe respiratory signs, but lacking neurological signs, were enrolled in the study. Twenty-five puppies were treated with a combination of IgG or F(ab')2 antibody fragments (Group 1) and supportive therapy and 16 puppies received routine supportive care only (Group 2). RESULTS The survival rate of dogs in Group 1 (19/25; 76%) was significantly higher than that in Group 2 (5/16; 31·3%) (P<0·05). During the therapy, 8 of the 25 dogs (32%) in Group 1 developed neurological signs versus 12 of the 16 dogs (75%) in Group 2 (P<0·05). Adverse reactions were limited to elevated body temperature in dogs that received IgG antibodies. CLINICAL SIGNIFICANCE Porcine anti-canine distemper virus antibodies improved survival in puppies affected with canine distemper with minimal adverse effects. Therefore, this therapy could be considered for treatment of endangered animal species infected with canine distemper virus.
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Affiliation(s)
- P C Liu
- Graduate Institute of Veterinary Medicine, National Taiwan University, 10617, Taipei, Taiwan
| | - C A Chen
- Institute of Veterinary Clinical Sciences, National Taiwan University, 10617, Taipei, Taiwan
| | - C M Chen
- Division of Animal Medicine, Animal Technology Laboratories, Agriculture Technology Research Institute, 35053, Miaoli, Taiwan
| | - C H Yen
- Division of Animal Technology, Animal Technology Laboratories, Agriculture Technology Research Institute, 35053, Miaoli, Taiwan
| | - M H Lee
- Division of Animal Technology, Animal Technology Laboratories, Agriculture Technology Research Institute, 35053, Miaoli, Taiwan
| | - C K Chuang
- Division of Animal Technology, Animal Technology Laboratories, Agriculture Technology Research Institute, 35053, Miaoli, Taiwan
| | - C F Tu
- Division of Animal Technology, Animal Technology Laboratories, Agriculture Technology Research Institute, 35053, Miaoli, Taiwan
| | - B L Su
- Institute of Veterinary Clinical Sciences, National Taiwan University, 10617, Taipei, Taiwan. .,National Taiwan University Veterinary Hospital, National Taiwan University, 10617, Taipei, Taiwan.
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Simmons M, Putnak R, Sun P, Burgess T, Marasco WA. Antibody Prophylaxis Against Dengue Virus 2 Infection in Non-Human Primates. Am J Trop Med Hyg 2016; 95:1148-1156. [PMID: 27645784 DOI: 10.4269/ajtmh.16-0319] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Accepted: 06/25/2016] [Indexed: 01/12/2023] Open
Abstract
Passive immunization with anti-dengue virus (DENV) immune serum globulin (ISG) or monoclonal antibodies (Mabs) may serve to supplement or replace vaccination for short-term dengue immune prophylaxis. In the present study, we sought to establish proof-of-concept by evaluating several DENV-neutralizing antibodies for their ability to protect rhesus macaques against viremia following live virus challenge, including human anti-dengue ISG, and a human Mab (Mab11/wt) and its genetically engineered variant (Mab11/mutFc) that is unable to bind to cells with Fc gamma receptors (FcγR) and potentiate antibody-dependent enhancement (ADE). In the first experiment, groups of animals received ISG or Mab11/wt at low doses (3-10 mg/kg) or a saline control followed by challenge with DENV-2 at day 10 or 30. After passive immunization, only low-titered circulating virus-neutralizing antibody titers were measured in both groups, which were undetectable by day 30. After challenge at day 10, a reduction in viremia duration compared with the control was seen only in the ISG group (75%). However, after a day 30 challenge, no reduction in viremia was observed in both immunized groups. In a second experiment to test the effect of higher antibody doses on short-term protection, groups received either ISG, Mab11/wt, Mab11/mutFc (each at 25 mg/kg) or saline followed by challenge with DENV-2 on day 10. Increased virus-neutralizing antibody titers were detected in all groups at day 5 postinjection, with geometric mean titers (GMTs) of 464 (ISG), 313 (Mab11/wt), and 309 (Mab11/mutFc). After challenge, there was complete protection against viremia in the group that received ISG, and a reduction in viremia duration of 89% and 83% in groups that received Mab11/wt and Mab11/mutFc, respectively. An in vitro ADE assay in Fcγ receptor-bearing K562 cells with sera collected immediately before challenge showed increased DENV-2 infection levels in the presence of both ISG and Mab11/wt, which peaked at a serum dilution of 1:90, but not in Mab11/mutFc containing sera. The results suggest that antibody prophylaxis for dengue might be beneficial in eliminating or reducing viral loads thereby minimizing disease progression. Our results also suggest that blocking FcγR interactions through Mab11 Fc engineering may further prevent ADE.
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Affiliation(s)
- Monika Simmons
- Viral and Rickettsial Diseases Department, Naval Medical Research Center, Silver Spring, Maryland.
| | - Robert Putnak
- Division of Viral Diseases, Walter Reed Army Institute of Research, Silver Spring, Maryland
| | - Peifang Sun
- Viral and Rickettsial Diseases Department, Naval Medical Research Center, Silver Spring, Maryland
| | - Timothy Burgess
- Viral and Rickettsial Diseases Department, Naval Medical Research Center, Silver Spring, Maryland
| | - Wayne A Marasco
- Department of Cancer Immunology and Virology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
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Morais V. An Old Solution for a New Problem: Antiserum against Emerging Infectious Diseases. Front Public Health 2016; 4:178. [PMID: 27617259 PMCID: PMC5000394 DOI: 10.3389/fpubh.2016.00178] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Accepted: 08/11/2016] [Indexed: 11/13/2022] Open
Affiliation(s)
- Victor Morais
- Department of Biotechnology, Faculty of Medicine, Institute of Hygiene, University of the Republic, Montevideo, Uruguay
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30
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Bergmann M, Friedl Y, Hartmann K. [Passive immunization in dogs and cats]. TIERAERZTLICHE PRAXIS AUSGABE KLEINTIERE HEIMTIERE 2016; 44:287-92. [PMID: 27410719 DOI: 10.15654/tpk-160189] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Accepted: 05/12/2016] [Indexed: 11/13/2022]
Abstract
Antibodies play an important role in the defense against infectious diseases. Passive immunization provides immediate protection through transfer of exogenous antibodies to a recipient. It is mainly used for prophylaxis in dogs and cats that failed to receive maternal antibodies through the colostrum or when there is an acute risk to acquire infectious diseases. Only a small number of placebo-controlled studies have been published regarding the therapeutic use of passive immunization in small animals. While positive effects were reported in cats with acute virus infections of the upper respiratory tract and in dogs with distemper, no statistically significant influence could be demonstrated in the treatment of canine parvovirosis. Prospective, double-blinded, and placebo-controlled studies using adequate numbers of patients are warranted for a definitive statement regarding the therapeutic and prophylactic use of passive immunization in dogs and cats.
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Affiliation(s)
- Michèle Bergmann
- Michèle Bergmann, Medizinische Kleintierklinik der Ludwig-Maximilians-Universität München, Veterinärstraße 13, 80539 München, E-Mail:
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The use of convalescent plasma to treat emerging infectious diseases: focus on Ebola virus disease. Curr Opin Hematol 2016; 22:521-6. [PMID: 26457963 DOI: 10.1097/moh.0000000000000191] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
PURPOSE OF REVIEW The purpose of this review is to discuss the use of convalescent plasma for the treatment of emerging infectious diseases, focusing on the recent use for the treatment of Ebola virus disease (EVD). RECENT FINDINGS Ebola convalescent plasma has been used as a therapy for treatment of EVD during the 2014 West Africa epidemic. Several cases from the United States and Europe have been recently published, in addition to multiple ongoing clinical trials in the United States and West Africa. Even more recently, convalescent plasma has been used for treatment of individuals with Middle East respiratory syndrome coronavirus (MERS-CoV) infection. SUMMARY Although the first reports of successful treatment with passive immune therapy date back to the early 1900s, convalescent plasma has materialized as a possible therapy for patients who develop infection from one of the emerging infectious diseases such as EVD or MERS-CoV, although the efficacy of such therapy has yet to be proven in clinical trials.
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Dixit R, Herz J, Dalton R, Booy R. Benefits of using heterologous polyclonal antibodies and potential applications to new and undertreated infectious pathogens. Vaccine 2016; 34:1152-61. [PMID: 26802604 PMCID: PMC7131169 DOI: 10.1016/j.vaccine.2016.01.016] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2015] [Revised: 01/06/2016] [Accepted: 01/08/2016] [Indexed: 01/31/2023]
Abstract
BACKGROUND Passive immunotherapy using polyclonal antibodies (immunoglobulins) has been used for over a century in the treatment and post-exposure prophylaxis of various infections and toxins. Heterologous polyclonal antibodies are obtained from animals hyperimmunised with a pathogen or toxin. AIMS The aims of this review are to examine the history of animal polyclonal antibody therapy use, their development into safe and effective products and the potential application to humans for emerging and neglected infectious diseases. METHODS A literature search of OVID Medline and OVID Embase databases was undertaken to identify articles on the safety, efficacy and ongoing development of polyclonal antibodies. The search contained database-specific MeSH and EMTREE terms in combination with pertinent text-words: polyclonal antibodies and rare/neglected diseases, antivenins, immunoglobulins, serum sickness, anaphylaxis, drug safety, post marketing surveillance, rabies, human influenza, Dengue, West Nile, Nipah, Hendra, Marburg, MERS, Hemorrhagic Fever Virus, and Crimean-Congo. No language limits were applied. The final search was completed on 20.06.2015. Of 1960 articles, title searches excluded many irrelevant articles, yielding 303 articles read in full. Of these, 179 are referenced in this study. RESULTS Serum therapy was first used in the 1890s against diphtheria. Early preparation techniques yielded products contaminated with reactogenic animal proteins. The introduction of enzymatic digestion, and purification techniques substantially improved their safety profile. The removal of the Fc fragment of antibodies further reduces hypersensitivity reactions. Clinical studies have demonstrated the efficacy of polyclonal antibodies against various infections, toxins and venoms. Products are being developed against infections for which prophylactic and therapeutic options are currently limited, such as avian influenza, Ebola and other zoonotic viruses. CONCLUSIONS Polyclonal antibodies have been successfully applied to rabies, envenomation and intoxication. Polyclonal production provides an exciting opportunity to revolutionise the prognosis of both longstanding neglected tropical diseases as well as emerging infectious threats to humans.
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Affiliation(s)
- Rashmi Dixit
- The Children's Hospital, Westmead, Sydney, Australia.
| | | | | | - Robert Booy
- The Children's Hospital, Westmead, Sydney, Australia
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Adapted Lethality: What We Can Learn from Guinea Pig-Adapted Ebola Virus Infection Model. Adv Virol 2016; 2016:8059607. [PMID: 26989413 PMCID: PMC4775767 DOI: 10.1155/2016/8059607] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Revised: 10/14/2015] [Accepted: 11/24/2015] [Indexed: 11/29/2022] Open
Abstract
Establishment of small animal models of Ebola virus (EBOV) infection is important both for the study of genetic determinants involved in the complex pathology of EBOV disease and for the preliminary screening of antivirals, production of therapeutic heterologic immunoglobulins, and experimental vaccine development. Since the wild-type EBOV is avirulent in rodents, the adaptation series of passages in these animals are required for the virulence/lethality to emerge in these models. Here, we provide an overview of our several adaptation series in guinea pigs, which resulted in the establishment of guinea pig-adapted EBOV (GPA-EBOV) variants different in their characteristics, while uniformly lethal for the infected animals, and compare the virologic, genetic, pathomorphologic, and immunologic findings with those obtained in the adaptation experiments of the other research groups.
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Zeitlin L, Whaley KJ, Olinger GG, Jacobs M, Gopal R, Qiu X, Kobinger GP. Antibody therapeutics for Ebola virus disease. Curr Opin Virol 2016; 17:45-49. [PMID: 26826442 DOI: 10.1016/j.coviro.2016.01.006] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Revised: 12/07/2015] [Accepted: 01/11/2016] [Indexed: 11/29/2022]
Abstract
With the unprecedented scale of the 2014-2016 West Africa outbreak, the clinical and scientific community scrambled to identify potential therapeutics for Ebola virus disease (EVD). Passive administration of antibodies has a long successful history for prophylaxis and therapy of a variety of infectious diseases, but the importance of antibodies in EVD has been unclear and is the subject of some debate. Recent studies in non-human primates have renewed interest in the potential of antibodies to impact EVD. Currently ongoing clinical evaluation of polyclonal and monoclonal antibody therapy in EVD patients in West Africa may finally offer a definitive answer to this debate.
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Affiliation(s)
- Larry Zeitlin
- Mapp Biopharmaceutical, Inc., 6160 Lusk Blvd #C105, San Diego, CA 92121, USA.
| | - Kevin J Whaley
- Mapp Biopharmaceutical, Inc., 6160 Lusk Blvd #C105, San Diego, CA 92121, USA
| | - Gene G Olinger
- Integrated Research Facility, 8200 Research Plaza Frederick, MD 21702, USA
| | - Michael Jacobs
- Royal Free London NHS Foundation Trust, Pond Street, London NW3 2QG, United Kingdom
| | - Robin Gopal
- High Containment Microbiology Department, National Infections Service, Public Health England, 61 Colindale Avenue, London NW9 5HT, United Kingdom
| | - Xiangguo Qiu
- Special Pathogens Program, National Microbiology Laboratory, Public Health Agency of Canada, 1015 Arlington Street, Winnipeg, Manitoba R3E 3R2, Canada; Department of Medical Microbiology, University of Manitoba, 745 Bannatyne Avenue, Winnipeg, Manitoba R3E 0J9, Canada
| | - Gary P Kobinger
- Special Pathogens Program, National Microbiology Laboratory, Public Health Agency of Canada, 1015 Arlington Street, Winnipeg, Manitoba R3E 3R2, Canada; Department of Medical Microbiology, University of Manitoba, 745 Bannatyne Avenue, Winnipeg, Manitoba R3E 0J9, Canada; Department of Immunology, University of Manitoba, 745 Bannatyne Avenue, Winnipeg, Manitoba R3E 0J9, Canada
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Dowall SD, Callan J, Zeltina A, Al-Abdulla I, Strecker T, Fehling SK, Krähling V, Bosworth A, Rayner E, Taylor I, Charlton S, Landon J, Cameron I, Hewson R, Nasidi A, Bowden TA, Carroll MW. Development of a Cost-effective Ovine Polyclonal Antibody-Based Product, EBOTAb, to Treat Ebola Virus Infection. J Infect Dis 2015; 213:1124-33. [PMID: 26715676 PMCID: PMC4779302 DOI: 10.1093/infdis/jiv565] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Accepted: 11/16/2015] [Indexed: 11/15/2022] Open
Abstract
The highly glycosylated glycoprotein spike of Ebola virus (EBOV-GP1,2) is the primary target of the humoral host response. Recombinant EBOV-GP ectodomain (EBOV-GP1,2ecto) expressed in mammalian cells was used to immunize sheep and elicited a robust immune response and produced high titers of high avidity polyclonal antibodies. Investigation of the neutralizing activity of the ovine antisera in vitro revealed that it neutralized EBOV. A pool of intact ovine immunoglobulin G, herein termed EBOTAb, was prepared from the antisera and used for an in vivo guinea pig study. When EBOTAb was delivered 6 hours after challenge, all animals survived without experiencing fever or other clinical manifestations. In a second series of guinea pig studies, the administration of EBOTAb dosing was delayed for 48 or 72 hours after challenge, resulting in 100% and 75% survival, respectively. These studies illustrate the usefulness of EBOTAb in protecting against EBOV-induced disease.
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Affiliation(s)
| | | | - Antra Zeltina
- Division of Structural Biology, Wellcome Trust Centre for Human Genetics, University of Oxford, United Kingdom
| | | | | | | | | | | | | | | | | | | | | | | | | | - Thomas A Bowden
- Division of Structural Biology, Wellcome Trust Centre for Human Genetics, University of Oxford, United Kingdom
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Mann E, Streng S, Bergeron J, Kircher A. A Review of the Role of Food and the Food System in the Transmission and Spread of Ebolavirus. PLoS Negl Trop Dis 2015; 9:e0004160. [PMID: 26633305 PMCID: PMC4669147 DOI: 10.1371/journal.pntd.0004160] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
The current outbreak of Ebola virus disease (EVD) centered in West Africa is the largest in history, with nearly ten times more individuals contracting the disease than all previous outbreaks combined. The details of human-to-human and zoonotic ebolavirus transmission have justifiably received the largest share of research attention, and much information exists on these topics. However, although food processing-in the form of slaughtering and preparing wildlife for consumption (referred to as bushmeat)-has been implicated in EVD outbreaks, the full role of food in EVD spread is poorly understood and has been little studied. A literature search was undertaken to assess the current state of knowledge regarding how food can or may transmit ebolaviruses and how the food system contributes to EVD outbreak and spread. The literature reveals surprising preliminary evidence that food and the food system may be more implicated in ebolavirus transmission than expected and that further research is urgently needed.
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Affiliation(s)
- Erin Mann
- Food Protection and Defense Institute, University of Minnesota, Saint Paul, Minnesota, United States of America
| | - Stephen Streng
- Food Protection and Defense Institute, University of Minnesota, Saint Paul, Minnesota, United States of America
| | - Justin Bergeron
- Food Protection and Defense Institute, University of Minnesota, Saint Paul, Minnesota, United States of America
| | - Amy Kircher
- Food Protection and Defense Institute, University of Minnesota, Saint Paul, Minnesota, United States of America
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Kombe F, Folayan MO, Ambe J, Igonoh A, Abayomi A. Taking the bull by the horns: Ethical considerations in the design and implementation of an Ebola virus therapy trial. Soc Sci Med 2015; 148:163-70. [PMID: 26653137 PMCID: PMC6858863 DOI: 10.1016/j.socscimed.2015.11.017] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Revised: 08/27/2015] [Accepted: 11/11/2015] [Indexed: 01/05/2023]
Abstract
Ebola virus is categorized as one of the most dangerous pathogens in the world. Although there is no known cure for Ebola virus, there is some evidence that the severity of the disease can be curtailed using plasma from survivors. Although there is a general consensus on the importance of research, methodological and ethical challenges for conducting research in an emergency situation have been identified. Performing clinical trials is important, especially for health conditions that are of public health significance (including rare epidemics) to develop new therapies as well as to test the efficacy and effectiveness of new interventions. However, routine clinical trial procedures can be difficult to apply in emergency public health crises hence require a consideration of alternative approaches on how therapies in these situations are tested and brought to the market. This paper examines some of the ethical issues that arise when conducting clinical trials during a highly dangerous pathogen outbreak, with a special focus on the Ebola virus outbreak in West Africa. The issues presented here come from a review of a protocol that was submitted to the Global Emerging Pathogens Treatment Consortium (GET). In reviewing the proposal, which was about conducting a clinical trial to evaluate the safety and efficacy of using convalescent plasma in the management of Ebola virus disease, the authors deliberated on various issues, which were documented as minutes and later used as a basis for this paper. The experiences and reflections shared by the authors, who came from different regions and disciplines across Africa, present wide-ranging perspectives on the conduct of clinical trials during a dangerous disease outbreak in a resource-poor setting.
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Affiliation(s)
- Francis Kombe
- KEMRI-Wellcome Trust Research Programme (KWTRP), P.O Box 230, Kilifi, Kenya.
| | - Morenike O Folayan
- Department of Child Dental Health, Obafemi Awolowo University, Ile-Ife, Nigeria; Global Emerging Pathogens Treatment Consortium (GET), 1 Mainland Hospital Road, Yaba, Lagos, Nigeria
| | - Jennyfer Ambe
- Global Emerging Pathogens Treatment Consortium (GET), 1 Mainland Hospital Road, Yaba, Lagos, Nigeria
| | - Adaora Igonoh
- Global Emerging Pathogens Treatment Consortium (GET), 1 Mainland Hospital Road, Yaba, Lagos, Nigeria
| | - Akin Abayomi
- Global Emerging Pathogens Treatment Consortium (GET), 1 Mainland Hospital Road, Yaba, Lagos, Nigeria; Division of Haematology, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg Hospital, Private Bag X3, Parow Valley, 7505 Cape Town, Cape Town, South Africa
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Convalescent plasma: new evidence for an old therapeutic tool? BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2015; 14:152-7. [PMID: 26674811 DOI: 10.2450/2015.0131-15] [Citation(s) in RCA: 157] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Accepted: 07/23/2015] [Indexed: 02/08/2023]
Abstract
Passive immunisation for the prevention and treatment of human infectious diseases can be traced back to the 20(th) century. The recent Ebola virus outbreak in West Africa has turned the spotlight onto the possible use of convalescent whole blood and convalescent plasma in the treatment of infectious diseases because they are the only therapeutic strategy available in some cases, given the unavailability of vaccines, drugs or other specific treatments. Convalescent blood products could be a valid option in the treatment/prophylaxis of several infectious diseases both in association with other drugs/preventive measures and as the only therapy when a specific treatment is not available. However, there are still some issues to consider in determining the advisability of implementing a large-scale convalescent plasma transfusion programme.
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Woźniak-Kosek A, Kosek J, Mierzejewski J, Rapiejko P. Progress in the Diagnosis and Control of Ebola Disease. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2015; 857:19-24. [PMID: 25724796 DOI: 10.1007/5584_2015_123] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
Ebola hemorrhagic fever is one of numerous viral hemorrhagic fevers. It is a severe, often fatal disease in humans and nonhuman primates (gorillas and chimpanzees). This article discusses the history of Ebola disease, already known routes of infection together with defining prevention methods and treatment trials. The importance of increasing awareness of the risk of disease among people who do not inhabit endemic regions is emphasized. This risk is associated especially with the increasing popularity of tourism to African countries, even to those where the virus is endemic. The research conducted over the years shows that three species of frugivorous bats are subjected to contamination by Ebola, but the infection is asymptomatic in them. It is believed that the saliva of these mammals and other body fluids may be a potential source of infection for primates and humans. In the laboratory, infection through small-particle aerosols has been demonstrated in primates, and airborne spread among humans is strongly suspected, although it has not yet been conclusively demonstrated. The importance of this route of transmission remains unclear. Poor hygienic conditions can aid the spread of the virus. These observations suggest approaches to the study of routes of transmission to and among humans.
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Affiliation(s)
- Agnieszka Woźniak-Kosek
- Epidemiological Response Center of Polish Armed Forces, 7 K. Leskiego St., 01-485, Warsaw, Poland,
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40
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Anthony SM, Bradfute SB. Filoviruses: One of These Things is (not) Like the Other. Viruses 2015; 7:5172-90. [PMID: 26426036 PMCID: PMC4632375 DOI: 10.3390/v7102867] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Revised: 09/15/2015] [Accepted: 09/16/2015] [Indexed: 12/11/2022] Open
Abstract
The family Filoviridae contains several of the most deadly pathogens known to date and the current Ebola virus disease (EVD) outbreak in Western Africa, due to Ebola virus (EBOV) infection, highlights the need for active and broad research into filovirus pathogenesis. However, in comparison, the seven other known filovirus family members are significantly understudied. Many of these, including Marburgviruses and Ebolaviruses other than EBOV, are also highly virulent and fully capable of causing widespread epidemics. This review places the focus on these non-EBOV filoviruses, including known immunological and pathological data. The available animal models, research tools and currently available therapeutics will also be discussed along with an emphasis in the large number of current gaps in knowledge of these less highlighted filoviruses. It is evident that much research is yet to be done in order to bring the non-EBOV filovirus field to the forefront of current research and, importantly, to the development of more effective vaccines and therapeutics to combat potential future outbreaks.
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Affiliation(s)
- Scott M Anthony
- Immunology Graduate Program, The University of Texas Graduate School of Biomedical Sciences at Houston, Department of Immunology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
| | - Steven B Bradfute
- University of New Mexico, Center for Global Health, Department of Internal Medicine.
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41
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Ebola Virus Infection: Overview and Update on Prevention and Treatment. Infect Dis Ther 2015; 4:365-90. [PMID: 26363787 PMCID: PMC4675769 DOI: 10.1007/s40121-015-0079-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Indexed: 11/08/2022] Open
Abstract
In 2014 and 2015, the largest Ebola virus disease (EVD) outbreak in history affected large populations across West Africa. The goal of this report is to provide an update on the epidemic and review current progress in the development,
evaluation and deployment of prevention and treatment strategies for EVD. Relevant information was identified through a comprehensive literature search using Medline, PubMed and CINAHL Complete and using the search terms Ebola, Ebola virus disease, Ebola hemorrhagic fever, West Africa outbreak, Ebola transmission, Ebola symptoms and signs, Ebola diagnosis, Ebola treatment, vaccines for Ebola and clinical trials on Ebola. Through 22 July 2015, a total of 27,741 EVD cases and 11,284 deaths were reported from all affected countries. Several therapeutic agents and novel vaccines for EVD have been developed and are now undergoing evaluation. Concurrent with active case investigation, contact tracing, surveillance and supportive care to patients and communities, there has been rapid progress in the development of new therapies and vaccines against EVD. Continued focus on strengthening clinical and public health infrastructure will have direct benefits in controlling the spread of EVD and will provide a strong foundation for deployment of new drugs and vaccines to affected countries when they become available. The unprecedented West Africa Ebola outbreak, response measures, and ensuing drug and vaccine development suggest that new tools for Ebola control may be available in the near future.
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42
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Fischer WA, Uyeki TM, Tauxe RV. Ebola virus disease: What clinicians in the United States need to know. Am J Infect Control 2015; 43:788-93. [PMID: 26116335 DOI: 10.1016/j.ajic.2015.05.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Accepted: 05/06/2015] [Indexed: 12/26/2022]
Abstract
In March 2014 the World Health Organization was notified of an outbreak of Ebola virus disease (EVD) in the forest region of Guinea. As of May 2015, the outbreak had become the most devastating EVD epidemic in history with more than 27,000 cases and more than 11,000 deaths. The introduction of EVD into noncontiguous countries, including the United States, from infected travelers highlights the importance of preparedness of all health care providers. Early identification and rapid isolation of patients suspected with EVD is critical to limiting the spread of Ebola virus. Additionally, enhanced understanding of EVD case definitions, clinical presentation, treatment procedures, and infection control strategies will improve the ability of health care workers to provide safe care for patients with EVD.
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43
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Martínez-Romero C, García-Sastre A. Against the clock towards new Ebola virus therapies. Virus Res 2015; 209:4-10. [PMID: 26057711 DOI: 10.1016/j.virusres.2015.05.025] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2015] [Revised: 05/23/2015] [Accepted: 05/29/2015] [Indexed: 10/23/2022]
Abstract
Since the end of 2013, West Africa has been suffering the largest Ebola virus (EBOV) outbreak in recorded history. The lack of health care infrastructure in the affected countries, as well as a concentration of infected cases in the most populated areas allowed the virus to spread with no control during the first months of the outbreak. With no specific treatment available to combat EBOV infection and its associated disease, an extraordinary worldwide effort was made to confront the severity of the situation and to establish new therapeutic strategies that would lead to better and faster control and eradicate the outbreak. In the last two years, several candidate therapies and potential vaccines against EBOV have arisen and human clinical trials are ongoing, in hopes of starting their deployment in the affected countries. This article reviews the current candidate therapies against EBOV, their stage of development and future prospects in battling EBOV outbreaks.
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Affiliation(s)
- Carles Martínez-Romero
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, USA; Global Health and Emerging Pathogens Institute, Icahn School of Medicine at Mount Sinai, New York, USA.
| | - Adolfo García-Sastre
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, USA; Global Health and Emerging Pathogens Institute, Icahn School of Medicine at Mount Sinai, New York, USA; Department of Medicine, Division of Infectious Diseases, Icahn School of Medicine at Mount Sinai, New York, USA.
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44
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Florescu DF, Kalil AC, Hewlett AL, Schuh AJ, Stroher U, Uyeki TM, Smith PW. Administration of Brincidofovir and Convalescent Plasma in a Patient With Ebola Virus Disease. Clin Infect Dis 2015; 61:969-73. [PMID: 25991468 DOI: 10.1093/cid/civ395] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2015] [Accepted: 05/11/2015] [Indexed: 11/14/2022] Open
Abstract
From 2014 to May 2015, >26 000 Ebola virus disease (EVD) cases were reported from West Africa. We present a patient with EVD who received brincidofovir and convalescent plasma. The relative contributions of supportive care, investigational therapies, and patient's immune-response on survival could not be determined. Randomized trials are needed.
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Affiliation(s)
- Diana F Florescu
- Infectious Diseases Division Transplant Surgery Program, University of Nebraska Medical Center, Omaha
| | | | | | - Amy J Schuh
- Viral Special Pathogens Branch, Division of High-Consequence Pathogens and Pathology National Center for Emerging and Zoonotic
| | - Ute Stroher
- Viral Special Pathogens Branch, Division of High-Consequence Pathogens and Pathology National Center for Emerging and Zoonotic
| | - Timothy M Uyeki
- Influenza Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
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45
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Rajak H, Jain DK, Singh A, Sharma AK, Dixit A. Ebola virus disease: past, present and future. Asian Pac J Trop Biomed 2015. [DOI: 10.1016/s2221-1691(15)30365-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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46
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Bradfute SB, Anthony SM, Stuthman KS, Ayithan N, Tailor P, Shaia CI, Bray M, Ozato K, Bavari S. Mechanisms of immunity in post-exposure vaccination against Ebola virus infection. PLoS One 2015; 10:e0118434. [PMID: 25785602 PMCID: PMC4364937 DOI: 10.1371/journal.pone.0118434] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Accepted: 01/16/2015] [Indexed: 01/07/2023] Open
Abstract
Ebolaviruses can cause severe hemorrhagic fever that is characterized by rapid viral replication, coagulopathy, inflammation, and high lethality rates. Although there is no clinically proven vaccine or treatment for Ebola virus infection, a virus-like particle (VLP) vaccine is effective in mice, guinea pigs, and non-human primates when given pre-infection. In this work, we report that VLPs protect Ebola virus-infected mice when given 24 hours post-infection. Analysis of cytokine expression in serum revealed a decrease in pro-inflammatory cytokine and chemokine levels in mice given VLPs post-exposure compared to infected, untreated mice. Using knockout mice, we show that VLP-mediated post-exposure protection requires perforin, B cells, macrophages, conventional dendritic cells (cDCs), and either CD4+ or CD8+ T cells. Protection was Ebola virus-specific, as marburgvirus VLPs did not protect Ebola virus-infected mice. Increased antibody production in VLP-treated mice correlated with protection, and macrophages were required for this increased production. However, NK cells, IFN-gamma, and TNF-alpha were not required for post-exposure-mediated protection. These data suggest that a non-replicating Ebola virus vaccine can provide post-exposure protection and that the mechanisms of immune protection in this setting require both increased antibody production and generation of cytotoxic T cells.
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Affiliation(s)
- Steven B. Bradfute
- United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland, United States of America
| | - Scott M. Anthony
- United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland, United States of America
| | - Kelly S. Stuthman
- United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland, United States of America
| | - Natarajan Ayithan
- Laboratory of Molecular Growth Regulation, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland, United States of America
| | | | - Carl I. Shaia
- United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland, United States of America
| | - Mike Bray
- Division of Clinical Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Keiko Ozato
- Laboratory of Molecular Growth Regulation, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Sina Bavari
- United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland, United States of America
- * E-mail:
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Abstract
The current Ebola virus disease (EVD) outbreak in West Africa is the largest with over 5100 deaths in four West African countries as of 14 November 2014. EVD has high case-fatality rates but no licensed treatment or vaccine is yet available. Several vaccine candidates that protected nonhuman primates are not yet available for clinical use. Slow development of vaccine-stimulated immunity, sporadic nature and fast progression of EVD underlines the need for the development of effective postexposure therapeutic drugs. WHO encouraged the use of untested drugs for EVD to curb the fast-spreading outbreak. Here, we summarize therapeutics for EVD including monoclonal antibody-based therapy and inhibitors of viral replication including our recently developed small-molecule inhibitors of VP30 dephosphorylation.
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Affiliation(s)
- Marina Jerebtsova
- Department of Microbiology, Howard University, Washington, DC 20059, USA
| | - Sergei Nekhai
- Department of Microbiology, Howard University, Washington, DC 20059, USA ; Center for Sickle Cell Disease, Howard University, Washington, DC 20059, USA ; Department of Medicine, Howard University, Washington, DC 20059, USA ; Department of Pharmacology, Howard University, Washington, DC 20059, USA
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48
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Chippaux JP, Boyer LV, Alagón A. Post-exposure treatment of Ebola virus using passive immunotherapy: proposal for a new strategy. J Venom Anim Toxins Incl Trop Dis 2015; 21:3. [PMID: 25705218 PMCID: PMC4336475 DOI: 10.1186/s40409-015-0003-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Accepted: 02/03/2015] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Better treatments are urgently needed for the management of Ebola virus epidemics in Equatorial Africa. METHODS We conducted a systematic review of the literature on the use of passive immunotherapy for the treatment or prevention of Ebola virus disease. We placed findings from this review into the context of passive immunotherapy currently used for venom-induced disease, and recent improvements in manufacturing of polyvalent antivenom products. RESULTS Passive immunotherapy appears to be one of the most promising specific treatments for Ebola. However, its potential has been incompletely evaluated, considering the overall experience and recent improvement of immunotherapy. Development and use of heterologous serum derivatives could protect people exposed to Ebola viruses with reasonable cost and logistics. CONCLUSION Hyperimmune equine IgG fragments and purified polyclonal whole IgG deserve further consideration as treatment for exposure to the Ebola virus.
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Affiliation(s)
- Jean-Philippe Chippaux
- />UMR 216, Mother and Child Facing Tropical Diseases, Research Institute for Development (IRD), Cotonou, Benin, and School of Pharmacy, Paris Descartes University, Sorbonne Paris Cité, Paris, France
- />Institut de Recherche pour le Développement (IRD), 08 BP 841 Cotonou, Bénin
| | - Leslie V Boyer
- />Venom Immunochemistry, Pharmacology and Emergency Response (VIPER) Institute, University of Arizona, Tucson, Arizona USA
| | - Alejandro Alagón
- />Institute of Biotechnology, National Autonomous University of Mexico (UNAM), Cuernavaca, Morelos Mexico
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Kilgore PE, Grabenstein JD, Salim AM, Rybak M. Treatment of Ebola Virus Disease. Pharmacotherapy 2015; 35:43-53. [DOI: 10.1002/phar.1545] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Paul E. Kilgore
- Department of Pharmacy Practice; Eugene Applebaum College of Pharmacy and Health Sciences; Wayne State University; Detroit Michigan
| | | | - Abdulbaset M. Salim
- Department of Pharmacy Practice; Eugene Applebaum College of Pharmacy and Health Sciences; Wayne State University; Detroit Michigan
| | - Michael Rybak
- Department of Pharmacy Practice; Eugene Applebaum College of Pharmacy and Health Sciences; Wayne State University; Detroit Michigan
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Zhu Z, Dimitrov AS, Chakraborti S, Dimitrova D, Xiao X, Broder CC, Dimitrov DS. Development of human monoclonal antibodies against diseases caused by emerging and biodefense-related viruses. Expert Rev Anti Infect Ther 2014; 4:57-66. [PMID: 16441209 DOI: 10.1586/14787210.4.1.57] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Polyclonal antibodies have a century-old history of being effective against some viruses; recently, monoclonal antibodies (mAbs) have also shown success. The humanized mAb Synagis (palivizumab), which is still the only mAb against a viral disease approved by the US FDA, has been widely used as a prophylactic measure against respiratory syncytial virus infections in neonates and immunocompromised individuals. The first fully human mAbs against two other paramyxoviruses, Hendra and Nipah virus, which can cause high (up to 75%) mortality, were recently developed; one of them, m101, showed exceptional potency against infectious virus. In an amazing pace of research, several potent human mAbs targeting the severe acute respiratory syndrome coronavirus S glycoprotein that can affect infections in animal models have been developed months after the virus was identified in 2003. A potent humanized mAb with therapeutic potential was recently developed against the West Nile virus. The progress in developing neutralizing human mAbs against Ebola, Crimean-Congo hemorrhagic fever, vaccinia and other emerging and biodefense-related viruses is slow. A major problem in the development of effective therapeutic agents against viruses, including therapeutic antibodies, is the viruses' heterogeneity and mutability. A related problem is the low binding affinity of crossreactive antibodies able to neutralize a variety of primary isolates. Combinations of mAbs or mAbs with other drugs, and/or the identification of potent new mAbs and their derivatives that target highly conserved viral structures, which are critical for virus entry into cells, are some of the possible solutions to these problems, and will continue to be a major focus of antiviral research.
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Affiliation(s)
- Zhongyu Zhu
- Protein Interactions Group, CCRNP, BRP, SAIC-Frederick, Inc., NCI-Frederick, NIH Bldg 469, Rm 139, PO Box B, MD 21702-1201, USA.
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