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Chakraborty P, Kumar R, Karn S, Raviya DD, Mondal P. Poxviruses as Agents of Biological Warfare: The Importance of Ensuring Ethical Standards for Research with Viruses. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2024; 1451:399-412. [PMID: 38801593 DOI: 10.1007/978-3-031-57165-7_26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2024]
Abstract
Historically, biological agents have been used to target various populations. One of the earliest examples could be the catastrophic effect of smallpox in Australia in the eighteenth century (as alleged by some historians). Modern biological techniques can be used to both create or provide protection against various agents of biological warfare. Any microorganism (viruses, bacteria, and fungi) or its toxins can be used as biological agents. Minnesota Department of Health has listed Smallpox (variola major) as a category A bioterrorism agent, even though it has been eradicated in 1980 through an extensive vaccination campaign. Category A agents are considered the highest risk to public health. Laboratory-associated outbreaks of poxviruses could cause unprecedented occupational hazards. Only two WHO-approved BSL-4 facilities in the United States and Russia are allowed to perform research on the variola virus. So, poxviruses present themselves as a classical case of a dual-use dilemma, since research with them can be used for both beneficial and harmful purposes. Although the importance of ethics in scientific research requires no further elaboration, ethical norms assume greater significance during experimentation with poxviruses. In this chapter, we will update the readers on the sensitive nature of conducting research with poxviruses, and how these viruses can be a source of potential biological weapons. Finally, specified ethical guidelines are explored to ensure safe research practices in virology.
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Affiliation(s)
- Prasenjit Chakraborty
- Department of Biosciences, School of Science, Indrashil University, Rajpur-Kadi, Mehsana, Gujarat, 382740, India.
| | - Randhir Kumar
- Department of Biosciences, School of Science, Indrashil University, Rajpur-Kadi, Mehsana, Gujarat, 382740, India
| | - Sanjay Karn
- Department of Biosciences, School of Science, Indrashil University, Rajpur-Kadi, Mehsana, Gujarat, 382740, India
| | - Dharmiben D Raviya
- Department of Biosciences, School of Science, Indrashil University, Rajpur-Kadi, Mehsana, Gujarat, 382740, India
| | - Priya Mondal
- Laboratory of Cell Biology, National Cancer Institute, National Institute of Health, Bethesda, MD, 20892, USA
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Bushmaker T, Feldmann F, Lovaglio J, Saturday G, Griffin AJ, O’Donnell KL, Strong JE, Sprecher A, Kobinger G, Geisbert TW, Marzi A, Feldmann H. Limited Benefit of Postexposure Prophylaxis With VSV-EBOV in Ebola Virus-Infected Rhesus Macaques. J Infect Dis 2023; 228:S721-S729. [PMID: 37474155 PMCID: PMC10651186 DOI: 10.1093/infdis/jiad280] [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: 04/25/2023] [Revised: 07/11/2023] [Accepted: 07/17/2023] [Indexed: 07/22/2023] Open
Abstract
Vesicular stomatitis virus-Ebola virus (VSV-EBOV) vaccine has been successfully used in ring vaccination approaches during EBOV disease outbreaks demonstrating its general benefit in short-term prophylactic vaccination, but actual proof of its benefit in true postexposure prophylaxis (PEP) for humans is missing. Animal studies have indicated PEP efficacy when VSV-EBOV was used within hours of lethal EBOV challenge. Here, we used a lower EBOV challenge dose and a combined intravenous and intramuscular VSV-EBOV administration to improve PEP efficacy in the rhesus macaque model. VSV-EBOV treatment 1 hour after EBOV challenge resulted in delayed disease progression but little benefit in outcome. Thus, we could not confirm previous results indicating questionable benefit of VSV-EBOV for EBOV PEP in a nonhuman primate model.
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Affiliation(s)
- Trenton Bushmaker
- Laboratory of Virology, Rocky Mountain Laboratories, National Institutes of Health, Hamilton, Montana
| | - Friederike Feldmann
- Rocky Mountain Veterinary Branch, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, Montana
| | - Jamie Lovaglio
- Rocky Mountain Veterinary Branch, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, Montana
| | - Greg Saturday
- Rocky Mountain Veterinary Branch, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, Montana
| | - Amanda J Griffin
- Laboratory of Virology, Rocky Mountain Laboratories, National Institutes of Health, Hamilton, Montana
| | - Kyle L O’Donnell
- Laboratory of Virology, Rocky Mountain Laboratories, National Institutes of Health, Hamilton, Montana
| | - James E Strong
- Special Pathogens Program, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | | | - Gary Kobinger
- Galveston National Laboratory, University of Texas Medical Branch at Galveston, Galveston, Texas
| | - Thomas W Geisbert
- Galveston National Laboratory, University of Texas Medical Branch at Galveston, Galveston, Texas
| | - Andrea Marzi
- Laboratory of Virology, Rocky Mountain Laboratories, National Institutes of Health, Hamilton, Montana
| | - Heinz Feldmann
- Laboratory of Virology, Rocky Mountain Laboratories, National Institutes of Health, Hamilton, Montana
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Kitaura S, Tobiume M, Kawahara M, Satoh M, Kato H, Nakayama N, Nakajima N, Komeno T, Furuta Y, Suzuki T, Moriya K, Saijo M, Ebihara H, Ito-Takayama M. Evaluation of a novel severe combined immunodeficiency mouse model for antiviral drug evaluation against Chandipura virus infection. Antiviral Res 2023; 213:105582. [PMID: 36948302 DOI: 10.1016/j.antiviral.2023.105582] [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: 12/12/2022] [Revised: 03/10/2023] [Accepted: 03/17/2023] [Indexed: 03/24/2023]
Abstract
Chandipura virus (CHPV) is a negative-sense single-stranded RNA virus known to cause fatal encephalitis outbreaks in the Indian subcontinent. The virus displays tropism towards the pediatric population and holds significant public health concerns. Currently, there is no specific, effective therapy for CHPV encephalitis. In this study, we evaluated a novel C.B-17 severe combined immunodeficiency (SCID) mouse model which can be used for pre-clinical antiviral evaluation. Inoculation of CHPV developed a lethal infection in our model. Plaque assay and immunohistochemistry detected increased viral loads and antigens in various organs, including the brain, spinal cord, adrenal glands, and whole blood. We further conducted a proof-of-concept evaluation of favipiravir in the SCID mouse model. Favipiravir treatment improved survival with pre-symptomatic (days 5-14) and post-symptomatic (days 9-18) treatment. Reduced viral loads were observed in whole blood, kidney/adrenal gland, and brain tissue with favipiravir treatment. The findings in this study demonstrate the utility of SCID mouse for in vivo drug efficacy evaluation and the potential efficacy of favipiravir against CHPV infection.
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Affiliation(s)
- Satoshi Kitaura
- Department of Virology I, National Institute of Infectious Diseases, Tokyo, Japan; Department of Internal Medicine, The University of Tokyo, Graduate School of Medicine, Tokyo, Japan
| | - Minoru Tobiume
- Department of Pathology, National Institute of Infectious Diseases, Tokyo, Japan
| | - Madoka Kawahara
- Department of Virology I, National Institute of Infectious Diseases, Tokyo, Japan
| | - Masaaki Satoh
- Department of Virology I, National Institute of Infectious Diseases, Tokyo, Japan
| | - Hirofumi Kato
- Department of Virology I, National Institute of Infectious Diseases, Tokyo, Japan
| | - Noriko Nakayama
- Department of Virology I, National Institute of Infectious Diseases, Tokyo, Japan
| | | | | | | | - Tadaki Suzuki
- Department of Pathology, National Institute of Infectious Diseases, Tokyo, Japan
| | - Kyoji Moriya
- Department of Infectious Diseases, The University of Tokyo Hospital, Tokyo, Japan
| | - Masayuki Saijo
- Department of Virology I, National Institute of Infectious Diseases, Tokyo, Japan
| | - Hideki Ebihara
- Department of Virology I, National Institute of Infectious Diseases, Tokyo, Japan.
| | - Mutsuyo Ito-Takayama
- Department of Virology I, National Institute of Infectious Diseases, Tokyo, Japan.
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Shmuelian Z, Warszawer Y, Or O, Arbel‐Alon S, Giladi H, Avgil Tsadok M, Cohen R, Shefer G, Shlomi D, Hoshen M, Maruotti A, Jona‐Lasinio G, Galun E. Postexposure-vaccine-prophylaxis against COVID-19. J Med Virol 2023; 95:e28274. [PMID: 36324272 PMCID: PMC9827940 DOI: 10.1002/jmv.28274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Revised: 10/03/2022] [Accepted: 10/27/2022] [Indexed: 11/06/2022]
Abstract
During the COVID-19 pandemic, postexposure-vaccine-prophylaxis is not a practice. Following exposure, only patient isolation is imposed. Moreover, no therapeutic prevention approach is applied. We asked whether evidence exists for reduced mortality rate following postexposure-vaccine-prophylaxis. To estimate the effectiveness of postexposure-vaccine-prophylaxis, we obtained data from the Israeli Ministry of Health registry. The study population consisted of Israeli residents aged 12 years and older, identified for the first time as PCR-positive for SARS-CoV-2, between December 20th, 2020 (the beginning of the vaccination campaign) and October 7th, 2021. We compared "recently injected" patients-that proved PCR-positive on the same day or on 1 of the 5 consecutive days after first vaccination (representing an unintended postexposure-vaccine-prophylaxis)s-to unvaccinated control group. Among Israeli residents identified PCR-positive for SARS-CoV-2, 11 687 were found positive on the day they received their first vaccine injection (BNT162b2) or on 1 of the 5 days thereafter. In patients over 65 years, 143 deaths occurred among 1412 recently injected (10.13%) compared to 255 deaths among the 1412 unvaccinated (18.06%), odd ratio (OR) 0.51 (95% confidence interval [CI]: 0.41-0.64; p < 0.001). A significant reduction in the death toll was observed among the 55-64 age group, with 8 deaths occurring among the 1320 recently injected (0.61%) compared to 24 deaths among the 1320 unvaccinated control (1.82%), OR 0.33 (95% CI: 0.13-0.76; p = 0.007). Postexposure-vaccine-prophylaxis is effective against death in COVID-19 infection.
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Affiliation(s)
- Zohar Shmuelian
- Goldyne Savad Institute of Gene and Cell TherapyHadassah Hebrew University HospitalJerusalemIsrael
| | - Yehuda Warszawer
- Goldyne Savad Institute of Gene and Cell TherapyHadassah Hebrew University HospitalJerusalemIsrael
| | - Omri Or
- Goldyne Savad Institute of Gene and Cell TherapyHadassah Hebrew University HospitalJerusalemIsrael
| | - Sagit Arbel‐Alon
- The Ministry of Welfare and Social Affairs, Chief PhysicianGovernment of IsraelJerusalemIsrael
| | - Hilla Giladi
- Goldyne Savad Institute of Gene and Cell TherapyHadassah Hebrew University HospitalJerusalemIsrael
| | - Meytal Avgil Tsadok
- TIMNA‐Israel Ministry of Health's Big Data PlatformMinistry of HealthJerusalemIsrael
| | - Roy Cohen
- TIMNA‐Israel Ministry of Health's Big Data PlatformMinistry of HealthJerusalemIsrael
| | - Galit Shefer
- TIMNA‐Israel Ministry of Health's Big Data PlatformMinistry of HealthJerusalemIsrael
| | - Dekel Shlomi
- Clalit Health Services Community Division, Ariel, Israel and the Pulmonary Clinic, Dan‐Petah‐Tiqwa District, Adelson School of MedicineAriel UniversityRamat‐GanIsrael
| | - Moshe Hoshen
- Research Unit, Department of Bioinformatics, Dan‐Petah‐Tiqwa District, Clalit Health ServicesJerusalem College of TechnologyJerusalemIsrael
| | - Antonello Maruotti
- Department of Law, Economics, Politics and Modern LanguagesLibera Università Maria SS AssuntaRomeItaly
| | | | - Eithan Galun
- Goldyne Savad Institute of Gene and Cell TherapyHadassah Hebrew University HospitalJerusalemIsrael
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Abstract
Several tropical or geographically confined infectious diseases may lead to organ failure requiring management in an intensive care unit (ICU), both in endemic low- and middle-income countries where ICU facilities are increasingly being developed and in (nonendemic) high-income countries through an increase in international travel and migration. The ICU physician must know which of these diseases may be encountered and how to recognize, differentiate, and treat them. The four historically most prevalent "tropical" diseases (malaria, enteric fever, dengue, and rickettsiosis) can present with single or multiple organ failure in a very similar manner, which makes differentiation based solely on clinical signs very difficult. Specific but frequently subtle symptoms should be considered and related to the travel history of the patient, the geographic distribution of these diseases, and the incubation period. In the future, ICU physicians may also be more frequently confronted with rare but frequently lethal diseases, such as Ebola and other viral hemorrhagic fevers, leptospirosis, and yellow fever. No one could have foreseen the worldwide 2019-up to now coronavirus disease 2019 (COVID-19) crisis caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which was initially spread by travel too. In addition, the actual pandemic due to SARS-CoV-2 reminds us of the actual and potential threat of (re)-emerging pathogens. If left untreated or when treated with a delay, many travel-related diseases remain an important cause of morbidity and even mortality, even when high-quality critical care is provided. Awareness and a high index of suspicion of these diseases is a key skill for the ICU physicians of today and tomorrow to develop.
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Wang LL, Estrada L, Wiggins J, Anantpadma M, Patten JJ, Davey RA, Xiang SH. Ligand-based design of peptide entry inhibitors targeting the endosomal receptor binding site of filoviruses. Antiviral Res 2022; 206:105399. [PMID: 36007601 DOI: 10.1016/j.antiviral.2022.105399] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 08/15/2022] [Accepted: 08/17/2022] [Indexed: 11/25/2022]
Abstract
Filoviruses enter cells through micropinocytosis and trafficking into the endosomes in which they bind to the receptor Niemann-Pick C1 protein (NPC1) for membrane fusion and entry into the cytoplasm. The endosomal receptor-binding is critical step for filovirus entry. Designing inhibitors to block receptor binding will prevent viral entry. Using available binding structural information from the co-crystal structures of the viral GP with the receptor NPC1 or with monoclonal antibodies, we have conducted structure-based design of peptide inhibitors to target the receptor binding site (RBS). The designed peptides were tested for their inhibition activity against pseudo-typed or replication-competent viruses in a cell-based assay. The results indicate that these peptides exhibited strong activities against both Ebola and Marburg virus infection. It is expected that these peptides can be further developed for therapeutic use to treat filovirus infection and combat the outbreaks.
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Affiliation(s)
- Leah Liu Wang
- School of Veterinary Medicine and Biomedical Sciences, USA; Nebraska Center for Virology, University of Nebraska-Lincoln, Lincoln, NE, 68583, USA
| | - Leslie Estrada
- School of Veterinary Medicine and Biomedical Sciences, USA; Nebraska Center for Virology, University of Nebraska-Lincoln, Lincoln, NE, 68583, USA
| | - Joshua Wiggins
- Nebraska Center for Virology, University of Nebraska-Lincoln, Lincoln, NE, 68583, USA; School of Biological Sciences, University of Nebraska-Lincoln, Lincoln, NE, 68583, USA
| | - Manu Anantpadma
- Department of Microbiology & National Emerging Infectious Diseases Laboratories, Boston University School of Medicine, Boston, MA, 02115, USA
| | - J J Patten
- Department of Microbiology & National Emerging Infectious Diseases Laboratories, Boston University School of Medicine, Boston, MA, 02115, USA
| | - Robert A Davey
- Department of Microbiology & National Emerging Infectious Diseases Laboratories, Boston University School of Medicine, Boston, MA, 02115, USA
| | - Shi-Hua Xiang
- School of Veterinary Medicine and Biomedical Sciences, USA; Nebraska Center for Virology, University of Nebraska-Lincoln, Lincoln, NE, 68583, USA.
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Treatment with Ad5-Porcine Interferon-α Attenuates Ebolavirus Disease in Pigs. Pathogens 2022; 11:pathogens11040449. [PMID: 35456124 PMCID: PMC9031749 DOI: 10.3390/pathogens11040449] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 04/04/2022] [Accepted: 04/05/2022] [Indexed: 02/04/2023] Open
Abstract
Under experimental conditions, pigs infected with Ebola Virus (EBOV) develop disease and can readily transmit the virus to non-human primates or pigs. In the event of accidental or intentional EBOV infection of domestic pigs, complex and time-consuming safe depopulation and carcass disposal are expected. Delaying or preventing transmission through a reduction in viral shedding is an absolute necessity to limit the spread of the virus. In this study, we tested whether porcine interferon-α or λ3 (porIFNα or porIFNλ3) delivered by a replication-defective human type 5 adenovirus vector (Ad5-porIFNα or Ad5-porIFNλ3) could limit EBOV replication and shedding in domestic pigs. Our results show that pigs pre-treated with Ad5-porIFNα did not develop measurable clinical signs, did not shed virus RNA, and displayed strongly reduced viral RNA load in tissues. A microarray analysis of peripheral blood mononuclear cells indicated that Ad5-porIFNα treatment led to clear upregulation in immune and inflammatory responses probably involved in protection against disease. Our results indicate that administration of Ad5-porIFNα can potentially be used to limit the spread of EBOV in pigs.
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Baller A, Padoveze MC, Mirindi P, Hazim CE, Lotemo J, Pfaffmann J, Ndiaye A, Carter S, Chabrat MAD, Mangala S, Banzua B, Umutoni C, Niang NR, Kabego L, Ouedraogo A, Houdjo B, Mwesha D, Ousman KB, Kolwaite A, Blaney DD, Choi MJ, Pallawo R, Legand A, Park B, Formenty P, Montgomery JM, Gueye AS, Allegranzi B, Yao NKM, Fall IS. Ebola virus disease nosocomial infections in the Democratic Republic of the Congo: a descriptive study of cases during the 2018-2020 outbreak. Int J Infect Dis 2021; 115:126-133. [PMID: 34883237 PMCID: PMC8755545 DOI: 10.1016/j.ijid.2021.11.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 11/25/2021] [Accepted: 11/25/2021] [Indexed: 12/03/2022] Open
Abstract
Health workers were among those most affected by nosocomial Ebola virus disease (EVD) in this outbreak. Children had a higher case fatality rate compared with other patients with nosocomial EVD. Referral health facilities and privately owned health facilities had the highest number of nosocomial infections (NI). Clear case definition of NI is required to prompt transmission chain interruption.
Objectives To describe the characteristics of nosocomial cases of Ebola virus disease (EVD) in the Democratic Republic of the Congo between July 2018 and May 2020 in order to inform future interventions. Methods Nosocomial cases of EVD were identified during outbreak response surveillance, and a retrospective analysis of cases was conducted according to demographic characteristics and type of health facility (HF). Results Of 3481 cases of EVD, 579 (16.6%) were nosocomial. Of these, 332 cases occurred in women (57.3%). Patients and visitors accounted for 419 cases (72.4%), of which 79 (18.9%) were aged 6–≤18 years and 108 (25.8%) were aged ≤5 years. Health workers (HWs) accounted for the remaining 160 (27.6%) nosocomial cases. The case fatality rate (CFR) for HWs (66/160, 41.3%) was significantly lower than the CFR for patients and visitors (292/419, 69.7%) (P<0.001). The CFR was higher among cases aged 6–≤18 years (54/79, 68.4%) and ≤5 years (89/108, 82.4%). Referral HFs (>39 beds) had the highest prevalence of nosocomial EVD (148/579, 25.6%). Among HFs with at least one case of nosocomial infection, 50.0% (98/196) were privately owned. Conclusions Nurses and traditional healers should be targeted for infection prevention and control training, and supportive supervision should be provided to HFs to mitigate EVD transmission.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Berthe Banzua
- Ministry of Health, Democratic Republic of the Congo
| | | | | | | | | | | | | | | | - Amy Kolwaite
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - David D Blaney
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Mary J Choi
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | | | - Benjamin Park
- Centers for Disease Control and Prevention, Atlanta, GA, USA
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Jaspard M, Juchet S, Serra B, Mayoum B, Kanta IM, Camara MS, Mbala P, Kojan R, Malvy D. Post-exposure prophylaxis following high-risk contact with Ebola virus, using immunotherapies with monoclonal antibodies, in the eastern Democratic Republic of the Congo: an emergency use program. Int J Infect Dis 2021; 113:166-167. [PMID: 34587535 DOI: 10.1016/j.ijid.2021.09.053] [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] [Received: 08/23/2021] [Revised: 09/20/2021] [Accepted: 09/22/2021] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION With the development of therapeutics and vaccine against Ebola virus disease (EVD), the question of post-exposure prophylaxis for high-risk contact has emerged. Immunotherapies (monoclonal antibodies [mAbs]) recently validated for treating infected patients appear to be a good candidate for protecting contacts. DESIGN During the tenth EVD outbreak in the Democratic Republic of the Congo, we have administrated mAbs (Mab114 or REGN-EB3) to high and intermediate-risk contacts of EVD patients. RESULTS Overall, 23 non-vaccinated contacts received mAbs after a median delay between contact and post-exposure prophylaxis of 1 day (interquartile range 1-2). All contacts were free of symptoms, and all had negative reverse transcriptase-polymerase chain reaction 14 days after the contact. CONCLUSION Immunotherapies appear to be promising candidates to protect EVD contacts. Interaction with vaccine needs to be analyzed and a larger study on efficacy conducted.
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Affiliation(s)
- Marie Jaspard
- University of Bordeaux, National Institute for Health and Medical Research (Inserm), Research Institute for Sustainable Development (IRD), Bordeaux Population Health Center, UMR 1219, Bordeaux, France; The Alliance for International Medical Action, Dakar, Senegal.
| | - Sylvain Juchet
- University of Bordeaux, National Institute for Health and Medical Research (Inserm), Research Institute for Sustainable Development (IRD), Bordeaux Population Health Center, UMR 1219, Bordeaux, France; The Alliance for International Medical Action, Dakar, Senegal.
| | - Béatrice Serra
- University of Bordeaux, National Institute for Health and Medical Research (Inserm), Research Institute for Sustainable Development (IRD), Bordeaux Population Health Center, UMR 1219, Bordeaux, France; The Alliance for International Medical Action, Dakar, Senegal.
| | - Baweye Mayoum
- The Alliance for International Medical Action, Dakar, Senegal.
| | | | | | - Placide Mbala
- Institut National de la Recherche Biomedicale, Kinshasa, Democratic Republic of the Congo.
| | - Richard Kojan
- The Alliance for International Medical Action, Dakar, Senegal.
| | - Denis Malvy
- University of Bordeaux, National Institute for Health and Medical Research (Inserm), Research Institute for Sustainable Development (IRD), Bordeaux Population Health Center, UMR 1219, Bordeaux, France; Department for infections and tropical diseases, University Hospital of Bordeaux, Bordeaux, France.
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The Methanolic Extract of Perilla frutescens Robustly Restricts Ebola Virus Glycoprotein-Mediated Entry. Viruses 2021; 13:v13091793. [PMID: 34578374 PMCID: PMC8473196 DOI: 10.3390/v13091793] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 08/25/2021] [Accepted: 09/04/2021] [Indexed: 11/17/2022] Open
Abstract
Ebola virus (EBOV), one of the most infectious human viruses and a leading cause of viral hemorrhagic fever, imposes a potential public health threat with several recent outbreaks. Despite the difficulties associated with working with this pathogen in biosafety level-4 containment, a protective vaccine and antiviral therapeutic were recently approved. However, the high mortality rate of EBOV infection underscores the necessity to continuously identify novel antiviral strategies to help expand the scope of prophylaxis/therapeutic management against future outbreaks. This includes identifying antiviral agents that target EBOV entry, which could improve the management of EBOV infection. Herein, using EBOV glycoprotein (GP)-pseudotyped particles, we screened a panel of natural medicinal extracts, and identified the methanolic extract of Perilla frutescens (PFME) as a robust inhibitor of EBOV entry. We show that PFME dose-dependently impeded EBOV GP-mediated infection at non-cytotoxic concentrations, and exerted the most significant antiviral activity when both the extract and the pseudoparticles are concurrently present on the host cells. Specifically, we demonstrate that PFME could block viral attachment and neutralize the cell-free viral particles. Our results, therefore, identified PFME as a potent inhibitor of EBOV entry, which merits further evaluation for development as a therapeutic strategy against EBOV infection.
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11
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Ciencewicki JM, Herbert AS, Storm N, Josleyn NM, Huie K, McKay LGA, Griffiths A, Dye JM, Willis T, Arora V. Characterization of an Anti-Ebola virus Hyperimmune Globulin Derived from Convalescent Plasma. J Infect Dis 2021; 225:733-740. [PMID: 34448858 DOI: 10.1093/infdis/jiab432] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 08/26/2021] [Indexed: 11/13/2022] Open
Abstract
BACKRGOUND Convalescent plasma has been used to treat many viral diseases including Ebola. The manufacture of a purified anti-Ebola virus (EBOV) intravenous immunoglobulin (IVIG) from pooled convalescent plasma is described in this paper. METHODS An ELISA targeting an EBOV surface glycoprotein antigen was used to determine the immunoglobulin titer of pooled plasma and purified anti-EBOV IVIG. Anti-EBOV IVIG was also tested in neutralization assays using a vesicular stomatitis virus pseudovirion expressing EBOV glycoprotein on its surface and with live EBOV. Finally, the efficacy of the anti-EBOV IVIG was assessed in a mouse model of EBOV infection. RESULTS In the ELISA, the anti-EBOV IVIG was shown to have a seven-fold increase in IgG titer over pooled convalescent plasma. In both the pseudovirion and live virus assays, the anti-EBOV IVIG showed approximately five- to six-fold increased potency over pooled plasma. Anti-EBOV IVIG also significantly improved survivability in mice infected with the virus when administered concurrently or two days after infection. CONCLUSIONS These data support this purified anti-EBOV IVIG merits additional investigation and clinical trials for treatment and post-exposure prophylaxis of Ebola virus disease. The experience gained can be applied to manufacture hyperimmune globulins against other emerging viruses.
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Affiliation(s)
| | - Andrew S Herbert
- United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, MD, USA
| | - Nadia Storm
- National Emerging Infectious Diseases Laboratories, Boston University School of Medicine, Boston, MA, USA
| | - Nicole M Josleyn
- United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, MD, USA
| | - Kathleen Huie
- United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, MD, USA
| | - Lindsay G A McKay
- National Emerging Infectious Diseases Laboratories, Boston University School of Medicine, Boston, MA, USA
| | - Anthony Griffiths
- National Emerging Infectious Diseases Laboratories, Boston University School of Medicine, Boston, MA, USA
| | - John M Dye
- United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, MD, USA
| | - Todd Willis
- Grifols Bioscience R&D, Research Triangle Park, NC, USA
| | - Vikram Arora
- Grifols Bioscience R&D, Research Triangle Park, NC, USA
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Davis C, Tipton T, Sabir S, Aitken C, Bennett S, Becker S, Evans T, Fehling SK, Gunson R, Hall Y, Jackson C, Johanssen I, Kieny MP, Mcmenamin J, Spence E, Strecker T, Sykes C, Templeton K, Thorburn F, Peters E, Henao Restrepo AM, White B, Zambon M, Carroll MW, Thomson EC. Postexposure Prophylaxis With rVSV-ZEBOV Following Exposure to a Patient With Ebola Virus Disease Relapse in the United Kingdom: An Operational, Safety, and Immunogenicity Report. Clin Infect Dis 2021; 71:2872-2879. [PMID: 31784751 PMCID: PMC7778350 DOI: 10.1093/cid/ciz1165] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 11/28/2019] [Indexed: 12/16/2022] Open
Abstract
Background In October 2015, 65 people came into direct contact with a healthcare worker presenting with a late reactivation of Ebola virus disease (EVD) in the United Kingdom. Vaccination was offered to 45 individuals with an initial assessment of high exposure risk. Methods Approval for rapid expanded access to the recombinant vesicular stomatitis virus–Zaire Ebola virus (rVSV-ZEBOV) vaccine as an unlicensed emergency medicine was obtained from the relevant authorities. An observational follow-up study was carried out for 1 year following vaccination. Results Twenty-six of 45 individuals elected to receive vaccination between 10 and 11 October 2015 following written informed consent. By day 14, 39% had seroconverted, increasing to 87% by day 28 and 100% by 3 months, although these responses were not always sustained. Neutralizing antibody responses were detectable in 36% by day 14 and 73% at 12 months. Common side effects included fatigue, myalgia, headache, arthralgia, and fever. These were positively associated with glycoprotein-specific T-cell but not immunoglobulin (Ig) M or IgG antibody responses. No severe vaccine-related adverse events were reported. No one exposed to the virus became infected. Conclusions This paper reports the use of the rVSV-ZEBOV vaccine given as an emergency intervention to individuals exposed to a patient presenting with a late reactivation of EVD. The vaccine was relatively well tolerated, but a high percentage developed a fever ≥37.5°C, necessitating urgent screening for Ebola virus, and a small number developed persistent arthralgia.
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Affiliation(s)
- Chris Davis
- Medical Research Council-University of Glasgow Centre for Virus Research, Glasgow, United Kingdom
| | - Tom Tipton
- Porton Down, National Infection Service, Public Health England, Salisbury, United Kingdom
| | - Suleman Sabir
- Medical Research Council-University of Glasgow Centre for Virus Research, Glasgow, United Kingdom
| | - Celia Aitken
- West of Scotland Specialist Virology Centre, Glasgow Royal Infirmary, Glasgow, United Kingdom
| | - Susan Bennett
- West of Scotland Specialist Virology Centre, Glasgow Royal Infirmary, Glasgow, United Kingdom
| | - Stephan Becker
- Institute of Virology, Philipps University Marburg, Marburg, Germany
| | - Tom Evans
- Department of Infectious Diseases, Queen Elizabeth University Hospital, Glasgow, United Kingdom
| | | | - Rory Gunson
- West of Scotland Specialist Virology Centre, Glasgow Royal Infirmary, Glasgow, United Kingdom
| | - Yper Hall
- Porton Down, National Infection Service, Public Health England, Salisbury, United Kingdom
| | - Celia Jackson
- West of Scotland Specialist Virology Centre, Glasgow Royal Infirmary, Glasgow, United Kingdom.,Department of Infectious Diseases, Queen Elizabeth University Hospital, Glasgow, United Kingdom
| | - Ingolfur Johanssen
- Department of Laboratory Medicine, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom
| | - Marie Paule Kieny
- World Health Organization, Geneva, Switzerland.,Inserm, Paris, France
| | | | - Elizabeth Spence
- Department of Infectious Diseases, Queen Elizabeth University Hospital, Glasgow, United Kingdom
| | - Thomas Strecker
- Institute of Virology, Philipps University Marburg, Marburg, Germany
| | - Catie Sykes
- Department of Infectious Diseases, Queen Elizabeth University Hospital, Glasgow, United Kingdom
| | - Kate Templeton
- Department of Laboratory Medicine, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom
| | - Fiona Thorburn
- West of Scotland Specialist Virology Centre, Glasgow Royal Infirmary, Glasgow, United Kingdom.,Department of Infectious Diseases, Queen Elizabeth University Hospital, Glasgow, United Kingdom
| | - Erica Peters
- Department of Infectious Diseases, Queen Elizabeth University Hospital, Glasgow, United Kingdom
| | | | - Beth White
- Department of Infectious Diseases, Queen Elizabeth University Hospital, Glasgow, United Kingdom
| | - Maria Zambon
- Public Health England Colindale, London, United Kingdom
| | - Miles W Carroll
- Porton Down, National Infection Service, Public Health England, Salisbury, United Kingdom
| | - Emma C Thomson
- Medical Research Council-University of Glasgow Centre for Virus Research, Glasgow, United Kingdom.,Department of Infectious Diseases, Queen Elizabeth University Hospital, Glasgow, United Kingdom
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13
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Akindele AJ, Agunbiade FO, Sofidiya MO, Awodele O, Sowemimo A, Ade-Ademilua O, Akinleye MO, Ishola IO, Orabueze I, Salu OB, Oreagba IA, Asekun OT, Odukoya O. COVID-19 Pandemic: A Case for Phytomedicines. Nat Prod Commun 2020; 15:1934578X20945086. [PMID: 34191921 PMCID: PMC7429914 DOI: 10.1177/1934578x20945086] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 06/28/2020] [Indexed: 12/27/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) is an infection caused by a newly discovered coronavirus which was identified in Wuhan, China. The race is on globally to repurpose drugs for COVID-19 and develop a safe and effective vaccine against the disease. There is an urgent need to search for effective remedies against COVID-19 from the rich and extensive flora of Africa and the world. A literature search was conducted to obtain information on drugs with the potential for effectiveness in the treatment of COVID-19 based mostly on outcomes of preclinical studies and a few clinical investigations. This was considered important to this perspective as some of the identified mechanisms of action may be related to potential anti-COVID-19 actions of phytomedicines. The findings from the literature search were also used to establish the need for exploration of phytomedicines in the fight against COVID-19. This perspective identifies the need to preserve the rich tradition of herbal medicine in Africa, repositioning it by inculcating all aspects of discovery, development, and chemical evaluation of pharmaceuticals from medicinal plants for effective management of prevalent diseases. The identified mechanisms of action of current drugs under consideration for the treatment of COVID-19 include preventing fusion of SARS-CoV-2 with human cells; decrease acidity in endosomes, cell membrane-derived vesicles for transportation of the virus within the host cell and within which the virus can replicate; and blockade of the production of proinflammatory cytokines. Phytomedicines may possibly elicit either one or a combination of these effects. The case for the exploration of phytomedicines against COVID-19 is strengthened by the emergence of a number of conventional drugs from medicinal plants and the emergence of botanicals with proven efficacy for some medical conditions. Caution against indiscriminate use of medicinal plants in the guise of treating COVID-19 has been highlighted and the need for reliable preclinical and clinical studies.
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Affiliation(s)
| | - Abidemi J Akindele
- African Center of Excellence for Drug Research, Herbal Medicine Development and Regulatory Science (ACEDHARS), University of Lagos (UNILAG), Lagos, Nigeria.,Department of Pharmacology, Therapeutics & Toxicology, Faculty of Basic Medical Sciences, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Foluso O Agunbiade
- African Center of Excellence for Drug Research, Herbal Medicine Development and Regulatory Science (ACEDHARS), University of Lagos (UNILAG), Lagos, Nigeria.,Department of Chemistry, Faculty of Science, University of Lagos, Lagos, Nigeria
| | - Margaret O Sofidiya
- African Center of Excellence for Drug Research, Herbal Medicine Development and Regulatory Science (ACEDHARS), University of Lagos (UNILAG), Lagos, Nigeria.,Department of Pharmacognosy, Faculty of Pharmacy, University of Lagos, Lagos, Nigeria
| | - Olufunsho Awodele
- African Center of Excellence for Drug Research, Herbal Medicine Development and Regulatory Science (ACEDHARS), University of Lagos (UNILAG), Lagos, Nigeria.,Department of Pharmacology, Therapeutics & Toxicology, Faculty of Basic Medical Sciences, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Abimbola Sowemimo
- African Center of Excellence for Drug Research, Herbal Medicine Development and Regulatory Science (ACEDHARS), University of Lagos (UNILAG), Lagos, Nigeria.,Department of Pharmacognosy, Faculty of Pharmacy, University of Lagos, Lagos, Nigeria
| | - Omobolanle Ade-Ademilua
- African Center of Excellence for Drug Research, Herbal Medicine Development and Regulatory Science (ACEDHARS), University of Lagos (UNILAG), Lagos, Nigeria.,Department of Botany, Faculty of Science, University of Lagos, Lagos, Nigeria
| | - Moshood O Akinleye
- African Center of Excellence for Drug Research, Herbal Medicine Development and Regulatory Science (ACEDHARS), University of Lagos (UNILAG), Lagos, Nigeria.,Department of Pharmaceutical Chemistry, Faculty of Pharmacy, University of Lagos, Lagos, Nigeria
| | - Ismail O Ishola
- African Center of Excellence for Drug Research, Herbal Medicine Development and Regulatory Science (ACEDHARS), University of Lagos (UNILAG), Lagos, Nigeria.,Department of Pharmacology, Therapeutics & Toxicology, Faculty of Basic Medical Sciences, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Ifeoma Orabueze
- African Center of Excellence for Drug Research, Herbal Medicine Development and Regulatory Science (ACEDHARS), University of Lagos (UNILAG), Lagos, Nigeria.,Department of Pharmacognosy, Faculty of Pharmacy, University of Lagos, Lagos, Nigeria
| | - Olumuyiwa B Salu
- African Center of Excellence for Drug Research, Herbal Medicine Development and Regulatory Science (ACEDHARS), University of Lagos (UNILAG), Lagos, Nigeria.,Department of Medical Microbiology & Parasitology, Faculty of Basic Medical Sciences, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Ibrahim A Oreagba
- African Center of Excellence for Drug Research, Herbal Medicine Development and Regulatory Science (ACEDHARS), University of Lagos (UNILAG), Lagos, Nigeria.,Department of Pharmacology, Therapeutics & Toxicology, Faculty of Basic Medical Sciences, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Olayinka T Asekun
- African Center of Excellence for Drug Research, Herbal Medicine Development and Regulatory Science (ACEDHARS), University of Lagos (UNILAG), Lagos, Nigeria.,Department of Chemistry, Faculty of Science, University of Lagos, Lagos, Nigeria
| | - Olukemi Odukoya
- African Center of Excellence for Drug Research, Herbal Medicine Development and Regulatory Science (ACEDHARS), University of Lagos (UNILAG), Lagos, Nigeria.,Department of Pharmacognosy, Faculty of Pharmacy, University of Lagos, Lagos, Nigeria
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14
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Vijayvargiya P, Esquer Garrigos Z, Castillo Almeida NE, Gurram PR, Stevens RW, Razonable RR. Treatment Considerations for COVID-19: A Critical Review of the Evidence (or Lack Thereof). Mayo Clin Proc 2020; 95:1454-1466. [PMID: 32561148 PMCID: PMC7190528 DOI: 10.1016/j.mayocp.2020.04.027] [Citation(s) in RCA: 65] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 04/16/2020] [Accepted: 04/22/2020] [Indexed: 01/08/2023]
Abstract
The novel severe acute respiratory syndrome coronavirus 2 is causing a worldwide pandemic that may lead to a highly morbid and potentially fatal coronavirus disease 2019 (COVID-19). There is currently no drug that has been proven as an effective therapy for COVID-19. Several candidate drugs are being considered and evaluated for treatment. This includes clinically available drugs, such as chloroquine, hydroxychloroquine, and lopinavir/ritonavir, which are being repurposed for the treatment of COVID-19. Novel experimental therapies, such as remdesivir and favipiravir, are also actively being investigated for antiviral efficacy. Clinically available and investigational immunomodulators, such as the interleukin 6 inhibitors tocilizumab and sarilumab and the anti-granulocyte-macrophage colony-stimulating factor lenzilumab, are being tested for their anticipated effect in counteracting the pro-inflammatory cytokine environment that characterizes severe and critical COVID-19. This review article examines the evidence behind the potential use of these leading drug candidates for the treatment of COVID-19. The authors conclude, based on this review, that there is still no high-quality evidence to support any of these proposed drug therapies. The authors, therefore, encourage the enrollment of eligible patients to multiple ongoing clinical trials that assess the efficacy and safety of these candidate therapies. Until the results of controlled trials are available, none of the suggested therapeutics is clinically proven as an effective therapy for COVID-19.
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Key Words
- ace2, angiotensin-converting enzyme 2
- ards, acute respiratory distress syndrome
- cc, 50% cytotoxic concentration
- covid-19, coronavirus disease 2019
- crp, c-reactive protein
- ec50, half-maximal effective concentration
- fda, us food and drug administration
- gm-csf, granulocyte-macrophage colony-stimulating factor
- hiv, human immunodeficiency viruses
- ifn-α, interferon-alpha
- ifn-β, interferon-beta
- il-6, interleukin 6
- lpv, lopinavir
- lpv/r, lopinavir/ritonavir
- mers-cov, middle east respiratory syndrome–related coronavirus
- sars, severe acute respiratory syndrome
- sars-cov, severe acute respiratory syndrome coronavirus
- sars-cov-2, severe acute respiratory syndrome coronavirus 2
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Affiliation(s)
- Prakhar Vijayvargiya
- Division of Infectious Diseases, Department of Medicine, Mayo Clinic College of Medicine and Science, Rochester, MN
| | - Zerelda Esquer Garrigos
- Division of Infectious Diseases, Department of Medicine, Mayo Clinic College of Medicine and Science, Rochester, MN
| | - Natalia E Castillo Almeida
- Division of Infectious Diseases, Department of Medicine, Mayo Clinic College of Medicine and Science, Rochester, MN
| | - Pooja R Gurram
- Division of Infectious Diseases, Department of Medicine, Mayo Clinic College of Medicine and Science, Rochester, MN
| | - Ryan W Stevens
- Department of Pharmacy Services, Mayo Clinic, Rochester, MN
| | - Raymund R Razonable
- Division of Infectious Diseases, Department of Medicine, Mayo Clinic College of Medicine and Science, Rochester, MN.
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15
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Madelain V, Mentré F, Baize S, Anglaret X, Laouénan C, Oestereich L, Nguyen THT, Malvy D, Piorkowski G, Graw F, Günther S, Raoul H, de Lamballerie X, Guedj J. Modeling Favipiravir Antiviral Efficacy Against Emerging Viruses: From Animal Studies to Clinical Trials. CPT Pharmacometrics Syst Pharmacol 2020; 9:258-271. [PMID: 32198838 PMCID: PMC7239338 DOI: 10.1002/psp4.12510] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 12/30/2019] [Indexed: 12/14/2022] Open
Abstract
In 2014, our research network was involved in the evaluation of favipiravir, an anti-influenza polymerase inhibitor, against Ebola virus. In this review, we discuss how mathematical modeling was used, first to propose a relevant dosing regimen in humans, and then to optimize its antiviral efficacy in a nonhuman primate (NHP) model. The data collected in NHPs were finally used to develop a model of Ebola pathogenesis integrating the interactions among the virus, the innate and adaptive immune response, and the action of favipiravir. We conclude the review of this work by discussing how these results are of relevance for future human studies in the context of Ebola virus, but also for other emerging viral diseases for which no therapeutics are available.
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Affiliation(s)
| | | | - Sylvain Baize
- UBIVEInstitut PasteurCentre International de Recherche en InfectiologieLyonFrance
| | - Xavier Anglaret
- INSERMUMR 1219Université de BordeauxBordeauxFrance
- Programme PACCI/site ANRS de Côte d’IvoireAbidjanCôte d’Ivoire
| | | | - Lisa Oestereich
- Bernhard‐Nocht‐Institute for Tropical MedicineHamburgGermany
- German Center for Infection Research (DZIF)Partner Site HamburgGermany
| | | | - Denis Malvy
- INSERMUMR 1219Université de BordeauxBordeauxFrance
- Centre Hospitalier Universitaire de BordeauxBordeauxFrance
| | - Géraldine Piorkowski
- UMR "Emergence des Pathologies Virales" (EPV: Aix‐Marseille University – IRD 190 – Inserm 1207 – EHESP) – Institut Hospitalo‐Universitaire Méditerranée InfectionMarseilleFrance
| | - Frederik Graw
- Center for Modeling and Simulation in the Biosciences (BIOMS)BioQuant‐CenterHeidelberg UniversityHeidelbergGermany
| | - Stephan Günther
- Bernhard‐Nocht‐Institute for Tropical MedicineHamburgGermany
- German Center for Infection Research (DZIF)Partner Site HamburgGermany
| | - Hervé Raoul
- Laboratoire P4 Inserm‐Jean MérieuxUS003 InsermLyonFrance
| | - Xavier de Lamballerie
- UMR "Emergence des Pathologies Virales" (EPV: Aix‐Marseille University – IRD 190 – Inserm 1207 – EHESP) – Institut Hospitalo‐Universitaire Méditerranée InfectionMarseilleFrance
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16
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Ebola Virus Disease: Epidemiology, Clinical Features, Management, and Prevention. Infect Dis Clin North Am 2020; 33:953-976. [PMID: 31668200 DOI: 10.1016/j.idc.2019.08.005] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Ebola virus disease (EVD) is a deadly zoonotic disease caused by the Ebola virus. There is no specific treatment approved for EVD. Supportive care and management of complications are mainstays of treatment. Effective outbreak control requires a multidisciplinary team effort applying case management, infection prevention and control practices, surveillance and contact tracing, a good laboratory service, safe and dignified burials, and social and community mobilization. This article highlights the epidemiology, clinical features, diagnosis, management, and prevention of EVD. The emerging diagnostic technologies, rapid viral characterization, geospatial mapping of EVD transmission, and new treatments and vaccines are discussed.
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17
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Fathi A, Dahlke C, Addo MM. Recombinant vesicular stomatitis virus vector vaccines for WHO blueprint priority pathogens. Hum Vaccin Immunother 2019; 15:2269-2285. [PMID: 31368826 PMCID: PMC6816421 DOI: 10.1080/21645515.2019.1649532] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
The devastating Ebola virus (EBOV) outbreak in West Africa in 2013-2016 has flagged the need for the timely development of vaccines for high-threat pathogens. To be better prepared for new epidemics, the WHO has compiled a list of priority pathogens that are likely to cause future outbreaks and for which R&D efforts are, therefore, paramount (R&D Blueprint: https://www.who.int/blueprint/priority-diseases/en/ ). To this end, the detailed characterization of vaccine platforms is needed. The vesicular stomatitis virus (VSV) has been established as a robust vaccine vector backbone for infectious diseases for well over a decade. The recent clinical trials testing the vaccine candidate VSV-EBOV against EBOV disease now have added a substantial amount of clinical data and suggest VSV to be an ideal vaccine vector candidate for outbreak pathogens. In this review, we discuss insights gained from the clinical VSV-EBOV vaccine trials as well as from animal studies investigating vaccine candidates for Blueprint pathogens.
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Affiliation(s)
- Anahita Fathi
- Department of Medicine, Division of Infectious Diseases, University Medical-Center Hamburg-Eppendorf , Hamburg , Germany.,Department for Clinical Immunology of Infectious Diseases, Bernhard Nocht Institute for Tropical Medicine , Hamburg , Germany.,German Center for Infection Research, Hamburg-Lübeck-Borstel-Riems , Germany
| | - Christine Dahlke
- Department of Medicine, Division of Infectious Diseases, University Medical-Center Hamburg-Eppendorf , Hamburg , Germany.,Department for Clinical Immunology of Infectious Diseases, Bernhard Nocht Institute for Tropical Medicine , Hamburg , Germany.,German Center for Infection Research, Hamburg-Lübeck-Borstel-Riems , Germany
| | - Marylyn M Addo
- Department of Medicine, Division of Infectious Diseases, University Medical-Center Hamburg-Eppendorf , Hamburg , Germany.,Department for Clinical Immunology of Infectious Diseases, Bernhard Nocht Institute for Tropical Medicine , Hamburg , Germany.,German Center for Infection Research, Hamburg-Lübeck-Borstel-Riems , Germany
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18
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Gallagher T, Lipsitch M. Postexposure Effects of Vaccines on Infectious Diseases. Epidemiol Rev 2019; 41:13-27. [PMID: 31680134 PMCID: PMC7159179 DOI: 10.1093/epirev/mxz014] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 10/04/2019] [Accepted: 10/21/2019] [Indexed: 12/18/2022] Open
Abstract
We searched the PubMed database for clinical trials and observational human studies about postexposure vaccination effects, targeting infections with approved vaccines and vaccines licensed outside the United States against dengue, hepatitis E, malaria, and tick-borne encephalitis. Studies of animal models, serologic testing, and pipeline vaccines were excluded. Eligible studies were evaluated by definition of exposure; attempts to distinguish pre- and postexposure effects were rated on a scale of 1 to 4. We screened 4,518 articles and ultimately identified for this review 14 clinical trials and 31 observational studies spanning 7 of the 28 vaccine-preventable diseases. For secondary attack rate, the following medians were found for postexposure vaccination effectiveness: hepatitis A, 85% (interquartile range (IQR), 28; n = 5 sources); hepatitis B, 85% (IQR, 22; n = 5 sources); measles, 83% (IQR, 21; n = 8 sources); varicella, 67% (IQR: 48; n = 9 sources); smallpox, 45% (IQR, 39; n = 4 sources); and mumps, 38% (IQR, 7; n = 2 sources). For case fatality proportions resulting from rabies and smallpox, the median vaccine postexposure efficacies were 100% (IQR, 0; n = 6 sources) and 63% (IQR, 50; n = 8 sources), respectively. Many available vaccines can modify or preclude disease if administered after exposure. This postexposure effectiveness could be important to consider during vaccine trials and while developing new vaccines.
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Affiliation(s)
- Tara Gallagher
- Dartmouth College Department of Physics and Astronomy, Hanover, New Hampshire
| | - Marc Lipsitch
- Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts
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19
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Okamoto K, Shoji T, Tsutsui M, Shida N, Chiba K. Synthesis of Ribo-Azanucleosides by Anodic Oxidation: Reactivity Control of Intermediate for Efficient Access to Pharmacophores. Chemistry 2018; 24:17902-17905. [PMID: 30216580 DOI: 10.1002/chem.201804285] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Indexed: 11/11/2022]
Abstract
Azanucleosides, the sugar-modified nucleoside analogues, have various biological activities, while their efficient synthetic strategy is still under development. Herein, a novel method for the synthesis of pharmaceutically relevant azanucleosides, β-anomers of ribo-azanucleosides, by means of site-specific anodic C-H activation by using a nitroalkane-lithium perchlorate medium is reported. A mechanistic study of the electrochemical reaction and the armed/disarmed concept from traditional glycochemistry revealed that the 2'-substituent has a significant effect on the reactivity of prolinol derivative, and suitable carboxylic acid additives can control the reactivity of the intermediate species, an iminium cation equivalent. Finally, this method was demonstrated to be applicable for the synthesis of β-anomers of ribo-azanucleosides with all four nucleobases in a stereoselective manner.
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Affiliation(s)
- Kazuhiro Okamoto
- Department of Applied Biological Science, Tokyo University of Agriculture and Technology, 3-5-8 Saiwai-cho, Fuchu, Tokyo, 183-8509, Japan
| | - Takao Shoji
- Department of Applied Biological Science, Tokyo University of Agriculture and Technology, 3-5-8 Saiwai-cho, Fuchu, Tokyo, 183-8509, Japan
| | - Mizuki Tsutsui
- Department of Applied Biological Science, Tokyo University of Agriculture and Technology, 3-5-8 Saiwai-cho, Fuchu, Tokyo, 183-8509, Japan
| | - Naoki Shida
- Department of Applied Biological Science, Tokyo University of Agriculture and Technology, 3-5-8 Saiwai-cho, Fuchu, Tokyo, 183-8509, Japan
| | - Kazuhiro Chiba
- Department of Applied Biological Science, Tokyo University of Agriculture and Technology, 3-5-8 Saiwai-cho, Fuchu, Tokyo, 183-8509, Japan
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20
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Madelain V, Baize S, Jacquot F, Reynard S, Fizet A, Barron S, Solas C, Lacarelle B, Carbonnelle C, Mentré F, Raoul H, de Lamballerie X, Guedj J. Ebola viral dynamics in nonhuman primates provides insights into virus immuno-pathogenesis and antiviral strategies. Nat Commun 2018; 9:4013. [PMID: 30275474 PMCID: PMC6167368 DOI: 10.1038/s41467-018-06215-z] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Accepted: 08/23/2018] [Indexed: 01/12/2023] Open
Abstract
Despite several clinical trials implemented, no antiviral drug could demonstrate efficacy against Ebola virus. In non-human primates, early initiation of polymerase inhibitors favipiravir and remdesivir improves survival, but whether they could be effective in patients is unknown. Here we analyze the impact of antiviral therapy by using a mathematical model that integrates virological and immunological data of 44 cynomolgus macaques, left untreated or treated with favipiravir. We estimate that favipiravir has a ~50% efficacy in blocking viral production, which results in reducing virus growth and cytokine storm while IFNα reduces cell susceptibility to infection. Simulating the effect of delayed initiations of treatment, our model predicts survival rates of 60% for favipiravir and 100% for remdesivir when treatment is initiated within 3 and 4 days post infection, respectively. These results improve the understanding of Ebola immuno-pathogenesis and can help optimize antiviral evaluation in future outbreaks.
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Affiliation(s)
- Vincent Madelain
- IAME, UMR 1137, INSERM, Université Paris Diderot, Sorbonne Paris Cité Paris, 75018, Paris, France.
| | - Sylvain Baize
- UBIVE, Institut Pasteur, Centre International de Recherche en Infectiologie, 69007, Lyon, France
| | - Frédéric Jacquot
- Laboratoire P4 Inserm-Jean Mérieux, US003 Inserm, 69365, Lyon, France
| | - Stéphanie Reynard
- UBIVE, Institut Pasteur, Centre International de Recherche en Infectiologie, 69007, Lyon, France
| | - Alexandra Fizet
- UBIVE, Institut Pasteur, Centre International de Recherche en Infectiologie, 69007, Lyon, France
| | - Stephane Barron
- Laboratoire P4 Inserm-Jean Mérieux, US003 Inserm, 69365, Lyon, France
| | - Caroline Solas
- Aix-Marseille Univ U105, APHM, SMARTc CRCM Inserm UMR1068 CNRS UMR7258, Hôpital La Timone, Laboratoire de Pharmacocinétique et Toxicologie, 13005, Marseille, France
| | - Bruno Lacarelle
- Aix-Marseille Univ U105, APHM, SMARTc CRCM Inserm UMR1068 CNRS UMR7258, Hôpital La Timone, Laboratoire de Pharmacocinétique et Toxicologie, 13005, Marseille, France
| | | | - France Mentré
- IAME, UMR 1137, INSERM, Université Paris Diderot, Sorbonne Paris Cité Paris, 75018, Paris, France
| | - Hervé Raoul
- Laboratoire P4 Inserm-Jean Mérieux, US003 Inserm, 69365, Lyon, France
| | - Xavier de Lamballerie
- UMR "Emergence des Pathologies Virales" (EPV: Aix-Marseille university - IRD 190 - Inserm 1207 - EHESP) - Institut Hospitalo-Universitaire Méditerranée Infection, 13385, Marseille, France
| | - Jérémie Guedj
- IAME, UMR 1137, INSERM, Université Paris Diderot, Sorbonne Paris Cité Paris, 75018, Paris, France
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21
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Nan Y, Zhang YJ. Antisense Phosphorodiamidate Morpholino Oligomers as Novel Antiviral Compounds. Front Microbiol 2018; 9:750. [PMID: 29731743 PMCID: PMC5920040 DOI: 10.3389/fmicb.2018.00750] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 04/03/2018] [Indexed: 01/23/2023] Open
Abstract
Phosphorodiamidate morpholino oligomers (PMO) are short single-stranded DNA analogs that are built upon a backbone of morpholine rings connected by phosphorodiamidate linkages. As uncharged nucleic acid analogs, PMO bind to complementary sequences of target mRNA by Watson–Crick base pairing to block protein translation through steric blockade. PMO interference of viral protein translation operates independently of RNase H. Meanwhile, PMO are resistant to a variety of enzymes present in biologic fluids, a characteristic that makes them highly suitable for in vivo applications. Notably, PMO-based therapy for Duchenne muscular dystrophy (DMD) has been approved by the United States Food and Drug Administration which is now a hallmark for PMO-based antisense therapy. In this review, the development history of PMO, delivery methods for improving cellular uptake of neutrally charged PMO molecules, past studies of PMO antagonism against RNA and DNA viruses, PMO target selection, and remaining questions of PMO antiviral strategies are discussed in detail and new insights are provided.
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Affiliation(s)
- Yuchen Nan
- Department of Preventive Veterinary Medicine, College of Veterinary Medicine, Northwest A&F University, Yangling, China.,Virginia-Maryland College of Veterinary Medicine and Maryland Pathogen Research Institute, University of Maryland, College Park, MD, United States
| | - Yan-Jin Zhang
- Virginia-Maryland College of Veterinary Medicine and Maryland Pathogen Research Institute, University of Maryland, College Park, MD, United States
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Chen S, Yu X, Guo D. CRISPR-Cas Targeting of Host Genes as an Antiviral Strategy. Viruses 2018; 10:E40. [PMID: 29337866 PMCID: PMC5795453 DOI: 10.3390/v10010040] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2017] [Revised: 01/12/2018] [Accepted: 01/14/2018] [Indexed: 12/20/2022] Open
Abstract
Currently, a new gene editing tool-the Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR) associated (Cas) system-is becoming a promising approach for genetic manipulation at the genomic level. This simple method, originating from the adaptive immune defense system in prokaryotes, has been developed and applied to antiviral research in humans. Based on the characteristics of virus-host interactions and the basic rules of nucleic acid cleavage or gene activation of the CRISPR-Cas system, it can be used to target both the virus genome and host factors to clear viral reservoirs and prohibit virus infection or replication. Here, we summarize recent progress of the CRISPR-Cas technology in editing host genes as an antiviral strategy.
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Affiliation(s)
- Shuliang Chen
- School of Basic Medical Sciences, Wuhan University, Wuhan 430071, China.
| | - Xiao Yu
- Institute of Health Inspection and Testing, Hubei Provincial Center for Disease Control and Prevention, Wuhan 430079, China.
| | - Deyin Guo
- School of Medicine (Shenzhen), Sun Yat-sen University, Guangzhou 510080, China.
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