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Posted: April 04 2006 at 8:01am |
Existing drugs show promise in treating bird flu
THOMAS M. BURTON April 4, 2006 7:15 AM The Wall Street Journal No one knows whether an avian flu pandemic will ever strike, or if a viable vaccine will be found before it does. But many of the life-threatening symptoms of the flu resemble other conditions that are occurring in thousands of patients now, and the drugs to treat these conditions could be used to treat the bird flu, researchers say. One of those conditions is acute respiratory distress syndrome, or ARDS, a lung condition involving inflammation and fluid buildup that often follows viral pneumonia and septic infections. Drugs to treat such conditions may be useful for treating bird flu, even if vaccines and antivirals aren't available. Because the avian flu virus acts much the same way as ARDS, researchers are now hard at work studying drugs currently used to treat ARDS that could have the potential to fight bird flu too. ''We have a lot to offer people if the flu should strike.'' says Michael A. Matthay, a researcher at the University of California-San Francisco. Some of the drugs are exotic and experimental, used so far only on mice. Other pills are household names, such as Merck & Co.'s cholesterol drug Zocor and the generically available asthma drug albuterol. Some are in-between, like Eli Lilly & Co.'s Xigris for septic infections, which is used in emergency settings at thousands of dollars a dose. What these medicines have in common is the ability to fight the constellation of lethal symptoms of ARDS, which some researchers call ''vascular leak'' because the walls of blood vessels supplying the lungs grow inflamed and porous, causing fluid to seep into the lungs. About 75,000 Americans die annually from ARDS and related conditions, according to critical-care physicians. Researchers at leading institutions like the ''If vaccinations do not prevent it, therapy for bird flu is no different than for the inflammatory process of ARDS,'' says Augustine Choi, chief of pulmonary and critical-care medicine at the University of Pittsburgh Medical Center. The avian flu virus has killed more than 100 humans since its detection in Doctors are optimistic that statins, the class of cholesterol-lowering drugs that includes Zocor and Pfizer Inc.'s Lipitor, could play a role. That's because statins also fight the inflammation that causes leaky vessels. Although these drugs aren't currently prescribed for respiratory illnesses, ''statins could be part of a world-wide effort to reduce morbidity and mortality from avian flu,'' says Joe G.N. Garcia, chief of medicine at the At the ''We've clearly demonstrated that these drugs affect blood-vessel function,'' Dr. Jacobson says. There's also evidence that statins can help in humans in respiratory distress. Doctors at While the study involved using statins as a cholesterol drug, researchers believe giving them early in treatment could produce similar beneficial effects for respiratory illnesses. Using Zocor ''would be the lowest-hanging fruit'' of possible drugs for bird flu because it's relatively inexpensive, and already widely available, Dr. Garcia says. It also could get patients off ventilators faster. That's important because the ventilator itself can cause injury to the lungs. And if an epidemic were to strike, ventilators could become a scarce commodity. Dr. Garcia and colleagues have found that experimental drugs that mimic a naturally occurring compound in the body, sphingosine 1-phosphate, produced ''significant decreases'' in vascular leakage in animal tests. Scientists also have found that Lilly's Xigris, already on the market, appears to build up capillary walls that hold in fluid. UCSF's Dr. Matthay and colleagues are investigating the use of the asthma drug albuterol in ARDS patients. It acts, he says, by ''removing fluid from the air spaces of the lungs, and it may also work by decreasing inflammation of the lungs.'' And if bird flu never strikes, much of this research will nevertheless be vital: The University of Chicago's Dr. Jacobson says that, at any given time, more than one-fourth of patients in the medical intensive-care unit are suffering from acute respiratory distress and related conditions. AP-WS-04-04-06 1013EDT |
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