Confronting an influenza pandemic with inexpensive generic agents : can it be done?
Identifieur interne : 001347 ( Main/Exploration ); précédent : 001346; suivant : 001348Confronting an influenza pandemic with inexpensive generic agents : can it be done?
Auteurs : David S. FedsonSource :
- Lancet. Infectious diseases : (print) [ 1473-3099 ] ; 2008.
Descripteurs français
- KwdFr :
- Antiviraux (pharmacologie), Antiviraux (usage thérapeutique), Chloroquine (pharmacologie), Chloroquine (usage thérapeutique), Facteurs immunologiques (pharmacologie), Facteurs immunologiques (usage thérapeutique), Flambées de maladies (), Gemfibrozil (pharmacologie), Gemfibrozil (usage thérapeutique), Grippe humaine (), Grippe humaine (traitement médicamenteux), Grippe humaine (épidémiologie), Humains, Inhibiteurs de l'hydroxyméthylglutaryl-CoA réductase (pharmacologie), Inhibiteurs de l'hydroxyméthylglutaryl-CoA réductase (usage thérapeutique), Sous-type H5N1 du virus de la grippe A ().
- MESH :
- pharmacologie : Antiviraux, Chloroquine, Facteurs immunologiques, Gemfibrozil, Inhibiteurs de l'hydroxyméthylglutaryl-CoA réductase.
- traitement médicamenteux : Grippe humaine.
- usage thérapeutique : Antiviraux, Chloroquine, Facteurs immunologiques, Gemfibrozil, Inhibiteurs de l'hydroxyméthylglutaryl-CoA réductase.
- épidémiologie : Grippe humaine.
- Pascal (Inist)
English descriptors
- KwdEn :
- Antiviral Agents (pharmacology), Antiviral Agents (therapeutic use), Chloroquine (pharmacology), Chloroquine (therapeutic use), Disease Outbreaks (prevention & control), Gemfibrozil (pharmacology), Gemfibrozil (therapeutic use), Humans, Hydroxymethylglutaryl-CoA Reductase Inhibitors (pharmacology), Hydroxymethylglutaryl-CoA Reductase Inhibitors (therapeutic use), Immunologic Factors (pharmacology), Immunologic Factors (therapeutic use), Influenza, Influenza A Virus, H5N1 Subtype (drug effects), Influenza, Human (drug therapy), Influenza, Human (epidemiology), Influenza, Human (prevention & control).
- MESH :
- chemical , pharmacology : Antiviral Agents, Chloroquine, Gemfibrozil, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Immunologic Factors.
- chemical , therapeutic use : Antiviral Agents, Chloroquine, Gemfibrozil, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Immunologic Factors.
- drug effects : Influenza A Virus, H5N1 Subtype.
- drug therapy : Influenza, Human.
- epidemiology : Influenza, Human.
- prevention & control : Disease Outbreaks, Influenza, Human.
- Humans.
Abstract
Avian influenza A H5N1 presents a serious and possibly imminent pandemic threat. In such an event, adequate supplies of affordable vaccines and antiviral agents will be unavailable to most people in the world. In view of the overwhelming need for effective alternatives, generic agents that target the host immune response or the pandemic virus should be considered. Many scientists doubt the effectiveness of these agents. Nonetheless, several studies suggest that statins improve outcomes in patients with bacteraemia and pneumonia and might be similarly effective against influenza. An experimental study has shown that the fibrate gemfibrozil, a peroxisome proliferator-activated receptor (PPAR) a agonist, reduces mortality in H2N2 influenza virus-infected mice. There is substantial molecular cross-talk between statins and PPAR agonists, and their clinical effects are additive in patients with cardiovascular diseases. Chloroquine increases endosomal pH, impairing influenza virus release into the cytosol. Statins, fibrates, and chloroquine are produced as generic medications in developing countries. They are inexpensive, could be stockpiled, and would be available on the first pandemic day. With a lack of realistic alternatives for confronting the next pandemic, research is urgently needed to determine whether these and other generic agents could mitigate the effects of what might otherwise become an unprecedented global public-health crisis.
Affiliations:
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Le document en format XML
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Fedson</name><affiliation><wicri:noCountry>no AF</wicri:noCountry></affiliation></author></analytic><series><title level="j" type="main">Lancet. Infectious diseases : (print)</title><title level="j" type="abbreviated">Lancet. Infect. dis. : (print)</title><idno type="ISSN">1473-3099</idno><imprint><date when="2008">2008</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Lancet. Infectious diseases : (print)</title><title level="j" type="abbreviated">Lancet. Infect. dis. : (print)</title><idno type="ISSN">1473-3099</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Antiviral Agents (pharmacology)</term><term>Antiviral Agents (therapeutic use)</term><term>Chloroquine (pharmacology)</term><term>Chloroquine (therapeutic use)</term><term>Disease Outbreaks (prevention & control)</term><term>Gemfibrozil (pharmacology)</term><term>Gemfibrozil (therapeutic use)</term><term>Humans</term><term>Hydroxymethylglutaryl-CoA Reductase Inhibitors (pharmacology)</term><term>Hydroxymethylglutaryl-CoA Reductase Inhibitors (therapeutic use)</term><term>Immunologic Factors (pharmacology)</term><term>Immunologic Factors (therapeutic use)</term><term>Influenza</term><term>Influenza A Virus, H5N1 Subtype (drug effects)</term><term>Influenza, Human (drug therapy)</term><term>Influenza, Human (epidemiology)</term><term>Influenza, Human (prevention & control)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Antiviraux (pharmacologie)</term><term>Antiviraux (usage thérapeutique)</term><term>Chloroquine (pharmacologie)</term><term>Chloroquine (usage thérapeutique)</term><term>Facteurs immunologiques (pharmacologie)</term><term>Facteurs immunologiques (usage thérapeutique)</term><term>Flambées de maladies ()</term><term>Gemfibrozil (pharmacologie)</term><term>Gemfibrozil (usage thérapeutique)</term><term>Grippe humaine ()</term><term>Grippe humaine (traitement médicamenteux)</term><term>Grippe humaine (épidémiologie)</term><term>Humains</term><term>Inhibiteurs de l'hydroxyméthylglutaryl-CoA réductase (pharmacologie)</term><term>Inhibiteurs de l'hydroxyméthylglutaryl-CoA réductase (usage thérapeutique)</term><term>Sous-type H5N1 du virus de la grippe A ()</term></keywords><keywords scheme="MESH" type="chemical" qualifier="pharmacology" xml:lang="en"><term>Antiviral Agents</term><term>Chloroquine</term><term>Gemfibrozil</term><term>Hydroxymethylglutaryl-CoA Reductase Inhibitors</term><term>Immunologic Factors</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Antiviral Agents</term><term>Chloroquine</term><term>Gemfibrozil</term><term>Hydroxymethylglutaryl-CoA Reductase Inhibitors</term><term>Immunologic Factors</term></keywords><keywords scheme="MESH" qualifier="drug effects" xml:lang="en"><term>Influenza A Virus, H5N1 Subtype</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Influenza, Human</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Influenza, Human</term></keywords><keywords scheme="MESH" qualifier="pharmacologie" xml:lang="fr"><term>Antiviraux</term><term>Chloroquine</term><term>Facteurs immunologiques</term><term>Gemfibrozil</term><term>Inhibiteurs de l'hydroxyméthylglutaryl-CoA réductase</term></keywords><keywords scheme="MESH" qualifier="prevention & control" xml:lang="en"><term>Disease Outbreaks</term><term>Influenza, Human</term></keywords><keywords scheme="MESH" qualifier="traitement médicamenteux" xml:lang="fr"><term>Grippe humaine</term></keywords><keywords scheme="MESH" qualifier="usage thérapeutique" xml:lang="fr"><term>Antiviraux</term><term>Chloroquine</term><term>Facteurs immunologiques</term><term>Gemfibrozil</term><term>Inhibiteurs de l'hydroxyméthylglutaryl-CoA réductase</term></keywords><keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Grippe humaine</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Humans</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Flambées de maladies</term><term>Grippe</term><term>Grippe humaine</term><term>Humains</term><term>Pandémie</term><term>Sous-type H5N1 du virus de la grippe A</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Avian influenza A H5N1 presents a serious and possibly imminent pandemic threat. In such an event, adequate supplies of affordable vaccines and antiviral agents will be unavailable to most people in the world. In view of the overwhelming need for effective alternatives, generic agents that target the host immune response or the pandemic virus should be considered. Many scientists doubt the effectiveness of these agents. Nonetheless, several studies suggest that statins improve outcomes in patients with bacteraemia and pneumonia and might be similarly effective against influenza. An experimental study has shown that the fibrate gemfibrozil, a peroxisome proliferator-activated receptor (PPAR) a agonist, reduces mortality in H2N2 influenza virus-infected mice. There is substantial molecular cross-talk between statins and PPAR agonists, and their clinical effects are additive in patients with cardiovascular diseases. Chloroquine increases endosomal pH, impairing influenza virus release into the cytosol. Statins, fibrates, and chloroquine are produced as generic medications in developing countries. They are inexpensive, could be stockpiled, and would be available on the first pandemic day. With a lack of realistic alternatives for confronting the next pandemic, research is urgently needed to determine whether these and other generic agents could mitigate the effects of what might otherwise become an unprecedented global public-health crisis.</div></front></TEI><affiliations><list></list><tree><noCountry><name sortKey="Fedson, David S" sort="Fedson, David S" uniqKey="Fedson D" first="David S." last="Fedson">David S. Fedson</name></noCountry></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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