Clinician-initiated research on treating the host response to pandemic influenza.
Identifieur interne : 000360 ( PubMed/Curation ); précédent : 000359; suivant : 000361Clinician-initiated research on treating the host response to pandemic influenza.
Auteurs : David S. FedsonSource :
- Human vaccines & immunotherapeutics [ 2164-554X ] ; 2018.
Descripteurs français
- KwdFr :
- Flambées de maladies (), Grippe humaine (), Grippe humaine (immunologie), Grippe humaine (traitement médicamenteux), Humains, Inhibiteurs de l'hydroxyméthylglutaryl-CoA réductase (immunologie), Inhibiteurs de l'hydroxyméthylglutaryl-CoA réductase (usage thérapeutique), Médicaments génériques (usage thérapeutique), Pandémies, Pneumopathie infectieuse (immunologie), Pneumopathie infectieuse (traitement médicamenteux), Sepsie (immunologie), Sepsie (traitement médicamenteux), Vaccins antigrippaux (immunologie).
- MESH :
- immunologie : Grippe humaine, Inhibiteurs de l'hydroxyméthylglutaryl-CoA réductase, Pneumopathie infectieuse, Sepsie, Vaccins antigrippaux.
- traitement médicamenteux : Grippe humaine, Pneumopathie infectieuse, Sepsie.
- usage thérapeutique : Inhibiteurs de l'hydroxyméthylglutaryl-CoA réductase, Médicaments génériques.
- Flambées de maladies, Grippe humaine, Humains, Pandémies.
English descriptors
- KwdEn :
- Disease Outbreaks (prevention & control), Drugs, Generic (therapeutic use), Humans, Hydroxymethylglutaryl-CoA Reductase Inhibitors (immunology), Hydroxymethylglutaryl-CoA Reductase Inhibitors (therapeutic use), Influenza Vaccines (immunology), Influenza, Human (drug therapy), Influenza, Human (immunology), Influenza, Human (prevention & control), Pandemics, Pneumonia (drug therapy), Pneumonia (immunology), Sepsis (drug therapy), Sepsis (immunology).
- MESH :
- chemical , immunology : Hydroxymethylglutaryl-CoA Reductase Inhibitors, Influenza Vaccines.
- chemical , therapeutic use : Drugs, Generic, Hydroxymethylglutaryl-CoA Reductase Inhibitors.
- drug therapy : Influenza, Human, Pneumonia, Sepsis.
- immunology : Influenza, Human, Pneumonia, Sepsis.
- prevention & control : Disease Outbreaks, Influenza, Human.
- Humans, Pandemics.
Abstract
To prepare for the next influenza pandemic and other emerging virus diseases, scientists and health officials are focused on developing new vaccines and treatments that target these viruses. Ideally, these interventions could be highly effective, but for many practical reasons these "top down" efforts are unlikely to provide clinicians with what they will need to manage their patients. As a "bottom up" alternative, combinations of generic drugs like statins and angiotensin receptor blockers (ARBs) might be used to treat the host response to infection. These drugs counteract endothelial dysfunction, a central abnormality in these diseases. Observational studies in patients with influenza, pneumonia, sepsis and Ebola suggest they might work. During the 1918 influenza pandemic, children were infected more frequently than adults, but their mortality rate was much lower. Their survival was probably due to better tolerance (reduced pathogen damage), not greater resistance (reduced pathogen burden). The same pattern of susceptibility characterizes other infectious diseases, and it probably reflects the heritage of human evolution. Drugs like statins and ARBs can metabolically reprogram the host response and improve tolerance to infection. Treating the host response is not on the research agendas of international agencies responsible for pandemic preparedness. Consequently, clinicians might have to undertake clinical trials in patients hospitalised with seasonal influenza, pneumonia and sepsis in order to show convincingly whether treating the host response would work. Most candidate generic drugs are inexpensive, widely available, known to be safe and used by clinicians every day. Demonstrating their efficacy would mean that patients in all countries would have access to treatment on the first pandemic or epidemic day.
DOI: 10.1080/21645515.2017.1378292
PubMed: 29058516
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Ideally, these interventions could be highly effective, but for many practical reasons these "top down" efforts are unlikely to provide clinicians with what they will need to manage their patients. As a "bottom up" alternative, combinations of generic drugs like statins and angiotensin receptor blockers (ARBs) might be used to treat the host response to infection. These drugs counteract endothelial dysfunction, a central abnormality in these diseases. Observational studies in patients with influenza, pneumonia, sepsis and Ebola suggest they might work. During the 1918 influenza pandemic, children were infected more frequently than adults, but their mortality rate was much lower. Their survival was probably due to better tolerance (reduced pathogen damage), not greater resistance (reduced pathogen burden). The same pattern of susceptibility characterizes other infectious diseases, and it probably reflects the heritage of human evolution. Drugs like statins and ARBs can metabolically reprogram the host response and improve tolerance to infection. Treating the host response is not on the research agendas of international agencies responsible for pandemic preparedness. Consequently, clinicians might have to undertake clinical trials in patients hospitalised with seasonal influenza, pneumonia and sepsis in order to show convincingly whether treating the host response would work. Most candidate generic drugs are inexpensive, widely available, known to be safe and used by clinicians every day. Demonstrating their efficacy would mean that patients in all countries would have access to treatment on the first pandemic or epidemic day.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">29058516</PMID><DateCompleted><Year>2019</Year><Month>01</Month><Day>02</Day></DateCompleted><DateRevised><Year>2019</Year><Month>01</Month><Day>02</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">2164-554X</ISSN><JournalIssue CitedMedium="Internet"><Volume>14</Volume><Issue>3</Issue><PubDate><Year>2018</Year><Month>03</Month><Day>04</Day></PubDate></JournalIssue><Title>Human vaccines & immunotherapeutics</Title><ISOAbbreviation>Hum Vaccin Immunother</ISOAbbreviation></Journal><ArticleTitle>Clinician-initiated research on treating the host response to pandemic influenza.</ArticleTitle><Pagination><MedlinePgn>790-795</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1080/21645515.2017.1378292</ELocationID><Abstract><AbstractText>To prepare for the next influenza pandemic and other emerging virus diseases, scientists and health officials are focused on developing new vaccines and treatments that target these viruses. Ideally, these interventions could be highly effective, but for many practical reasons these "top down" efforts are unlikely to provide clinicians with what they will need to manage their patients. As a "bottom up" alternative, combinations of generic drugs like statins and angiotensin receptor blockers (ARBs) might be used to treat the host response to infection. These drugs counteract endothelial dysfunction, a central abnormality in these diseases. Observational studies in patients with influenza, pneumonia, sepsis and Ebola suggest they might work. During the 1918 influenza pandemic, children were infected more frequently than adults, but their mortality rate was much lower. Their survival was probably due to better tolerance (reduced pathogen damage), not greater resistance (reduced pathogen burden). The same pattern of susceptibility characterizes other infectious diseases, and it probably reflects the heritage of human evolution. Drugs like statins and ARBs can metabolically reprogram the host response and improve tolerance to infection. Treating the host response is not on the research agendas of international agencies responsible for pandemic preparedness. Consequently, clinicians might have to undertake clinical trials in patients hospitalised with seasonal influenza, pneumonia and sepsis in order to show convincingly whether treating the host response would work. Most candidate generic drugs are inexpensive, widely available, known to be safe and used by clinicians every day. Demonstrating their efficacy would mean that patients in all countries would have access to treatment on the first pandemic or epidemic day.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Fedson</LastName><ForeName>David S</ForeName><Initials>DS</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2017</Year><Month>10</Month><Day>31</Day></ArticleDate></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Hum Vaccin Immunother</MedlineTA><NlmUniqueID>101572652</NlmUniqueID><ISSNLinking>2164-5515</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D016568">Drugs, Generic</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D019161">Hydroxymethylglutaryl-CoA Reductase 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