A new millennium conundrum: how to use a powerful class of influenza anti-neuraminidase drugs (NAIs) in the community
Identifieur interne : 000520 ( Ncbi/Merge ); précédent : 000519; suivant : 000521A new millennium conundrum: how to use a powerful class of influenza anti-neuraminidase drugs (NAIs) in the community
Auteurs : John Oxford [Royaume-Uni] ; Shobana Balasingam [Royaume-Uni] ; Rob Lambkin [Royaume-Uni]Source :
- Journal of Antimicrobial Chemotherapy [ 0305-7453 ] ; 2004.
Descripteurs français
- KwdFr :
- MESH :
- antagonistes et inhibiteurs : Sialidase.
- traitement médicamenteux : Grippe humaine.
- usage thérapeutique : Antienzymes, Antiviraux.
- virologie : Grippe humaine.
- Flambées de maladies, Grippe humaine, Humains, Infections communautaires, Résistance virale aux médicaments.
English descriptors
- KwdEn :
- Antiviral Agents (therapeutic use), Community-Acquired Infections (prevention & control), Disease Outbreaks (prevention & control), Drug Resistance, Viral, Enzyme Inhibitors (therapeutic use), Humans, Influenza, Human (drug therapy), Influenza, Human (prevention & control), Influenza, Human (virology), Neuraminidase (antagonists & inhibitors).
- MESH :
- chemical , antagonists & inhibitors : Neuraminidase.
- chemical , therapeutic use : Antiviral Agents, Enzyme Inhibitors.
- drug therapy : Influenza, Human.
- prevention & control : Community-Acquired Infections, Disease Outbreaks, Influenza, Human.
- virology : Influenza, Human.
- Drug Resistance, Viral, Humans.
Abstract
Influenza A and B viruses cause serious medical problems and social disruption every year in particular countries of the world. The virus is notoriously fickle and may attack citizens in say two adjacent countries but not the third. More rarely a global pandemic virus emerges causing millions of deaths worldwide. The SARS outbreak has illuminated weaknesses in planning for sudden outbreaks of disease in a modern society and in particular how panic can grip and cause intense economic disruption. Many communities in the world are neither prepared for a global pandemic nor a very acute epidemic of influenza. The neuraminidase inhibitors (NAIs) are a new class of antiviral drug targeting a viral influenza enzyme, the neuraminidase, which acts both to facilitate virus infection of cells by clearing a passage through otherwise protective respiratory fluids and also by helping release of the virus by cutting the chemical umbilical cord which links up the virus to the infected cell. Extensive laboratory studies of the two molecules zanamivir and oseltamivir have shown that they block all influenza A and B viruses yet tested and would, in theory, even inhibit the 1918 pandemic virus. Both drugs can be used prophylactically to prevent spread of infection in families and communities where 80–90% protection has been documented. The therapeutic effects are also strong in adults and children abbreviating infection, reducing quantities of excreted virus and reducing antibiotic prescriptions. The drugs have to be taken within 48 h of the onset of symptoms. Drug resistance is not a problem at present because although such mutants occur the mutants are compromised and are less virulent than their drug-sensitive parents and they spread less easily. The two drugs could be stockpiled to prepare for an influenza pandemic but, importantly, clinical and scientific experience need to be gained by using these inhibitors in the yearly conflagrations of epidemic influenza, which unchecked do great harm to our communities.
Url:
DOI: 10.1093/jac/dkh037
PubMed: 14688047
PubMed Central: 7110053
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PMC:7110053Le document en format XML
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<p>Influenza A and B viruses cause serious medical problems and social disruption every year in particular countries of the world. The virus is notoriously fickle and may attack citizens in say two adjacent countries but not the third. More rarely a global pandemic virus emerges causing millions of deaths worldwide. The SARS outbreak has illuminated weaknesses in planning for sudden outbreaks of disease in a modern society and in particular how panic can grip and cause intense economic disruption. Many communities in the world are neither prepared for a global pandemic nor a very acute epidemic of influenza. The neuraminidase inhibitors (NAIs) are a new class of antiviral drug targeting a viral influenza enzyme, the neuraminidase, which acts both to facilitate virus infection of cells by clearing a passage through otherwise protective respiratory fluids and also by helping release of the virus by cutting the chemical umbilical cord which links up the virus to the infected cell. Extensive laboratory studies of the two molecules zanamivir and oseltamivir have shown that they block all influenza A and B viruses yet tested and would, in theory, even inhibit the 1918 pandemic virus. Both drugs can be used prophylactically to prevent spread of infection in families and communities where 80–90% protection has been documented. The therapeutic effects are also strong in adults and children abbreviating infection, reducing quantities of excreted virus and reducing antibiotic prescriptions. The drugs have to be taken within 48 h of the onset of symptoms. Drug resistance is not a problem at present because although such mutants occur the mutants are compromised and are less virulent than their drug-sensitive parents and they spread less easily. The two drugs could be stockpiled to prepare for an influenza pandemic but, importantly, clinical and scientific experience need to be gained by using these inhibitors in the yearly conflagrations of epidemic influenza, which unchecked do great harm to our communities.</p>
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<author><name sortKey="Balasingam, Shobana" sort="Balasingam, Shobana" uniqKey="Balasingam S" first="Shobana" last="Balasingam">Shobana Balasingam</name>
</author>
<author><name sortKey="Lambkin, Rob" sort="Lambkin, Rob" uniqKey="Lambkin R" first="Rob" last="Lambkin">Rob Lambkin</name>
</author>
</analytic>
<series><title level="j">The Journal of antimicrobial chemotherapy</title>
<idno type="ISSN">0305-7453</idno>
<imprint><date when="2004" type="published">2004</date>
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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Antiviral Agents (therapeutic use)</term>
<term>Community-Acquired Infections (prevention & control)</term>
<term>Disease Outbreaks (prevention & control)</term>
<term>Drug Resistance, Viral</term>
<term>Enzyme Inhibitors (therapeutic use)</term>
<term>Humans</term>
<term>Influenza, Human (drug therapy)</term>
<term>Influenza, Human (prevention & control)</term>
<term>Influenza, Human (virology)</term>
<term>Neuraminidase (antagonists & inhibitors)</term>
</keywords>
<keywords scheme="KwdFr" xml:lang="fr"><term>Antienzymes (usage thérapeutique)</term>
<term>Antiviraux (usage thérapeutique)</term>
<term>Flambées de maladies ()</term>
<term>Grippe humaine ()</term>
<term>Grippe humaine (traitement médicamenteux)</term>
<term>Grippe humaine (virologie)</term>
<term>Humains</term>
<term>Infections communautaires ()</term>
<term>Résistance virale aux médicaments</term>
<term>Sialidase (antagonistes et inhibiteurs)</term>
</keywords>
<keywords scheme="MESH" type="chemical" qualifier="antagonists & inhibitors" xml:lang="en"><term>Neuraminidase</term>
</keywords>
<keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Antiviral Agents</term>
<term>Enzyme Inhibitors</term>
</keywords>
<keywords scheme="MESH" qualifier="antagonistes et inhibiteurs" xml:lang="fr"><term>Sialidase</term>
</keywords>
<keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Influenza, Human</term>
</keywords>
<keywords scheme="MESH" qualifier="prevention & control" xml:lang="en"><term>Community-Acquired Infections</term>
<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>Antienzymes</term>
<term>Antiviraux</term>
</keywords>
<keywords scheme="MESH" qualifier="virologie" xml:lang="fr"><term>Grippe humaine</term>
</keywords>
<keywords scheme="MESH" qualifier="virology" xml:lang="en"><term>Influenza, Human</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Drug Resistance, Viral</term>
<term>Humans</term>
</keywords>
<keywords scheme="MESH" xml:lang="fr"><term>Flambées de maladies</term>
<term>Grippe humaine</term>
<term>Humains</term>
<term>Infections communautaires</term>
<term>Résistance virale aux médicaments</term>
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<front><div type="abstract" xml:lang="en">Influenza A and B viruses cause serious medical problems and social disruption every year in particular countries of the world. The virus is notoriously fickle and may attack citizens in say two adjacent countries but not the third. More rarely a global pandemic virus emerges causing millions of deaths worldwide. The SARS outbreak has illuminated weaknesses in planning for sudden outbreaks of disease in a modern society and in particular how panic can grip and cause intense economic disruption. Many communities in the world are neither prepared for a global pandemic nor a very acute epidemic of influenza. The neuraminidase inhibitors (NAIs) are a new class of antiviral drug targeting a viral influenza enzyme, the neuraminidase, which acts both to facilitate virus infection of cells by clearing a passage through otherwise protective respiratory fluids and also by helping release of the virus by cutting the chemical umbilical cord which links up the virus to the infected cell. Extensive laboratory studies of the two molecules zanamivir and oseltamivir have shown that they block all influenza A and B viruses yet tested and would, in theory, even inhibit the 1918 pandemic virus. Both drugs can be used prophylactically to prevent spread of infection in families and communities where 80-90% protection has been documented. The therapeutic effects are also strong in adults and children abbreviating infection, reducing quantities of excreted virus and reducing antibiotic prescriptions. The drugs have to be taken within 48 h of the onset of symptoms. Drug resistance is not a problem at present because although such mutants occur the mutants are compromised and are less virulent than their drug-sensitive parents and they spread less easily. The two drugs could be stockpiled to prepare for an influenza pandemic but, importantly, clinical and scientific experience need to be gained by using these inhibitors in the yearly conflagrations of epidemic influenza, which unchecked do great harm to our communities.</div>
</front>
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