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Published on: October 11, 2013
The discovery and development of novel treatment strategies for filoviruses
1Center for Global Health, Department of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, USA.
Introduction:
Filoviruses are negative-stranded, enveloped RNA viruses that can cause hemorrhagic fever in humans and include Ebola and Marburg viruses. Lethality rates can reach 90% in isolated outbreaks. The 2013-2016 Ebola virus epidemic demonstrated the global threat of filoviruses and hastened development of vaccines and therapeutics. There are six known filoviruses that cause disease in humans, but still few therapeutics are available for treatment.
Areas Covered:
This review summarizes identification, testing, and development of therapeutics based on the peer-reviewed scientific literature beginning with the discovery of filoviruses in 1967. Small molecules, antibodies, cytokines, antisense, post-exposure vaccination, and host-targeted therapeutic approaches are discussed. An emphasis is placed on therapeutics that have shown promise in in vivo studies.
Expert Opinion:
Two monoclonal antibody regimens are approved for use in humans for one filovirus (Ebola virus), and preclinical nonhuman primate studies suggest that other monoclonal-based therapies are likely to be effective against other filoviruses. Significant progress has been made in small-molecule antivirals and host-targeted approaches. An important consideration is the necessity of pan-filovirus therapeutics via broadly effective small molecules, antibody cocktails, and cross-reactive antibodies. The use of filovirus therapeutics as prophylactic treatment or in chronically infected individuals should be considered.
Insights
Developing effective filovirus therapeutics, including small molecules and antibodies, is crucial due to high fatality rates. Research focuses on pan-filovirus treatments and prophylactic strategies for diseases like Ebola and Marburg virus infections.
Area of Science:
- Virology
- Infectious Diseases
- Drug Development
Background:
- Filoviruses, including Ebola and Marburg viruses, are dangerous RNA viruses causing hemorrhagic fevers with high mortality rates.
- The 2013-2016 Ebola epidemic highlighted the global threat and accelerated the need for effective treatments.
- Despite progress, limited therapeutic options exist for the six known human-pathogenic filoviruses.
Purpose of the Study:
- To review the identification, testing, and development of filovirus therapeutics.
- To summarize promising therapeutic strategies based on peer-reviewed literature since 1967.
- To emphasize treatments showing efficacy in preclinical in vivo studies.
Main Methods:
- Literature review of scientific publications on filovirus therapeutics.
- Discussion of various therapeutic modalities including small molecules, antibodies, and host-targeted approaches.
- Focus on studies demonstrating promise in nonhuman primate models.
Main Results:
- Two monoclonal antibody regimens are FDA-approved for Ebola virus treatment.
- Preclinical data suggest antibody-based therapies are effective against other filoviruses.
- Significant advancements are noted in small-molecule antivirals and host-targeted strategies.
Conclusions:
- Pan-filovirus therapeutics, such as broad-spectrum small molecules and antibody cocktails, are essential.
- Development of cross-reactive antibodies is a key area for future research.
- Consideration of filovirus therapeutics for prophylaxis and chronic infection management is warranted.
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