NEW YORK (Reuters Health) - Early use of pegylated interferon-alpha (IFN-alpha) in an outbreak of the SARS coronavirus (SARS CoV) may improve the outcome of infection and reduce the spread of SARS, according to results of a study in macaques. These findings support the results of an earlier preliminary pilot trial.
In the earlier trial, adding IFN-alpha to corticosteroid treatment seemed to ameliorate SARS damage to lungs and speed recovery (see Reuters Health report, December 23, 2003).
The new study also suggests that prophylactic or early postexposure treatment with IFN-alpha may protect health care workers and others exposed to the virus, Dr. Albert D. M. E. Osterhaus and colleagues note in their report, published in the March issue of Nature Medicine.
To further explore the role of IFN-alpha, Dr. Osterhaus, at Erasmus Medical Centre, Rotterdam, Netherlands, and his team injected macaques with SARS CoV. Treatment with pegylated recombinant interferon alpha-2b, initiated 3 days before infection, abrogated virus excretion from the pharynx and reduced virus titers in the lungs 4 days postinfection. The extent and severity of diffuse alveolar damage was reduced by 80%.
Although less effective than prophylactic use, IFN-alpha administered at days 1 and 3 post exposure also reduced virologic and pathological parameters compared with those observed in untreated infected animals. The authors theorize that the reduced protection was probably because initiation of therapy was too close to the peak of viral infection in the lungs, which occurs at 2 days post infection in macaques.
However, peak SARS CoV infection in humans does not occur until about 16 days post-infection. Therefore, the research group theorizes “the time interval during which effective postexposure treatment with pegylated IFN-alpha can be initiated may be longer in humans than in experimentally infected macaques.”
They conclude that clinical studies with pegylated IFN-alpha are warranted if SARS re-emerges in human populations.
Source: Nature Med 2004. [ Google search on this article ]
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