Article: Delayed antiviral plus immunomodulator treatment still reduces mortality in mice infected by high inoculum of influenza A/H5N1 virus
| Title | Delayed antiviral plus immunomodulator treatment still reduces mortality in mice infected by high inoculum of influenza A/H5N1 virus |
|---|---|
| Authors | Zheng, BJ1 Chan, KW1 Lin, YP1 Zhao, GY1 Chan, C1 Zhang, HJ1 Chen, HL1 Wong, SSY1 Lau, SKP1 Woo, PCY1 Chan, KH1 Jin, DY1 Yuen, KY1 |
| Keywords | Celecoxib Mesalazine Zanamivir |
| Issue Date | 2008 |
| Publisher | National Academy of Sciences. The Journal's web site is located at http://www.pnas.org |
| Citation | Proceedings Of The National Academy Of Sciences Of The United States Of America, 2008, v. 105 n. 23, p. 8091-8096 [How to Cite?] DOI: http://dx.doi.org/10.1073/pnas.0711942105 |
| Abstract | The mortality of human infection by influenza A/H5N1 virus can exceed 80%. The high mortality and its poor response to the neuraminidase inhibitor oseltamivir have been attributed to uncontrolled virus-induced cytokine storm. We challenged BALB/c mice with 1,000 LD50 of influenza A/Vietnam/1194/04. Survival, body weight, histopathology, inflammatory markers, viral loads, T lymphocyte counts, and neutralizing antibody response were documented in infected mice treated individually or in combination with zanamvir, celecoxib, gemfibrozil, and mesalazine. To imitate the real-life scenario, treatment was initiated at 48 h after viral challenge. There were significant improvements in survival rate (P = 0.02), survival time (P < 0.02), and inflammatory markers (P < 0.01) in the group treated with a triple combination of zanamivir, celecoxib, and mesalazine when compared with zanamivir alone. Zanamivir with or without immunomodulators reduced viral load to a similar extent. Insignificant prolongation of survival was observed when individual agents were used alone. Significantly higher levels of CD4 + and CD8 + T lymphocytes and less pulmonary inflammation were also found in the group receiving triple therapy. Zanamivir alone reduced viral load but not inflammation and mortality. The survival benefits of adding celecoxib and mesalazine to zanamivir could be caused by their synergistic effects in reducing cytokine dysfunction and preventing apoptosis. Combinations of a neuraminidase inhibitor with these immunomodulators should be considered in randomized controlled treatment trials of patients suffering from H5N1 infection. © 2008 by The National Academy of Sciences of the USA. |
| ISSN | 0027-8424 2011 Impact Factor: 9.681 2011 SCImago Journal Rankings: 1.754 |
| DOI | http://dx.doi.org/10.1073/pnas.0711942105 |
| ISI Accession Number ID | WOS:000256781800035 |
| References | References in Scopus |
| dc.contributor.author | Zheng, BJ |
|---|---|
| dc.contributor.author | Chan, KW |
| dc.contributor.author | Lin, YP |
| dc.contributor.author | Zhao, GY |
| dc.contributor.author | Chan, C |
| dc.contributor.author | Zhang, HJ |
| dc.contributor.author | Chen, HL |
| dc.contributor.author | Wong, SSY |
| dc.contributor.author | Lau, SKP |
| dc.contributor.author | Woo, PCY |
| dc.contributor.author | Chan, KH |
| dc.contributor.author | Jin, DY |
| dc.contributor.author | Yuen, KY |
| dc.date.accessioned | 2010-09-06T06:01:08Z |
| dc.date.available | 2010-09-06T06:01:08Z |
| dc.date.issued | 2008 |
| dc.description.abstract | The mortality of human infection by influenza A/H5N1 virus can exceed 80%. The high mortality and its poor response to the neuraminidase inhibitor oseltamivir have been attributed to uncontrolled virus-induced cytokine storm. We challenged BALB/c mice with 1,000 LD50 of influenza A/Vietnam/1194/04. Survival, body weight, histopathology, inflammatory markers, viral loads, T lymphocyte counts, and neutralizing antibody response were documented in infected mice treated individually or in combination with zanamvir, celecoxib, gemfibrozil, and mesalazine. To imitate the real-life scenario, treatment was initiated at 48 h after viral challenge. There were significant improvements in survival rate (P = 0.02), survival time (P < 0.02), and inflammatory markers (P < 0.01) in the group treated with a triple combination of zanamivir, celecoxib, and mesalazine when compared with zanamivir alone. Zanamivir with or without immunomodulators reduced viral load to a similar extent. Insignificant prolongation of survival was observed when individual agents were used alone. Significantly higher levels of CD4 + and CD8 + T lymphocytes and less pulmonary inflammation were also found in the group receiving triple therapy. Zanamivir alone reduced viral load but not inflammation and mortality. The survival benefits of adding celecoxib and mesalazine to zanamivir could be caused by their synergistic effects in reducing cytokine dysfunction and preventing apoptosis. Combinations of a neuraminidase inhibitor with these immunomodulators should be considered in randomized controlled treatment trials of patients suffering from H5N1 infection. © 2008 by The National Academy of Sciences of the USA. |
| dc.description.nature | Link_to_subscribed_fulltext |
| dc.identifier.citation | Proceedings Of The National Academy Of Sciences Of The United States Of America, 2008, v. 105 n. 23, p. 8091-8096 [How to Cite?] DOI: http://dx.doi.org/10.1073/pnas.0711942105 |
| dc.identifier.doi | http://dx.doi.org/10.1073/pnas.0711942105 |
| dc.identifier.epage | 8096 |
| dc.identifier.hkuros | 142916 |
| dc.identifier.isi | WOS:000256781800035 |
| dc.identifier.issn | 0027-8424 2011 Impact Factor: 9.681 2011 SCImago Journal Rankings: 1.754 |
| dc.identifier.issue | 23 |
| dc.identifier.openurl | ![]() |
| dc.identifier.scopus | eid_2-s2.0-45849109558 |
| dc.identifier.spage | 8091 |
| dc.identifier.uri | http://hdl.handle.net/10722/68078 |
| dc.identifier.volume | 105 |
| dc.language | eng |
| dc.publisher | National Academy of Sciences. The Journal's web site is located at http://www.pnas.org |
| dc.publisher.place | United States |
| dc.relation.ispartof | Proceedings of the National Academy of Sciences of the United States of America |
| dc.relation.references | References in Scopus |
| dc.rights | Proceedings of the National Academy of Sciences. Copyright © National Academy of Sciences. |
| dc.subject | Celecoxib |
| dc.subject | Mesalazine |
| dc.subject | Zanamivir |
| dc.title | Delayed antiviral plus immunomodulator treatment still reduces mortality in mice infected by high inoculum of influenza A/H5N1 virus |
| dc.type | Article |
Author Affiliations
- The University of Hong Kong


