Skip to main content
Top
Published in: Critical Care 2/2014

Open Access 01-04-2014 | Commentary

The dysfunctional host response to influenza A H7N9: a potential treatment option?

Authors: Steven M Opal, David S Fedson

Published in: Critical Care | Issue 2/2014

Login to get access

Abstract

The newly emerging human pathogen influenza A H7N9 represents a potentially major threat to human health. The virus was first shown to be pathogenic in humans in 2013, and outbreaks continue to occur in China to the present time. The current incident mortality rate is disturbingly high despite the frequent use of antiviral therapy and intensive care management. If the virus gains the capacity for efficient person-to-person transmission, a global influenza pandemic could ensue with devastating consequences. In the absence of an effective vaccine, targeted regulation of the host immune response by immune modulators might be considered. Readily available, approved drugs with immune-modulating activities might prove to be a treatment option in combination with existing antiviral agents and supportive care.
Literature
1.
go back to reference Wu W, Shi Y, Hainv G, Liang W, Sheng J, Li L: Immune derangement occurs in patients with H7N9 avian influenza. Crit Care 2014, 18: R43. 10.1186/cc13788PubMedCentralCrossRefPubMed Wu W, Shi Y, Hainv G, Liang W, Sheng J, Li L: Immune derangement occurs in patients with H7N9 avian influenza. Crit Care 2014, 18: R43. 10.1186/cc13788PubMedCentralCrossRefPubMed
2.
go back to reference Gao HN, Lu HZ, Cao B, Du B, Shang H, Gan J-H, Lu SH, Yang Y-D, Fang Z, Shen Y-Z, Xi X-M, Gu Q, Zhou Z-M, Qu H-P, Yan Z, Li F-M, Zhao W, Gao Z-C, Wang G-F, Ruan L-X, Wang W-H, Ye J, Cao H-F, Li X-W, Zhang W-H, Fang X-C, He J, Liang W-F, Xie J, Zeng M, Wu X-Z, et al.: Clinical findings in 111 cases of influenza A (H7N9) virus infection. N Engl J Med 2013, 368: 2277-2285. 10.1056/NEJMoa1305584CrossRefPubMed Gao HN, Lu HZ, Cao B, Du B, Shang H, Gan J-H, Lu SH, Yang Y-D, Fang Z, Shen Y-Z, Xi X-M, Gu Q, Zhou Z-M, Qu H-P, Yan Z, Li F-M, Zhao W, Gao Z-C, Wang G-F, Ruan L-X, Wang W-H, Ye J, Cao H-F, Li X-W, Zhang W-H, Fang X-C, He J, Liang W-F, Xie J, Zeng M, Wu X-Z, et al.: Clinical findings in 111 cases of influenza A (H7N9) virus infection. N Engl J Med 2013, 368: 2277-2285. 10.1056/NEJMoa1305584CrossRefPubMed
3.
go back to reference Gao R, Cao B, Hu Y, Feng Z, Wang D, Wanfu H, Chen J, Jie Z, Qiu H, Xu K, Xu X, Lu H, Zhu W, Gao Z, Ziang N, Shen Y, Zebao H, Gu Y, Zhang Z, Yang Y, Zhao X, Zhou L, Li X, Zou S, Zhang Y, Li X, Yang L, Guo J, Dong J, Li Q, et al.: Human infection with a novel avian-origin influenza A (H7N9) virus. N Engl J Med 2013, 368: 1862-1864. 10.1056/NEJMp1304661CrossRef Gao R, Cao B, Hu Y, Feng Z, Wang D, Wanfu H, Chen J, Jie Z, Qiu H, Xu K, Xu X, Lu H, Zhu W, Gao Z, Ziang N, Shen Y, Zebao H, Gu Y, Zhang Z, Yang Y, Zhao X, Zhou L, Li X, Zou S, Zhang Y, Li X, Yang L, Guo J, Dong J, Li Q, et al.: Human infection with a novel avian-origin influenza A (H7N9) virus. N Engl J Med 2013, 368: 1862-1864. 10.1056/NEJMp1304661CrossRef
5.
go back to reference Viboud C, Simonsen L: Global mortality of 2009 pandemic influenza A H1N1. Lancet Infect Dis 2012, 12: 651-653. 10.1016/S1473-3099(12)70152-4CrossRefPubMed Viboud C, Simonsen L: Global mortality of 2009 pandemic influenza A H1N1. Lancet Infect Dis 2012, 12: 651-653. 10.1016/S1473-3099(12)70152-4CrossRefPubMed
6.
go back to reference Dawood FS, Iuliano D, Reed C, Cheng P-Y, Bandaranayake D, Breiman RF, Brooks WA, Buchy P, Fiekin DR, Fowler KB, Gordon A, Hien NT, Horby P, Huang QS, Katz M, Krishnan A, Lal R, Montgomery JM, Molbak K, Pebody R, Presanis AM, Razuri H, Steens A, Tinoco YA, Wallinga J, Yu H, Vong S, Bresee J, Widdowson MA: Estimated global mortality associated with the first 12 months of 2009 pandemic influenza A H1N1 virus circulation: a modeling study. Lancet Infect Dis 2012, 12: 687-695. 10.1016/S1473-3099(12)70121-4CrossRefPubMed Dawood FS, Iuliano D, Reed C, Cheng P-Y, Bandaranayake D, Breiman RF, Brooks WA, Buchy P, Fiekin DR, Fowler KB, Gordon A, Hien NT, Horby P, Huang QS, Katz M, Krishnan A, Lal R, Montgomery JM, Molbak K, Pebody R, Presanis AM, Razuri H, Steens A, Tinoco YA, Wallinga J, Yu H, Vong S, Bresee J, Widdowson MA: Estimated global mortality associated with the first 12 months of 2009 pandemic influenza A H1N1 virus circulation: a modeling study. Lancet Infect Dis 2012, 12: 687-695. 10.1016/S1473-3099(12)70121-4CrossRefPubMed
7.
go back to reference Leitner J, Rieger A, Pickl WF, Zlabinger G, Grabmeier-Pfistershammer K, Steinberger P: TIM-3 does not act as a receptor for Galectin-9. PLOS Path 2013, 9: e1003253. 10.1371/journal.ppat.1003253CrossRef Leitner J, Rieger A, Pickl WF, Zlabinger G, Grabmeier-Pfistershammer K, Steinberger P: TIM-3 does not act as a receptor for Galectin-9. PLOS Path 2013, 9: e1003253. 10.1371/journal.ppat.1003253CrossRef
8.
go back to reference Fedson DS: How will physicians respond to the next influenza pandemic. Clin Infect Dis 2014, 58: 233-237. 10.1093/cid/cit695CrossRefPubMed Fedson DS: How will physicians respond to the next influenza pandemic. Clin Infect Dis 2014, 58: 233-237. 10.1093/cid/cit695CrossRefPubMed
9.
go back to reference Fedson DS, Opal SM: The controversy over H5N1 transmissibility research: an opportunity to define a practical response to a global threat. Hum Vaccin Immunother 2013, 9: 1-10. 10.4161/hv.23606CrossRef Fedson DS, Opal SM: The controversy over H5N1 transmissibility research: an opportunity to define a practical response to a global threat. Hum Vaccin Immunother 2013, 9: 1-10. 10.4161/hv.23606CrossRef
11.
go back to reference Shirey KA, Lai W, Scott AJ, Lipsky M, Mistry P, Pletneva LM, Karp CL, McAlees J, Gioannini TL, Weiss J, Chen WH, Ernst RK, Rossignol DP, Gusovsky F, Blanco JCG, Vogel SN: The TLR4 antagonist, Eritoran, protects mice from lethal influenza infection. Nature 2013, 497: 498-502. 10.1038/nature12118PubMedCentralCrossRefPubMed Shirey KA, Lai W, Scott AJ, Lipsky M, Mistry P, Pletneva LM, Karp CL, McAlees J, Gioannini TL, Weiss J, Chen WH, Ernst RK, Rossignol DP, Gusovsky F, Blanco JCG, Vogel SN: The TLR4 antagonist, Eritoran, protects mice from lethal influenza infection. Nature 2013, 497: 498-502. 10.1038/nature12118PubMedCentralCrossRefPubMed
12.
go back to reference Shi X, Zhou W, Huang H, Zhu H, Zhou P, Zhu H, Dianwen J: Inhibition of the inflammatory cytokine tumor necrosis factor-alpha with etaneracept provides protection against lethal H1N1 influenza infection in mice. Crit Care 2013, 17: R301. 10.1186/cc13171PubMedCentralCrossRefPubMed Shi X, Zhou W, Huang H, Zhu H, Zhou P, Zhu H, Dianwen J: Inhibition of the inflammatory cytokine tumor necrosis factor-alpha with etaneracept provides protection against lethal H1N1 influenza infection in mice. Crit Care 2013, 17: R301. 10.1186/cc13171PubMedCentralCrossRefPubMed
13.
go back to reference Fedson DS: Treating influenza with statins and other immunomodulatory agents. Antiviral Res 2013, 99: 417-435. 10.1016/j.antiviral.2013.06.018CrossRefPubMed Fedson DS: Treating influenza with statins and other immunomodulatory agents. Antiviral Res 2013, 99: 417-435. 10.1016/j.antiviral.2013.06.018CrossRefPubMed
15.
go back to reference Lurie N, Maniolo T, Patterson AP, Collins F, Frieden T: Research as a part of the public health emergency response. N Engl J Med 2013, 368: 1251-1255. 10.1056/NEJMsb1209510CrossRefPubMed Lurie N, Maniolo T, Patterson AP, Collins F, Frieden T: Research as a part of the public health emergency response. N Engl J Med 2013, 368: 1251-1255. 10.1056/NEJMsb1209510CrossRefPubMed
Metadata
Title
The dysfunctional host response to influenza A H7N9: a potential treatment option?
Authors
Steven M Opal
David S Fedson
Publication date
01-04-2014
Publisher
BioMed Central
Published in
Critical Care / Issue 2/2014
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/cc13839

Other articles of this Issue 2/2014

Critical Care 2/2014 Go to the issue