Olszanecki Rafał, Gawlik Grzegorz
Chair of Pharmacology, Jagiellonian University Medical College, Krakow, Poland.
Folia Med Cracov. 2014;54(3):67-77.
The 2014 outbreak clearly showed that Ebola viruses (EBOV) remain a substantial threat for public health. The mainstay of management of patients with Ebola disease is isolation of patients and use of strict barrier nursing procedures; the present treatment strategies are mainly symptomatic and supportive (fluid resuscitation, antypyretics, antidiarrheal drugs). Currently, there is no approved therapy for Ebola hemorrhagic fever (EHF), however several advanced treatment options were tested in animal models (on non-human primates or rodents). They include use of both symptomatic (e.g. use of tissue factor inhibitors - rhNAPc2, rhAPC - to abolish coagulopathy) and specific antiviral approaches: e.g. monoclonal anti EBOV antibodies (ZMapp, MB-003), phosphorodiamidate morpholino oligomers (PMOs), liposomes containing siRNA (LNP-siRNA:TKM-Ebola) and small molecule inhibitors (e.g. BCX4430, favipiravir). The scope of this article is to briefly review the most promising therapeutics for EHF, based on the data coming from rare clinical reports, studies on animals and results from in vitro models.
2014年的疫情清楚地表明，埃博拉病毒（EBOV）仍然对公共卫生构成重大威胁。埃博拉病患者管理的主要支柱是隔离患者并采用严格的屏障护理程序；目前的治疗策略主要是对症和支持性的（液体复苏、退烧药、止泻药）。目前，尚无批准用于治疗埃博拉出血热（EHF）的疗法，不过在动物模型（非人灵长类动物或啮齿动物）中对几种先进的治疗方案进行了测试。这些方案包括使用对症疗法（例如使用组织因子抑制剂——重组人活化蛋白C（rhNAPc2）、重组活化蛋白C（rhAPC）——来消除凝血病）和特异性抗病毒方法：例如单克隆抗埃博拉病毒抗体（Z Mapp、MB - 003）、磷酰二胺吗啉代寡聚物（PMO）、含小干扰RNA的脂质体（LNP - siRNA:TKM - 埃博拉）和小分子抑制剂（例如BCX4430、法匹拉韦）。本文的范围是基于来自罕见临床报告、动物研究和体外模型结果的数据，简要回顾最有前景的埃博拉出血热治疗方法。
