While an experimental vaccine Previously, it was proven that people who had already been infected were protected against Ebola. "From now on, we will no longer say that Ebola is incurable," said Jean-Jacques Muyembe, director general of the National Institute for Biomedical Research in the DRC, who oversaw the conduct of trials on the subject. ground.
Megan Molteni covers DNA technologies, drugs and genetic confidentiality for WIRED.
Since last November, patients at four treatment centers in the eastern part of the country, where the epidemic is most severe, have been randomly assigned to one of four experimental treatments: an antiviral drug called remdesivir or one of three drugs using monoclonal antibodies. Scientists have concocted these large Y-shaped proteins to recognize the specific forms of invading bacteria and viruses, then to recruit immune cells to attack these pathogens. One of these drugs, a drug called ZMapp, is currently considered the standard of care during Ebola outbreaks. It had been tested and used during the devastating epidemic of Ebola in West Africa in 2014, the goal was to see if these other drugs could surpass it. But preliminary data from the first 681 patients (out of 725 planned) showed results so convincing that the trial was stopped.
Patients receiving Zmapp at the four test centers experienced an overall death rate of 49%, according to Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases at NIH. (Mortality rates are above 75% for those infected who are not seeking any form of treatment.) The monoclonal antibody cocktail produced by a company called Regeneron Pharmaceuticals had the greatest impact on reducing the death rate, falling to 29%, while that of NIAID. The monoclonal antibody, called mAb114, had a mortality rate of 34%. The most striking results were the most striking in patients who received treatment shortly after becoming ill, while their viral load was still low – mortality rates dropped to 11% with mAb114 and only 6 % with the drug Regeneron, against 24% with ZMapp and 33% with Remdesivir. .
Monoclonal antibodies-based drugs have become a pillar of modern medicine– Eliminate various diseases, from cancer to lupus. But it takes several years of careful reverse engineering to make them. Zmapp, for example, was developed by infecting mice with Ebola and then collecting antibodies produced by mice against the virus. These antibodies then had to be modified to look more like a human antibody, so as not to provoke an immune reaction. The Ebola virus infiltrates the cells of its victims by using thorny proteins on the outer shell of the virus. The researchers then examined the antibodies to determine which ones had worked best to bind to these proteins. Block access, and the virus can not replicate and spread. But, compared to other viruses, the Ebola virus is large and can change shape, which prevents an antibody from blocking its infection. This is why the cocktail approach was favored, like the Regeneron product – a combination of three monoclonal antibodies generated first in mice.
An even better solution, some asked, would exploit the serum of the Ebola survivors and harvest the DNA of the white blood cells that produce the antibodies. This would provide a set of genetic instructions for the production of antibodies that have been proven against the Ebola virus. This is the NIH mAb114 – an antibody isolated from the blood of a survivor 1995 epidemic in Kikwit, DRC. Scientists discovered it a few years ago – they had been circulating in his body for over a decade.
. (tagsToTranslate) Ebola (t) medicine (t) public health (t) epidemic</pre></pre>