Treatment options for 2009 H1N1 influenza: evaluation of the published evidence

Falagas, Matthew E.; Vouloumanou, Evridiki K.; Baskouta, Evagelia; Rafailidis, Petros I.; Polyzos, Konstantinos A.; Rello, Jordi

doi:10.1016/j.ijantimicag.2010.01.006

Cited by 56 publications

(34 citation statements)

References 22 publications

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“…No studies allow us to conclude when to suspend antiviral treatment in seriously ill patients, though in the Spanish ICUs the patients received a median of 10 days of treatment. 44,71,82,83,95 Recent studies have described much longer PCR positivity for the virus in critical patients, particularly in those with pneumonia. Ling et al 15 found the mean elimination time to be 6 days, though the virus was still detected in 37% of the patients by day 7, with no apparent relationship to early therapy.…”

Section: Which Antiviral Drug At What Dose and For How Long?mentioning

confidence: 99%

Recommendations of the Infectious Diseases Work Group (GTEI) of the Spanish Society of Intensive and Critical Care Medicine and Coronary Units (SEMICYUC) and the Infections in Critically Ill Patients Study Group (GEIPC) of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC) for the diagnosis and treatment of influenza A/H1N1 in seriously ill adults admitted to the Intensive Care Unit

Rodríguez

Álvarez–Rocha

Sirvent

et al. 2012

Medicina Intensiva (English Edition)

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Section: Which Antiviral Drug At What Dose and For How Long?mentioning

confidence: 99%

Recommendations of the Infectious Diseases Work Group (GTEI) of the Spanish Society of Intensive and Critical Care Medicine and Coronary Units (SEMICYUC) and the Infections in Critically Ill Patients Study Group (GEIPC) of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC) for the diagnosis and treatment of influenza A/H1N1 in seriously ill adults admitted to the Intensive Care Unit

Rodríguez

Álvarez–Rocha

Sirvent

et al. 2012

Medicina Intensiva (English Edition)

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“…Modulating the immune response post infection to control inflammation or pre-infection to provide increased protection for high risk groups has been a major theme in severe influenza infection research [10][11][12][13][14][15][16][17][18][19][20]. Corticosteroids have been suggested as a potential treatment option for patients undergoing severe IAV infection with accompanied cytokine storm [21][22][23][24][25], while pre-stimulating interferon-associated pathways have been suggested to protect high-risk groups [7,20,26,27].…”

Section: Immune Modulation For the Treatment Of Iav Infectionmentioning

confidence: 99%

A Systems and Treatment Perspective of Models of Influenza Virus-Induced Host Responses

2018

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Abstract:Severe influenza infections are often characterized as having unique host responses (e.g., early, severe hypercytokinemia). Neuraminidase inhibitors can be effective in controlling the severe symptoms of influenza but are often not administered until late in the infection. Several studies suggest that immune modulation may offer protection to high risk groups. Here, we review the current state of mathematical models of influenza-induced host responses. Selecting three models with conserved immune response components, we determine if the immune system components which most affect virus replication when perturbed are conserved across the models. We also test each model's response to a pre-induction of interferon before the virus is administered. We find that each model emphasizes the importance of controlling the infected cell population to control viral replication. Moreover, our work shows that the structure of current models does not allow for significant responses to increased interferon concentrations. These results suggest that the current library of available published models of influenza infection does not adequately represent the complex interactions of the virus, interferon, and other aspects of the immune response. Specifically, the method used to model virus-resistant cells may need to be adapted in future work to more realistically represent the immune response to viral infection.

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“…Modulating inflammation during ongoing antiviral therapy to reduce resultant immunopathology should be beneficial and increase the chances for lower morbidity and mortality. However, the anti-inflammatory drugs currently on the market to combat influenza virus-induced inflammation, such as corticosteroids, have not been effective in improving disease outcome [64][65][66].…”

Section: S1p Receptor Signaling In Established Influenza Virus Infectmentioning

confidence: 99%

Quelling the storm: utilization of sphingosine-1-phosphate receptor signaling to ameliorate influenza virus-induced cytokine storm

et al. 2011

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Initial and early tissue injury associated with severe influenza virus infection is the result of both virus-mediated lysis of infected pulmonary cells coupled with an exuberant immune response generated against the virus. The excessive host immune response associated with influenza virus infection has been termed "cytokine storm." Therapies that target virus replication are available; however, the selective pressure by such antiviral drugs on the virus often results in mutation and the escape of virus progeny now resistant to the antiviral regimen, thereby rendering such treatments ineffective. This event highlights the necessity for developing novel methods to combat morbidity and mortality caused by influenza virus infection. One potential method is restricting the host's immune response. However, prior treatment regimens employing drugs like corticosteroids that globally suppress the host's immune response were found unsatisfactory in large part because they disrupted the host's ability to control virus replication. Here, we discuss a novel therapy that utilizes sphingosine-1-phosphate (S1P) receptor signaling that has the ability to significantly limit immunopathologic injury caused by the host's innate and adaptive immune response, thereby significantly aborting morbidity and mortality associated with influenza virus infection. Moreover, S1P analog therapy allows for sufficient anti-influenza T cell and antibody formation to control infection. We review the anti-inflammatory effects of S1P signaling pathways and how modulation of these pathways during influenza virus infection restricts immunopathology. Finally, we discuss that combinatorial administration of S1P simultaneously with a current antiviral enhances the treatment efficacy for virulent influenza virus infections above that of either drug treatment alone. Interestingly, the scope of S1P receptor therapy reported here is likely to extend beyond influenza virus infection and could prove useful for the treatment of multiple maladies like other viral infections and autoimmune diseases where the host's inflammatory response is a major component in the disease process.

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Treatment options for 2009 H1N1 influenza: evaluation of the published evidence

Cited by 56 publications

References 22 publications

A Systems and Treatment Perspective of Models of Influenza Virus-Induced Host Responses

Quelling the storm: utilization of sphingosine-1-phosphate receptor signaling to ameliorate influenza virus-induced cytokine storm

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