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View Diary: Where We Stand With Pandemic Preparedness, and Where We Need To Go (106 comments)

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  •  Thanks (2+ / 0-)
    Recommended by:
    Shadan7, rini6

    you know, there are new, bioengineered autoimmune drugs. My understanding is some of them inhibit portions of the immune system For example, the way it's been explained to me, Humira -- at about a grand a month btw -- works by cooling off the cytokine response. Is it at all possible that someone already on Humira or something like it might fare better in the midst of the potentially deadly cytokine storm said to be produced by the immune response to H5N1?

    Read UTI, your free thought forum

    by DarkSyde on Sun Jun 01, 2008 at 06:38:57 AM PDT

    [ Parent ]

    •  the cheaper and more readily available (2+ / 0-)
      Recommended by:
      Shadan7, AmericanRiverCanyon

      alternatives are statins.

      The next influenza pandemic may be imminent. Because antiviral agents and vaccines will be unavailable to people in most countries, we need to determine whether other agents could offer clinical benefits. Influenza is associated with an increase in acute cardiovascular diseases, and influenza viruses induce proinflammatory cytokines. Statins are cardioprotective and have anti-inflammatory and immunomodulatory effects, and they thus might benefit patients with influenza. This hypothesis should be evaluated by using administrative databases to search for reduced rates of hospitalization and death due to influenza-related conditions among people taking statins. These studies should be followed by laboratory studies of statins in animal and cell-based models of influenza virus infection and, later, by clinical trials. Positive results from such studies would provide physicians in all countries with something to offer patients for treatment and prophylaxis of pandemic influenza. Generic statins will be widely distributed and inexpensive. They might be the only agents that could alter the course of a global pandemic.

      "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

      by Greg Dworkin on Sun Jun 01, 2008 at 06:44:47 AM PDT

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      •  My guess is that statins are anti-inflammatory (0+ / 0-)

        to a degree (which helps prevent cardiac disease), but that they aren't potent enough for a systemic inflammation, like that from pandemic influenza. This inflammation involves an overwhelming total body response that lowers the blood pressure and fills the lungs with fluid. I can't imagine statins making a big difference.

        But I could be wrong.

        An eye for an eye and the whole world will be blind.

        by rini6 on Sun Jun 01, 2008 at 07:12:16 AM PDT

        [ Parent ]

        •  true (3+ / 0-)
          Recommended by:
          fla1sun, AmericanRiverCanyon, rini6

          but the questions comes "what if you are already on them?" rather than using them in extremis.

          http://www.nature.com/...

          Immunomodulation: a new role for statins?

          "Politics is the art of looking for trouble, finding it everywhere, diagnosing it incorrectly and applying the wrong remedies." - Groucho Marx

          by Greg Dworkin on Sun Jun 01, 2008 at 07:19:18 AM PDT

          [ Parent ]

          •  Still no data on infection (1+ / 0-)
            Recommended by:
            DemFromCT

            The article seems to be more about auto-immune disease and transplant (two situations where you would definitely want to suppress the immune system.)

            But interesting. It's funny that statins were developed to decrease cholesterol but may work though an entirely different mechanism. Although, isn't this the way science often works? What was it that Bob Ross (that hilarious painter) said? "Happy accidents."

            An eye for an eye and the whole world will be blind.

            by rini6 on Sun Jun 01, 2008 at 07:24:21 AM PDT

            [ Parent ]

          •  Outstanding diary! (0+ / 0-)

            Ode magazine has run a series of articles that are quite interesting.  One of those articles addresses the  1918 pandemic and the successful use of homeopathy.  Very informative....
            http://www.google.com/...
            Ode mag bird flu homeopathy - Google Search

    •  Or it is possible that (1+ / 0-)
      Recommended by:
      Shadan7

      the suppression of the immune response could make things worse. It blocks tumor necrosis factor alpha. Does this factor help or hurt during the influenza? We don't know. I don't think it has been tried for any infection before, but I could be wrong.

      If someone is dying, it could be worth it. I guess informed consent might work a bit differently during a pandemic.

      An eye for an eye and the whole world will be blind.

      by rini6 on Sun Jun 01, 2008 at 07:10:12 AM PDT

      [ Parent ]

    •  Do the other meds in the same (0+ / 0-)

      catagory work the same way?

      I know that Remicade works similarly (and was preapproved for many of the same diseases before Humira was developed).

      Remicade's spendy, but it'd be ironic if Crohn's Disease, rhematoid arthritis and other folks taking it would do better in the face of this flu than otherwise expected.

    •  Chances are that if one is already getting treat- (0+ / 0-)

      ... treated with the anti tumor necrosis factor biologicals, they already have enough other health problems that getting a bad viral infection on top of it will kill them because of their immune system being depressed.
      (because of insurance company rules, the atncf drugs are not the first choice of treatment, they make patients going the drug route use all the other harmful drugs first, and then when they've made themselves sick enough, they are allowed to use things like humira as a sort of last resort, until their insurance balks. then the patients end up trying to get on disability to get the govt. to end up paying for the stuff.  don't even get me going on this topic of how the pharmaceutical companies market this crap.  It's a very dangerous drug.)

      On the other hand, some of the wierder auto immune diseases do give people the genes that might make them more resistant to plagues, if they haven't been busy trying to beat the stuffing out of their own over reactive immune systems.... you can never tell until it happens who's going to have the right genetic combo to win the survivor's betting pool.

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