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Inside The Mystery Serum That Could Save Ebola Victims

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Earlier this month, Dr. Kent Brantly and Nancy Writebol were close to death. The two American aid workers infected with the deadly Ebola virus were flown from Liberia to Atlanta, Georgia, where they were promptly sent to the Emory University Hospital. At the moment, there is no officially approved treatment or vaccine for the Ebola virus, which has a 50 to 90 percent mortality rate. But Brantly and Writebol were each given doses of an experimental anti-Ebola serum that had never been tested in humans. Soon after, according to Emory University doctors, both patients were improving.

Named after the Ebola River in the Democratic Republic of the Congo, near where the first outbreak occurred in 1976, the Ebola virus causes fever, muscle pain, vomiting and diarrhea, among many other symptoms. The Zaire strain at the center of the current outbreak in West Africa is the most fatal of the five known strains. Though highly pathogenic, the virus is not airborne and can only be transmitted via bodily fluids.

The experimental drug administered to the infected aid workers, called ZMapp, is one of a number of treatments that have shown some promising results in animal models. Developed by San Diego-based company Mapp Biopharmaceuticals Inc., ZMapp comes in the form of a serum, which is a portion of blood that contains antibodies—the disease-fighting proteins that bind to harmful substances (called antigens) and either neutralize the threat directly or flag down other immune system cells to do the job. A serum is different from a vaccine, which uses either a similar or weakened version of a disease-causing agent to stir up a person’s immune system to produce antibodies against that pathogen. There are a couple approaches to making anti-Ebola serum. One uses antibodies from humans who have recovered from Ebola infection; another uses antibodies obtained from infected lab animals to create what’s called a monoclonal antibody.

ZMapp is the latter, a mixture of three monoclonal antibodies harvested from the immune systems of Ebola-infected mice. One of the challenges in developing this kind of serum is finding the right combination of antibodies that bind to a virus to keep it from replicating itself. As John Timmer at Ars Technica explains, our immune system is likely to attack these foreign mouse-borne antibodies, so part of the process in making ZMapp involves removing and replacing mouse portions of the antibody genes with human genetic material. Then, the antibody genes are implanted into the cells of tobacco leaves, which produce more of these synthetic antibodies and thus, more ZMapp.

Whether a serum is developed synthetically or obtained from a recovered person, it’s hard to evaluate or compare the efficacy and safety of anti-Ebola treatments. This is because few of these drugs barely make it past the first phase of the FDA drug approval process, according to Charles Chiu, an infectious disease physician at the University of California, San Francisco. One of the Ebola-specific roadblocks to this approval process arises when it comes to testing these drugs on human subjects. Because the virus infects people in remote parts of the world served by little or poor infrastructure, transporting the drugs to these places and administering them presents major logistical challenges.

ZMapp was selected after the Samaritan’s Purse, the charity Brantly and Writebol were working for, reached out to the U.S. Centers for Disease Control and Prevention. The CDC then referred Samaritan’s Purse officials to a National Institutes of Health researcher who consulted with them on experimental treatments for Ebola.

Mapp Biopharmaceuticals has also explored using monoclonal antibodies to treat as well as prevent Ebola. In research published in Science Translational Medicine, Mapp researchers provided a monoclonal antibody cocktail to rhesus macaque monkeys within 48 hours of infection. With that serum, known as “MB-003,” 43 percent of the treated monkeys survived, while none survived in the control group. By January 2014, ZMapp, a mixture of MB-003 and another serum developed by Toronto-based Defyrus, Inc., officially became an anti-Ebola drug candidate.

While Brantly and Writebol’s current status is encouraging, it’s hardly the death knell for Ebola. “It would be premature to conclude that these patients recovered because of this treatment,” says Daniel Bausch, a Tulane University professor of tropical medicine. “Especially considering that these patients worked for this humanitarian organization; there are a lot of resources they had access to that other patients don’t, like one-on-one care  and more aggressive fluid management.” There are many unknowns in treating Ebola; more clinical trials, human subjects and diverse settings will be needed to determine this promising serum’s full potential.

Comments

Comments

  1. PaulHazelwood says

    While I understand there can be a lot of hype surrounding ebola, what no article I have read has addressed is….. what bodily fluids the workers came in contact with that caused them to contract the virus? oh, it will be ok, they say,  no threat to the US they say (that may revealed to be true, but do they actually KNOW IT???????????????????????????, They haven’t said how the people they brought here got it.  how DID THEY GET IT????????????????????????????

  2. Susie says

    I agree with you Paul, what fluid transfer actually carried the virus??!!!??? Why won’t they be more specific?? Why are there only two survivors?? Why haven’t they used this treatment on those suffering in Africa??? Why are they now reporting that an Ebola case has been discovered in a man who has NEVER had contact with any heathcare workers in Africa??? Why is Monsanto and the DOD developing a vaccine?? Why do we STILL have so many questions unanswered?????

  3. peggi says

    they are probably lying as usual so people don’t get scared-especially those that don’t care or don’t understand! never seen a virus that looks like that!! why is a virus responding to whatever treatment they are supposedly using? same with hiv-why is that treatable if it’s a virus-i don’t think either are viruses! if anybody knows any different please let me know!

  4. Larry Wilkins says

    Why hasn’t anyone tried an ascorbate I.V. drip on these patients? It is inexpensive and has an incredible track record at reversing viral infections of every origin including the often deadly meningitis. If it’s not made by a drug company it probably has no value. Right?
    Wrong! Please Google, “Dr. Klenner” 
    The work has already been done. Why do we feel the need to reinvent the wheel? It’s frustrating to know that the cure is inexpensive and at our fingertips and yet we completely ignore the historical facts of medicine. Take the blinders off. Viruses cannot survive in the presence of high serum levels of vitamin C. 
    If ebola reaches Canada…Please remember this post. It could save your life.

  5. AliceDerman says

    Larry Wilkins There are a lot of quack cures out there on the internet. Fortunately, Drs. Brantly and Writebol were treated by physicians who did not try any of them.

  6. AliceDerman says

    @peggi There seems to be something wrong with either your reasoning or with the facts on which you are basing your reasoning. You are asking “shy is a virus responding to whatever treatment they are supposedly using” as if there is some general principle that says that viruses do not ever respond to any treatment. Though there are not as many antiviral medications as antibacterial medications, there definitely are some. Most common viral infections, such as most “colds” are relatively minor and self limited. So it is not worthwhile to accept medication side effects just to try to make the infection go away a little faster. There are treatments for some herpes viruses that have been proven to be helpful in specific situations. Recently, a very effective (and very expensive) treatment for the hepatitis C virus has been developed. This is Sovaldi. It apparently works very well but it costs $1000 a pill. Amantadine, which has been around for decades, fights many strains of influenza A. But there a lot of resistant strains and Amantadine has generally not been thought to be worthwhile as a treatment for something that generally goes away by itself. But HIV is a good example of a virus that can be treated reasonably well with medications. Here is a long list of medications active against HIV, http://www.webmd.com/drugs/condition-157-HIV+Infection.aspx?diseaseid=157&diseasename=HIV+Infection&source=2.  Many of the different names on this list refer to the same drugs but there as are at least 10 separate drugs out there which are effective to some degree.

    Regarding antibodies, vaccine treatments have been successfully used for decades against viruses. “Convalescent serum” (i.e. serum from the blood of disease survivors) has been used through the years against many viral infections. The problems are 1) there is a lot of variability 2) the transfusions may introduce other infections into the patient because it generally is not as pure as established drugs 3) the variability has made it virtually impossible to establish the level of proof that one can get for highly purified medications. This is why well defined laboratory produced antibody treatments are now looking promising. These are more readily testable.

    It has been harder to produce medications which cure viral infections but it certainly is possible and it is very likely that there will be more such treatments in the future.

  7. beth says

    Watch the ebola hunters from the 1st breakout of ebola in zaire and youll understand the whole thing..I just pray that they can contain and stop ebola before its widespread in the US..and that they have sufficient serum tx just incase..this is another black plague.

  8. ChadHerczeg says

    AliceDerman Larry Wilkins First, let me say Larry, great comment and Frederick Klenner was definitely ahead of his time and a brilliant man. Second, Alice, how exactly is Klenner’s cure quackery in any way? First off, Klenner died before the internet was even around, so don’t try to label his work as some garbage that a 12 year old in his basement made up. Klenner was a pioneer in Polio and viral treatments and many physicians are still using his methods successfully well over 60 years later. Honestly, I think AliceDerman is just a blowhard who would rather be a troll than actually try to benefit society. As seen on all of her comments, all she does is post easily available statistics and information that reinforces her specific opinion. As usual with the internet, trolls know all and we are the stupid ones. lol

  9. Larry Wilkins says

    I’m having a difficult time understanding how this virus infects people. I’ve seen the suits these health care workers are wearing. Can the virus pass through rubber, vynel and skin to enter the serum? Usually this happens through mucosa: eyes, mouth, genitals, nose. The health care suits seem to have those areas well protected. What about mosquitoes or other biting insects? If I remember my history correctly, it was fleas that carried the Black Plague. 
    I’m sure that if you came in contact with the bodily fluids of an ebola carrier, then wiped your eyes or went for a potty break without sanitizing, you stand a good chance of being infected, but that is NOT what we are seeing. Seemingly every precaution against bodily fluid transmission is being taken and yet health care workers are still being infected.
    Sorry…I’m not buying it. 
    Here’s another one to add to your list of quacks…How about Linus Pauling, generally considered the greatest scientist of the 20th century, with 2 unassisted Nobel Prizes. Is he, along with Dr, Klenner on your quack list? They agreed on the power of ascorbate IV. therapy. Read a book. Again, why do we completely ignore the facts of history when it comes to medicine? 
    There will be no cure for ebola until it reaches North America on a large scale. Follow the money. Aids is still killing people in Africa. Why? Because they can’t afford the medicine. Does anyone honestly believe that a drug company will invest in the development of drugs in order to give them away? By the way, the cure for Hep C is $60,000 Can. I know people with Hep C. They can’t afford it.
    Vitamin C and a buffer in an IV bag is pennys and yet given the historical evidence for its efficacy in treating other viral infections…We still don’t even give it a try…Follow the money.
    Aids started in Africa. 35 years later it is still a death sentence for Africans but not for us.

  10. Larry Wilkins says

    Chad Herczeg,
    Wow, you actually read books ! It’s refreshing to know that there are still intelligent, well read people out there. Thank you for your comments. Trolls, that’s funny.

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