Abstract

Anti-viral chemotherapy plays an important part in treating and preventing influenza illness. However, its effectiveness in severe infections can be debated and a reoccurring problem is the emergence of resistant virus. Passive immunisation has for a long time been and is still used for prophylaxis and treatment of a number of infectious diseases. In this experimental study anti-influenza antibodies were passively administrated to mice, subsequently they were infected with influenza virus and treated with oseltamivir. The aim was to investigate, if anti-influenza antibodies influenced the out come of oseltamivir treatment and development of resistance towards oseltamivir. We show, that oseltamivir alone was not able to effectively prevent a fatal outcome, but that oseltamivir administered together with a limited amount of antibodies, resulted in improvement of the clinical condition of the mice. The results also showed that a higher dosage of antibodies alone were able to protect the mice from a lethal dose of virus. These findings suggest that the effectiveness of oseltamivir depends on the host’s immune response to the influenza virus, and that that passive immunization is an option that should be considered in the in control of influenza.

Highlights

  • Passive immunisation has for a long time been and is still used for prophylaxis and treatment of a number of infectious diseases [1]

  • We investigated the relationship of immune status on the effect of oseltamivir, including development of resistance, in BALB/c mice with a severe influenza infection

  • Antiviral treatment of the avian influenza H5N1 with oseltamivir was reported to decrease the fatalities from 88% (49/56) in patients not receiving antiviral treatment to 53% (100/188) [44]

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Summary

Introduction

Passive immunisation has for a long time been and is still used for prophylaxis and treatment of a number of infectious diseases [1]. Since the 2009 pandemic, the proposal of using convalescent plasma as an early control measurement, in a future influenza pandemic or as treatment for severely ill patients, has been raised by several voices [2,3,4,5,6]. Though there have been recent successful applications of passive immunisation as treatment for human influenza infections, in experimental settings [7,8,9,10,11,12], further investigations are warranted before it can be implemented in the control of influenza. Passive transfer treatment with such anti-influenza antibodies or convalescent plasma administration, may be effective in preventing disease but could minimize transmission of the virus and have influence on the spread of the virus during a future pandemic [14,20,21,22]. The use of such antibodies is expected to be expensive and escape mutants may develop making such treatment less efficient

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