Abstract
New treatments and new drugs for avian influenza virus (AIV) infection are developed continually, but there are still high mortality rates. The main reason may be that not all cell death pathways induced by AIV were blocked by the current therapies. In this review, drugs for AIV and associated acute respiratory distress syndrome (ARDS) are summarized. The roles of antioxidant (vitamin C) and multiple immunomodulators (such as Celecoxib, Mesalazine and Eritoran) are discussed. The clinical care of ARDS may result in ischemia reperfusion injury to poorly ventilated alveolar cells. Cyclosporin A should effectively inhibit this kind of damages and, therefore, may be the key drug for the survival of patients with virus-induced ARDS. Treatment with protease inhibitor Ulinastatin could also protect lysosome integrity after the infection. Through these analyses, a large drug combination is proposed, which may hypothetically greatly reduce the mortality rate.
Highlights
The infection of avian influenza induces reactive oxygen species accumulation, causing hyperimmune response to the virus, which may have adverse effects on vital organs and result in high pathogenicity and mortality
Clinical care of acute respiratory distress syndrome may result in ischemia reperfusion injury to alveolar cells that are poorly ventilated or poorly supplied with blood
As reported on 10 May 2013, of the 111 patients we studied 76.6% were admitted to an intensive care unit and 27.0% died.[1]
Summary
New treatments and new drugs for avian influenza are developed continually; why is there still such a high mortality rate?. Why did acute respiratory distress syndrome clinical cares enable the survival of only partially AIV-infected patients, whereas the others died?
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