Possible roles of oxidative stress, local circulatory failure and nutrition factors in the pathogenesis of hypervirulent influenza: Implications for therapy and global emergency preparedness

Abstract

A pandemic with some highly virulent and also highly contagious form of avian influenza may be the most serious health threat facing the world today. Nutrients such as selenium and glutathione stimulate the antiviral immune response, counteract activation of the transcription factor NF-kappaB which is needed for replication of the influenza virus, will help to protect the mitochondria of infected organs, and counteract cytokine-induced activation of neutral sphingomyelinase, while the acid sphingomyelinase is inhibited by carnitine. A combination of high-dose coenzyme Q10, acetylcarnitine and lipoic acid will also help to defend mitochondrial function, while a combination of selenium, glutathione (or some GSH precursor), antioxidants (which may include taurine and melatonin) and high-dose 5,6,7,8-tetrahydrobiopterin or 5- methyltetrahydrofolate (plus a stable prostacyclin analog?) may help to counteract local circulatory failure as a consequence of too much oxidative stress. It is imperative for the sake of better global contingency planning to test new treatment strategies (emphasizing antioxidant protection and defense against local circulatory failure) on human patients with malignant influenza, as well as on experimental animals suffering from the same disease, as soon as possible. It may also be very important to enhance global production and stockpiles of high-quality protein foods with a composition matching the needs of patients suffering from severe infectious diseases. Key words: Avian influenza, pathogenesis, oxidative stress, nutrition, selenium