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Abstract
BackgroundBetter treatments are urgently needed for the management of Ebola virus epidemics in Equatorial Africa.MethodsWe conducted a systematic review of the literature on the use of passive immunotherapy for the treatment or prevention of Ebola virus disease. We placed findings from this review into the context of passive immunotherapy currently used for venom-induced disease, and recent improvements in manufacturing of polyvalent antivenom products.ResultsPassive immunotherapy appears to be one of the most promising specific treatments for Ebola. However, its potential has been incompletely evaluated, considering the overall experience and recent improvement of immunotherapy. Development and use of heterologous serum derivatives could protect people exposed to Ebola viruses with reasonable cost and logistics.ConclusionHyperimmune equine IgG fragments and purified polyclonal whole IgG deserve further consideration as treatment for exposure to the Ebola virus.
Highlights
The epidemic of Ebola virus disease (EVD) currently taking place in West Africa has revived debate on the treatment of this severe infection [1]
This study presents the arguments in favor of passive immunotherapy to control EVD after exposure, i.e. during either the incubation of the disease, or the disease itself
Three chimeric humanized monoclonal antibodies against Ebola virus (c13C6, h-13 F6, and c6D8; their combination is known as MB-003) were produced by an ovarian cell line of the Chinese hamster (Cricetulus griseus) and a whole plant, Nicotiana benthamiana [2]
Summary
The epidemic of Ebola virus disease (EVD) currently taking place in West Africa has revived debate on the treatment of this severe infection [1]. Horse IgG was evaluated independently in a Macaca cynomolgus model In these monkeys, viremia and clinical signs appeared later than in controls showing a reduced replication of the virus but not complete stop, despite use of interferon with passive immunotherapy [19]. Three chimeric humanized monoclonal antibodies against Ebola virus (c13C6, h-13 F6, and c6D8; their combination is known as MB-003) were produced by an ovarian cell line of the Chinese hamster (Cricetulus griseus) and a whole plant, Nicotiana benthamiana [2] The antibodies of these two systems, respectively at doses of 50 mg · kg−1 and 16.7 mg · kg−1, protected rhesus monkeys from lethal viral challenge when administered one hour prior to treatment. Implementation of passive immunotherapy can be divided into seven steps:
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