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Researchers investigate antibody immunotherapy for MERS treatment
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Middle East respiratory syndrome, or MERS, coronavirus has been making headlines, especially since the first two cases were confirmed in the United States. No known vaccine or antiviral therapy has been developed for MERS, and the mortality rate is more than 30%, so researchers are looking for ways to treat the disease, first reported in 2012.
Among those attempting to establish a potential treatment for MERS is Wayne Marasco, MD, PhD, professor and scientific director of the Center for Human Antibody Therapies (CHAT) at Dana-Farber Cancer Institute. Marasco and colleagues have been studying human neutralizing antibodies with the objective of developing human monoclonal antibody-based immunotherapy. Their most recent research is published in the Proceedings of the National Academy of Sciences of the United States of America.
Wayne Marasco
“In the absence of a licensed vaccine or antiviral for MERS, this panel of [neutralizing antibodies] offers the possibility of developing human monoclonal antibody-based immunotherapy, especially for health care workers,” Marasco said.
Marasco, who has worked on MERS research since 2012 at the request of the Department of Defense, said effective drugs may already be available.
“These are the same kind of drugs that you’ve heard about, such as Humira (adalimumab, AbbVie), which treats rheumatoid arthritis, and Herceptin (trastuzumab, Genentech) that’s used to treat breast cancer. These are antibody drugs. There are 35 of them that are FDA-approved right now. They’re injectable, but they can be given intramuscularly or delivered by a pen or given intravenously.”
He said the treatments are effective for about 3 weeks.
“They are naturally occurring proteins that we make. When you get a vaccine, you’re protected because you make human antibodies, and we’ve been able to use technology to isolate those antibodies in pure form and get the genetic information that encodes them and get antibody drugs directly from them.”
Marasco said they also could be used to treat people who have already become infected with the disease to prevent complications.
Other researchers are looking for existing drugs that can be repurposed to treat MERS.
Researchers from the University of Maryland, the NIH, the United States Army Medical Research Institute of Infectious Diseases and Zalicus Inc., identified 27 compounds with activity against both MERS and severe acute respiratory syndrome (SARS) after screening a panel of drugs. The drugs included those approved for use and those with a “well-defined cellular pathway for in vitro efficacy against MERS infection,” researchers said in the study, which was published in Antimicrobial Agents and Chemotherapy,a journal from the American Society for Microbiology.
A subset of drugs also was screened against SARS to explore whether the drugs may be useful for coronaviruses, in general.
“We utilized this approach with the rationale that drugs that have been approved for use in humans would be more readily accepted as potential therapeutic options for MERS infection if shown to have antiviral activity. The screening of approved drugs to identify therapeutics for drug repurposing is a valid approach and several approved drugs have been identified with activity against many viral diseases,” the researchers wrote.
To date, there have been a total of 701 cases globally, with 249 confirmed deaths, according to WHO. The disease is believed to have originated in Saudi Arabia, and cases have been reported in surrounding countries and parts of Europe and Asia. So far, only two cases have been reported in the United States, and both individuals were confirmed to have traveled to Saudi Arabia together.
Marasco said the disease will not be easy to eradicate because it appears to be carried by camels, which are commonly used as transportation in some parts of the Arabian Peninsula.
“[This is] unlike SARS, where the Chinese military came in and clubbed to death all the intermediate hosts, like prairie dogs, in 1 day, removing them from the wild animal market; that is not going to happen in the Arabian Peninsula. The virus is endemic there, so to what extent and how large of a population is infected is unknown,” Marasco said in an interview.
He said, however, that he believes that the disease will eventually be well controlled.
“I don’t think this is going to be easy to extinguish, but I’m optimistic that this could be managed properly,” he said. “We are fortunate that it happened at this time of year and not in the middle of winter when you would be confusing cases of MERS with influenza and may not be asking the appropriate questions.” – by Shirley Pulawski
For more information:
Dyall J. Antimicrob Agents Chemother. 2014;doi:10.1128/AAC.03036-14.
Tang XC. Proc Natl Acad Sci USA. 2014;111:E2018-2016.
Disclosure: Two of the researchers report being an employee or former employee of Zalicus Inc. The other researchers report no relevant financial disclosures.