By Matthew Jack
A team of researchers led by University of Iowa virologist Wendy Maury has made strides towards creating a treatment for a diseased that has plagued Western Africa recently.
Ebola is a particularly difficult virus to study, and an effective vaccine eluded discovery until July 2015, when clinical trials showed a particular candidate — developed by the pharmaceutical company Merck — reduced new infections by 100 percent in a small sample size.
This breakthrough allowed physicians in the field to identify infected patients and then vaccinate those closest to them, such as family and others sharing their living space.
Still, hope for those already infected with the virus is low.
Maury and a colleague, now-retired UI professor Martha Monick, began their study after discussing “how a normal immune system might respond to an Ebola infection,” Monick said.
Maury, an expert on the Ebola virus, and Monick, an expert on the type of cell the Ebola virus infects, began “an exciting and productive collaboration between laboratories,” Monick said.
“My lab performed the gene expression studies leading up to our original hypothesis: that interferon-gamma might block Ebola infection,” she said.
They found interferon-gamma, a naturally occurring protein in the human body, and an FDA-approved drug already used to treat a range of diseases, to be effective in reducing the infection of a surrogate virus in mice, as well as improving their chance of survival.
Because of the risks scientists face handling samples of the Ebola virus, they may only conduct research in highly regulated Biosafety Level 4 laboratories.
Instead, UI researchers used a virus that had a similar enough structure to be used to simulate its more deadly biological relative.
A member of Maury’s team, UI postdoctoral student Bethany Rhein, said because the surrogate virus is from the same biological order as Ebola, the “internal replication and processes are very similar.”
When early trials proved promising, Maury submitted her team’s results to a BSL4 lab at Texas Biomedical Research Institute that replicated their findings using real Ebola samples.
Mice infected with the virus experienced positive results after being administered the interferon-gamma treatment anywhere between 24 hours before or after exposure.
Although these results are significant on their own, further trials must be conducted — first on primates, and eventually on humans — for the treatment to be fully accepted and implemented.
“The gold standard in virology is non-human primate testing, and we’re working towards it, but BSL4 labs are really backed up due to recent outbreaks,” Rhein said.
Until then, Rhein expects the genetics of infection to be one next crucial area of research.
Because of the unprecedented scale of the 2014 Ebola outbreak, researchers are noticing collateral damage that was not apparent in smaller epidemics, such as patients experiencing hearing or vision loss after recovering from an Ebola infection.
Looking at the genes that encode interferon-gamma in humans, and at specific mutations in those more susceptible to the virus, may have implications for treatment, Rhein said.
“There were a lot of big question marks about the infection overall, we’re studying things that are happening in the body during infection,” she said.
However, bringing these results to patients in under-developed countries is a challenge in itself.
“People who received good medical care mostly overcame infection,” Rhein said, but patients may be reluctant to accept care partially due to bad public health education.
“Patients thought Ebola treatment centers were death camps because of what they’d heard happened there,” she said.
Rhein recalled stories told by field physicians where patients “begged their family members not to provide care for them to avoid infecting themselves” but were refused, and spread the virus to their caregivers.
