
A Breakthrough Cure for Ebola - ihodes
http://genome.fieldofscience.com/2010/05/breakthrough-cure-for-ebola.html
======
maxklein
The problem with Ebola is not really the cure. It's the factors around the
disease that make it very difficult to cure.

First of all, Ebola is very similar to malaria. In all the areas that Ebola
occurs, malaria also occurs, and it would be impossible for normal people to
tell the difference. Malaria is a very common disease and the infected usually
just take anti-malarial tablets and wait it out, which I assume they also do
for Ebola.

By the time the symptoms diverge away from Malaria - i.e, the blood starts
coming out, it's very difficult to cure. The people taking care of the
infected person would have already been sick, and the original person would
already be pretty close to death, that is unlikely that this treatment will
help him.

I'm not sure when the treatment starts getting effective, but the described
article starts treatment 30 minutes after the introduction of the virus. This
will not happen in the real world. In the real world, treatment is likely
going to start when the disease is pretty advanced all round.

Ebola is also a disease that is going to stay in underdeveloped isolated
areas. It puts the person in bed so quickly that the person would hardly have
a chance to infect anyone in countries with proper hospital systems.

The diagnoses equipment for Ebola are also not so accurate, and the response
for it is expensive, so false scares are going to have more of a damage than
the actual disease.

~~~
philk
From the article itself:

 _This is a breakthrough not only because it may give us a cure for an
uncurable, incredibly nasty virus, but also because the same method might work
for other viruses, and because we have woefully few effective antiviral
treatments._

The exciting thing is not that we have a potential cure for a rare[1],
exotic[2] virus. The exciting thing is the technique and its potential
applicability to other viruses.

[1]<http://en.wikipedia.org/wiki/List_of_Ebola_outbreaks>

[2] Part of the reason they're probably using Ebola is to get DoD funding (ie
in the anti-biowarfare space)

~~~
riahi
Unfortunately, this piece is affected by typical science journalism that hypes
up everything a titch. Fundamentally, this treatment is a textbook case of
applied RNA interference (RNAi). While it is really awesome to see RNAi used
in a medical context (these nano-payloads of RNA are really interesting), all
the caveats of RNAi apply.

If the virus has a highly variable DNA sequence, different RNAi sequences will
need to be designed, validated, and grown up in lab for each viral strain.
Viral strains will need to be identified upon infection so the right RNAi
sequences are used, which can increase time until treatment. We won't be
seeing this technique used on a highly variable virus like HIV or the common
cold anytime soon, because these viruses mutate incredibly quickly within the
host.

~~~
ihodes
Yes, typical journalist hype by this hack Steven Salzberg
(<http://en.wikipedia.org/wiki/Steven_Salzberg>). Ah, "the Director of the
Center for Bioinformatics and Computational Biology at the University of
Maryland, College Park"? Well nevermind.

And while yes, RNAi has been around for a while, nothing like this has been
done with the technology. This is a breakthrough.

~~~
bbgm
Iddo Friedberg has a nice review of the paper as well

[http://bytesizebio.net/index.php/2010/05/29/a-cure-for-
ebola...](http://bytesizebio.net/index.php/2010/05/29/a-cure-for-ebola/)

The key for me is this part

"this is the first time that siRNA treatment has been shown to work in primate
models of a human disease."

That's a big deal under any circumstances.

------
slapshot
Fascinating to see that they started with the most interesting virus rather
than the most commercially valuable virus. Stopping the common cold is
probably worth 100 times more money, but stopping Ebola is more scientifically
interesting. Kudos.

~~~
celoyd
More power to them. But notice they have defense funding. As the article
hints, right now, if someone with Ebola got on a plane to Cairo or
Johannesburg, billions of people would die. That’s not worth much in the $10 ×
1,000,000,000 people way of the common cold, but it will get you enormous
government grants and a huge amount of prestige.

~~~
tomjen3
Unlikely.

I just checked the wikipedia article, and the Ebola virus is not naturally
transmitted as an aerosol (<http://en.wikipedia.org/wiki/Ebola#Transmission>).
It is transmitted through bodily fluids, including supertiny droblets but that
won't effect more than the ten people closest to the infected person on that
plane, and before they have a chance to infect anybody else the worlds medical
system will have indentified and dealt with the case.

In addition, the virus kills within 2-21 days, so it is unlikely to have time
to spread to that many people from each source.

Therefore, this won't be the new black death, but that won't stop the media
from comming all over the story.

------
nixy
_All known strains of Ebola virus have very high mortality rates, ranging from
25% to 90%, and there is no cure._

This is not entirely true, the _Ebola Reston_ strain is seemingly harmless to
human beings.

<http://en.wikipedia.org/wiki/Reston_ebolavirus>

------
tokenadult
"They report a 100% success rate, although admittedly the test group was very
small, just 4 rhesus monkeys.

"This is a breakthrough"

I'd hold off on the word "breakthrough" until

a) there is replication of the result in a larger sample by other
investigators

and

b) there are some human trials of the treatment. The technique is interesting,
but it needs more study.

<http://norvig.com/experiment-design.html>

~~~
sliverstorm
b) might take a while. I can't see anyone voluntarily getting infected by
Ebola, and there haven't been any outbreaks recently.

------
Kilimanjaro
"Ebola has very few genes - only 8. One of its genes, called L protein, is
responsible for copying the virus itself. Two others, called VP24 and VP35,
interfere with the human immune response, making it difficult for our immune
system to defeat the virus."

Genomics and nanomeds, now that's amazing!

------
aaronbrethorst
run directly towards the slowest virus, since it has a wounded leg? (sorry,
couldn't resist :-)

In all seriousness, though, this is very exciting. I wonder how easily this
technique could be adapted to work on other viruses, like HIV.

~~~
ars
It would probably only work while HIV was active, but not when it hides inside
a T cell. (HIV is very unusual in that regard.) It's called "HIV latent
reservoir" and it's the reason nothing has worked. This is unlikely to change
that.

~~~
aaronbrethorst
Pardon my ignorance, but if an individual's HIV is 'active' (I'd be curious to
know more about the definition of active in this case) does that mean that's
the case across every cell of their body, or might some cells be active and
others inactive?

~~~
ars
Active means the virus is either attempting to infect a cell, or copying
itself. When it's inactive it just sits in the cell doing nothing.

Some are active, some are not.

I believe it starts with lots of active viruses, then many go dormant, while
others continue infecting. Then pretty much all of them go dormant, while
slowly activating in small numbers over a long time (20 years even).

It's sort of a war of attrition, the virus kills immunity (T) cells slowly,
over time. It's possible to prevent it from killing cells (which will then
recover to normal levels), but the virus keeps hiding in other cells.

