Via The Lancet Global Health: Hyperimmune serum from healthy vaccinated individuals for Ebola virus disease?
As highlighted by Rajesh Gupta (October issue),1 strategies for developing treatments for Ebola virus disease (EVD) need to be rethought. New treatments have to be safe and effective, and in this sense testing already-approved drugs for a new indication is a good approach. With the same philosophy in mind, there are old approaches that could be saving lives in the current outbreak of EVD.
Hyperimmune serum from convalescent patients is regarded by WHO as a potential treatment for EVD.2 The rationale for convalescent serum treatment is provided by limited experiences during the Ebola outbreak in the Democratic Republic of Congo in 19953 and also from tests in non-human primates.4
Additionally, convalescent serum has been used in Spain and other countries to treat patients with EVD during the current outbreak. Nonetheless, obtaining convalescent serum is a difficult task and not free of risk. The logistics of identifying survivors is not easy. Also, blood from survivors needs to be tested to rule out presence of virus.
Vaccinated individuals might represent a safer source of hyperimmune serum. Two vaccine candidates will be tested soon in west Africa.5 If serum from vaccinated individuals has neutralising activity against the virus in cell models, this serum could be used as adjuvant therapy for EVD. In parallel, animal models could be developed to compare hyperimmune serum against a placebo.
In the current scenario, this strategy could offer some hope to patients with this devastating disease.