Treating Ebola patients: a 'bottom up' approach using generic statins and angiotensin receptor blockers

Int J Infect Dis. 2015 Jul;36:80-4. doi: 10.1016/j.ijid.2015.04.019.

Abstract

The international community has responded to the Ebola outbreak in West Africa with a 'top down' approach. This has contributed to outbreak control, but has done much less to reduce the high mortality rate in individual patients. Ebola patients experience a breakdown in endothelial barrier integrity that leads to massive fluid losses and vascular collapse. Statins and angiotensin receptor blockers (ARBs) maintain or restore endothelial barrier integrity. Local physicians in Sierra Leone have treated approximately 100 consecutive Ebola patients with atorvastatin and irbesartan, and all but two inadequately treated patients have survived. The results of this experience have not been released and they need to be reviewed and validated. Unlike other treatments that target the Ebola virus itself, this 'bottom up' approach to treatment represents a paradigm shift by targeting the host response to infection. Treatment with these safe, inexpensive generic agents could be implemented readily throughout West Africa.

Keywords: Angiotensin receptor blockers; Ebola; Endothelial dysfunction; Host response; Statins; ‘Bottom up’.

MeSH terms

  • Adolescent
  • Adult
  • Africa, Western / epidemiology
  • Angiotensin Receptor Antagonists / therapeutic use*
  • Atorvastatin / therapeutic use
  • Biphenyl Compounds / therapeutic use
  • Child
  • Disease Outbreaks
  • Female
  • Hemorrhagic Fever, Ebola / drug therapy*
  • Hemorrhagic Fever, Ebola / epidemiology
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use*
  • Irbesartan
  • Male
  • Middle Aged
  • Tetrazoles / therapeutic use
  • Young Adult

Substances

  • Angiotensin Receptor Antagonists
  • Biphenyl Compounds
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Tetrazoles
  • Atorvastatin
  • Irbesartan