Cure for the flu?

[Guest guest]

_http://www.bupa.co.uk/health_information/html/health_news/281003flu.html_

(http://www.bupa.co.uk/health_information/html/health_news/281003flu.html)

(http://www.bupa.co.uk/index.asp) | _health information_

(http://www.bupa.co.uk/health_information/) | _health news_

(http://www.bupa.co.uk/health_information/asp/health_news/index.asp)

K E Y P O I N T S

Flu is a serious disease, accounting for thousands of deaths in the elderly

in the UK each year.

Flu infection triggers the body's immune system to destroy any cells with

the flu virus in and then to produce antibodies to stop reinfection.

Some experts believe that the most serious symptoms of flu are caused by the

immune system overreacting to the virus.

British scientists studying the most serious strain of flu virus have

developed a way of controlling the immune system's response to it, minimising

the

symptoms of the disease.

Experts are interested in the findings, but stress that at this stage the

research has only been conducted in mice. Research in humans will need to be

conducted before the treatment can be used.

Current treatment options for flu include rest, painkillers, antiviral

medication and plenty of fluids.

If you're over 65, or in one of the at-risk groups, an annual flu

vaccination is recommended.

Cure for flu found?

BUPA investigative news - 28 October 2003

written by Newcombe, reporter for BUPA's Health Information Team

As the colder weather descends, the annual UK flu season begins. For many

people it is an unpleasant, but ultimately harmless illness, while for others

can lead to serious conditions, such as bronchitis or pneumonia. And, for 3,000

to 4,0000 people in the UK each year, it causes their death - usually

amongst the elderly. British researchers have been investigating the most

deadly

form of flu- strain A - and have come up with a potential treatment that

minimises the worst symptoms of the disease. So, how far have they got with

their

research?

What were the headlines?

Details of the flu research appeared in a range of UK newspapers and

websites, gaining headlines such as, " Cure for killer flu 'discovered' " ,

" Scientists

develop novel flu strategy " , " New flu drug calms the 'storm' " , " Scientists

hope to end flu misery within five years " and " Brits cure 'flu! " .

Some reports were detailed and informative, whereas others provided a brief

overview and appeared to imply that a definite cure is ready and waiting to be

given to humans, which isn't quite the case just yet.

What is the bigger picture?

The study was carried out by researchers from _Imperial College London_

(http://www.ic.ac.uk/) and published in the _Journal of Experimental

Medicine_

(http://www.jem.org/) .

They investigated the influenza A virus - the type responsible for pandemics

such as the 1919 Spanish flu outbreak which killed more than 20 million

people worldwide - and developed a way of eliminating symptoms in mice by

reducing

the response of active T white blood cells by one third. Some experts

believe that it is the body's response and not the virus that causes the

damage. By

reducing the body's response, it is hoped that the harmful effects of flu

will be reduced too.

The body's immune system consists of two major types of white blood cells: T

and B cells. B cells produce tailor-made antibodies that help the body

remember and quickly respond to invaders, and T cells are responsible for

patrolling the body, seeking out and destroying diseased cells.

When the lungs are infected with the flu virus, the T cells release chemical

signals that cause them to stay longer in the lungs. However, more T cells

are always arriving, and they in turn release more signal and stay longer in

the cells, leading to a build up of T cells and chemical signals. This is

called a " cytokine storm " and it is thought that this causes damage to the

lungs.

Senior author of the paper, Dr. Hussell, from Imperial's Centre for

Molecular Microbiology and Infection, said, " During flu infection the immune

system has an 'all hands on deck' attitude to the viral assault. But it's this

that causes most of the damage. The exaggerated immune response produces

inflammatory molecules that lead to what's known as a 'cytokine storm'.

Essentially too many cells clog up the airways and prevent efficient transfer of

oxygen into the bloodstream. "

Ways to stop the cytokine storm have focused on blocking all T cells, but

this stops the patient's immune system from clearing the virus and leaves the

body open to other infections. The goal is to prevent the storm forming without

stopping the T cells attacking the flu virus. To acheive this, the

researchers developed a way of down-regulating one of the T cells signalling

chemicals

(called OX40).

" OX40 sends out a survival signal instructing activated T cells to remain in

the lungs for longer to help fight the infection, " explained lead researcher,

Dr. Ian Humphreys. " Inhibiting this signal therefore allows T cells to

vacate the lungs earlier whilst leaving behind a sufficient immune presence. "

The researchers blocked the action of OX40 by using a fusion protein

(OX40:Ig) supplied by the pharmaceutical company _Xenova Research_

(http://www.xenova.co.uk/) . It was found that six days after infection with

flu, mice treated

with OX40:Ig were indistinguishable from uninfected control mice. In

contrast, infected mice that had not been treated lost 25 per cent of their

body

weight, lost their appetite and looked withdrawn and hunched - aspects the

researchers say are characteristic of flu symptoms. Even when treatment was

delayed

for several days after infection, when the mice had lost 20 per cent of

their body weight, treatment with OX40:Ig reversed the symptoms.

In theory, this treament could be given after symptoms are known to present,

unlike yearly vaccinations that rely on predicting how the virus might

mutate, or antiviral drugs that have to be given as soon as contact is made

with

the virus.

Dr. Hussell also believes that the treatment could have " tremendous scope "

for aiding other diseases " characterised by excessive T cell inflammatory

response, " such as bronchitis, asthma, pneumonia, SARS or rheumatoid arthritis.

The next stage is a clinical trial, which may be started next year, involving

the use of OX40:Ig in nasal spray or inhaler form. If this proves

successful, it may be developed as a treatment.

" For most people getting the flu means some unpleasant symptoms but they

recover in a week or two. However, in vulnerable people flu can cause serious

complications or even death. People who are more vulnerable are the elderly,

the very young and those who have longterm medical conditions such as diabetes,

heart disease, asthma, kidney failure or immune problems such as HIV/AIDS. A

yearly flu vaccination is a good way of protecting against flu. It's

available on the NHS to over 65s and vulnerable people. Other people can chose

to

have it privately and many employers provide it for their staff. "

Dr. bel Bentley,

assistant medical director,

BUPA Group

What does this mean?

Dr. Alan Hay, a flu expert from the _National Institute for Medical

Research_ (http://www.nimr.mrc.ac.uk/) , was interested in the findings. " Flu is

a serious disease, " he told BUPA. " It may be that in the last year or two

we've had very mild winters in terms of the attack rate of flu, but one doesn't

have to go too far back [for another picture]. The last major epidemic was

probably in 1989 when we had in excess of 20,000 deaths due to flu, and there

are several thousand deaths each year in the UK. "

" The experiments that have been done at Imperial College relate to the fact

that a lot of the symptoms you have following flu infection are due to the

immune response, the inflammatory response, to the infection. We know from other

studies that the severity of the disease in animals and in humans is related

to that immune response, " he explained.

" As far as I understand it, what these people have done is to use the protein

to reduce the immune response to an experimental infection in mice to a

level such as they can reduce the symptomology - the pathogenic consequences of

the infection - but have not eliminated the beneficial effects of the immune

response in removing the virus following the infection, " he continued. " This

is where it seems optimistic that some therapeutic way of reducing the

symptoms without reducing the ability of the immune system to combat and get

rid of

the virus infection could be developed. "

However, he added that, " It's important to remember that this has been done

in mice, not humans. The principle is quite attractive, but it's important to

stress that this does not prevent virus infection, but rather simply treats

the symptoms. What we really want is something that can prevent you from being

infected by the virus in the first place. "

A C T I O N P O I N T S

If you're over 65, or in one of the at-risk groups, flu vaccinations are

recommended.

Stop the spread of flu by covering your mouth and nose when coughing and

sneezing, and regularly washing your hands.

If you succumb to flu, bed rest, along with painkillers, plenty of fluids

and steam inhalation will help. Your local pharmacist is a good source of

further advice.

If flu is prolonged, or you develop any additional complications, seek

medical advice.

What does this mean to me?

With no cure available at the moment, vaccination for those most vulnerable

to flu infection is the best choice. For those aged 65 and over, plus younger

people considered at high risk, yearly flu vaccinations are free through the

NHS and are recommended.

Dr. , from the _Health Protection Agency_ (http://www.hpa.org.uk/)

, said, " For most people flu is an unpleasant rather than dangerous illness.

However, for the at-risk groups, such as the elderly and patients with heart

problems, diabetes or asthma, it can be much more dangerous. This is why it

is important for those in the at-risk groups who are recommended for

vaccination take up the opportunity. "

He added that, " In recent years the strains in the flu vaccine have been a

good match with those circulating and the vaccine has therefore offered good

protection. "

If you do end up succumbing to flu, the symptoms - a high temperature,

headache, muscle aches and pain, weakness and loss of appetite - normally begin

after an incubation period of one to four days and last for an average of one

week. The virus is spread through coughing, sneezing and skin contact, so if

you do have flu, it's important to regularly wash your hands and cover your

nose and mouth when coughing or sneezing.

Existing treatments include painkillers, such as paracetamol, to relieve

muscular aches and pains and fever, fluids to prevent dehydration, and steam

inhalation to aid stuffy blocked noses. In certain circumstances, two antiviral

drugs, zanamir and oseltamivir, may be prescribed to at-risk children and

adults who have had flu-like symptoms for less than 48 hours. Antibiotics are

only prescribed when a secondary bacterial infection, such as pneumonia, is

present.

Summary

Although common and generally not dangerous, flu can be nasty and cause

disruptive symptoms. This research finding offers an interesting new approach to

the illness, but more research and clinical trials are needed before the drug

can be fully developed for use by humans.

____________________________________

Links for more information

* _BUPA colds and flu factsheet_

(http://hcd2.bupa.co.uk/fact_sheets/html/colds.html)

* _Journal of Experimental Medicine_ (http://www.jem.org/)

* _Imperial College London_ (http://www.ic.ac.uk/)

* _Xenova_ (http://www.xenova.co.uk/)

* _National Institute for Medical Research_

(http://www.nimr.mrc.ac.uk/)

* _Health Protection Agency_ (http://www.hpa.org.uk/)

* _Health Protection Agency flu information_

(http://www.hpa.org.uk/infections/topics_az/influenza/seasonal/default.htm)

* _Department of Health flu campaign_

(http://www.dh.gov.uk/PolicyAndGuidance/HealthAndSocialCareTopics/Flu/FluGeneral\

Information/FluGeneral/fs/en?CON

TENT_ID=4087158 & chk=Kq7ZSC)

* _Department of Health flu vaccination leaflet_

(http://www.dh.gov.uk/PublicationsAndStatistics/LettersAndCirculars/Professional\

Letters/ChiefMedicalO

fficerLetters/ChiefMedicalOfficerLettersArticle/fs/en?CONTENT_ID=4116516 & chk=q

sKsaR)

* _European Influenza Surveillance Scheme_

(http://www.eiss.org/index.cgi)

[Guest guest]

My Rheumy has been giving me flu shots every Fall. Works wonders for me.

aclavern33@... wrote:

_http://www.bupa.co.uk/health_information/html/health_news/281003flu.html_

(http://www.bupa.co.uk/health_information/html/health_news/281003flu.html)

(http://www.bupa.co.uk/index.asp) | _health information_

(http://www.bupa.co.uk/health_information/) | _health news_

(http://www.bupa.co.uk/health_information/asp/health_news/index.asp)

K E Y P O I N T S

Flu is a serious disease, accounting for thousands of deaths in the elderly

in the UK each year.

Flu infection triggers the body's immune system to destroy any cells with

the flu virus in and then to produce antibodies to stop reinfection.

Some experts believe that the most serious symptoms of flu are caused by the

immune system overreacting to the virus.

British scientists studying the most serious strain of flu virus have

developed a way of controlling the immune system's response to it, minimising

the

symptoms of the disease.

Experts are interested in the findings, but stress that at this stage the

research has only been conducted in mice. Research in humans will need to be

conducted before the treatment can be used.

Current treatment options for flu include rest, painkillers, antiviral

medication and plenty of fluids.

If you're over 65, or in one of the at-risk groups, an annual flu

vaccination is recommended.

Cure for flu found?

BUPA investigative news - 28 October 2003

written by Newcombe, reporter for BUPA's Health Information Team

As the colder weather descends, the annual UK flu season begins. For many

people it is an unpleasant, but ultimately harmless illness, while for others

can lead to serious conditions, such as bronchitis or pneumonia. And, for 3,000

to 4,0000 people in the UK each year, it causes their death - usually

amongst the elderly. British researchers have been investigating the most

deadly

form of flu- strain A - and have come up with a potential treatment that

minimises the worst symptoms of the disease. So, how far have they got with

their

research?

What were the headlines?

Details of the flu research appeared in a range of UK newspapers and

websites, gaining headlines such as, " Cure for killer flu 'discovered' " ,

" Scientists

develop novel flu strategy " , " New flu drug calms the 'storm' " , " Scientists

hope to end flu misery within five years " and " Brits cure 'flu! " .

Some reports were detailed and informative, whereas others provided a brief

overview and appeared to imply that a definite cure is ready and waiting to be

given to humans, which isn't quite the case just yet.

What is the bigger picture?

The study was carried out by researchers from _Imperial College London_

(http://www.ic.ac.uk/) and published in the _Journal of Experimental

Medicine_

(http://www.jem.org/) .

They investigated the influenza A virus - the type responsible for pandemics

such as the 1919 Spanish flu outbreak which killed more than 20 million

people worldwide - and developed a way of eliminating symptoms in mice by

reducing

the response of active T white blood cells by one third. Some experts

believe that it is the body's response and not the virus that causes the

damage. By

reducing the body's response, it is hoped that the harmful effects of flu

will be reduced too.

The body's immune system consists of two major types of white blood cells: T

and B cells. B cells produce tailor-made antibodies that help the body

remember and quickly respond to invaders, and T cells are responsible for

patrolling the body, seeking out and destroying diseased cells.

When the lungs are infected with the flu virus, the T cells release chemical

signals that cause them to stay longer in the lungs. However, more T cells

are always arriving, and they in turn release more signal and stay longer in

the cells, leading to a build up of T cells and chemical signals. This is

called a " cytokine storm " and it is thought that this causes damage to the

lungs.

Senior author of the paper, Dr. Hussell, from Imperial's Centre for

Molecular Microbiology and Infection, said, " During flu infection the immune

system has an 'all hands on deck' attitude to the viral assault. But it's this

that causes most of the damage. The exaggerated immune response produces

inflammatory molecules that lead to what's known as a 'cytokine storm'.

Essentially too many cells clog up the airways and prevent efficient transfer of

oxygen into the bloodstream. "

Ways to stop the cytokine storm have focused on blocking all T cells, but

this stops the patient's immune system from clearing the virus and leaves the

body open to other infections. The goal is to prevent the storm forming without

stopping the T cells attacking the flu virus. To acheive this, the

researchers developed a way of down-regulating one of the T cells signalling

chemicals

(called OX40).

" OX40 sends out a survival signal instructing activated T cells to remain in

the lungs for longer to help fight the infection, " explained lead researcher,

Dr. Ian Humphreys. " Inhibiting this signal therefore allows T cells to

vacate the lungs earlier whilst leaving behind a sufficient immune presence. "

The researchers blocked the action of OX40 by using a fusion protein

(OX40:Ig) supplied by the pharmaceutical company _Xenova Research_

(http://www.xenova.co.uk/) . It was found that six days after infection with

flu, mice treated

with OX40:Ig were indistinguishable from uninfected control mice. In

contrast, infected mice that had not been treated lost 25 per cent of their

body

weight, lost their appetite and looked withdrawn and hunched - aspects the

researchers say are characteristic of flu symptoms. Even when treatment was

delayed

for several days after infection, when the mice had lost 20 per cent of

their body weight, treatment with OX40:Ig reversed the symptoms.

In theory, this treament could be given after symptoms are known to present,

unlike yearly vaccinations that rely on predicting how the virus might

mutate, or antiviral drugs that have to be given as soon as contact is made

with

the virus.

Dr. Hussell also believes that the treatment could have " tremendous scope "

for aiding other diseases " characterised by excessive T cell inflammatory

response, " such as bronchitis, asthma, pneumonia, SARS or rheumatoid arthritis.

The next stage is a clinical trial, which may be started next year, involving

the use of OX40:Ig in nasal spray or inhaler form. If this proves

successful, it may be developed as a treatment.

" For most people getting the flu means some unpleasant symptoms but they

recover in a week or two. However, in vulnerable people flu can cause serious

complications or even death. People who are more vulnerable are the elderly,

the very young and those who have longterm medical conditions such as diabetes,

heart disease, asthma, kidney failure or immune problems such as HIV/AIDS. A

yearly flu vaccination is a good way of protecting against flu. It's

available on the NHS to over 65s and vulnerable people. Other people can chose

to

have it privately and many employers provide it for their staff. "

Dr. bel Bentley,

assistant medical director,

BUPA Group

What does this mean?

Dr. Alan Hay, a flu expert from the _National Institute for Medical

Research_ (http://www.nimr.mrc.ac.uk/) , was interested in the findings. " Flu is

a serious disease, " he told BUPA. " It may be that in the last year or two

we've had very mild winters in terms of the attack rate of flu, but one doesn't

have to go too far back [for another picture]. The last major epidemic was

probably in 1989 when we had in excess of 20,000 deaths due to flu, and there

are several thousand deaths each year in the UK. "

" The experiments that have been done at Imperial College relate to the fact

that a lot of the symptoms you have following flu infection are due to the

immune response, the inflammatory response, to the infection. We know from other

studies that the severity of the disease in animals and in humans is related

to that immune response, " he explained.

" As far as I understand it, what these people have done is to use the protein

to reduce the immune response to an experimental infection in mice to a

level such as they can reduce the symptomology - the pathogenic consequences of

the infection - but have not eliminated the beneficial effects of the immune

response in removing the virus following the infection, " he continued. " This

is where it seems optimistic that some therapeutic way of reducing the

symptoms without reducing the ability of the immune system to combat and get

rid of

the virus infection could be developed. "

However, he added that, " It's important to remember that this has been done

in mice, not humans. The principle is quite attractive, but it's important to

stress that this does not prevent virus infection, but rather simply treats

the symptoms. What we really want is something that can prevent you from being

infected by the virus in the first place. "

A C T I O N P O I N T S

If you're over 65, or in one of the at-risk groups, flu vaccinations are

recommended.

Stop the spread of flu by covering your mouth and nose when coughing and

sneezing, and regularly washing your hands.

If you succumb to flu, bed rest, along with painkillers, plenty of fluids

and steam inhalation will help. Your local pharmacist is a good source of

further advice.

If flu is prolonged, or you develop any additional complications, seek

medical advice.

What does this mean to me?

With no cure available at the moment, vaccination for those most vulnerable

to flu infection is the best choice. For those aged 65 and over, plus younger

people considered at high risk, yearly flu vaccinations are free through the

NHS and are recommended.

Dr. , from the _Health Protection Agency_ (http://www.hpa.org.uk/)

, said, " For most people flu is an unpleasant rather than dangerous illness.

However, for the at-risk groups, such as the elderly and patients with heart

problems, diabetes or asthma, it can be much more dangerous. This is why it

is important for those in the at-risk groups who are recommended for

vaccination take up the opportunity. "

He added that, " In recent years the strains in the flu vaccine have been a

good match with those circulating and the vaccine has therefore offered good

protection. "

If you do end up succumbing to flu, the symptoms - a high temperature,

headache, muscle aches and pain, weakness and loss of appetite - normally begin

after an incubation period of one to four days and last for an average of one

week. The virus is spread through coughing, sneezing and skin contact, so if

you do have flu, it's important to regularly wash your hands and cover your

nose and mouth when coughing or sneezing.

Existing treatments include painkillers, such as paracetamol, to relieve

muscular aches and pains and fever, fluids to prevent dehydration, and steam

inhalation to aid stuffy blocked noses. In certain circumstances, two antiviral

drugs, zanamir and oseltamivir, may be prescribed to at-risk children and

adults who have had flu-like symptoms for less than 48 hours. Antibiotics are

only prescribed when a secondary bacterial infection, such as pneumonia, is

present.

Summary

Although common and generally not dangerous, flu can be nasty and cause

disruptive symptoms. This research finding offers an interesting new approach to

the illness, but more research and clinical trials are needed before the drug

can be fully developed for use by humans.

____________________________________

Links for more information

* _BUPA colds and flu factsheet_

(http://hcd2.bupa.co.uk/fact_sheets/html/colds.html)

* _Journal of Experimental Medicine_ (http://www.jem.org/)

* _Imperial College London_ (http://www.ic.ac.uk/)

* _Xenova_ (http://www.xenova.co.uk/)

* _National Institute for Medical Research_

(http://www.nimr.mrc.ac.uk/)

* _Health Protection Agency_ (http://www.hpa.org.uk/)

* _Health Protection Agency flu information_

(http://www.hpa.org.uk/infections/topics_az/influenza/seasonal/default.htm)

* _Department of Health flu campaign_

(http://www.dh.gov.uk/PolicyAndGuidance/HealthAndSocialCareTopics/Flu/FluGeneral\

Information/FluGeneral/fs/en?CON

TENT_ID=4087158 & chk=Kq7ZSC)

* _Department of Health flu vaccination leaflet_

(http://www.dh.gov.uk/PublicationsAndStatistics/LettersAndCirculars/Professional\

Letters/ChiefMedicalO

fficerLetters/ChiefMedicalOfficerLettersArticle/fs/en?CONTENT_ID=4116516 & chk=q

sKsaR)

* _European Influenza Surveillance Scheme_

(http://www.eiss.org/index.cgi)