Hurst biologist says antibiotic may fight West Nile

Posted Monday, Aug. 27, 2012  comments  Print Reprints

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HURST -- Before age slowed him down, expeditionary biologist Terry Fredeking of Hurst went to the ends of the earth to advance medicine.

His company, Antibody Systems of Hurst, uses substances that Fredeking, 68, and his associates bring back from far-flung locations to develop raw materials with which pharmaceutical companies make tests and treatments for diseases.

According to the British medical journal The Lancet, Fredeking and his team, which includes physicians, are credited, for instance, with helping discover the first treatment for Ebola virus -- in hookworm saliva.

Today, Fredeking believes that West Nile virus could be treated with a pill that has been around since man first walked on the moon.

"Doxycycline is an antibiotic approved for more than four decades, but not for West Nile because nobody ever did a study," he said.

Antibody Systems funded a three-year study that looked at doxycycline's effect on dengue fever, which Fredeking said acts very similar to West Nile virus. Both produce a condition called cytokine storm, he said.

The result, published in the 2011 Clinical and Developmental Immunology, was that the death rate was halved, Fredeking said.

In a group of 200 dengue fever patients, 100 were given doxycycline.

"Twenty of those who didn't get it died," he said. "Ten of those who did get it died. So we got a 50 percent higher survival rate in the treatment group."

A cytokine storm can be produced by any infection, said Dr. Nikhil Bhayani, director of infection control for Texas Health Harris Methodist Hospital HEB.

"It's more profound in viral illnesses," he said.

It's also the element of the disease that leads to organ damage, Bhayani said. The effect causes the body's immune system to overproduce cytokines, the messengers that tell the immune system how to fight an infection.

"It's like General Motors employees putting out 100 cars a day and suddenly being told to put out 500 cars a day with the same number of people," Fredeking said.

Before long the assembly workers would get exhausted and start making mistakes and "you'd get cars without starters, or no drive shaft or whatever," Fredeking said. "You would have 500 cars a day, but none of them would work."

Doxycycline makes the immune system ignore the order to overproduce, slowing it enough that it makes complete, effective white blood cells and antibodies, Fredeking said.

"The body's normal immunological response will clear the virus, and the doxycycline brings it back down to a normal response," he said.

Proving that true would make a lot of doctors happy.

It's frustrating that physicians have no way to treat West Nile virus, said Dr. Scott Norville, John Peter Smith Hospital's medical director for infection control.

"There's no way to know at this point if doxycycline would make West Nile symptoms less severe, because it hasn't been studied at all," Norville said.

An official at the federal Centers for Disease Control and Prevention believes that no study is called for, because the drug can't affect the West Nile virus itself.

"Doxycycline is an antibacterial drug," said Dr. Marc Fischer of the CDC's arboviral (transmitted by tick or mosquito) diseases branch. "It has no antiviral activity against West Nile virus or other viruses. I am not aware of any data or ongoing studies regarding the use of doxycycline to treat West Nile virus or other viral infections."

Most health professionals won't use antibiotics to treat a virus-related illness, because antibiotics kill bacteria, not viruses, Fredeking said. Doxycycline is approved for treating diseases including Rocky Mountain spotted fever, typhus, chlamydia and cholera.

Considering the number of West Nile virus cases, now would be the ideal time for a similar humanitarian effort here, said Dr. Norwood Hill, a retired hematologist in Irving who has worked with Fredeking.

"We're going to have these outbreaks in the future, because West Nile isn't going away," Hill said. "I would think it's worth studying doxycycline in connection with West Nile. I would think physicians would be very interested in it. The low cost of the medicine should make it more attractive."

Fredeking said that doctors who believe that the drug would help their patients can prescribe doxycycline off-label, which means using a medication in a way that the federal Food and Drug Administraton hasn't approved.

Fredeking's dengue fever report was intriguing, but it wasn't enough by itself to persuade Bhayani to use doxycycline off-label.

"If someone else could reproduce this data I'd probably say yes I would," he said.

In the 12 West Nile cases Bhayani has dealt with in the past month, all he could offer was supportive care, measures that just keep them alive.

In about a third of the cases "the illness resolved on its own," he said. "The people were better in 48 hours. Those who went on ventilators, who needed feeding tubes, a tracheotomy, were the older patients with underlying conditions."

Norville said he likes the idea of "investigator-initiated research," like Fredeking's dengue fever study. "That's what we call it when drug companies won't pay for it."

He added that he'd be happy to talk with Fredeking about such a study.

"In the long term, a study would be a great project to start," he said.

This report includes material from Star-Telegram archives.

Terry Evans, 817-390-7620;Twitter: @fwstevans

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